The winning client-therapist relationship

 Authors: Reenu M. & Sneha V.S.

Photo by youssef naddam on Unsplash

Kanak got off her video call with her therapist Ms. Kirti who happened to be someone she had known since her childhood. They were not close friends but since they were from the same locality, they roamed in the same circles. That is how Kanak decided to seek Ms. Kirti’ help for her anxiety issues. However, Kanak did not feel she had made the right choice right now. She thought that maybe therapy is not for people like her and she cannot be helped. She told this to her friends via IM immediately. Among them were few of them who were waiting for her review to try therapy like Vikas who was under tremendous pressure from his parents both doctors to get a good NEET score so he was so scared of failure and subsequent perceived rejection from his parents. Or like Kavita who had doubts about her relationship with her boyfriend due to his obsessive nature. Or like Bonnie whose parents were in the midst of a messy divorce. Or like Gia who just wanted help with how to set her goals and achieve them.

Unfortunately, because of Kanak sharing her unhappiness about the progress of her therapy, all of her friends started thinking that maybe they need to go through their problems alone. This is absolutely wrong. All of these people could benefit from therapy had the tuning of the client-therapist relationship been set favourably throughout.

So, let us introspect on the factors of the client-therapist relationship which in turn predicts the success of therapy -

1. Rapport: Sometimes, while there is a lot of effort initially to build a harmonious therapeutic relationship, later it dulls. Every relationship needs constant check whether the care is effective. Kanak and Kirti have known each other since long so, there were assumptions from both sides, and they took each other for granted. Rapport that was built well was not maintained by managing expectations on both sides.
2. Regularity of sessions: The sessions at least the initial and middle ones must be fairly regular else the continuity may be lost thereby hampering the smooth progress of the therapy. Kanak kept rescheduling her therapy sessions, and then Kirti had to find suitable slots which was sometimes not possible. The sessions like today’ was spent mostly in catching up about the previous session’ goals and their status. So, there was hardly much time for Kirti to check effectiveness and regulate the present session.
3. Communication: There should be openness & honesty in the sessions. Kanak hid one of her key anxiety triggers from Kirti i.e. guilt over having a crush on Kavita’ boyfriend since she was afraid of being judged and this news getting leaked in the community to which all of them belonged. Since this was continuously triggered and not managed, there was constant stress. 
4. Openness to new techniques & types of therapy: Both the therapist and client should be open to trying new techniques which have been researched and proven to be beneficial in situations similar to what the client is facing. The type of therapy is usually decided based on the comfort of the client and best suited for the issue. Sometimes, the therapist may favour a particular therapy over others because of their expertise & experience on it without reviewing periodically whether the client is at ease or the therapy is proving effective for the client’ issue. Kanak would not do certain activities that were to be completed prior to the session. But Kirti being an expert on this therapeutic technique persisted that Kanak do them to realise its benefit which led to some resentment thereby dulling the harmony in the relationship. 
5. Self-work: Therapy and all associated activities should be a priority for the client. Whatever is practised during sessions if practised personally, then the benefits of the session are sustained through till the next session. Kanak had an issue but did not prioritise its resolution. Kirti did not get through to the root cause and stuck to the therapeutic technique.

Therapy is a two-way street and proves to be a win-win when both the client and their therapist are mindful of the factors that determine its success and nurture them throughout.