Building trust in psychotherapy

Embarking on therapy is an important and difficult decision. The client may not have experienced anything similar to this before. Seeing a stranger for the first time and talking about personal, intimate issues can be very difficult and the client might perceive it as an artificial situation.

Usually the first session is about gathering basic information: Life situation, specific problems, social context and complaints (reasons why someone decided to go to counseling). So after the counselor introduces him or herself, his or her credentials and the counseling process, the first session (and the subsequent ones) are usually dedicated to finding out more about the client and his or her life situation. Clients may be tense and evasive at first but they tend to relax in a sense that they do not self-censor as much as in the first session. If the counselor listens carefully, the client will most probably open up spontaneously and talk about the reasons which brought him or her to therapy.

Unconditional positive regard is of primary importance here: The counselor should accept the other person without judging him or her in any way. No ‘special techniques’ and ice-breakers are necessary for the client to open up—in fact, sometimes it is counterproductive to use a preplanned approach, because it can be easily seen as non-genuine and thus can be very harmful to forming a trusting therapeutic relationship. Active listening is crucial for developing mutual trust from the first session onward. When the client feels that he or she is accepted, and that her problems are acknowledged, emotions are released, and something tremendous happens. Therapists call this process or development ‘therapeutic alliance’ whereas in everyday life we just call it trust and willingness to help each other.

The therapist is there to help the client, of course. But in building the therapeutic alliance both participants in therapy gradually realize that they have to depend on each other. The client must place her trust on the therapist and hope for the best possible outcome. The therapist, on the other hand, must trust that the client will be honest and open about his or her problems.

This does not mean that people cannot present their problems in any way that they like. Clients have the right to be confused and to struggle with words and meanings. In fact, one of the reasons why someone comes to therapy might exactly be the struggle to find meaning in life and articulate personal problems. Trust in psychotherapy refers to something else. It is the intention to approach another human being openly. The therapist and the client try to find the ‘middle ground’ where they can communicate, share and evolve as individuals. This is the true beauty of psychotherapy, because it enriches everyone who is involved in the process. After a certain period of time, both the therapist and the client will be transformed. The therapy process is valuable for the therapist as well as he or she will have had the opportunity to see the world through client’s eyes. The client will hopefully resolve his or her issues and continue with her life on her own.

Effective psychotherapy most certainly requires trust and mutual respect. The client must feel safe enough to reveal her own authentic self. She should be able to freely and spontaneously show her deep emotions and to confront her fears and doubts. If the client does not have a negativity bias towards psychotherapy, everything should go on naturally. It is perfectly normal to feel ambiguity in the beginning and to be a little bit anxious. That’s fine. And what is good about psychotherapy is that you can always change the therapist and find another one. One should be brave and positively stubborn, because she cannot expect to find a perfect therapist for her immediately—although it might happen, of course. Sometimes the chemistry is simply not quite right and two persons do not click. But that is fine too. It can take some time to find the right person with whom you can feel safe enough to place your faith in. People usually do not know that the search for the right therapist can be exhausting but also very rewarding at the end of the quest. As much as one therapist can be very good and skillful in what he or she does, maybe his personality does not ‘match’ the personality of the client, so the ‘right’ relationship cannot be established and true therapeutic alliance cannot be forged. Moving from one therapist to another means that you are willing to find the person with whom you will feel comfortable—and that is the key to developing trust in psychotherapy.

Just as in life outside the therapy room, you need to find people you can trust. This is quite normal. Why should you limit yourself only to one experience and one person? Unless you find the right therapist, you shouldn’t settle for less than perfect. When you find the right person, you will know. At that time, patience and perseverance become very important. The client must be patient, because psychotherapy usually takes same time to work. But if the client is trusting there shouldn’t be a problem, and both the therapist and the client should find a way to slowly step forward towards positive transformation.

The journey of psychotherapy is based on trust. The client leans on the therapist for a certain period of time, but after a while, she should be able to continue on her own. The responsibility of the therapist is to be there as much as he can for that period of time. It is a great honor and a privilege to be involved in someone’s life. Having trust and earning trust are two sides of the same coin. In the end, saying good bye to the therapist is usually full of sadness and joy at the same time. The trust invested in the therapist is not wasted, therapy goals should have been achieved, but a form of sadness remains, because saying good bye always comes with a blue note or two. It is inevitable. Nevertheless, doing something valuable is a reward in and of itself for the therapist and if client’s trust is well-deserved and not wasted, psychotherapy can be finished with a heart full of joy and a clear mind which is ready for new challenges.