What Does a Successful Relationship with Your Therapist Look Like?

Making the decision to reach out to a therapist can be nerve wracking. 

When you start to the process of finding a therapist, it’s likely you’ll come across several different kinds of professionals, each one with their own therapy speciality, such as anxiety therapy, and method (known as a therapy modality), such as Cognitive Behavioural Therapy (CBT). You might start to worry you’ll choose the wrong “kind” of therapist or counsellor. 

On top of that, it can feel uncomfortable to think about telling a perfect stranger your feelings, personal history and challenges. It is difficult to talk about what’s going on, especially if we’re seeking help for something that’s making us upset, or about something that is painful and we feel vulnerable. 

That’s completely normal and why, ultimately, great results from therapy come down to the relationship you are able to build with your therapist. 

Dozens of studies have shown that the client/therapist relationship is the number one factor for success, more than the method or approach used. When you and your therapist or counsellor are able to work together, you’re most likely to have positive outcomes from therapy.

“Therapy is a relationship,” says Registered Social Worker, and Psychotherapist Ahilia Singh Morales. “It’s a conversation, and you should feel comfortable. It might be scary to think I’m going to share intimate details of my life with a complete stranger. But with a good fit, you should really feel comfortable, like you have someone in your life that you can turn to and who can support you.”

How do you know if the relationship is successful?

Assessing the potential for a good therapist fit 

To build a good relationship, think about how and why they might be a good fit in the first place. Finding a good therapist fit is very subjective: what works for you may not work for others, and vice versa. 

Early signs that you’ll enjoy working with them could be that you feel comfortable by the sound of their voice or their body language, and the way they describe things resonates with you. They might work with people from the same community or background as you, or who have similar lived experiences and it signals to you they’ll understand the nuances of your life. They will be able to meet you where you are, and tailor their approach to your needs. 

Morales adds, “You should also feel empowered to speak up and advocate for yourself. If you’re exploring something in therapy and maybe you don’t agree, you should feel comfortable enough saying ‘I don’t agree with that.’ Or ‘I don’t want to talk about that.’ Or ‘That’s not where I want to go.’”

The therapist does not hold all of the power in your relationship. The therapist brings expertise and training but you are the expert on you. Holding a therapist on a pedestal can create an unbalanced power dynamic. Knowing you can speak up if something isn’t working is another good sign you have the right fit.

Take some time to look up therapists’ online profiles, social media accounts, or their written or video content online to get a better sense of who they are. Knowing you have an initial connection, you’ll be in a better position to work with them during therapy.

Characteristics of a good relationship with your therapist

The client and therapist relationship works best when you agree on your goals and you work together to achieve them—when you are working in a partnership with your therapist. 

There is an entire Task Force at the American Psychological Association that analyzes and reports on research about the importance of relationships in therapy. One of the key findings from their 2019 report was that therapy works best when it is a two-way relationship; the client and therapist are equal partners to help clients reach their goals, rather than the therapist acting as the “commander.” 

One way a therapist might show you that you have a partnership is asking you questions about how you think things are going. The APA Task Force found that feedback was an incredibly powerful tool to ensure the relationship feels like a collaboration and that it remains working functionally for both you and your therapist. 

You can do your part by being honest about what’s working and what’s not working. 

Jacqueline Groves, a Registered Social Worker who focuses on a holistic approach with her clients says, “The therapeutic relationship needs to be interactive, needs to go both ways. I’m not your solution finder. I’m the one who asks you questions and guides you and introduces you to concepts that I know can get you to the place where you want to be. I’m going to give you a strategy for your mental health. You’re going to come back and say, you know, I liked this part, but I didn’t like this part, so I’m doing something different. You make it your own.”

How do you know if the therapy relationship is not working?

It’s okay if a therapist is not working out for you. They are professionals and you can (and should) be honest about wanting to end your work together. Signs the relationship is not, or no longer working, could include feeling like you don’t have anything to talk about, you aren’t connecting with their questions, your needs have changed, you are disagreeing with the therapists’ approach or you simply want a new perspective. It’s very normal that a therapist might ask for feedback when you pause or end therapy; it’s good practice for them to ask, they’ll have genuine interest in your next steps. 

On the other hand, if you’ve been in therapy a long time, there is also a chance the relationship with a therapist can become too strong (too “buddy buddy”) and it can throw the dynamic off. This can also negatively impact your work together.

Karl Deisseroth, Stanford University professor of psychiatry and behavioural science cautions patients to take note when the relationship gets too deep. He says, “You want to have trust, you want to have a therapeutic alliance, we sometimes call it. But it's got to be enough of a blank slate that the patient is not consciously or unconsciously constrained in what they choose to share.”

If the dynamic starts to slip, it’s not necessarily the end of the relationship and it’s possible it can be repaired. In fact, the APA Task Force also found that fixing those breakdowns, or “repairing ruptures” such as disagreements about goals miscommunications or misinterpretations, can ultimately be beneficial to the client and therapist’s progress. 

Relationships are ongoing work, and they evolve

To know if your relationship is successful, you should feel like you are “clicking” (this feels natural, instinctual, it’s subjective), your outlook and your goals are aligned, and you can communicate well, even through conflict. 

Remember that your experience is likely to evolve and change as you do. Here is a summary of what to keep in mind as you check in on the relationship along the way.

1. Relationships are the number one predictor for success in therapy. 
2. You are in partnership, the therapist does not hold the authority and those partnerships are built on mutual trust and accountability. They are not your solution-finder, they give you tools and strategies to help you reach your goals.
3. A good fit is subjective, and personal to you. You should not feel judgement from a therapist, or feel you cannot show up authentically.
4. A good relationship can also become too close, especially after a long time, and it might affect accountability and neutrality. 
5. You and your therapist can manage the evolving relationship by checking in, asking questions to discuss if you’re still getting value from therapy, and adjusting to your needs as needed.