The Therapeutic Alliance: Why The Relationship with Your Therapist Matters

When most people think about therapy, they think about techniques: CBT, DBT, EMDR, or somatic approaches. But research has shown again and again that the most important factor for a successful therapy outcome isn’t the modality, it’s the relationship between therapist and client.

This bond, known as the therapeutic alliance, is what allows real psychological growth and transformation to happen. Without it, even the most sophisticated techniques fall flat.

What Is the Therapeutic Relationship?

The therapeutic relationship is the emotional bond between you and your therapist. It’s the sense of trust, empathy, and understanding that makes you feel safe enough to open up and be vulnerable.

Good therapy feels human. You might sense that your therapist “gets you,” or that they hold space for you without judgment. This therapeutic rapport doesn’t mean you’re friends, it’s a professional relationship with clear boundaries. But the relationship is deeply personal.

Studies consistently show that, while the therapeutic alliance is hard to measure objectively, it is one of the most important predictors of a successful outcome in therapy for the client.[¹]

What Is the Therapeutic Alliance?

Psychologist Jonathan Shedler, PhD, describes the therapeutic alliance beautifully:

“A therapeutic alliance is based on a shared purpose—an agreement about the work you’re there to do. It requires three elements:

• Connection.
• Mutual agreement about the purpose of therapy.
• Mutual agreement about the methods to achieve that purpose.

All three elements are necessary. I often see the first without the other two. This makes for warmth and support, but not psychological change.”

A strong therapeutic alliance is more than liking your therapist, it’s a strong collaborative working relationship between you both.

Therapists call this the working alliance: the ongoing cooperation between client and therapist toward shared goals. When you both understand what you’re working on and how, therapy gains direction and accountability.

Research across hundreds of studies confirms that the strength of this alliance is one of the best predictors of positive outcomes in therapy, regardless of the type of therapy or diagnosis.[²]

What Is Client–Therapist Fit?

You’ve probably heard the term therapist fit. It’s exactly what it sounds like: how well you and your therapist connect and communicate.

Fit can depend on personality, communication style, lived experience, or even sense of humour. It can also relate to cultural background, gender identity, or shared values.

That sense of fit helps you relax, trust, and stay open. But it should also include a level of respect and willingness for dialogue and feedback about what is working, and what is not. These are vital ingredients in a healthy therapeutic relationship, and ultimately getting the most out of therapy.

Why Does Therapist Fit Matter?

Therapist fit shouldn’t be just a nice to have. It’s a foundation for both success in therapy, and efficiency in getting the outcomes you came to therapy for, in a timely matter.

If you feel misunderstood, you’re less likely to open up. If you can’t open up, therapy can’t go anywhere meaningful. And if you’re paying $150+ per session, your frustrations will certainly be valid—particularly if you have a limited budget for therapy, as most of us do.

At First Session, we’ve seen this firsthand. Many clients find their therapist not by searching for a specific technique, but by watching our short video interviews and realizing, “I could actually talk to this person.” That initial sense of connection often becomes the beginning of healing, especially if money and time are limited.

How Do You Build Trust and Rapport with Your Therapist?

Trust takes time, and it’s built through consistency. It’s important to be comfortable to show up as yourself, even when you’re not at your best.

Notice how your therapist listens and responds. Do you feel safe? Heard? Challenged appropriately?

A good therapist meets you with genuine curiosity and care, but they’ll also hold you accountable. Rapport isn’t just comfort; it’s mutual respect and honesty.

Therapists are trained to build this working alliance with intention, through empathy, attunement, and clear communication. It’s important to check in with your intuition when choosing a therapist, and during the first few sessions to ensure you feel the relationship building, and you believe you and your therapist are seeing eye-to-eye.

Is Being Open with Your Therapist Important?

Yes, but it’s okay if openness takes time.

Therapy isn’t about spilling everything right away; it’s about learning to share honestly, at a pace that feels safe.

Some people benefit from opening up right away, and feel the cathartic relief of getting things off their chest quickly. But for folks who are more adverse to opening up, due to breaches of trust in past relationships, or simply being “new” to opening up to strangers, going slow is okay.

Holding back feelings or details can slow your progress, but forcing disclosure before you’re ready can also backfire. The key is being truthful (or working towards it) about what you’re feeling, even if that truth is, “I don’t feel ready to talk about this yet.”

That honesty strengthens the therapeutic alliance.

Is It Important to Respect Your Therapist?

Mutual respect keeps therapy healthy. You don’t have to agree with everything your therapist says, but respecting their role, their training, boundaries, and time, is essential.

That being said, it’s common for folks to hold their therapist “on a pedestal”, which can cause blocks in progress in therapy. You are the expert of your life, and your therapist brings their training and their experiences. 

Respect is reciprocal. The sooner the dialogue and energy of the therapeutic relationship conveys mutual respect, the better.

A good therapist respects your autonomy, values, and perspective. This balance maintains the integrity of the therapeutic relationship.

The Importance of Boundaries in the Therapeutic Relationship

Boundaries create the container for therapy to work.

Sessions are time-limited for a reason. The structure of therapy sessions allows emotional depth without chaos. Communication between sessions should be clear and limited.

While many popular therapy platforms promote 24/7 text access with your therapist, we don’t believe this is a good idea. While it might sound comforting, it can create a reliance and insecure attachment with your therapist, which is not healthy.

A therapist’s role is to support your growth, not to become part of your everyday life. A good therapist should want you to “graduate” from therapy when you’re ready. Maintaining professional boundaries ensures therapy remains a space for reflection and change, not dependence.

What Is Transference in Therapy?

Transference happens when you unconsciously project feelings from past relationships onto your therapist — for example, seeing them as a parental figure, or expecting criticism from them like a past teacher.

In fact, the same transference can occur when a therapist experiences emotions from past relationships, and projects them towards you as the client.

It’s a natural and often helpful part of therapy. These patterns show up for a reason, offering insight into how you relate to others and yourself.

How Do You Deal with Transference in Therapy?

The best way to handle transference is to talk about it.

A skilled therapist will notice these dynamics and invite you to explore them together. Discussing transference can feel uncomfortable, but it’s where profound growth often happens.

Instead of suppressing the reaction, curiosity helps transform it into understanding.

Transference and the Therapeutic Alliance

Far from being a threat, transference can actually strengthen the alliance when worked through collaboratively.

By noticing and reflecting on these feelings, you and your therapist deepen your shared understanding, exactly what Jonathan Shedler described as the heart of the therapeutic alliance.

When therapy becomes a safe place to explore these emotional patterns, you can begin to rewrite them in real time.

How Do You Know If a Therapist Is a Good Fit?

• You feel a professional level of respect towards your therapist.
• You feel heard and respected.
• You can be honest about discomfort without fear of judgment.
• You sense real progress over time.
  

And if the fit isn’t right? That’s okay. Finding the right therapist can take a few tries. It’s important for you to prioritize your needs and preferences. The therapist is working for you, not the other way around.

If you’re looking for a place to start your search for the right therapist, explore First Session. You can filter by location, gender, specialization, and even watch short video introductions to get a sense of fit before booking a consultation.

Summary: Why the alliance matters

Healing and transformation in therapy happens in relationship. The therapeutic relationship is a professional bond built on trust, safety, and shared purpose.

Techniques matter, but the connection provides the energy and engagement that makes growth possible.

A strong therapeutic alliance isn’t just good chemistry, it’s a foundation for transformation.

References

1. Horvath A. O., Symonds B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. J. Couns. Psychol. 38, 139–149
2. Castonguay L. G., Constantino M. J., & Grosse Holtforth M. (2006). The working alliance: where are we and where should we go? Psychotherapy, 43, 271–279.