Families Resources

THE ALLIANCE: THE IMPORTANCE OF RELATIONSHIPS

THERAPEUTIC ALLIANCE : The collaborative relationship a particular therapist is able to form with a particular client/resident.

Research has long found a relationship between alliance and outcome. Specifically, that when there is a fruitful working relationship between two people the outcome is more likely to be positive, than if a less desirable relationship exists. Fostering a sense of teamwork is helpful at a fundamental level. It can be difficult to proceed without. Mutual respect, reliability, and trustworthiness are a sampling of the characteristics which each party must experience for maximum benefit.

As is obvious to many of you having watched your family member develop relationships in treatment and also having experienced the attachment that is often formed between you and the individuals who are treating your loved one, you know that the attachment which occurs in a hospital or residential treatment center differs considerably from the sort of working alliances we form with our accountant, or house painter for instance. Obviously, in the case of accountants and painters, our feelings have no effect upon their competence. Suppose you live in an apartment and the owner sends someone to paint whom you find offensive in some way; your attitude will likely not make any difference to the ultimate out come of the job. If he or she is a good painter, it’s a good paint job regardless of your dislike for the personality or habits of the individual. But, with therapists and clinicians, his or her competence—the capacity to help—depends directly on our attitude towards him or her. We can hash out miscommunications with others, but there must be a basic sense of trust for progress to occur.

A good alliance keeps things going even when the rehabilitation or ‘daily grind’ becomes rocky, boring, or hard work. The working relationship and alliance is what keeps us involved in experiences that we might ordinarily avoid. When PT grows physically painful or counseling becomes emotionally difficult, we as therapists and staff members encourage your loved one to see the pain as good – a sign that progress is being made. When you as a parent, spouse or caretaker have a question or concern, we see it as a chance to educate you about an issue or work in tandem to problem-solve. Like marriage or parenthood, rehabilitation and therapy for all of us—therapist, family members, clients/residents, is a ‘for-better-or-worse’ proposition. A situation into which we all have been thrust together and must align for the common goal and good.

Trust, consistency, and professional closeness are part and parcel of the relationships we form with you and your loved one. These are qualities which health care clinicians go to great pains to learn, practice in training, study in formal education, and foster in them selves throughout their careers through ongoing continuing education, peer supervision and the like. Its importance can not be minimized. It has even been hypothesized that it is this relationship that is the single most helpful ingredient in promoting therapeutic gains. In other words, when this basic building block is present and strong, it is the ‘glue that binds’ and results in a positive outcome. As such, we must all encourage and nourish this experience along the long road of rehabilitation and treatment.