Psychotherapy and the therapeutic relationship

Psychotherapy is a voluntary relationship between a person who needs help (the client) and a trained professional (the therapist), aimed at solving psychological problems.

It is not just friendly advice. It applies psychological theory systematically, and it needs trained practitioners: an untrained person, however well-meaning, may do harm.

Goals of psychotherapy include:

• reducing the client's distress;
• modifying harmful habits;
• changing unhelpful patterns of thinking;
• increasing self-awareness;
• improving relationships and decision-making.

The therapeutic alliance is the special relationship between client and therapist. It is:

• contractual: both agree to work together, with the goal of helping the client;
• time-limited: it lasts only as long as the therapy;
• trusting and confidential: the client can speak freely, knowing it stays private;
• professional: not a friendship.

The therapist shows two key attitudes:

• Unconditional positive regard: accepting the client completely, whatever they reveal, without judging.
• Empathy: understanding the client's experience as if one were in their shoes, feeling it from inside.

Empathy is different from:

• sympathy: feeling sorry for someone, from the outside;
• intellectual understanding: knowing about a situation without feeling what the other person feels.

Trust is the vehicle for change: only in a safe relationship can a client open up and change.