So, you’re looking for a therapist. You want someone who is well-trained, knowledgeable about the challenges with which you’re struggling, successful in ameliorating those problems, and highly recommended, right?
To my mind, MyWellbeing is unique among the growing flood of online therapy resource sites in that they will match you with three therapists whom they think will best meet your needs.
However, it’s not simple to know how to match clients to therapists on potential rapport, and no way to quantify the variables that lead to a sense of connection with your prospective therapist.
In the “old days” of psychotherapy (and I was there, having been in practice since the early 90s!), before the advent of psychotherapy search sites, most clients found therapists through “word of mouth.” A friend or colleague would recommend a therapist they found helpful, or a gracious mental health professional might refer you to a colleague with whom they believed you would establish a good working relationship.
Now, searching for a therapist can be like searching for a new friend or partner on a dating website!
So, what is this “rapport” thing, anyway? And how can you determine whether your prospective therapist and you will establish a good rapport?
Lucky for you, psychotherapy research has answers. Literally thousands of studies have been conducted on the qualities that lead to better or worse therapeutic relationships, and outcomes in therapy.
First of all, ever since the days of pioneering psychotherapist researcher Carl Rogers, decades of research on what we call the “common factors” of therapy effectiveness have firmly established that effective therapists possess the qualities of warmth, empathy, and genuineness (Sprenkle et al., 2009).
Like much of psychology research, you could say that this finding seems pretty obvious! After all, who wants a therapist who is cold and rejecting, seems unable to resonate to or grasp how you’re feeling, or seems so stiff and formal that you feel they are hiding behind their degree and notepad.
In defense of the field of psychology and all the effort (and time and money) we put into research, one major purpose of social science is to establish through empirical methods whether ideas that seem commonsense and that you grandma could’ve told you are in fact true!
You can count on the finding that good therapists are warm, empathic, and genuine as you begin your search for one with whom you can have rapport. That’s a good start!
As to the qualities of the therapy relationship itself that contribute to building rapport, a pioneering article published in 1979 by psychologist Edward Bordin in the top journal Psychotherapy sheds some light. It started the exploration of the nature of the “therapeutic (or working) alliance” and what exactly it is that predicts a better or worse connection between therapist and client.
Bordin specified three core aspects of the therapeutic alliance: Agreement on goals (what you want the therapist to help you achieve), agreement on tasks (being specific about what the therapist will do and what you will need to do as an active, engaged client), and a positive bond between you.
Goals and tasks are fairly easy to specify: You want to overcome depression or anxiety, you want to have an easier time forming friendships and intimate relationships, and/or you’ve experienced trauma and you want relief, and the therapist has the training, knowledge, and specific methods at hand to help you achieve those goals.
But what about the “bond”? How do you know from an initial consultation whether you are likely to feel emotionally connected and supported by your therapist over time?
Let’s start with what you should NOT be searching for. Your therapist is not going to be your friend.
Satisfying close friendships involve a fairly equal level of personal self-disclosure. In therapy, you’ll be talking about your life, your thoughts, your feelings, and your struggles, but your therapist will rarely disclose their own personal thoughts, feelings, and struggles. In friendships, we tend to take our friend’s side when they’re upset about another person or a situation, even though we haven’t spoken to that other person and may be validating our friend’s perceptions incorrectly (Lemay et al., 2020). Even if we do have a sense that our friend is possibly misinterpreting the “offending person’s” behavior, we may avoid being honest in our assessment because we want our friend to like us and not be pissed that we challenged their viewpoint (Lemay et al., 2020). Not helpful!
In contrast, your therapist is there simultaneously to “validate” or support your feelings, BUT ALSO to challenge you to think about how you might have contributed to that unpleasant interaction with your friend or partner, that conflict with your parents or your siblings, that difficult moment with your boss or colleague, or how your beliefs about yourself and the world contribute to your chronic depression and anxiety.
A good therapist is going to ask you to describe what actually happened in those interactions, blow by blow, frame by frame, and is going to listen carefully for moments when you MIGHT have approached a situation with the wrong assumptions about the other person, with unrealistic expectations, or with a pre-existing readiness to perceive criticism or rejection that may not be warranted, and will listen for how you behaved with the other person in ways that might have led to their less-than-desired responses.
A good therapist is prepared for you to be pissed off or hurt by them from time to time because you felt challenged and not completely validated, and because the therapist is there to help you with your goals for change. We therapists know that all productive therapy relationships will experience these “ruptures,” and we have techniques to repair the bond -- helping you reestablish a trusting bond with us (Eubanks et al., 2018). You might even learn from this process of rupture and repair to become more honest with the people in your life, having seen in therapy that repair of a rupture strengthens the relationship.
So, in short, when you’re trying to get a sense of whether you and a therapist you’re checking out will develop the kind of rapport you need to reach your goals for therapy, don’t apply the “friendship model.” In fact, I’d say that if you find yourself sensing that “Wow, he/she/they are so much like me, and so supportive sounding, I’d like them as a friend!”, you may have found someone who can’t do what you need to help you change.
Instead, you might ask the therapist during a consultation for some constructively critical views on your issues. After telling them the kinds of situations that trouble you, or your negative beliefs and feelings about yourself and the world, you could ask the following sorts of questions: “Do you have some thoughts about how I might be wrong about how I see myself? Do you have a sense of how I might contribute to these difficult interactions with my partner/boss/colleague/family member?” A good therapist will jump at the chance to help you reevaluate your thoughts, predisposing feelings, and behavior, and will do it in a kind and supportive manner.
A therapist who just wants you to sign on to work with them may stifle those constructive critical perspectives and just support and validate your feelings. That’s not a sign of rapport: That’s the friendship paradigm inappropriately transferred to the therapy relationship.
I’ve had people come to me for therapy after years of a cozy, supportive relationship with another therapist that led to no change whatsoever, and now they want to be challenged. They’re ready to change, and I’m ready to help them by challenging their ways of seeing themselves and others.
Most importantly, realize that rapport is something that builds over time.
In this day and age, I’ve found some younger folks (meaning, in their 20s and 30s) expect to experience an immediate, deep, profound connection with a therapist with whom they’ve only spoken for 15 minutes! With many clients who have reached out to me through another psychotherapy matching site, I’ve been a bit taken aback that they are interviewing seven, eight, nine, or more therapists to somehow find just the right fit.
I recently had a consultation with someone who found me on another site that turned into a full first session. He was an intelligent man in his early 30s who described high levels of anxiety and a complicated relationship with his lover. I offered him a number of perspectives and some mindfulness techniques to immediately reduce his anxiety. He then declared that he wanted to meet twice a week because he’s really in a crisis, and I said, “Ok, well let’s schedule a time.”
To my surprise, he literally pulled back from his computer screen as if in shock and said, “Oh, no, I’m not ready to start – I have consultation appointments with five other therapists!”
I must say, I was taken aback. Two weeks after our initial consultation, he let me know that he’s still searching for the perfect match even though he said he really enjoyed our session.
Folks, don’t overdue the search process: Find someone with whom you have agreement on goals, tasks, and the beginning of a bond, and “give it a go,” as the British say. And expect some bumps in the relationship along the way, because that’s part of building rapport.
If it turns out to not be a great fit, a responsible therapist will point that out, and refer you to someone else who can better meet your needs. Don’t get captured by the “paradox of choice,” where you endlessly search for the “perfect match” and never get started on the challenging but ultimately rewarding process of change.
Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy, 16, 252-260.
Eubanks, C. F., Muran, J. C., & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55, 508-519.
Lemay, E. P., Jr., Ryan, J. E., Fehr, R., & Gelfand, M. J. (2020). Validation of negativity: Drawbacks of interpersonal responsiveness during conflicts with outsiders. Journal of Personality and Social Psychology, 119, 104-135.
Sprenkle, D. H., Davis, S. D., & Lebow, J. L. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. New York: Guilford.
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Peter Fraenkel, PhD, is an award-winning clinical psychologist with 30 years of experience as a psychotherapist and trainer of graduate students in psychotherapy at the Ackerman Institute for the Family, New York University Medical School, Lenox Hill Hospital, and at the City College of New York. He lectures internationally and has been featured numerous times in the popular media.
