The Therapeutic Relationship: Its Role in Therapeutic Change

If you’re reading this, you may be thinking about starting therapy. Taking that first step to seek therapy takes courage. It means that there is a part of you that is ready for something to change in your life. But, if you’ve never sought out therapy before, you may not know what to expect. You may wonder how it works. What IS therapy? What is the therapeutic relationship?

So to address these questions, the focus of this post is on the therapeutic relationship. I’ll go over what the therapeutic relationship is and why it’s so important in therapy. I’ll also look a bit more closely at how I use music to support the therapeutic relationship in my work.

This post is part of a short series in which I’ve been exploring aspects of therapy and how it can help you in your life. In one post I wrote about the role of curiosity and acceptance in the therapy process. Most recently, I wrote about how music therapy can create change. I hope that these posts will help you gain a better understanding of what therapy is. As well I hope this post encourages you to think about what you may be looking for from therapy and a therapist.

What The Therapeutic Relationship Is

This is because as far as relationships go, the therapeutic relationship is unique. For many people, it is unlike any other kind of relationship they’ve had before. It’s a relationship that allows for safety, vulnerability, reflection, and honesty. As a therapist, I strive to meet clients where they’re at in a nonjudgmental way so that I can help guide them to where they want to go. This requires being able to be present and listen deeply so that I can help them find the answers to the questions that are bothering them. This results in a special kind of relationship.

Some people may not have experienced a relationship like this with others. If you’ve never felt safe to be yourself and express your own needs to others, it can feel strange to be in a relationship that encourages that. Some may find it strange because they haven’t ever experienced such a relationship with themself. This is because they haven’t yet learned how to identify who they are or what they need.

This is what makes the therapeutic relationship so important. It can help you to learn how to take care of yourself and to recognize that you’re worth taking care of.

The Importance of the Therapeutic Relationship

Because of this, it’s perhaps not surprising then that the therapeutic relationship is important to therapy. The therapeutic relationship is a key factor in the success of therapy. Studies show this to be true regardless of therapeutic approach or treatment modality. [1]

A female-presenting therapist and a male-presenting client are seated across from each other and have a good therapeutic relationship
Photo by cottonbro on

You may sometimes see the therapeutic relationship referred to as the “therapeutic alliance.” I like to think of this is as being how well the therapist and the person seeking therapy work together in therapy. In other words, how good is their “therapeutic relationship?” Does the person seeking therapy feel safe with their therapist? Do they feel accepted, heard, and understood? Do they feel like they have a voice in the focus and direction of therapy?

If the answer to these questions is yes, it’s they’ll likely experience success in therapy. If the answer is no, they may drop out of therapy altogether and not benefit at all. This is why finding a therapist who is a “good fit” for you is important. You may have to interview a few therapists to find the right one for you, but it will be worth it.

Our Close Relationships Also Play a Part

Yet, it’s also important to recognize that the therapeutic relationship can extend beyond the therapist and the person seeking therapy. [1] We have other significant relationships in our lives. And these relationships can also affect the therapeutic relationship. As well, the therapeutic relationship you have with your therapist can also affect these close outside relationships.

For example, if the people closest to you support your seeking therapy, this can have a positive effect on therapy. You may feel encouraged and supported. This can help you feel confident in the changes that you’re making. The people in your life may be open to the changes you’re making and even feel inspired to make changes of their own. At the very least, they don’t get in your way of making changes for yourself. Your relationships may change for the better.

But if the people closest to you don’t support you, you may feel conflicted about therapy and your course in therapy. You may feel reluctant or worried about making the changes you want to in your life. You may fear their judgment. It may be hard trusting yourself and what you want in life because of this lack of support from those close to you. Making the changes you want may feel impossible if the people closest to you don’t actively support you.

So, while the therapeutic relationship you have with your therapist is important, just know that there’s more to it than that. The support of others who are important in your life plays a part too.

Qualities of a Good Therapeutic Relationship

By now you may be wondering what makes for a good therapeutic relationship. There are three essential qualities to a good therapeutic relationship. They are:

  • An emotional bond of trust, caring, and respect
  • Agreement on the goals of therapy
  • Collaboration on the “work” or tasks of the treatment [1]

Going a bit deeper, other qualities that make for a good therapeutic relationship are:

  • Mutual trust, respect, and caring
  • General agreement on the goals and tasks of the therapy
  • Shared decision-making
  • Mutual engagement in “the work” of the treatment
  • The ability to talk about the “here-and-now” aspects of the relationship
  • The freedom to share any negative emotional responses with each other
  • The ability to correct any problems or difficulties that may arise in the relationship [1]

The Therapeutic Relationship in Music Therapy

Now let’s look at the therapeutic relationship within music therapy. In music therapy, I believe that there are two therapeutic relationships at play. The first is with the therapist, naturally, but the second is with the music. Music can serve as this second entity within therapy that can also foster the qualities that make for a good therapeutic relationship.

Ways That Music Can Enhance This Relationship

I like to think of the therapeutic relationship with music as that of a “co-therapist.” The fact that music can serve as a “co-therapist” is one of the things I love most about being able to use music in my work. This is because sometimes it’s able to do things that I may not always be able to do alone as a therapist. In this way, music is another vehicle in which the client can feel safe, supported, and seen. It can help “amplify” the therapeutic relationship, so to speak, and make it even better.

Music As a Way to Feel Safe

For example, music can create a sense of safety necessary for therapy. Bringing music into the session can help you to feel grounded and less anxious. If you are someone who finds it difficult talking to other people, listening to a song in therapy that you enjoy can help break the ice and help you feel more comfortable. Your musical preferences can be another way of sharing in therapy who you are without having to use many words. Listening to the lyrics of a song can sometimes provide the words that you may be lacking due to feeling anxious.

Because of this, music can also serve as another way of expressing yourself. In this way, it can provide a way for you to express things that you may not have the words for. Making music on an easy-to-play instrument that allows for a range of expression can also be another way for you to express yourself in a way where words aren’t necessary.

Music As a Way to Explore Feelings and Memories

As well, music can bring up feelings and meaningful memories that can be worth exploring in therapy. The reason why music can do this is because of how our bodies and brains respond to music. Amongst other areas in our brains, music activates our limbic system. The limbic system is the part of our brain that involves emotions and emotional memories. When we engage with music, long-forgotten memories or feelings may come up to the surface. These memories or feelings may not have come up if it weren’t for the prompt of music.

From there we can talk about those memories or feelings. How are they affecting you now? How did they affect you then? What sort of meaning do they have for you? Does that help you or hinder you?

Music As a Way to Foster Feelings of Non-Judgment

Additionally, listening to personally meaningful music together in therapy can further enhance a sense of non-judgment. This is especially important in the work I do with the teens. My willingness to share their music with them helps them feel heard. By being open and curious about the music that they bring to a session, they know that I’m accepting of who they are. As such, they feel more open to sharing with me their thoughts, feelings, worries, and wishes. This can lead to positive therapeutic change.

If you’d like to know more about how I use music in my work as a counselor and music therapist, you can learn more here.

Experiencing the Therapeutic Relationship For Yourself

The therapeutic relationship is important to the success of therapy. Because of this, you need to find one that feels good to you if you’re seeking therapy. After all, choosing to pursue therapy takes courage and it takes a willingness to be vulnerable and honest with yourself. That’s why it’s important to find a therapist with who you can work well as you navigate making changes in your life.

Contact me if to see if I am a good fit for you. I offer a free 15-minute online or phone consultation that you can schedule here.


The Importance of the Relationship With the Therapist – The Family Institute at Northwestern University

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