The connection that exists in a helping relationship, as between therapist or other service provider and their clients. Repeated research findings indicate that this is the most significant factor under the control of the practitioner that correlates with positive change in the client.

Therapeutic relationship is also tied to Motivational Interviewing (MI). In MI, the effectiveness of counseling isn’t all down to the counselor nor is it completely within the control of the client, according to research.

What’s happening with the client both in terms of beliefs and of circumstances is a key factor (40%). So is the therapeutic relationship (30%). Smaller contributors include the client’s degree of hopefulness (15%) and the type of therapy used by the counsellor (15%).

Extra-Therapeutic Client Factors (40 per cent of effectiveness).
These include the client’s personal strengths, weaknesses and other characteristics including beliefs and attitudes; and also factors in the client’s environment that help or hinder.

How the therapist can help: Identify and talk about strengths while helping client to deal with weaknesses. Tailor solutions to client’s beliefs and values.

Therapeutic Relationship (30 per cent of effectiveness).
Empathy, warmth, acceptance (i.e. Rogerian factors) perceived by client.

How the therapist can help: Be warm and empathic. Address issues the client wants to deal with i.e. work with the client’s goals rather than those of your theoretical model. Be collaborative – don’t dictate.

Realistic Hope (15 per cent of effectiveness).
This refers to the client’s hopefulness about the outcome and the possibility of improvement.

How the therapist can help: Communicate hopefulness about what can be achieved. Don’t get stuck in the past – look also at what is possible now and in the future.

Model of Counseling (15 per cent of effectiveness)
Using the right approach for the particular client or situation. The approach should be tailored to the client’s needs, beliefs and strengths.

How the therapist can help: Be willing to change the approach/model to suit the needs of the client on the day.

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Recovery SUD Substance Use Disorder treatment Mental Health Disorder psychotherapy co-occurring disorders IDDT COD Dual Diagnosis MI motivational interviewing