Our Co-Constructed MASTER List of Therapeutic Alliance Tools
Throughout the month of April I asked in group supervision what you are doing to create therapeutic alliance in your work. Behold, the master (unedited, because who has time?) list!
(You all are geniuses.)
Talking about their interests- and returning to it (hobbies)
Remembering their friend’s names
Using their vernacular, diffuses the power
Asking for permission, consent before giving feedback, teaching a skill
Swearing
Showing that you are listening thru body language, eye contact, leaning in, nodding
Using own breath- noticing it, noticing own reactions
Going for walks, doing activities together
Asking about their goals
Using self-disclosure
Talking with them if something feels off in relationship
Trying to understand their family culture and what their role is, how they see themselves in their family
Asking lots of questions
In beginning, providing info about what sessions look like, what they can expect in sessions
Greeting them in open, warm, positive manner
Authenticity-
Self-disclose in service of the relationship
Validating when clients set boundaries with you, and returning to that to celebrate it (negative feedback)
Tending to the relationship
Recognizing when there was a break and we got through it
Anything and everything they do that’s a step forward- celebrating it
Letting them see your pets/seeing their pets/knowing their pets (via telehealth)
Being informal
“This is for you, this is your space”
Eliciting feedback, esp with telehealth, and validating it’s not ideal
“Am I talking too much?, was this ok for you?”- give them permission to give feedback for better or worse
Checking in on frequency of meetings
Giving them permission to call the shots
Adjusting attitude for each client based on age group, “each client gets a different part of my personality that fits with them”
School: remembering what they are taking, when they graduate, which classes they like/don’t like
Pets names, kids names, grandkids names
Opposite of toxic positivity, “this really does suck”
Transparency when losing train of thought
Give them permission to not follow social standards, to be totally selfish and not worry about social niceties
Stream of consciousness speech “works great”- let it follow this pattern
Communicating trust in what they talk about- let them direct
Normalizing thoughts and feelings with psychotic folks
Being present- no phone, no ppwk, giving full attention
Intentionally checking in with everyone in the group home (immediate check-in: hello, how are you)
Non-judgment: controlling face, nonjudgmental language, no labels or non-pathologizing
Slowing self down when talking to someone in crisis
Giving choices to group home residents as much as possible, awareness of power
Casual dress to affect power dynamic
Share how you utilize the tools yourself
Alternative sentencing advocate- putting judgment aside
Feedback: what could have been different, did this help, did i answer all your questions?
Eating with clients
Meeting clients family members for safety planning
Build alliance with family to increase bond with client
Listening to peoples’ stories
Eliciting feedback
Unconditional positive regard- people want to feel heard, supported, validated
Balancing the power- permission to discuss, explaining why doing what doing
Anything we missed- we’re here for you
TIC
My love language- words of affirmation
That thing you did seemed cool because …
Glasser’s 5 basic needs- everything you do is meeting a need somehow; i’m not judging you meeting this need this way, but it doesn’t seem like it’s work for you
Unconditional positive regard
Looking at “weaknesses are strengths out of balance”
Empathizing like: You have a desire to feel safe so you took it out on your partner
Narrating what is happening in your head
Giving people time to think
Process work- paying attention to microexpressions
Attuning to even small things getting out of balance
“I’m not scared of you”
Not getting scared of clients
Address rescue fantasies of clients quickly; understand how they think things will improve, make sure realistic expectations
authenticity/consistency
“I don’t think it’s possible to heal pain”----just experience it
“I challenged you because I care about you and I see these things in your life”
Reflecting on self identities out of session to see how they impact the TA
Sometimes in session
Indicators of trust: client can tell me when I’m going in the wrong direction, when i’ve gotten something wrong
If client struggling with identities, use of self disclosure (trans, queer)
Getting permission to call clients on or around birthdays
Inappropriate humor together
Being friendly with clients
Verbalize your own appreciation for the relationship- it’s good to see you, it’s nice hearing your voice, it thought about you while you were away
Acknowledge your positive feelings towards a client
Having agape, non-sexual love with clients (article from Colin)
Making meeting out of small interactions- leads to empathy and connect; asking how they make meaning out of things too
Giving clients control in subtle ways- meet when they want to, etc (esp with clients who've been institutionalized)
Transparency about communications need to have with tx team or board (when reporting, parole, etc.)
Connect with clients about food- get to know their culture and upbringing around it
Remembering the parts of their story that are important to them that you remember
Honesty
Transparency
Humor
Vulnerability
Reduce power
Start by believing clients
Meet them where they are
Offer shared experience when clinically appropriate
Hugs if requested
Shared community space (black trans march)
Being non-judgmental list
Teaching kids the power they have (saying hi in public, they say hi first) and informed consent and the power they have in confidentiality- explaining to them the “protected connection”
Being “unprofessional”
With black clients, saying hi if seen in public (saying hi first, with their consent)
Being non-clinical, “there’s nothing wrong with you!”
With teens, esp when it’s not heir choice, taking the pressure off, letting them know therapy doesn’t have to look any certain way, no expectations
With kids, keeping things skill-based, non-pathologizing
Breaking down parental overwhelm and their interpretation, not making it feel so big for parents, can they be willing to be in a space to hear what it’s like for their teen?
Helping parents change their interpretations of their kids
Offering walk + talk therapy with kids to enhance connection, remove clinical stuff
Movement to create therapeutic alliance, take face2face therapy room and concept off of coming to talk
Trying not to assume, ask open ended questions at beginning of relationship
Reflective listening
Getting feedback about how sessions are going
Making sure we’re on the same page
Finding common ground (self-disclosure sometimes, in small ways)
Use humor when possible
Communicate client’s self-determination with sessions, putting the ball in their court
If they’ve been to therapy before, what has/hasn’t work
Own personal self-care and wellness
Maintaining bio/psycho/social/spiritual perspective, person-in-environment and intersectional needs
Offer referrals/options for basic needs
That positive regard with students and parents
Acting like i’m genuinely happy to see them! “I’m so glad you’re here!”
Communicating that they are someone I enjoy- intentionally warmly demonstrating this
Follow-up with them, remembering what they said before
Remember the important people in their life, use their names
Talk about what we talked about before
Normalizing: all people need help all the time
Normalize so they don’t feel like i could never understand what it’s like
Lean into the fact that my face never hides how I feel (even if the person across from me isn’t as expressive)
(Communicates a level of safety, comfort)
Learn to relate to clients more as therapist than as a friend. Is this as if we’re in a bar having cocktails? That’s not ok.
Reflecting on how I felt when with the client and making adjustments
Managing own social needs and loneliness so not coming out with sessions
Remember what they are paying you for, letting that guide your approach.
Using pieces of own experience to understand pieces of theirs, without making focus on self (esp when it comes to race); noting feelings of being othered, letting it create a connection of shared humanity
Ask: is it like this, or like that? Use their feedback to inform how I understand their experience. “You’re not alone in that”
Self-disclosure in light of: how do I bring my nervous system to the therapeutic relationship? How do I feel with this person, and is that how others feel (in light of building relationship in gestalt work)
Noticing my own need for acknowledgement in self-disclosure--------
Noticing own counter-transference- when my own unmet needs or my own wounding comes to the table
Learning to assess client’s readiness around different levels of self-disclosure
