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