For therapy to be effective, a patient and their therapist must establish a good level of comfort, trust, and understanding that therapy requires both parties to actively participate.
What is the therapeutic alliance in mental health nursing?
The therapeutic alliance is the relationship between patient and therapist. Establishing a relationship based on trust and mutual understanding is important in making a patient comfortable and willing to be honest about their feelings and the nature of the issues they are experiencing.
Both patient and therapist must be willing to put effort into the relationship. This means that therapists need to empathize with their clients whenever possible to build trust while the patient must be willing to consider and often follow the advice of the therapist.
Open and honest communication is a must.
A therapist must be willing to listen to all concerns and issues that a patient is experiencing which might provide insight that can help them form realistic solutions and coping strategies.
When a patient trusts their therapist they tend to be more open with communicating their concerns, thoughts, desires, and mindset. If a therapist thinks that a patient is holding back, then they must consider why the patient is so hesitant to open up and try to find a way to encourage more openness.
Keys elements of a great therapeutic alliance
A positive environment for listening and understanding
It is important for therapists to ensure that clients experience a nonjudgmental approach to therapy. A good therapist must set aside some of their own judgments in order to do this. Empathizing with at least some aspects of a client’s emotions and situation is important to building trust. Feedback and advice must acknowledge a client’s personal feelings and emotions.
Clear goals that are agreed upon by both patient and therapist
Within the first few appointments, it is important that the patient and therapist define the main goals of therapy. When there are clearly defined goals, session time is used more effectively. Honing in on the most prominent problems and evaluating a client’s main concerns may take more time for some than others. It is also important to remember that new issues may be discovered as a client begins to feel comfortable and open up about what they are experiencing, and it may take a few sessions to establish this level of comfort and trust.
Therapy goals should be realistic
Healing and overcoming mental health issues can take a significant amount of time in some cases. In the case of a patient with a chronic issue, therapy might be something that the patient uses as a coping mechanism throughout their life. For example, someone with a mental health disorder caused by a chemical imbalance that cannot be cured may require therapy regularly.
Regardless of the condition or severity of the mental illness, clearly defined and realistic goals are critical. Meeting goals is encouraging for patients, but they must be achievable. If goals are set that are far too difficult to achieve in a specific time period or are simply not realistic on any given timeline, it can be a recipe for disappointment. Not meeting goals can lead to patients abandoning therapy entirely, and as you can imagine, this can have dire consequences.
Mutual responsibility
Therapists need to provide patients with the tools and support they need to be empowered toward healing and take charge of their mental health. When patients feel some measure of control over their mental health then they will try harder to meet goals.
The client must take responsibility for their own treatment. A therapist is there to guide and support a patient, but if a patient does not participate in treatment, then it won’t be successful.
Types of therapeutic alliances
Directive
This type of alliance requires the therapist to provide a lot of advice and directions for the patient to follow.
Nondirective
In some cases, a patient may benefit from or request that therapy is not micro-focused on a specific issue from the start. Sessions may mostly be a patient talking about what they need to do on that specific day. This is common for patients that are experiencing a lot of stress or anxiety or just trying to figure out what the root causes driving them to seek help are.
Facilitative
Therapy that explores feelings and emotions to help a client grow on a personal level is facilitative. This therapy is common for patients that are trying to improve their emotional well-being but that otherwise have good mental health.
Supportive
Everyone needs someone to listen to them sometimes. Supportive therapy involves therapists offering strong emotional support and offering advice to help patients heal from trauma or life-changing events.
Task-oriented
When therapists give patients assignments and tasks to help them achieve goals then they are taking a task-oriented approach. A good example of this would be couples therapy, where a therapist might give a couple of activities to work through together.
The demand for therapists is high
There is a growing demand for mental health services that is not going away anytime in the near future. Current and future mental health professionals must understand the need to strengthen the therapeutic alliance they have with those in their care. Because of this demand, therapists can expect good wages and job security.
Online DNP PMHNP programs are a great educational option for those looking to become mental health professionals. Baylor University offers an excellent accredited online program in psychiatric mental health nursing that is great for registered nurses looking to advance their careers or enter a specialization. The course explores clinical, conceptual, and theoretical mental health treatment models and prepares students with the skills needed to implement these in practice.
The online program requires only one year of experience practicing as a professional nurse. This allows motivated nurses to advance their careers much sooner than many other programs available.
Conclusion
Trust and setting realistic goals for therapy are important to the therapeutic alliance. By building a stronger bond with clients, therapists can deliver a higher level of care and empower patients to take personal control of their mental health throughout their lives.
A good therapeutic alliance ensures that patients will continue to attend the therapy sessions they need rather than abandoning them before they make any progress. By setting realistic expectations with a patient early on, a therapist can improve a client’s mental health faster and more effectively.
