Therapeutic Alliance: Genuine or Just a Technique?

Therapeutic Alliance is a technique and concept that has gained quite a bit of attention in the medical and allied medical fields in recent years. In a nutshell, the therapist, nurse, physician, health coach etc., adopts the approach in order to:

  • Understand the patient’s values, beliefs, and culture without judging them
  • Help them reach for and achieve their goals, not the practitioner’s
  • Assist them to resolve any of their ambivalence to a desired, healthier option

It takes a whole lot of Empathy with a capital “E.”

In our own organization, we value this concept as much as we value clinical competence. We track every patient’s outcome and we have a very high percentage of clients who meet their goals. This “therapeutic alliance” accounts for a significant part of that success.

But is this a technique to be employed, or is it something more genuine? It is the difference between merely checking off boxes to get to the next person on the list and a genuine interest to help. You can even spend a lot of time with clients, but if you are not truly interested in each and every person, how can you really “care” for them? In our organization, we hire people who have an inherent motivation to help. Then we strengthen and reinforce that inner drive to care with training and support.

The secret is finding things in each and every person that is interesting. It may be as simple as the wild variety of socks that an individual always seems to wear. Find something that you truly admire about them and take it to heart. Maybe, most importantly, don’t simply NOT judge them.

Accept them for who they are and let them be who THEY want to be. Denying a personal feeling about someone is quite different than affirming another person’s beingness.

It’s been my observation in over 40 years of care that if you don’t genuinely find the person in front of you interesting, you will get limited results, no matter the level of your clinical competence. And I see the reverse as true too. A clinician who may not appear as clinically skilled as a peer, but really connects with each and every client, develops greater relationships and treatment outcomes. The true value of Therapeutic Alliance is not well achieved when delivered as the mechanics of a technology. It only comes from a genuine interest to help.

Now, how about taking all of that “good stuff” of the therapeutic alliance: the interest, admiration, empathy, acceptance and understanding, and applying it, not just to working clients/patients, but to everyone you meet. Wouldn’t that be a game changer?


Best Regards,

Billy Cioffredi

Cioffredi & Associates Founder & Physical Therapist


“When I first came to Cioffredi I was nearly immobile my back pain was so great. I thought I would do some stretches and gain a bit of mobility, but instead I got my life back. I can do everything I used to before my injury, and now  I also have the tools I need to relieve the pain naturally from home if and when things get tense. Thank you for this life-giving, redemptive experience.” -HM