Key Takeaways

• The therapist-client relationship — also called the therapeutic alliance or rapport — is an essential part of what makes therapy effective.

• Child therapists use specialized approaches, like play and art, to help children feel safe enough to open up at their own pace.

• If you or your child struggles to connect with a therapist, there are steps you can take to build trust and make the process more comfortable.

Opening up to a therapist can be scary. Even if you made the decision yourself to go to therapy, it can take time to feel safe enough to talk about the things that matter to you.

But the relationship you build with your therapist is one of the most important parts of the process, and research shows that a strong therapeutic alliance is one of the best predictors of positive treatment outcomes.

This doesn’t mean you need to immediately feel comfortable or trust your therapist right away. Like any meaningful relationship, it takes time to develop.

And if you’re bringing your child to therapy, the process of building trust can look a little different.

Whether you’re a young adult seeking therapy for yourself or a parent looking to support your child, understanding how to strengthen this connection can make therapy more effective and meaningful.

Why the Therapist-Client Relationship Matters

Having a strong, trusting relationship with your therapist isn’t just about feeling good. Research shows that this relationship — also called the therapeutic alliance, or rapport — is an essential part of the overall therapeutic process.

It’s one of the strongest predictors of a positive treatment outcome. In other words, for therapy to work, you must have a strong relationship with your therapist.

Therapy is a unique process, and it can be a vulnerable one.

You may be sharing things with your therapist that you’ve never talked about with anyone else (although your therapist will never force you to talk about anything you’re not comfortable with).

Having trust in the relationship, and believing that they want what’s best for you, is essential to feeling safe.

Building a relationship with your therapist isn’t entirely up to you — but it isn’t entirely up to your therapist, either.

It’s a collaborative process; both you and your therapist play important roles in building that rapport. It can take some time for the relationship to build, and that’s normal.

But if you aren’t open to trusting your therapist, then it may be difficult for therapy to be effective.

Building Trust with Your Therapist as an Adult

As an adult, the most important way you can build a strong alliance with your therapist is to be open and honest.

Therapy requires vulnerability. It’s okay to take it slow, but honest communication goes a long way.

Communicating openly and honestly

Honest communication doesn’t mean you need to tell them your deepest secrets immediately upon meeting your therapist for the first time (although if you feel comfortable doing so, your therapist won’t judge you).

It’s okay for the trust to build over time, but the more open and vulnerable you can be in sessions, the stronger the therapeutic relationship will become — and the more helpful therapy will be for you. 

Handling difficult or uncomfortable topics

Some uncomfortable topics may come up during the therapeutic process that you might worry could affect the therapeutic relationship.

For example, you may need to give your therapist feedback about changing how they do something. Or you may need to share something about yourself that you’ve kept secret for a long time.

When this happens, try to remember that you and your therapist are on the same team. Good therapists hold unconditional positive regard for their clients, which means that no matter what you tell them, they’ll still see your worth as a human being.

They aren’t there to judge you or criticize you.

Helping a Child Build a Relationship with Their Therapist

For children, rapport-building in therapy can be a little bit more complex.

Some children connect and open up immediately to therapists. For others, especially children who are in therapy against their will, it may take a lot longer. 

Why children may struggle to open up in therapy

There are so many reasons why children may have a difficult time opening up with their therapist, especially at first.

This is completely normal. If they live with attachment difficulties (like reactive attachment disorder), then they may have a hard time trusting any adult.

Many teens also worry about their confidentiality in sessions — that their therapist will tell their parents about things they’d rather keep private.

Child therapists are highly trained in dealing with these types of obstacles and using special techniques to connect with your child.

They often spend several sessions just on building trust with your child through play. They can help you explain the process of therapy to your child so it’s not as intimidating, as well as assure them of their right to confidentiality (and its limits).

How parents can support the therapist-child bond

As a parent, you play an important role in the relationship that your child builds with their therapist.

Research shows that parent involvement is crucial in making therapy as effective as possible. Stay on the same page with your child’s therapist by meeting for regular progress updates. 

Respect your child’s confidentiality within sessions. Ask them about their sessions, but also allow them to build their own relationship with their therapist — try not to get angry or worried if there are things they’d rather keep private. 

Signs your child is connecting with their therapist

Watch for signs that your child is engaged in therapy and starting to trust their therapist.

These signs might look different depending on how old your child is.

But some things to look out for include:

• They seem to look forward to therapy sessions, or at least be more willing to attend them

• They talk to their therapist about things they don’t typically feel comfortable talking about with other adults

• You observe small, but noticeable, changes and progress

• They talk about the skills they’ve learned in therapy or mention their therapist between sessions

• They express their emotions more openly

• The therapist assures you that the relationship is building

Overcoming Common Challenges in Therapy

Some common challenges may arise that may get in the way of building trust with your therapist.

Most of these can be overcome by being honest with your therapist about how you’re feeling and working collaboratively to find a way forward. Challenges in the rapport-building process can look different for children and adults.

For Adults

Feeling disconnected or unheard

Adults in therapy can feel unheard or misunderstood. It might feel like your therapist isn’t quite “getting” you.

This doesn’t necessarily mean that the therapist is judging you or misunderstanding you — sometimes, it takes several sessions to feel like you and your therapist are truly on the same page. 

Be honest with your therapist, and give them immediate feedback if you’re feeling like they’re not hearing you. If things don’t improve or if it’s just not the right fit, it’s 100% okay to look for a new therapist.

What to do if you feel stuck in therapy

As an adult, you may also feel stuck in therapy, like you’re going in circles and not getting anywhere.

This usually happens because you and your therapist haven’t gotten clear enough on what your exact goals and expectations are for this process. 

Firstly, it’s important to reflect on your own about what you hope to gain from therapy. Then, talk to your therapist. Collaborate with them to set specific and measurable goals that can help you clearly see the progress you’ve been making.

For Children

When a child resists or refuses therapy

One major barrier that comes up for children in therapy is not wanting to go to therapy to begin with. While adults often (but not always) choose to seek therapy for themselves, children don’t have the same level of autonomy.

They may be in therapy because an adult in their lives referred them, sometimes without even understanding what, exactly, therapy is. 

If your child is unsure about the idea of therapy, then let your therapist know right away. They can help guide you in supporting your child through this process.

It can also help to validate your child’s feelings of uncertainty and assure them that they don’t need to open up right away.

How therapists use play and creative methods to build rapport

Therapists don’t enter into a first session with a child and immediately start asking intrusive and personal questions. Relationship-building is a key component of the therapeutic process.

Typically, therapists will spend several sessions when starting therapy with a child just playing with them and using creative methods like art or music.

This is essential in helping children feel comfortable and safe, and for therapy to be effective moving forward.

The importance of consistency in child therapy

When your child sees their therapist regularly, then they’re more likely to be able to build trust with them. Most typically, your child will need therapy once a week, although some children may need sessions more or less frequently. 

If you’re having a difficult time bringing your child to therapy consistently, talk to their therapist about brainstorming solutions. For example, could your child have virtual sessions some weeks? If finances are a barrier, can you talk to the therapist about going on a payment plan?

Takeaway

The therapeutic relationship is one of the most essential parts of an effective therapy process, and it’s just as important — if not more so — for children. In child therapy, it’s important for both the parent and the child themselves to trust the therapist.

This can take time, but your therapist can help you overcome common barriers and address any concerns you may have.

At Emora Health, we have a wide network of experienced child therapists you can choose from — just look through their bios and choose a therapist who seems like a good fit. If the relationship doesn’t end up building, then we also make it easy to switch therapists any time.

Sources

Haine-Schlagel, R., & Walsh, N. E. (2015). A review of Parent Participation Engagement in child and family Mental health treatment. Clinical Child and Family Psychology Review, 18(2), 133–150. https://doi.org/10.1007/s10567-015-0182-x

Opland, C., & Torrico, T. J. (2024, October 6). Psychotherapy and therapeutic relationship. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK608012/