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Kinder Mind
Kinder Mind
Exploring Rapport and Relationship Building Techniques as an Intervention Strategy for Therapists
Unlock the secrets to building a strong therapeutic alliance with our insightful conversation featuring Ashleigh Hala, LICSW, on the Kinder Mind podcast. Discover how trust and vulnerability between therapist and client can transform therapeutic outcomes. Ashleigh shares expert techniques like active listening, validation, and appropriate self-disclosure that create a supportive and effective environment for therapy. As we explore the unique challenges of short-term therapy, you'll learn how to make those critical first interactions both comfortable and productive.
Our discussion takes a deep dive into the essence of collaboration in therapy, where the focus is on working with clients, not just for them. Ashleigh emphasizes the power of language in shaping therapeutic relationships, illustrating how subtle changes, such as shifting from "should" to "could," empower clients by providing options rather than directives. The importance of boundaries, mutual participation, and finding the right therapist fit are all critical elements in fostering an environment where clients feel truly supported and engaged in their journeys.
We also examine how to effectively evaluate therapeutic rapport and ensure that therapy sessions remain goal-oriented and client-centered. From using a one-to-ten scale to gauge comfort levels with difficult topics to the importance of feedback loops, we discuss strategies that maintain the delicate balance between rapport-building and the application of therapeutic techniques. Whether you're a therapist or someone seeking therapy, this episode offers valuable insights into creating a meaningful and empowering therapeutic relationship. Connect with Ashleigh for a deeper exploration of mental wellness and accessible support.
Kinder Mind offers therapy services in Illinois, Maryland, Massachusetts, Mississippi, Pennsylvania, Virginia, and Texas. Follow us and feel free to share with anyone looking for therapy in a state where we're located.
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Thanks so much to our listeners for joining us for another episode of the Kinder Mind podcast. Today we're exploring rapport and relationship building techniques as an intervention strategy for therapists, and I'm joined today with Ashley Hala LICSW. Thanks so much for joining us today. Ashley, thanks so much for having me. You're very welcome. Can you start off by explaining what rapport means in the context of therapy and why it's so important for both the therapist and the client foundation of a strong relationship that is built within trust and vulnerability.
Ashleigh Hala, LICSW:You can do hard things together, right, like you can accomplish things that are challenging. You can work through struggles, those types of things. But also I've found that when you've got a strong rapport and you've got a strong relationship, the intervention you're choosing to use is far more likely to be effective. And so, as a therapist, I think that we can't underscore enough the importance of rapport and relationship building early and often, and what I mean by that is certainly when we do some of our initial sessions and we're getting to know our clients, absolutely building in some of that relationship building, some of those tools and skills, but also maintaining that over time. And that can look like having shut down time during your sharing.
Ashleigh Hala, LICSW:Let me tell you this piece about myself, this story that I've experienced, let me share a little bit with you. So, again, we can do these difficult things together. So I think that it's really important to prioritize that as a therapist to actually be able to do better, more successful, higher efficacy work. Now for the client, it's all it's about comfort, right. It's about feeling like you can trust somebody with, sometimes, things that they've never told anyone else and yet they just met you. And so when you build some of those skills into it, it allows our clients to go to maybe difficult places and move forward and get some good work done. So again, I can't really quite underscore it enough and find it to be such a foundational piece to successful therapy, writ large.
Dr. Elizabeth Barlow:I could not agree more. In fact, I think the thing that I tell all of my brand new providers that I supervise, no matter their licensure level, is really about the rapport piece and those things that we have to do with clients when we're first meeting them. So like the biopsychosocial so many times because obviously the biopsychosocial is very important for understanding the client's needs and their background and their history but so many times I think in this therapeutic work we get really used to forms as providers and like being on the receiving end of those questions can feel a little off-putting. If you're a brand new client and one of your first interactions with your new therapist is them reading questions to you and then you happen to basically spill about all this stuff. So I really like to encourage my providers that I supervise to make it conversational. Don't read from the script. Have an organic conversation about their family history and their medical history and try to take the pieces of those things that you learn and incorporate that through conversation and then if you're missing anything that you need on that biopsychosocial, then you can ask those targeted questions.
Dr. Elizabeth Barlow:So I completely again agree with you that like building a rapport with the client is a very human behavior that can have a very impactful I lost my train of thought Can have a very impactful effect on your work together. So, thinking about building rapport and sometimes we have multiple sessions to work with clients Sometimes, like yourself, you work in an environment where you don't have as many sessions that a client will come to you Sorry, I mixed up my word. What are some effective techniques to build rapport quickly with a client?
Ashleigh Hala, LICSW:some effective techniques to build rapport quickly with a client. Absolutely, I agree with you. I think that sometimes we have I've got clients who I've worked with for a year over a year, a long period of time and I've had clients where they come in for brittic treatment, they come in for solutions-based treatment and it's really about one, two, three, four sessions to try to work through whatever that issue might be, whatever challenges facing them in that moment. And I think that when we think about building rapport quickly, we can lean on our fundamental clinical skillset right, and that's going to be things like validation, normalization, active listening, checking in, stabilizing in the moment, right, what can I do for you right now? And then delivering on that and really showing our clients I'm here to give you what you're looking for. And when we're able to do that, we're reinforcing again this sense of trust where the client then feels like they can be, reinforcing again this sense of thrust where the client then feels like they can be more. And so I think that there are a lot of ways that we can, from the get-go, be able to build a rapport and a relationship that can thrive in a long or short-term capacity.
Ashleigh Hala, LICSW:Again, the other piece that I'll come back to, and this is one that I think is tricky for a lot of therapists. When we think about building a relationship, it really is mutual, and we need to talk about self-disposure as therapists, and so what I often tell my clients is part of this relationship is that I'm going to get to know you really well and you're going to get to know me a little bit, and you're going to get to know me a little bit, and that's how I phrase it. This time is about you. This time is about hearing you and seeing you and working through whatever it is you're bringing to the table that day. But when we check in the beginning, I'll tell you a little bit about my week, I'll tell you a funny story from my life, and part of that is just creating that mutuality that allows for that relationship to grow. So, anyway, I think that those are some really kind of concrete things that you can do from session one and I love that you brought up the biopsychosocial, because there are definitely ways to do that that feel like an interview, right.
Ashleigh Hala, LICSW:But when you build in some of these other tools, like normalizing, like validation, like active listening, those types of things, like adding in a little bit of sort of personal information that biopsychosocial can in itself be almost like an intervention. It can actually cause that client to be reflective and say, huh, what might need to change? And how is this relationship going to help me do that? And so I don't know. I think that these skills can be used in lots of different ways and I love your concept of starting with something like the even the first 15-minute client consultation. You can build some rapport there, move into the biopsychosocial and then, honestly, leaning in on that rapport throughout the entire relationship I've had clients who, after seeing each other for a little while, I might have to use a safety assessment or a suicide assessment, and having that rapport makes that easier, makes it faster, makes it more effective and again, we're able to do hard things. So all really important.
Dr. Elizabeth Barlow:I also love the fact that you brought up self-disclosure. That is one of my favorite topics ever because back in the day when I was in school for social work, it was dependent on who you asked. It was like subjective, not everybody had the same view. Some professors were like hardcore against self-disclosure. Others were like oh, it's completely fine. And then there were folks in the middle I like right in the middle.
Dr. Elizabeth Barlow:So another thing I always share with my supervisees is always ask yourself kind of the question of why am I about to disclose and go forward with that, do no harm mindset?
Dr. Elizabeth Barlow:So are you dumping on your client because you've had a hard day, or is your motivation and your intention to make a connection and really share with your client like I am human too and I can also connect with you on this level because we do have this shared experience. And then thinking about shared experiences, another place where I think this rapport building comes in is I don't have to have been a survivor of domestic violence to be able to see you and help you through your trauma with domestic violence. That, I think, is another huge piece of this rapport building, of breaking it down to that humanistic piece. I am someone who is going to connect with you on that human level, who is also clinically trained, and help you to navigate through this really difficult life experience that has happened. So, thinking about common challenges with rapport building what are some common challenges therapists face when trying to establish rapport with clients and how do you think that they can overcome these barriers?
Ashleigh Hala, LICSW:Yeah, I think that self-disclosure is the absolute number one and I totally agree with you that within the field there are some varied opinions on how we use self-disclosure and my personal perspective is that it's a tool. It's a tool that we can use and we don't need to use it all the time. We don't need to use it in every session, certainly not at every sort of moment, every comment that our client shares, but there can be times in my experience where, by sharing an anecdote or a story or something that might help you relate to what your client's experience is, or maybe something that helps you illustrate a clinical technique or approach that you're trying to implement, it can be worth it. But I do think that when you bring up this concept of challenges, I think you have to find that sweet spot for yourself and I would say it takes time. My sort of comfort level with self-displosuring sessions has changed drastically since I started as a young British and I have a deeper level of comfort with it now. I feel like I know when and how to use it. But that took me a minute and I think that could definitely be a challenge.
Ashleigh Hala, LICSW:Another one that immediately came to mind when you asked this question was a fundamental belief that I have about relationships, particularly about therapeutic relationships, is that we are doing things with our clients, not to them or for them. And I think that sometimes, as therapists, we can feel this pressure as maybe someone with some expertise or someone who's another person is seeking help from. We might feel this pressure to jump in and fix or to jump in and be really directive. And the thing that I'll say about that is A that's probably not what our client is actually looking for. And, b those things detract from building a healthy relationship and rapport with our clients. And so something I'll often say to younger clinicians when I'm working with them is that sort of working with can sometimes take longer, but it's worth it, it's absolutely worth it.
Ashleigh Hala, LICSW:And then really the other piece and this kind of connects to both of those things and really the other piece and this kind of connects to both of those things is just being really clear about boundary setting and being able to be ready to enforce those boundaries if they get crossed, and so being able to have a sense of, when you're in session with a client, what are your sort of firm boundaries, the walls that are built in concrete that you will not cross. What are your lines in the sand? That like what's the preference, but it's easier to waffle do I do this or do I not? And then what's in the middle? And then, most critically, how do you communicate those boundaries to your clients? A great example is how you talk about confidentiality. To your earlier point about biopsychosocials, we can just read a statement or we can have a really productive conversation about it. That helps us learn about mutuality, helps us define our boundaries and our roles and reinforces that relationship. Lots of things to consider here.
Dr. Elizabeth Barlow:I love the fact that you shared about this is something that we're not doing something to our clients or for our clients because that's such a really great thing like not. I love therapists. Don't get me wrong, I am a therapist. I love fellow therapists, but sometimes, just like with medical doctors, I feel like some therapists can develop a complex of being a savior and I think it can be easy to fall victim to that if you're a really good therapist because you're seeing these amazing accomplishments that your clients are doing left and right and so then really separating our ego from that of, okay, did we do that for them? No, we did not. We helped teach them the tools, the strategies and the approaches to do that for themselves.
Dr. Elizabeth Barlow:So I always want to pay special attention to language, and that's another thing I talk to my supervisees about. We talk about a lot of things Anytime a client does something that you're super happy about, that they're super happy about. When your client has a win, be careful with your something that you're super happy about that they're super happy about. When your client has a win, be careful with your language that you use around that. So I would never say I am so proud of you. I have no right to pride for that client. I do not own their accomplishment and by saying I'm so proud of you, that kind of implies to that client that they need my approval and my pride. I'll say you must be so proud or I'm so proud for you. So I think thinking about language as well, on this like discussion about rapport, can be really important, because words matter, words have meaning and so do statements and you want to be really mindful of, kind of the words and the language that you're using, right.
Ashleigh Hala, LICSW:I think one easy skill and this is something that I say to my supervisees and I'm sure you said a version of it as well is, I think that sometimes, as therapists, we get into this place of this trap. I would call it using the word should Like. Here's what you should do. You should try this. You should do a mindfulness exercise. You should do this, and my advice is, whenever you feel compelled to say the word should, I want you to say the word could, and the reason is all about connotation.
Ashleigh Hala, LICSW:When I say the word should, it implies that it's the right thing to do. It implies that I might be disappointed if you don't. When I say the word could, it's just an option that you have and it's neutral, even if you feel like you need to express that to your client. Be like hey, this is something that I'm going to put on the table and it's okay if you do and it's okay if you don't, and just making sure that you, you allow for those things, because we don't want to set up a situation where certainly, we're feeling like we're coming in as rescuing right, that's not a sort of a role that's healthy for us as therapists, but we also don't want our clients to think that's our job either?
Dr. Elizabeth Barlow:um, because it's not a reasonable expectation and that's, quite frankly, not what therapy is I've actually never had that conversation, but from this day forward, I will have that conversation because I think that is so important. Could not, should, and now my brain's already spinning about. Yeah, I feel like that should be a blog article, the language that we use in therapy. So, from the client's perspective, why does finding the right fit with a therapist matter so much? From a client's perspective?
Ashleigh Hala, LICSW:Oh man, that is such a wonderful question and something that I often talk to clients about when we do those first consultations, because I think that there's a I think there's like a hesitancy sometimes to shop around, if you will, to meet a bunch of different therapists and see how you feel. But I think that, as a client, it's important for a couple of reasons, right, one is maybe you're looking for someone who mirrors or affirms an identity that you have and that's really something that's important to you, and so finding a therapist that maybe either specializes in certain issues or the therapist themselves identifies in a specific way, can be really important. And then it's really critical to get a sense of the sort of background of the person that you're meeting with, right, is this person, based on their experience, going to understand me? A great example from my life is I worked with college students my whole career, and so when I do a consultation for someone within the college age, we click pretty quickly because I'm very accustomed to that population and I let them know that, ok, I have a sense of kind of what might be going on for you, and here's to you, here's to affirm that. And then I think you also want to feel like the interventions that your therapist uses are ones that sound appealing to you, the ones that sound like you'd actually be interested in engaging in them because therapy is work. And so when you talk to your therapist and you get a sense of what's that work going to look like, does that fit really well with you or not? And then the last piece is do you just enjoy each other's company?
Ashleigh Hala, LICSW:I had a client once who recently actually the last couple of months we were ending a session and she said to me can I just give you some feedback? And I said, of course you can. And she said I love how much we last in our sessions. And I was just like that is so cool. And we had that relationship to the point where, trust me, we did hard things, we did deep trauma work together, but what she took is and we're able to laugh together. And again, if that fit didn't happen, I don't know how effective the work would have been.
Dr. Elizabeth Barlow:That makes so much sense. You've got to have that connection. And thinking back to one of my first interns that I took on at the group practice, I remember her calling me, bawling her eyes out because her client never came back to see her and she thought that everything was great. Her client would definitely be back. And it was her first client that ever didn't come back to see her. And we had to have that conversation about you are not for everyone, everyone is not for you.
Dr. Elizabeth Barlow:We'll never know why that client did not come back. We'll never know if she was looking for other therapists, but it's got to be the right fit on both sides. So I love that you highlight that point because if, like you mentioned, if it's not there and you don't have that connection, you don't have that rapport, then you can't do the work together and therapy doesn't feel good from either side and that's definitely not what you want to happen. So that's another reason why, since day one at kinder mind, we offer those 15 minute consultations. You can have 15 minute consultations with multiple providers. You're not stuck if you see one provider and you're like, ah, it's not really working, who else might be a good fit, or if you need an external referral. Can you help me find somebody that's in network with my insurance that does this kind of work? Absolutely we can, because our biggest goal is you finding somebody that fits for you.
Ashleigh Hala, LICSW:So thank you so much for bringing up all those great points and the last point I would say about that, just because you're inspiring me about this is and I think this is hard for younger clinicians, but the more experience you get, the easier this becomes.
Ashleigh Hala, LICSW:You brought up that, yes, the client needs to feel like we're a good fit for them, but we can also gain goodness to fit for us, and one thing that is really hard to do is to talk to a client about hey, I as the therapist, don't think this is totally working right now. And here's my recommendations for you moving forward. Here's my sort of idea of what a plan might be, and just my piece of advice is there's no right or wrong way to do that per se, but as you gain clinical experience and you start to get a sense of you figuring out is this a good fit or not, Think about what language you would use to say hey, I think a referral might actually be more effective for you. And then to your point about your intern be okay with it. It's about getting the client the best service that we can.
Dr. Elizabeth Barlow:Absolutely, absolutely. I could not agree more, and you're completely inspiring me too, because I'm thinking about times with clients when I've learned that we might not be a good fit and what did that look like? And it can be so difficult for a clinician to have that conversation with their client, like you mentioned. Or if it's something that you're not comfortable working with because you don't specialize in that area. I've had clients that I loved working with and then later, deeper in our conversations and sessions, learned that they would actually benefit more from somebody who had a specialization in something that I really didn't know much about and was not qualified to help with. So I've offered like we can continue to work on ADHD or anxiety or something that I do specialize in and I do work with, and you can see a provider that specializes in this other thing that I don't, or you can go work with this other provider. I just want you to get the best care possible. How can clients communicate their needs and expectations early on to foster a better therapeutic relationship?
Ashleigh Hala, LICSW:Absolutely. I think that we need to give clients an opportunity to do that. I think that because of the dynamics of therapy, especially when you're first starting out in a therapeutic relationship, I think it could be hard for maybe your typical client to say here's what I need. And so I want us to think about it as clinicians. And again in those first few sessions, including the biopsychosocial, how can we ask questions that invite that right and then again allow those questions to continue as you move on in the next session? And there are a couple of questions that I tend to use as a provider that I think allow for my clients to they give permission for my clients to provide that feedback to me.
Ashleigh Hala, LICSW:How I start every biopsychosocial is listen, if you were to wake up tomorrow and felt 100% better, what would be different? What would have changed? What would we have worked on? What would you not feel anymore? What would you feel instead? And it allows for them to clearly state in my first question what their goals are and why they're here.
Ashleigh Hala, LICSW:And then one of my last questions that I ask in a biopsychosocial is what can I do as your therapist to help you feel as comfortable and confident in this relationship as you can so that we can do more things together.
Ashleigh Hala, LICSW:It's actually a super important question to ask everybody, but I find that it's particularly important for people who've had other therapists to be able to reflect on what could make this a more successful experience for me. Sometimes I talk to them about other adults or people in their lives that give them advice in some way, shape or form Could be teachers, could be parents, could be a boss at a job. What works for you? How do you appreciate communication? How do you know and how do we create a safe space for you to provide feedback and really asking that question and then continuing to invite those answers and that information throughout your sessions moving forward? And so I think that we have a lot of power as therapists in the therapeutic relationship, and one thing that we need to do with that power is give it away, and asking questions in the right way at the right time can be a way to do that.
Dr. Elizabeth Barlow:I'm so overwhelmed with the amount of amazing structure that you provide in your biopsychosocial and how effective the communication is and it just I'm like epiphany moment. It makes so much sense that you would start out that way, because if you were just to flat out ask the client, okay, what do you want to work on? They might not have any idea. I don't know. That's what I'm here for you to tell me. But then to use those questions to really map out thinking about how you feel and how you want to feel, and if everything was all of a sudden better, that's just so insightful and so client-centered. So good on you for figuring that out. Not going to lie, I'm going gonna go and incorporate some of that into my work on the biopsychosocial and like other areas of practice, because I think that's just a really great strategy oh yeah, and I think you you hit the nail on the head.
Ashleigh Hala, LICSW:There are clients who who come in and they don't package what they're experiencing as anxiety or depression or adjustment issues, but what they will say is man, I get overwhelmed and I would love to not feel that way anymore, or I catastrophize and it totally ruins my day. And then that allows us as therapists, even in that one moment, to provide a little bit of feedback and say this is what that sounded like to me, but asking them that question in that way I think you're right it can be a really client-centered way to start their relationship.
Dr. Elizabeth Barlow:For sure, and then so we're using the tools, we're using the strategies, we're building rapport. How would you recommend measuring that rapport? What are some effective ways to, as both therapists and clients, to measure the rapport in the session, because sometimes you can just feel it and then sometimes maybe you're not sure. So what would you recommend doing, as a therapist, to measure that rapport?
Ashleigh Hala, LICSW:Yeah, I think it depends on the client. You've got clients who will easily tell you how they think it's going and you've got clients who you have. They're very easy to read as far as whether or not that rapport is working and is helping you in that therapeutic relationship or not. Sometimes we have clients that are a little bit harder to read. I'm gonna steal this from motivational interviewing a little bit.
Ashleigh Hala, LICSW:I love a one to 10 question. Right On a scale of one to 10, how do you feel about this? How do you feel about being able to share about a really hard day? How do you feel about maybe telling me something that's really uncomfortable? How do you feel about me being welcoming and open?
Ashleigh Hala, LICSW:And what I love about using the one to 10 scale is A you can do it over and over again and C change over time, but B it's actually not so much about the number that they choose as it is about what we do with that number, and so they might say, today, as far as sharing something really hard, I feel like I'm at like a five and one of my favorite things to do is say, okay, tell me why you're not at a one or two.
Ashleigh Hala, LICSW:So what, what's working for us and then tell me what it would take to get to a six or a seven. And what I really enjoy about that sort of what am I skill is that it's not about perfection, it's not about thinking about how it's going in a binary way. It's fluid, it allows the client to maybe change their answer based on context and circumstance and it allows us to grow. And so, if you don't have those sort of feedback loops already built into your sessions, add it to the end. At the end of your session, do a quick check-in. How did today feel for you and allow for clients to again give that permission to call for clients to give you information? That's helpful.
Dr. Elizabeth Barlow:I love that recommendation. If you don't know, ask the questions is what I'm hearing, and I love the use of that as well, because if you do that scale of one to 10, and maybe there's a difference of a couple points from the last time you asked that question then you've got another question that you can ask to get more information and maybe you learn that they got really judged by like their mom or another important person in their life earlier that day and they're just feeling very guarded right now. They're not feeling really safe overall right now, and then that's super useful information for you as their therapist to know. So now you've opened a bigger conversation to have about why are you feeling guarded today? Let's talk about that conversation you had with your mom.
Ashleigh Hala, LICSW:And on a scale of one to 10, how effective do you think today's session was? And Aileen again gives us feedback about our own work, but also acknowledges that the client needs to show up and do some work too. And so okay, if we're not feeling like it was effective, where is that resistance? Where did we get off the track? Where can we readjust and try again next time? And the relationship and rapport may very well be one of those answers.
Dr. Elizabeth Barlow:Completely agree. And so thinking about effective therapy and wrapping us up, when it comes to effective therapy, what do you believe is more crucial rapport or the specific therapeutic technique, or do you think it's about finding the right balance between the two?
Ashleigh Hala, LICSW:Sure, sure.
Ashleigh Hala, LICSW:I'm immediately tempted to say rapport, and then my brain says okay, it's really about a balance and one thing that I say to my clients actually in the 15-minute consultations, when I talk about myself and about just myself as a therapist and what they can expect For me, I will often say the relationship is what's most important to me because, again, we'll be able to do more difficult work together and be vulnerable in spaces together and deal with challenges if that relationship exists.
Ashleigh Hala, LICSW:But then I often say and we're going to use specific strategies within the context of that relationship, and usually what I say honestly is because I'm not here to chit chat, we're here to do work together and we do share a space together where we check in and talk about maybe a funny story from the day or talk about family or whatever. But at the end of the day there has to be some accountability for us as clinicians as well to actually be moving these clients forward towards their goals, towards those things that they mentioned at the beginning of the biopsychosocial wanting to change. And I think that rapport absolutely needs to be the first kind of foot that we lead with.
Dr. Elizabeth Barlow:Rapport absolutely needs to be the first kind of foot that we lead with and then being able to more effectively use specific intervention strategies under the benefits of utilizing rapport in the therapeutic process, both from the therapist standpoint and the client standpoint. If anyone would like to meet with Ashley for a 15-minute consultation, you can find Ashley online at kindermindcom. Ashley is currently seeing clients in Massachusetts. Again, thank you so much, ashley. We really appreciate you joining, absolutely. Thanks so much.