How Do You Address Issues of Trust?
Trust is a cornerstone of effective therapy, yet it can often be a challenging element to establish. In this article, a Marriage and Family Therapist and a Board-Certified Psychiatrist share their expert strategies for building trust in therapeutic settings. Discover why discussing the therapeutic relationship openly is crucial and how prioritizing open communication and consistency can foster trust. Explore four key insights from these professionals that could transform the way trust is built with clients.
- Discuss the Therapeutic Relationship Openly
- Trust Clients to Build Trust
- Create a Welcoming Environment
- Prioritize Open Communication and Consistency
Discuss the Therapeutic Relationship Openly
Trust is an important component of therapy. If I don't trust my therapist, how can I be open, honest, and vulnerable as we explore how I function and respond to the world? This is why a client's relationship with her therapist is so important. And the readiness of a therapist to talk about this relationship makes a huge difference in the ability to trust. Even though it might not be comfortable to hear, a therapist can ask, "How are we doing—you and I, in our relationship?" to explore honestly the most fundamental interaction in your therapy—the one happening right then and there. An open door to discuss issues that arise in the therapeutic relationship breeds trust, transparency, and realness.
Trust Clients to Build Trust
Irrespective of clinical theory or perspective, TRUST is by all measures one of the biggest indicators of therapeutic success and positive treatment outcomes. Throughout my education, 25 years of experience, and countless hours of receiving and providing supervision, conversations about how we can create an environment and experience that engenders trust and allows the client to feel safe in opening up and sharing have been a mainstay of conversations. However, I would like to counter this stance and conversation. Because "trust" can be thought of as a mutual experience, the question is NOT how can we get clients to trust us better but instead, how can we trust our clients more? The notion that trust builds from trust is powerful, so that as we "do the work" associated with trusting our clients to a greater extent, inherently their level of trust in us and the process will inevitably increase. The real question then is: what are the barriers to trusting our clients more? How do we trust clients that are engaging in poor behaviors? How do we transcend our own pre-conceived notions and biases and actually put non-judgmental psychotherapy into practice? So, in short, when "issues" come up in a therapeutic setting regarding trust, it may be because we are not trusting our clients enough. So, continue to do your own psychological work, engage in your own interpersonal growth, and cultivate more deeply your own rendition of Buddhist non-attachment so that you can grow in your capacity to truly trust your clients and allow them to be actually helped in the ways in which we're advocating for.
Create a Welcoming Environment
In a therapeutic setting, trust is foundational. From the very first session, I focus on creating a welcoming, judgment-free environment where patients feel safe sharing their concerns and physical limitations. Years of experience have taught me that listening carefully and validating a patient's experiences go a long way in building this trust. Many people come in feeling vulnerable due to chronic pain or previous negative healthcare experiences. My approach, shaped by over 30 years in musculoskeletal and sports physiotherapy, involves explaining each step of the process, from assessment to treatment, in straightforward, relatable terms. I prioritize transparency, outlining not only what will happen in sessions but also the expected timeline for recovery. This way, patients know exactly what to expect, which helps ease anxiety and establish trust from the outset.
For example, I worked with a patient suffering from a persistent shoulder injury. This patient had seen multiple specialists but felt dismissed each time because they'd never received a clear diagnosis or plan. When he came to me, I took time to fully understand his history and explain the potential causes of his pain in layman's terms. We discussed each phase of his tailored treatment, breaking down how specific exercises and manual techniques would help and how we'd measure his progress. Over the months, he saw improvement and, more importantly, felt heard and understood, which was instrumental in his recovery. By bringing together technical expertise, clear communication, and an empathetic approach, I was able to create an environment of trust that led to a positive therapeutic outcome.
Prioritize Open Communication and Consistency
Addressing trust in therapy starts with creating a safe and non-judgmental environment. I prioritize open communication and consistency to help patients feel comfortable over time. It's about validating their experiences, being transparent, and recognizing that trust is built gradually. Patience and empathy are key, as everyone's journey to trusting their therapist is unique.
