Drug Rehab and the Importance of a Therapeutic Alliance

Therapy is one of the most versatile and valuable tools that healthcare professionals can employ in a substance abuse recovery plan. Individuals who abuse substances often experience co-occurring mental health issues that can contribute to addiction. Therapy can help these individuals identify the underlying emotional issues, such as grief, anxiety, anger, or guilt, which can fuel a dependence on substances. It can give addicted individuals new, healthier perspectives on themselves, their problems, and the right ways to cope. Through the creation of an action plan to achieve sobriety and other important life goals, therapy provides a sense of accountability and structure. The cornerstone of all this work is the relationship between the addicted person and his or her therapist. This is known as the therapeutic alliance.

Components of a Therapeutic Alliance

Counseling Today quotes American Counseling Association member, John Sommers-Flanagan, in describing the basic components of a therapeutic alliance, as:

  • goal consensus between counselor and client
  • collaboration on counseling-related tasks
  • and emotional bonding

A goal consensus means that the counselor and client are on the same page, in regard to the client’s current concerns and issues, as well as any desired outcomes of treatment and related expectations. Collaboration requires the client to show up, be present, and put forth their best effort in any tasks the counselor uses. Similarly, the counselor must be willing to reasonably accommodate the client and work through initial hesitance or difficulties that may arise. Finally, emotional bonding involves counselors creating an atmosphere of calm acceptance and empathy, where the client is comfortable to share their experiences and the counselor is receptive, understanding, and supportive.

How Does a Therapeutic Alliance Impact Recovery?

As with any relationship, a therapeutic alliance is not a one-way street. Clients and counselors both need to try and be as open-minded, empathetic, and goal-oriented as possible. Specific counseling techniques and methods may not matter as much as a strong therapeutic alliance. Counseling Today noticing that one comprehensive study found “a strong therapeutic alliance was more closely correlated with positive client outcomes than any specific treatment interventions”. A healthy therapeutic alliance is linked with higher retention of clients, an obviously critical key to continued recovery. In the context of substance abuse, a strong early therapeutic alliance was to be a strong predictor of longer term retention and engagement. Interestingly, some studies have found a closer relation between “patient contribution to the alliance” and treatment outcome than between therapist and outcome. In other words, in some cases, it may matter more what a client brings to a therapeutic relationship than what a counselor does. This shows that individuals seeking help for substance abuse must try and be open to positive change, as difficult as facing one’s problems and implementing healthy strategies in therapy may be.

What to Look for in a Therapist

When searching for the right therapist, clients and their loved ones should seek someone empathetic, flexible, and understanding, who makes them feel they are being genuinely listened to and taken seriously. People struggling with substance abuse may be resistant to the idea of therapy, so finding someone who is patient, experienced, and willing to work past initial emotional roadblocks is can be key. Family, friends, and loved ones may speak with the addicted individual about the uses and importance of therapy and its role in helping one recover.

Therapy as a Part of Drug Rehab Treatment

The therapeutic alliance is the foundation for a great deal of recovery work. No matter the style or format therapy takes, finding that trust, emotional safety, and compatibility is crucial for any client; especially, in the case of recovering from addiction in a drug rehab environment.


Granite Recovery Centers offers numerous levels of addiction recovery care across 12 New Hampshire drug rehab facilities, many of which feature a number of evidence-based clinical modalities from caring, experienced professionals. With years of experience in helping those struggling with addiction achieve lasting, real recovery, we will give you or your loved one the necessary tools and strategies to beat addiction and any underlying emotional issues that are holding you back from the life you want. If you or a loved one is struggling with addiction (or a co-occurring disorder), call our admissions specialists at 855.712.7784 . We can help.

Call 855.712.7784 for Immediate Help

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