The Treatment Alliance and Building Trust

According to the National Institute of Mental Health, a bond of trust is “one of the most robust predictors of treatment outcomes in those with co-occurring disorders.” This means that success for individuals seeking help overcoming addiction and other mental health illnesses largely depends on the ability of the client and members of their treatment team to trust one another.

In fact, this trust is so pivotal to a client’s success that clinicians refer to this rapport as the Treatment Alliance, where both the client and the clinician are working together towards a shared goal and rely on each other to do what is best for the individual.

These strategies are suggested to be employed by a therapist or counselor who wants to help clients feel comfortable in making treatment decisions. The National Institute of Mental Health recommends clinicians utilize these tools to empower clients and treat them with empathy.

Understanding the methods used to establish the essential trust in a therapeutic alliance helps individuals in treatment remain open to the process and fulfill their role in the relationship.

Maintaining a Recovery Perspective

Particularly for those with co-occurring disorders, the word “recovery” is colored with varied meanings.

Some individuals beginning treatment have an awareness that either substance use or mental health has played a significant role in the need to seek help, but they may be conflicted as to the level of importance of treating the symptoms of either mental health disorders or substance use disorders.

It is up to the clinician to engage clients in a way that allows them to recognize that treating each of these components will lead to a better way of life. While treating a substance use disorder may mean an individual is in recovery for life, many individuals see overcoming other mental health disorders as overcoming an obstacle they wish to put behind them.

Having a receptive clinician who can understand a client’s perspective on what recovery means allows the therapeutic alliance to work in tandem on both of these objectives. 

By being compassionate as to what recovery means to the individual, the goals of the Therapeutic Alliance can be based on a mutual understanding of what it means to be in recovery from co-occurring disorders. Some clients may feel addressing their needs holistically will remain essential to the continuity of care.

Others may find they must first process trauma or understand their mental health diagnoses before looking at their addictions. The important factor is that the client and clinician are in agreement with the goals of the treatment and stay true to the shared understanding of what recovery will look like for the individual.

Balancing Structure and Support

Free time is a trigger for substance use cravings as well as many mental health disorders. A lack of organized structure can leave individuals feeling restless and lonely.

A one-size-fits-all approach, however, would be inappropriate because individuals have different levels of need for social interaction and scheduled activities. It is important the client is open to communicating as to what they feel the best use of their time is.

The clinician, in turn, can assist the client in balancing the needs of the individual by suggesting appropriate ways to avoid loneliness or boredom. Some will feel a rigorous schedule is too restrictive and doesn’t allow time for chosen activities, relaxation, or socializing with others.

On the other hand, some may desire that nearly all their time be filled to avoid feeling unproductive or isolating.

This is where a balance is ideal. Social support allows those in treatment relief from the feeling of being alone in their recovery process while simultaneously filling time that may otherwise be spent alone. In a successful therapeutic alliance, a good clinician can uncover who among a client’s social support network is contributing to their success. 

Some relationships may bring added stress, especially in the early phases of the process. Establishing healthy boundaries may be an effective way to allow the client to continue engaging only when it is comfortable and helpful to their treatment.

Past associates who participated in substance abuse or family members who may have gone through traumas with the client may wish to be a part of the treatment process, but it may be best to put off reassociating with these people until later.

It is up to the client to decide with whom and how to interact with these people, but if they have trust in their treatment team, they can decide together on how to navigate potentially harmful interactions and draw strength from friends and loved ones who can contribute to their success.


Trust After Treatment

Perhaps the most important part of the relationship between client and clinician is that each person feels understood and capable of their role. Building confidence within the relationship is important, but the ultimate goal is to empower the individual to find their own strength to recover.

By practicing empathy, trust grows from feeling that one’s truth is being heard. The strengths discovered through an honest, trusting relationship with a good therapist can be practiced in other relationships and the benefits can be just as powerful as those established in treatment.


Burning Tree serves people who struggle with addiction, co-occurring disorders, and find themselves ready to accept help. Our specialists focus on meditation and holistic practices to help build a better recovery for you. We include your family and meet you where you are emotionally and spiritually to support your journey of healing. We hope you will find the strength to get you on your way and call us now at 855-381-6224.


We are here for you and your family. You don't have to suffer any longer, find recovery today!

We are in-network with 15+ health insurance providers.

This field is for validation purposes and should be left unchanged.


Leave a Reply

Your email address will not be published. Required fields are marked *