October 11, 2024 • 32 mins
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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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Elizabeth Barlow (00:00):
Thanks so much to our listeners for
joining us for another episodeof the Kinder Mind podcast.
Today we're exploring rapportand relationship building
techniques as an interventionstrategy for therapists, and I'm
joined today with Ashley HalaLICSW.
Thanks so much for joining ustoday.
Ashley, thanks so much forhaving me.
You're very welcome.
(00:20):
Can you start off by explainingwhat rapport means in the
context of therapy and why it'sso important for both the
therapist and the clientfoundation of a strong
(00:42):
relationship that is builtwithin trust and vulnerability.
Ashleigh Hala, LICSW (00:48):
You can do hard things together, right,
like you can accomplish thingsthat are challenging.
You can work through struggles,those types of things.
But also I've found that whenyou've got a strong rapport and
you've got a strong relationship, the intervention you're
choosing to use is far morelikely to be effective.
And so, as a therapist, I thinkthat we can't underscore enough
(01:10):
the importance of rapport andrelationship building early and
often, and what I mean by thatis certainly when we do some of
our initial sessions and we'regetting to know our clients,
absolutely building in some ofthat relationship building, some
of those tools and skills, butalso maintaining that over time.
And that can look like havingshut down time during your
(01:32):
sharing.
Let me tell you this piece aboutmyself, this story that I've
experienced, let me share alittle bit with you.
So, again, we can do thesedifficult things together.
(01:53):
So I think that it's reallyimportant to prioritize that as
a therapist to actually be ableto do better, more successful,
higher efficacy work.
Now for the client, it's allit's about comfort, right.
It's about feeling like you cantrust somebody with, sometimes,
(02:14):
things that they've never toldanyone else and yet they just
met you.
And so when you build some ofthose skills into it, it allows
our clients to go to maybedifficult places and move
forward and get some good workdone.
So again, I can't really quiteunderscore it enough and find it
to be such a foundational pieceto successful therapy, writ
(02:34):
large.
Dr. Elizabeth Barlow (02:36):
I could not agree more.
In fact, I think the thing thatI tell all of my brand new
providers that I supervise, nomatter their licensure level, is
really about the rapport pieceand those things that we have to
do with clients when we'refirst meeting them.
So like the biopsychosocial somany times because obviously the
(02:57):
biopsychosocial is veryimportant for understanding the
client's needs and theirbackground and their history but
so many times I think in thistherapeutic work we get really
used to forms as providers andlike being on the receiving end
of those questions can feel alittle off-putting.
If you're a brand new clientand one of your first
(03:19):
interactions with your newtherapist is them reading
questions to you and then youhappen to basically spill about
all this stuff.
So I really like to encouragemy providers that I supervise to
make it conversational.
Don't read from the script.
Have an organic conversationabout their family history and
their medical history and try totake the pieces of those things
that you learn and incorporatethat through conversation and
(03:41):
then if you're missing anythingthat you need on that
biopsychosocial, then you canask those targeted questions.
So I completely again agree withyou that like building a
rapport with the client is avery human behavior that can
have a very impactful I lost mytrain of thought Can have a very
impactful effect on your worktogether.
(04:02):
So, thinking about buildingrapport and sometimes we have
multiple sessions to work withclients Sometimes, like yourself
, you work in an environmentwhere you don't have as many
sessions that a client will cometo you Sorry, I mixed up my
word.
What are some effectivetechniques to build rapport
(04:22):
quickly with a client?
Ashleigh Hala, LICSW (04:27):
some effective techniques to build
rapport quickly with a client.
Absolutely, I agree with you.
I think that sometimes we haveI've got clients who I've worked
with for a year over a year, along period of time and I've had
clients where they come in forbrittic treatment, they come in
for solutions-based treatmentand it's really about one, two,
three, four sessions to try towork through whatever that issue
might be, whatever challengesfacing them in that moment.
(04:47):
And I think that when we thinkabout building rapport quickly,
we can lean on our fundamentalclinical skillset right, and
that's going to be things likevalidation, normalization,
active listening, checking in,stabilizing in the moment, right
(05:09):
, what can I do for you rightnow?
And then delivering on that andreally showing our clients I'm
here to give you what you'relooking for.
And when we're able to do that,we're reinforcing again this
sense of trust where the clientthen feels like they can be,
reinforcing again this sense ofthrust where the client then
feels like they can be more.
And so I think that there are alot of ways that we can, from
(05:34):
the get-go, be able to build arapport and a relationship that
can thrive in a long orshort-term capacity.
Again, the other piece that I'llcome back to, and this is one
that I think is tricky for a lotof therapists.
When we think about building arelationship, it really is
mutual, and we need to talkabout self-disposure as
therapists, and so what I oftentell my clients is part of this
(05:56):
relationship is that I'm goingto get to know you really well
and you're going to get to knowme a little bit, and you're
going to get to know me a littlebit, and that's how I phrase it
.
This time is about you.
This time is about hearing youand seeing you and working
through whatever it is you'rebringing to the table that day.
But when we check in thebeginning, I'll tell you a
little bit about my week, I'lltell you a funny story from my
(06:17):
life, and part of that is justcreating that mutuality that
allows for that relationship togrow.
So, anyway, I think that thoseare some really kind of concrete
things that you can do fromsession one and I love that you
brought up the biopsychosocial,because there are definitely
ways to do that that feel likean interview, right.
(06:38):
But when you build in some ofthese other tools, like
normalizing, like validation,like active listening, those
types of things, like adding ina little bit of sort of personal
information thatbiopsychosocial can in itself be
almost like an intervention.
It can actually cause thatclient to be reflective and say,
huh, what might need to change?
(07:00):
And how is this relationshipgoing to help me do that?
And so I don't know.
I think that these skills canbe used in lots of different
ways and I love your concept ofstarting with something like the
even the first 15-minute clientconsultation.
You can build some rapportthere, move into the
biopsychosocial and then,honestly, leaning in on that
rapport throughout the entirerelationship I've had clients
(07:24):
who, after seeing each other fora little while, I might have to
use a safety assessment or asuicide assessment, and having
that rapport makes that easier,makes it faster, makes it more
effective and again, we're ableto do hard things.
So all really important.
Dr. Elizabeth Barlow (07:43):
I also love the fact that you brought
up self-disclosure.
That is one of my favoritetopics ever because back in the
day when I was in school forsocial work, it was dependent on
who you asked.
It was like subjective, noteverybody had the same view.
Some professors were likehardcore against self-disclosure
.
Others were like oh, it'scompletely fine.
And then there were folks inthe middle I like right in the
(08:04):
middle.
So another thing I always sharewith my supervisees is always
ask yourself kind of thequestion of why am I about to
disclose and go forward withthat, do no harm mindset?
So are you dumping on yourclient because you've had a hard
day, or is your motivation andyour intention to make a
connection and really share withyour client like I am human too
(08:28):
and I can also connect with youon this level because we do
have this shared experience.
And then thinking about sharedexperiences, another place where
I think this rapport buildingcomes in is I don't have to have
been a survivor of domesticviolence to be able to see you
and help you through your traumawith domestic violence.
(08:51):
That, I think, is another hugepiece of this rapport building,
of breaking it down to thathumanistic piece.
I am someone who is going toconnect with you on that human
level, who is also clinicallytrained, and help you to
navigate through this reallydifficult life experience that
has happened.
So, thinking about commonchallenges with rapport building
(09:15):
what are some common challengestherapists face when trying to
establish rapport with clientsand how do you think that they
can overcome these barriers?
Ashleigh Hala, LICSW (09:31):
Yeah, I think that self-disclosure is
the absolute number one and Itotally agree with you that
within the field there are somevaried opinions on how we use
self-disclosure and my personalperspective is that it's a tool.
It's a tool that we can use andwe don't need to use it all the
time.
We don't need to use it inevery session, certainly not at
every sort of moment, everycomment that our client shares,
but there can be times in myexperience where, by sharing an
(09:57):
anecdote or a story or somethingthat might help you relate to
what your client's experience is, or maybe something that helps
you illustrate a clinicaltechnique or approach that
you're trying to implement, itcan be worth it.
But I do think that when youbring up this concept of
challenges, I think you have tofind that sweet spot for
(10:20):
yourself and I would say ittakes time.
My sort of comfort level withself-displosuring sessions has
changed drastically since Istarted as a young British and I
have a deeper level of comfortwith it now.
I feel like I know when and howto use it.
But that took me a minute and Ithink that could definitely be
a challenge.
Another one that immediatelycame to mind when you asked this
(10:41):
question was a fundamentalbelief that I have about
relationships, particularlyabout therapeutic relationships,
is that we are doing thingswith our clients, not to them or
for them.
And I think that sometimes, astherapists, we can feel this
pressure as maybe someone withsome expertise or someone who's
(11:06):
another person is seeking helpfrom.
We might feel this pressure tojump in and fix or to jump in
and be really directive.
And the thing that I'll sayabout that is A that's probably
not what our client is actuallylooking for.
And, b those things detractfrom building a healthy
relationship and rapport withour clients.
(11:27):
And so something I'll often sayto younger clinicians when I'm
working with them is that sortof working with can sometimes
take longer, but it's worth it,it's absolutely worth it.
And then really the other pieceand this kind of connects to
both of those things and reallythe other piece and this kind of
connects to both of thosethings is just being really
(11:48):
clear about boundary setting andbeing able to be ready to
enforce those boundaries if theyget crossed, and so being able
to have a sense of, when you'rein 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?
(12:08):
And then what's in the middle?
And then, most critically, howdo you communicate those
boundaries to your clients?
A great example is how you talkabout confidentiality.
To your earlier point aboutbiopsychosocials, we can just
read a statement or we can havea really productive conversation
about it.
That helps us learn aboutmutuality, helps us define our
(12:30):
boundaries and our roles andreinforces that relationship.
Lots of things to consider here.
Dr. Elizabeth Barlow (12:39):
I love the fact that you shared about this
is something that we're notdoing something to our clients
or for our clients becausethat's such a really great thing
like not.
I love therapists.
Don't get me wrong, I am atherapist.
I love fellow therapists, butsometimes, just like with
medical doctors, I feel likesome therapists can develop a
(13:00):
complex of being a savior and Ithink it can be easy to fall
victim to that if you're areally good therapist because
you're seeing these amazingaccomplishments that your
clients are doing left and rightand so then really separating
our ego from that of, okay, didwe do that for them?
(13:21):
No, we did not.
We helped teach them the tools,the strategies and the
approaches to do that forthemselves.
So I always want to pay specialattention to language, and
that's another thing I talk tomy supervisees about.
We talk about a lot of thingsAnytime a client does something
that you're super happy about,that they're super happy about.
When your client has a win, becareful with your something that
you're super happy about thatthey're super happy about.
(13:42):
When your client has a win, becareful with your language that
you use around that.
So I would never say I am soproud of you.
I have no right to pride forthat client.
I do not own theiraccomplishment and by saying I'm
so proud of you, that kind ofimplies to that client that they
need my approval and my pride.
(14:03):
I'll say you must be so proudor I'm so proud for you.
So I think thinking aboutlanguage as well, on this like
discussion about rapport, can bereally important, because words
matter, words have meaning andso do statements and you want to
be really mindful of, kind ofthe words and the language that
(14:24):
you're using, right.
Ashleigh Hala, LICSW (14:26):
I think one easy skill and this is
something that I say to mysupervisees and I'm sure you
said a version of it as well is,I think that sometimes, as
therapists, we get into thisplace of this trap.
I would call it using the wordshould Like.
Here's what you should do.
You should try this.
You should do a mindfulnessexercise.
(14:47):
You should do this, and myadvice is, whenever you feel
compelled to say the word should, I want you to say the word
could, and the reason is allabout connotation.
When I say the word should, itimplies that it's the right
thing to do.
It implies that I might bedisappointed if you don't.
(15:08):
When I say the word could, it'sjust an option that you have
and it's neutral, even if youfeel like you need to express
that to your client.
Be like hey, this is somethingthat I'm going to put on the
table and it's okay if you doand it's okay if you don't, and
just making sure that you, youallow for those things, because
we don't want to set up asituation where certainly, we're
feeling like we're coming in asrescuing right, that's not a
sort of a role that's healthyfor us as therapists, but we
(15:30):
also don't want our clients tothink that's our job either?
Dr. Elizabeth Barlow (15:33):
um, because it's not a reasonable
expectation and that's, quitefrankly, not what therapy is
I've actually never had thatconversation, but from this day
forward, I will have thatconversation because I think
that is so important.
Could not, should, and now mybrain's already spinning about.
Yeah, I feel like that shouldbe a blog article, the language
that we use in therapy.
(15:53):
So, from the client'sperspective, why does finding
the right fit with a therapistmatter so much?
From a client's perspective?
Ashleigh Hala, LICSW (16:04):
Oh man, that is such a wonderful
question and something that Ioften talk to clients about when
we do those first consultations, because I think that there's a
I think there's like ahesitancy sometimes to shop
around, if you will, to meet abunch 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 maybeyou're looking for someone who
(16:28):
mirrors or affirms an identitythat you have and that's really
something that's important toyou, and so finding a therapist
that maybe either specializes incertain issues or the therapist
themselves identifies in aspecific way, can be really
important.
And then it's really criticalto get a sense of the sort of
background of the person thatyou're meeting with, right, is
(16:50):
this person, based on theirexperience, going to understand
me?
A great example from my life isI worked with college students
my whole career, and so when Ido a consultation for someone
within the college age, we clickpretty quickly because I'm very
accustomed to that populationand I let them know that, ok, I
(17:10):
have a sense of kind of whatmight be going on for you, and
here's to you, here's to affirmthat.
And then I think you also wantto feel like the interventions
that your therapist uses areones that sound appealing to you
, the ones that sound like you'dactually be interested in
engaging in them because therapyis work.
And so when you talk to yourtherapist and you get a sense of
(17:32):
what's that work going to looklike, does that fit really well
with you or not?
And then the last piece is doyou just enjoy each other's
company?
I had a client once who recentlyactually the last couple of
months we were ending a sessionand she said to me can I just
give you some feedback?
And I said, of course you can.
(17:52):
And she said I love how much welast in our sessions.
And I was just like that is socool.
And we had that relationship tothe point where, trust me, we
did hard things, we did deeptrauma work together, but what
she took is and we're able tolaugh together.
And again, if that fit didn'thappen, I don't know how
effective the work would havebeen.
Dr. Elizabeth Barlow (18:15):
That makes so much sense.
You've got to have thatconnection.
And thinking back to one of myfirst interns that I took on at
the group practice, I rememberher calling me, bawling her eyes
out because her client nevercame back to see her and she
thought that everything wasgreat.
Her client would definitely beback.
And it was her first clientthat ever didn't come back to
(18:35):
see her.
And we had to have thatconversation about you are not
for everyone, everyone is notfor you.
We'll never know why that clientdid not come back.
We'll never know if she waslooking for other therapists,
but it's got to be the right fiton both sides.
So I love that you highlightthat point because if, like you
(18:59):
mentioned, if it's not there andyou don't have that connection,
you don't have that rapport,then you can't do the work
together and therapy doesn'tfeel good from either side and
that's definitely not what youwant to happen.
So that's another reason why,since day one at kinder mind, we
offer those 15 minuteconsultations.
You can have 15 minuteconsultations with multiple
(19:20):
providers.
You're not stuck if you see oneprovider and you're like, ah,
it's not really working, whoelse might be a good fit, or if
you need an external referral.
Can you help me find somebodythat's in network with my
insurance that does this kind ofwork?
Absolutely we can, because ourbiggest goal is you finding
somebody that fits for you.
Ashleigh Hala, LICSW (19:39):
So thank you so much for bringing up all
those great points and the lastpoint I would say about that,
just because you're inspiring meabout this is and I think this
is hard for younger clinicians,but the more experience you get,
the easier this becomes.
You brought up that, yes, theclient needs to feel like we're
a good fit for them, but we canalso gain goodness to fit for us
(20:01):
, and one thing that is reallyhard to do is to talk to a
client about hey, I as thetherapist, don't think this is
totally working right now.
And here's my recommendationsfor you moving forward.
Here's my sort of idea of whata plan might be, and just my
piece of advice is there's noright or wrong way to do that
(20:22):
per se, but as you gain clinicalexperience and you start to get
a sense of you figuring out isthis a good fit or not, Think
about what language you woulduse to say hey, I think a
referral might actually be moreeffective for you.
And then to your point aboutyour intern be okay with it.
It's about getting the clientthe best service that we can.
Dr. Elizabeth Barlow (20:43):
Absolutely , absolutely.
I could not agree more, andyou're completely inspiring me
too, because I'm thinking abouttimes with clients when I've
learned that we might not be agood fit and what did that look
like?
And it can be so difficult fora clinician to have that
conversation with their client,like you mentioned.
Or if it's something thatyou're not comfortable working
(21:05):
with because you don'tspecialize in that area.
I've had clients that I lovedworking with and then later,
deeper in our conversations andsessions, learned that they
would actually benefit more fromsomebody who had a
specialization in something thatI really didn't know much about
and was not qualified to helpwith.
So I've offered like we cancontinue to work on ADHD or
(21:27):
anxiety or something that I dospecialize in and I do work with
, and you can see a providerthat specializes in this other
thing that I don't, or you cango work with this other provider
.
I just want you to get the bestcare possible.
How can clients communicatetheir needs and expectations
early on to foster a bettertherapeutic relationship?
Ashleigh Hala, LICSW (21:49):
Absolutely .
I think that we need to giveclients an opportunity to do
that.
I think that because of thedynamics of therapy, especially
when you're first starting outin a therapeutic relationship, I
think it could be hard formaybe your typical client to say
here's what I need.
And so I want us to think aboutit as clinicians.
(22:10):
And again in those first fewsessions, including the
biopsychosocial, how can we askquestions that invite that right
and then again allow thosequestions to continue as you
move on in the next session?
And there are a couple ofquestions that I tend to use as
a provider that I think allowfor my clients to they give
permission for my clients toprovide that feedback to me.
(22:34):
How I start everybiopsychosocial is listen, if
you were to wake up tomorrow andfelt 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 toclearly state in my first
(22:55):
question what their goals areand why they're here.
And then one of my lastquestions that I ask in a
biopsychosocial is what can I doas your therapist to help you
feel as comfortable andconfident in this relationship
as you can so that we can domore things together.
It's actually a super importantquestion to ask everybody, but I
(23:17):
find that it's particularlyimportant for people who've had
other therapists to be able toreflect on what could make this
a more successful experience forme.
Sometimes I talk to them aboutother adults or people in their
lives that give them advice insome way, shape or form Could be
teachers, could be parents,could be a boss at a job.
(23:38):
What works for you?
How do you appreciatecommunication?
How do you know and how do wecreate a safe space for you to
provide feedback and reallyasking that question and then
continuing to invite thoseanswers and that information
throughout your sessions movingforward?
And so I think that we have alot of power as therapists in
(23:58):
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 canbe a way to do that.
Dr. Elizabeth Barlow (24:11):
I'm so overwhelmed with the amount of
amazing structure that youprovide in your biopsychosocial
and how effective thecommunication is and it just I'm
like epiphany moment.
It makes so much sense that youwould start out that way,
because if you were just to flatout ask the client, okay, what
do you want to work on?
(24:32):
They might not have any idea.
I don't know.
That's what I'm here for you totell me.
But then to use those questionsto really map out thinking
about how you feel and how youwant 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 figuringthat out.
(24:53):
Not going to lie, I'm goinggonna go and incorporate some of
that into my work on thebiopsychosocial and like other
areas of practice, because Ithink that's just a really great
strategy oh yeah, and I thinkyou you hit the nail on the head
.
Ashleigh Hala, LICSW (25:06):
There are clients who who come in and they
don't package what they'reexperiencing as anxiety or
depression or adjustment issues,but what they will say is man,
I get overwhelmed and I wouldlove to not feel that way
anymore, or I catastrophize andit totally ruins my day.
And then that allows us astherapists, even in that one
(25:27):
moment, to provide a little bitof feedback and say this is what
that sounded like to me, butasking them that question in
that way I think you're right itcan be a really client-centered
way to start their relationship.
Dr. Elizabeth Barlow (25:37):
For sure, and then so we're using the
tools, we're using thestrategies, we're building
rapport.
How would you recommendmeasuring that rapport?
What are some effective ways to, as both therapists and clients
, to measure the rapport in thesession, because sometimes you
(25:58):
can just feel it and thensometimes maybe you're not sure.
So what would you recommenddoing, as a therapist, to
measure that rapport?
Ashleigh Hala, LICSW (26:06):
Yeah, I think it depends on the client.
You've got clients who willeasily tell you how they think
it's going and you've gotclients who you have.
They're very easy to read asfar as whether or not that
rapport is working and ishelping you in that therapeutic
relationship or not.
Sometimes we have clients thatare a little bit harder to read.
(26:26):
I'm gonna steal this frommotivational interviewing a
little bit.
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 beingable to share about a really
hard day?
How do you feel about maybetelling me something that's
really uncomfortable?
How do you feel about me beingwelcoming and open?
(26:48):
And what I love about using theone to 10 scale is A you can do
it over and over again and Cchange over time, but B it's
actually not so much about thenumber that they choose as it is
about what we do with thatnumber, and so they might say,
today, as far as sharingsomething really hard, I feel
like I'm at like a five and oneof my favorite things to do is
(27:09):
say, okay, tell me why you'renot at a one or two.
So what, what's working for usand then tell me what it would
take to get to a six or a seven.
And what I really enjoy aboutthat 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 theclient to maybe change their
(27:31):
answer based on context andcircumstance and it allows us to
grow.
And so, if you don't have thosesort of feedback loops already
built into your sessions, add itto the end.
At the end of your session, doa quick check-in.
How did today feel for you andallow for clients to again give
that permission to call forclients to give you information?
(27:51):
That's helpful.
Dr. Elizabeth Barlow (27:53):
I love that recommendation.
If you don't know, ask thequestions is what I'm hearing,
and I love the use of that aswell, because if you do that
scale of one to 10, and maybethere's a difference of a couple
points from the last time youasked that question then you've
got another question that youcan ask to get more information
(28:13):
and maybe you learn that theygot really judged by like their
mom or another important personin their life earlier that day
and they're just feeling veryguarded right now.
They're not feeling really safeoverall right now, and then
that's super useful informationfor you as their therapist to
know.
So now you've opened a biggerconversation to have about why
are you feeling guarded today?
(28:34):
Let's talk about thatconversation you had with your
mom.
Ashleigh Hala, LICSW (28:37):
And on a scale of one to 10, how
effective do you think today'ssession was?
And Aileen again gives usfeedback about our own work, but
also acknowledges that theclient needs to show up and do
some work too.
And so okay, if we're notfeeling like it was effective,
where is that resistance?
Where did we get off the track?
Where can we readjust and tryagain next time?
(28:58):
And the relationship andrapport may very well be one of
those answers.
Dr. Elizabeth Barlow (29:03):
Completely agree.
And so thinking about effectivetherapy and wrapping us up,
when it comes to effectivetherapy, what do you believe is
more crucial rapport or thespecific therapeutic technique,
or do you think it's aboutfinding the right balance
between the two?
Ashleigh Hala, LICSW (29:20):
Sure, sure .
I'm immediately tempted to sayrapport, and then my brain says
okay, it's really about abalance and one thing that I say
to my clients actually in the15-minute consultations, when I
talk about myself and about justmyself as a therapist and what
they can expect For me, I willoften say the relationship is
(29:44):
what's most important to mebecause, again, we'll be able to
do more difficult work togetherand be vulnerable in spaces
together and deal withchallenges if that relationship
exists.
But then I often say and we'regoing to use specific strategies
within the context of thatrelationship, and usually what I
say honestly is because I'm nothere to chit chat, we're here
(30:07):
to do work together and we doshare a space together where we
check in and talk about maybe afunny story from the day or talk
about family or whatever.
But at the end of the day therehas to be some accountability
for us as clinicians as well toactually be moving these clients
forward towards their goals,towards those things that they
mentioned at the beginning ofthe biopsychosocial wanting to
(30:27):
change.
And I think that rapportabsolutely needs to be the first
kind of foot that we lead with.
Dr. Elizabeth Barlow (30:46):
Rapport absolutely needs to be the first
kind of foot that we lead withand then being able to more
effectively use specificintervention strategies under
the benefits of utilizingrapport in the therapeutic
process, both from the therapiststandpoint and the client
standpoint.
If anyone would like to meetwith Ashley for a 15-minute
consultation, you can findAshley online at kindermindcom.
(31:08):
Ashley is currently seeingclients in Massachusetts.
Again, thank you so much,ashley.
We really appreciate youjoining, absolutely.
Thanks so much.
Thanks so much to our listeners for
joining us for another episodeof the Kinder Mind podcast.
Today we're exploring rapportand relationship building
techniques as an interventionstrategy for therapists, and I'm
joined today with Ashley HalaLICSW.
Thanks so much for joining ustoday.
Ashley, thanks so much forhaving me.
You're very welcome.
(00:20):
Can you start off by explainingwhat rapport means in the
context of therapy and why it'sso important for both the
therapist and the clientfoundation of a strong
(00:42):
relationship that is builtwithin trust and vulnerability.
Ashleigh Hala, LICSW (00:48):
You can do hard things together, right,
like you can accomplish thingsthat are challenging.
You can work through struggles,those types of things.
But also I've found that whenyou've got a strong rapport and
you've got a strong relationship, the intervention you're
choosing to use is far morelikely to be effective.
And so, as a therapist, I thinkthat we can't underscore enough
(01:10):
the importance of rapport andrelationship building early and
often, and what I mean by thatis certainly when we do some of
our initial sessions and we'regetting to know our clients,
absolutely building in some ofthat relationship building, some
of those tools and skills, butalso maintaining that over time.
And that can look like havingshut down time during your
(01:32):
sharing.
Let me tell you this piece aboutmyself, this story that I've
experienced, let me share alittle bit with you.
So, again, we can do thesedifficult things together.
(01:53):
So I think that it's reallyimportant to prioritize that as
a therapist to actually be ableto do better, more successful,
higher efficacy work.
Now for the client, it's allit's about comfort, right.
It's about feeling like you cantrust somebody with, sometimes,
(02:14):
things that they've never toldanyone else and yet they just
met you.
And so when you build some ofthose skills into it, it allows
our clients to go to maybedifficult places and move
forward and get some good workdone.
So again, I can't really quiteunderscore it enough and find it
to be such a foundational pieceto successful therapy, writ
(02:34):
large.
Dr. Elizabeth Barlow (02:36):
I could not agree more.
In fact, I think the thing thatI tell all of my brand new
providers that I supervise, nomatter their licensure level, is
really about the rapport pieceand those things that we have to
do with clients when we'refirst meeting them.
So like the biopsychosocial somany times because obviously the
(02:57):
biopsychosocial is veryimportant for understanding the
client's needs and theirbackground and their history but
so many times I think in thistherapeutic work we get really
used to forms as providers andlike being on the receiving end
of those questions can feel alittle off-putting.
If you're a brand new clientand one of your first
(03:19):
interactions with your newtherapist is them reading
questions to you and then youhappen to basically spill about
all this stuff.
So I really like to encouragemy providers that I supervise to
make it conversational.
Don't read from the script.
Have an organic conversationabout their family history and
their medical history and try totake the pieces of those things
that you learn and incorporatethat through conversation and
(03:41):
then if you're missing anythingthat you need on that
biopsychosocial, then you canask those targeted questions.
So I completely again agree withyou that like building a
rapport with the client is avery human behavior that can
have a very impactful I lost mytrain of thought Can have a very
impactful effect on your worktogether.
(04:02):
So, thinking about buildingrapport and sometimes we have
multiple sessions to work withclients Sometimes, like yourself
, you work in an environmentwhere you don't have as many
sessions that a client will cometo you Sorry, I mixed up my
word.
What are some effectivetechniques to build rapport
(04:22):
quickly with a client?
Ashleigh Hala, LICSW (04:27):
some effective techniques to build
rapport quickly with a client.
Absolutely, I agree with you.
I think that sometimes we haveI've got clients who I've worked
with for a year over a year, along period of time and I've had
clients where they come in forbrittic treatment, they come in
for solutions-based treatmentand it's really about one, two,
three, four sessions to try towork through whatever that issue
might be, whatever challengesfacing them in that moment.
(04:47):
And I think that when we thinkabout building rapport quickly,
we can lean on our fundamentalclinical skillset right, and
that's going to be things likevalidation, normalization,
active listening, checking in,stabilizing in the moment, right
(05:09):
, what can I do for you rightnow?
And then delivering on that andreally showing our clients I'm
here to give you what you'relooking for.
And when we're able to do that,we're reinforcing again this
sense of trust where the clientthen feels like they can be,
reinforcing again this sense ofthrust where the client then
feels like they can be more.
And so I think that there are alot of ways that we can, from
(05:34):
the get-go, be able to build arapport and a relationship that
can thrive in a long orshort-term capacity.
Again, the other piece that I'llcome back to, and this is one
that I think is tricky for a lotof therapists.
When we think about building arelationship, it really is
mutual, and we need to talkabout self-disposure as
therapists, and so what I oftentell my clients is part of this
(05:56):
relationship is that I'm goingto get to know you really well
and you're going to get to knowme a little bit, and you're
going to get to know me a littlebit, and that's how I phrase it
.
This time is about you.
This time is about hearing youand seeing you and working
through whatever it is you'rebringing to the table that day.
But when we check in thebeginning, I'll tell you a
little bit about my week, I'lltell you a funny story from my
(06:17):
life, and part of that is justcreating that mutuality that
allows for that relationship togrow.
So, anyway, I think that thoseare some really kind of concrete
things that you can do fromsession one and I love that you
brought up the biopsychosocial,because there are definitely
ways to do that that feel likean interview, right.
(06:38):
But when you build in some ofthese other tools, like
normalizing, like validation,like active listening, those
types of things, like adding ina little bit of sort of personal
information thatbiopsychosocial can in itself be
almost like an intervention.
It can actually cause thatclient to be reflective and say,
huh, what might need to change?
(07:00):
And how is this relationshipgoing to help me do that?
And so I don't know.
I think that these skills canbe used in lots of different
ways and I love your concept ofstarting with something like the
even the first 15-minute clientconsultation.
You can build some rapportthere, move into the
biopsychosocial and then,honestly, leaning in on that
rapport throughout the entirerelationship I've had clients
(07:24):
who, after seeing each other fora little while, I might have to
use a safety assessment or asuicide assessment, and having
that rapport makes that easier,makes it faster, makes it more
effective and again, we're ableto do hard things.
So all really important.
Dr. Elizabeth Barlow (07:43):
I also love the fact that you brought
up self-disclosure.
That is one of my favoritetopics ever because back in the
day when I was in school forsocial work, it was dependent on
who you asked.
It was like subjective, noteverybody had the same view.
Some professors were likehardcore against self-disclosure
.
Others were like oh, it'scompletely fine.
And then there were folks inthe middle I like right in the
(08:04):
middle.
So another thing I always sharewith my supervisees is always
ask yourself kind of thequestion of why am I about to
disclose and go forward withthat, do no harm mindset?
So are you dumping on yourclient because you've had a hard
day, or is your motivation andyour intention to make a
connection and really share withyour client like I am human too
(08:28):
and I can also connect with youon this level because we do
have this shared experience.
And then thinking about sharedexperiences, another place where
I think this rapport buildingcomes in is I don't have to have
been a survivor of domesticviolence to be able to see you
and help you through your traumawith domestic violence.
(08:51):
That, I think, is another hugepiece of this rapport building,
of breaking it down to thathumanistic piece.
I am someone who is going toconnect with you on that human
level, who is also clinicallytrained, and help you to
navigate through this reallydifficult life experience that
has happened.
So, thinking about commonchallenges with rapport building
(09:15):
what are some common challengestherapists face when trying to
establish rapport with clientsand how do you think that they
can overcome these barriers?
Ashleigh Hala, LICSW (09:31):
Yeah, I think that self-disclosure is
the absolute number one and Itotally agree with you that
within the field there are somevaried opinions on how we use
self-disclosure and my personalperspective is that it's a tool.
It's a tool that we can use andwe don't need to use it all the
time.
We don't need to use it inevery session, certainly not at
every sort of moment, everycomment that our client shares,
but there can be times in myexperience where, by sharing an
(09:57):
anecdote or a story or somethingthat might help you relate to
what your client's experience is, or maybe something that helps
you illustrate a clinicaltechnique or approach that
you're trying to implement, itcan be worth it.
But I do think that when youbring up this concept of
challenges, I think you have tofind that sweet spot for
(10:20):
yourself and I would say ittakes time.
My sort of comfort level withself-displosuring sessions has
changed drastically since Istarted as a young British and I
have a deeper level of comfortwith it now.
I feel like I know when and howto use it.
But that took me a minute and Ithink that could definitely be
a challenge.
Another one that immediatelycame to mind when you asked this
(10:41):
question was a fundamentalbelief that I have about
relationships, particularlyabout therapeutic relationships,
is that we are doing thingswith our clients, not to them or
for them.
And I think that sometimes, astherapists, we can feel this
pressure as maybe someone withsome expertise or someone who's
(11:06):
another person is seeking helpfrom.
We might feel this pressure tojump in and fix or to jump in
and be really directive.
And the thing that I'll sayabout that is A that's probably
not what our client is actuallylooking for.
And, b those things detractfrom building a healthy
relationship and rapport withour clients.
(11:27):
And so something I'll often sayto younger clinicians when I'm
working with them is that sortof working with can sometimes
take longer, but it's worth it,it's absolutely worth it.
And then really the other pieceand this kind of connects to
both of those things and reallythe other piece and this kind of
connects to both of thosethings is just being really
(11:48):
clear about boundary setting andbeing able to be ready to
enforce those boundaries if theyget crossed, and so being able
to have a sense of, when you'rein 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?
(12:08):
And then what's in the middle?
And then, most critically, howdo you communicate those
boundaries to your clients?
A great example is how you talkabout confidentiality.
To your earlier point aboutbiopsychosocials, we can just
read a statement or we can havea really productive conversation
about it.
That helps us learn aboutmutuality, helps us define our
(12:30):
boundaries and our roles andreinforces that relationship.
Lots of things to consider here.
Dr. Elizabeth Barlow (12:39):
I love the fact that you shared about this
is something that we're notdoing something to our clients
or for our clients becausethat's such a really great thing
like not.
I love therapists.
Don't get me wrong, I am atherapist.
I love fellow therapists, butsometimes, just like with
medical doctors, I feel likesome therapists can develop a
(13:00):
complex of being a savior and Ithink it can be easy to fall
victim to that if you're areally good therapist because
you're seeing these amazingaccomplishments that your
clients are doing left and rightand so then really separating
our ego from that of, okay, didwe do that for them?
(13:21):
No, we did not.
We helped teach them the tools,the strategies and the
approaches to do that forthemselves.
So I always want to pay specialattention to language, and
that's another thing I talk tomy supervisees about.
We talk about a lot of thingsAnytime a client does something
that you're super happy about,that they're super happy about.
When your client has a win, becareful with your something that
you're super happy about thatthey're super happy about.
(13:42):
When your client has a win, becareful with your language that
you use around that.
So I would never say I am soproud of you.
I have no right to pride forthat client.
I do not own theiraccomplishment and by saying I'm
so proud of you, that kind ofimplies to that client that they
need my approval and my pride.
(14:03):
I'll say you must be so proudor I'm so proud for you.
So I think thinking aboutlanguage as well, on this like
discussion about rapport, can bereally important, because words
matter, words have meaning andso do statements and you want to
be really mindful of, kind ofthe words and the language that
(14:24):
you're using, right.
Ashleigh Hala, LICSW (14:26):
I think one easy skill and this is
something that I say to mysupervisees and I'm sure you
said a version of it as well is,I think that sometimes, as
therapists, we get into thisplace of this trap.
I would call it using the wordshould Like.
Here's what you should do.
You should try this.
You should do a mindfulnessexercise.
(14:47):
You should do this, and myadvice is, whenever you feel
compelled to say the word should, I want you to say the word
could, and the reason is allabout connotation.
When I say the word should, itimplies that it's the right
thing to do.
It implies that I might bedisappointed if you don't.
(15:08):
When I say the word could, it'sjust an option that you have
and it's neutral, even if youfeel like you need to express
that to your client.
Be like hey, this is somethingthat I'm going to put on the
table and it's okay if you doand it's okay if you don't, and
just making sure that you, youallow for those things, because
we don't want to set up asituation where certainly, we're
feeling like we're coming in asrescuing right, that's not a
sort of a role that's healthyfor us as therapists, but we
(15:30):
also don't want our clients tothink that's our job either?
Dr. Elizabeth Barlow (15:33):
um, because it's not a reasonable
expectation and that's, quitefrankly, not what therapy is
I've actually never had thatconversation, but from this day
forward, I will have thatconversation because I think
that is so important.
Could not, should, and now mybrain's already spinning about.
Yeah, I feel like that shouldbe a blog article, the language
that we use in therapy.
(15:53):
So, from the client'sperspective, why does finding
the right fit with a therapistmatter so much?
From a client's perspective?
Ashleigh Hala, LICSW (16:04):
Oh man, that is such a wonderful
question and something that Ioften talk to clients about when
we do those first consultations, because I think that there's a
I think there's like ahesitancy sometimes to shop
around, if you will, to meet abunch 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 maybeyou're looking for someone who
(16:28):
mirrors or affirms an identitythat you have and that's really
something that's important toyou, and so finding a therapist
that maybe either specializes incertain issues or the therapist
themselves identifies in aspecific way, can be really
important.
And then it's really criticalto get a sense of the sort of
background of the person thatyou're meeting with, right, is
(16:50):
this person, based on theirexperience, going to understand
me?
A great example from my life isI worked with college students
my whole career, and so when Ido a consultation for someone
within the college age, we clickpretty quickly because I'm very
accustomed to that populationand I let them know that, ok, I
(17:10):
have a sense of kind of whatmight be going on for you, and
here's to you, here's to affirmthat.
And then I think you also wantto feel like the interventions
that your therapist uses areones that sound appealing to you
, the ones that sound like you'dactually be interested in
engaging in them because therapyis work.
And so when you talk to yourtherapist and you get a sense of
(17:32):
what's that work going to looklike, does that fit really well
with you or not?
And then the last piece is doyou just enjoy each other's
company?
I had a client once who recentlyactually the last couple of
months we were ending a sessionand she said to me can I just
give you some feedback?
And I said, of course you can.
(17:52):
And she said I love how much welast in our sessions.
And I was just like that is socool.
And we had that relationship tothe point where, trust me, we
did hard things, we did deeptrauma work together, but what
she took is and we're able tolaugh together.
And again, if that fit didn'thappen, I don't know how
effective the work would havebeen.
Dr. Elizabeth Barlow (18:15):
That makes so much sense.
You've got to have thatconnection.
And thinking back to one of myfirst interns that I took on at
the group practice, I rememberher calling me, bawling her eyes
out because her client nevercame back to see her and she
thought that everything wasgreat.
Her client would definitely beback.
And it was her first clientthat ever didn't come back to
(18:35):
see her.
And we had to have thatconversation about you are not
for everyone, everyone is notfor you.
We'll never know why that clientdid not come back.
We'll never know if she waslooking for other therapists,
but it's got to be the right fiton both sides.
So I love that you highlightthat point because if, like you
(18:59):
mentioned, if it's not there andyou don't have that connection,
you don't have that rapport,then you can't do the work
together and therapy doesn'tfeel good from either side and
that's definitely not what youwant to happen.
So that's another reason why,since day one at kinder mind, we
offer those 15 minuteconsultations.
You can have 15 minuteconsultations with multiple
(19:20):
providers.
You're not stuck if you see oneprovider and you're like, ah,
it's not really working, whoelse might be a good fit, or if
you need an external referral.
Can you help me find somebodythat's in network with my
insurance that does this kind ofwork?
Absolutely we can, because ourbiggest goal is you finding
somebody that fits for you.
Ashleigh Hala, LICSW (19:39):
So thank you so much for bringing up all
those great points and the lastpoint I would say about that,
just because you're inspiring meabout this is and I think this
is hard for younger clinicians,but the more experience you get,
the easier this becomes.
You brought up that, yes, theclient needs to feel like we're
a good fit for them, but we canalso gain goodness to fit for us
(20:01):
, and one thing that is reallyhard to do is to talk to a
client about hey, I as thetherapist, don't think this is
totally working right now.
And here's my recommendationsfor you moving forward.
Here's my sort of idea of whata plan might be, and just my
piece of advice is there's noright or wrong way to do that
(20:22):
per se, but as you gain clinicalexperience and you start to get
a sense of you figuring out isthis a good fit or not, Think
about what language you woulduse to say hey, I think a
referral might actually be moreeffective for you.
And then to your point aboutyour intern be okay with it.
It's about getting the clientthe best service that we can.
Dr. Elizabeth Barlow (20:43):
Absolutely , absolutely.
I could not agree more, andyou're completely inspiring me
too, because I'm thinking abouttimes with clients when I've
learned that we might not be agood fit and what did that look
like?
And it can be so difficult fora clinician to have that
conversation with their client,like you mentioned.
Or if it's something thatyou're not comfortable working
(21:05):
with because you don'tspecialize in that area.
I've had clients that I lovedworking with and then later,
deeper in our conversations andsessions, learned that they
would actually benefit more fromsomebody who had a
specialization in something thatI really didn't know much about
and was not qualified to helpwith.
So I've offered like we cancontinue to work on ADHD or
(21:27):
anxiety or something that I dospecialize in and I do work with
, and you can see a providerthat specializes in this other
thing that I don't, or you cango work with this other provider
.
I just want you to get the bestcare possible.
How can clients communicatetheir needs and expectations
early on to foster a bettertherapeutic relationship?
Ashleigh Hala, LICSW (21:49):
Absolutely .
I think that we need to giveclients an opportunity to do
that.
I think that because of thedynamics of therapy, especially
when you're first starting outin a therapeutic relationship, I
think it could be hard formaybe your typical client to say
here's what I need.
And so I want us to think aboutit as clinicians.
(22:10):
And again in those first fewsessions, including the
biopsychosocial, how can we askquestions that invite that right
and then again allow thosequestions to continue as you
move on in the next session?
And there are a couple ofquestions that I tend to use as
a provider that I think allowfor my clients to they give
permission for my clients toprovide that feedback to me.
(22:34):
How I start everybiopsychosocial is listen, if
you were to wake up tomorrow andfelt 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 toclearly state in my first
(22:55):
question what their goals areand why they're here.
And then one of my lastquestions that I ask in a
biopsychosocial is what can I doas your therapist to help you
feel as comfortable andconfident in this relationship
as you can so that we can domore things together.
It's actually a super importantquestion to ask everybody, but I
(23:17):
find that it's particularlyimportant for people who've had
other therapists to be able toreflect on what could make this
a more successful experience forme.
Sometimes I talk to them aboutother adults or people in their
lives that give them advice insome way, shape or form Could be
teachers, could be parents,could be a boss at a job.
(23:38):
What works for you?
How do you appreciatecommunication?
How do you know and how do wecreate a safe space for you to
provide feedback and reallyasking that question and then
continuing to invite thoseanswers and that information
throughout your sessions movingforward?
And so I think that we have alot of power as therapists in
(23:58):
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 canbe a way to do that.
Dr. Elizabeth Barlow (24:11):
I'm so overwhelmed with the amount of
amazing structure that youprovide in your biopsychosocial
and how effective thecommunication is and it just I'm
like epiphany moment.
It makes so much sense that youwould start out that way,
because if you were just to flatout ask the client, okay, what
do you want to work on?
(24:32):
They might not have any idea.
I don't know.
That's what I'm here for you totell me.
But then to use those questionsto really map out thinking
about how you feel and how youwant 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 figuringthat out.
(24:53):
Not going to lie, I'm goinggonna go and incorporate some of
that into my work on thebiopsychosocial and like other
areas of practice, because Ithink that's just a really great
strategy oh yeah, and I thinkyou you hit the nail on the head
.
Ashleigh Hala, LICSW (25:06):
There are clients who who come in and they
don't package what they'reexperiencing as anxiety or
depression or adjustment issues,but what they will say is man,
I get overwhelmed and I wouldlove to not feel that way
anymore, or I catastrophize andit totally ruins my day.
And then that allows us astherapists, even in that one
(25:27):
moment, to provide a little bitof feedback and say this is what
that sounded like to me, butasking them that question in
that way I think you're right itcan be a really client-centered
way to start their relationship.
Dr. Elizabeth Barlow (25:37):
For sure, and then so we're using the
tools, we're using thestrategies, we're building
rapport.
How would you recommendmeasuring that rapport?
What are some effective ways to, as both therapists and clients
, to measure the rapport in thesession, because sometimes you
(25:58):
can just feel it and thensometimes maybe you're not sure.
So what would you recommenddoing, as a therapist, to
measure that rapport?
Ashleigh Hala, LICSW (26:06):
Yeah, I think it depends on the client.
You've got clients who willeasily tell you how they think
it's going and you've gotclients who you have.
They're very easy to read asfar as whether or not that
rapport is working and ishelping you in that therapeutic
relationship or not.
Sometimes we have clients thatare a little bit harder to read.
(26:26):
I'm gonna steal this frommotivational interviewing a
little bit.
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 beingable to share about a really
hard day?
How do you feel about maybetelling me something that's
really uncomfortable?
How do you feel about me beingwelcoming and open?
(26:48):
And what I love about using theone to 10 scale is A you can do
it over and over again and Cchange over time, but B it's
actually not so much about thenumber that they choose as it is
about what we do with thatnumber, and so they might say,
today, as far as sharingsomething really hard, I feel
like I'm at like a five and oneof my favorite things to do is
(27:09):
say, okay, tell me why you'renot at a one or two.
So what, what's working for usand then tell me what it would
take to get to a six or a seven.
And what I really enjoy aboutthat 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 theclient to maybe change their
(27:31):
answer based on context andcircumstance and it allows us to
grow.
And so, if you don't have thosesort of feedback loops already
built into your sessions, add itto the end.
At the end of your session, doa quick check-in.
How did today feel for you andallow for clients to again give
that permission to call forclients to give you information?
(27:51):
That's helpful.
Dr. Elizabeth Barlow (27:53):
I love that recommendation.
If you don't know, ask thequestions is what I'm hearing,
and I love the use of that aswell, because if you do that
scale of one to 10, and maybethere's a difference of a couple
points from the last time youasked that question then you've
got another question that youcan ask to get more information
(28:13):
and maybe you learn that theygot really judged by like their
mom or another important personin their life earlier that day
and they're just feeling veryguarded right now.
They're not feeling really safeoverall right now, and then
that's super useful informationfor you as their therapist to
know.
So now you've opened a biggerconversation to have about why
are you feeling guarded today?
(28:34):
Let's talk about thatconversation you had with your
mom.
Ashleigh Hala, LICSW (28:37):
And on a scale of one to 10, how
effective do you think today'ssession was?
And Aileen again gives usfeedback about our own work, but
also acknowledges that theclient needs to show up and do
some work too.
And so okay, if we're notfeeling like it was effective,
where is that resistance?
Where did we get off the track?
Where can we readjust and tryagain next time?
(28:58):
And the relationship andrapport may very well be one of
those answers.
Dr. Elizabeth Barlow (29:03):
Completely agree.
And so thinking about effectivetherapy and wrapping us up,
when it comes to effectivetherapy, what do you believe is
more crucial rapport or thespecific therapeutic technique,
or do you think it's aboutfinding the right balance
between the two?
Ashleigh Hala, LICSW (29:20):
Sure, sure .
I'm immediately tempted to sayrapport, and then my brain says
okay, it's really about abalance and one thing that I say
to my clients actually in the15-minute consultations, when I
talk about myself and about justmyself as a therapist and what
they can expect For me, I willoften say the relationship is
(29:44):
what's most important to mebecause, again, we'll be able to
do more difficult work togetherand be vulnerable in spaces
together and deal withchallenges if that relationship
exists.
But then I often say and we'regoing to use specific strategies
within the context of thatrelationship, and usually what I
say honestly is because I'm nothere to chit chat, we're here
(30:07):
to do work together and we doshare a space together where we
check in and talk about maybe afunny story from the day or talk
about family or whatever.
But at the end of the day therehas to be some accountability
for us as clinicians as well toactually be moving these clients
forward towards their goals,towards those things that they
mentioned at the beginning ofthe biopsychosocial wanting to
(30:27):
change.
And I think that rapportabsolutely needs to be the first
kind of foot that we lead with.
Dr. Elizabeth Barlow (30:46):
Rapport absolutely needs to be the first
kind of foot that we lead withand then being able to more
effectively use specificintervention strategies under
the benefits of utilizingrapport in the therapeutic
process, both from the therapiststandpoint and the client
standpoint.
If anyone would like to meetwith Ashley for a 15-minute
consultation, you can findAshley online at kindermindcom.
(31:08):
Ashley is currently seeingclients in Massachusetts.
Again, thank you so much,ashley.
We really appreciate youjoining, absolutely.
Thanks so much.
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