Therapeutic Alliance Qualities
Clients with co-occurring disorders (CODs) can benefit from a therapeutic alliance grounded in practical assistance, sensitivity to diverse needs, and non-judgement. Consumer-driven, or client-centered care is the foundation for a collaborative process and informed decision making. Assisting your client to understand how substance use, mental illness, and physical health concerns are impacting one another.
Taking time to explore the intersections between various aspects of health can help your client explore what recovery looks like in many parts of his or her life. Responding to your client according to his or her stage of change serves to enhance your working alliance. Attempting to effect change the client is not motivated or prepared to make can result in both client and practitioner feeling frustrated and/or ineffective, and could lead to the client leaving treatment altogether. Taking a nonjudgmental stance when assessing a client's desire to change and utilizing motivational strategies are both helpful.
Finally, do not underestimate the power of hope in the therapeutic alliance. See research evidence on how the role of hope plays a large role in theraeputic relationships. Clients with CODs have likely experienced many relationships characterized by disappointment, resentment, or apathy. Celebrating small victories and remaining patient when a client experiences a setback are practical ways of demonstrating to the client hope for recovery and wellness are possible.
Larsen, D., Edey, W., & Lemay, L. (2007). Understanding the role of hope in counselling: Exploring the intentional uses of hope. Counselling Psychology Quarterly, 20(4), 401-416.