Rapport building with clients is widely accepted as an important part of effective therapy, and it has a significant impact on therapeutic outcomes. Rapport in therapy is “a close and harmonious relationship in which the people or groups concerned understand each other’s feelings or ideas and communicate well”. (Cambridge Dictionary, 2019)
We often build relationships with people by exchanging stories: about ourselves, our families, and our lives. But in therapy, the information is flowing in pretty much one direction from the client to you, and, as a therapist, the responsibility for building a good level of rapport will fall mostly on you.
How Important is Rapport Building to Therapy Outcomes?
I have seen the odd post on social media from therapists who believe that rapport building really isn’t important. As long as they have the skills to help a client, they argue, they don’t need a relationship with them. However:
- Strupp (2001) said that the outcome of psychotherapy is influenced more by the personal characteristics of the therapist and the positive feelings that arise in the client than by the type of intervention.
- Eysenck (1952) went further, claiming that any improvements were ‘spontaneous remission’ and that ‘the efficacy of psychotherapy had not been demonstrated’.
- The APA’s Society of Clinical Psychology found that ‘the therapy relationship makes substantial and consistent contributions to psychotherapy outcome, independent of the specific type of treatment … [and] accounts for why clients improve (or fail to improve) at least as much as the particular treatment method’.
- Ackerman and Hilsenroth (2001) discovered that ‘Therapist’s personal attributes such as being rigid, uncertain, critical, distant, tense, and distracted were found to contribute negatively to the alliance. Moreover, therapist techniques such as over structuring the therapy, inappropriate self-disclosure, unyielding use of transference interpretation, and inappropriate use of silence were also found to contribute negatively to the alliance.’
So if rapport is that important, what can you do to help build that trust and move forward with your client?
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Ten Ways to Build Rapport with Therapy Clients
Using your client notes
1. Read through them before each appointment to remind yourself of what you talked about last time, any feedback the client gave you, and what tasks (if any) you asked them to complete before this meeting. (You can also read our advice on what to put in your therapy notes elsewhere in this blog)
2. If the chance arises, remember something personal that’s not necessarily connected to the therapy. Greeting them by asking how a child’s birthday party went, or asking about a hobby, shows that you recognise them as an individual as well as a client. Include a quick reminder in your notes if it helps.
Therapeutic skills to build rapport
3. Use active listening and non-judgmental responses when your client is telling their story.
4. Pay attention to the client’s non-verbal cues as well as their words, including silences.
5. Give positive feedback whenever you can, without going over the top.
6. Empower the client by involving them in their therapy; check that your therapy plan feels good to them, that you have understood their goals correctly and that they understand what you are trying to achieve in each session. Ask for feedback.
7. When it’s necessary to challenge the client (for example about an unhelpful or self-limiting belief) do so gently and respectfully.
Professional boundaries help rapport
8. Be professional – be friendly but professional from the first contact, which is often your website, an email or social media message. Reply to texts, emails and answerphone messages promptly.
9. Allow the client to feel unrushed; yes, you have just an hour (or whatever time slot you allow) but clock-watching or looking at your watch will unsettle your client and put them under pressure. I keep my clock behind the client so I can glance at it without being obvious. For other tips about setting up your therapy room, check out the article elsewhere on the blog.
10. Make your therapy room a restful therapy space where the client can feel safe. For tips on how to do this, have a look at our article on setting up your therapy room. One important tip is that if you work from home, ensure the space is uncluttered by personal photos, children’s toys, dog or cat beds and the like, before they arrive.
References
Ackerman, S.J. and Hilsenroth, M.J. (2001) ‘A review of therapist characteristics and techniques negatively impacting the therapeutic alliance’, Psychotherapy: Theory, Research, Practice, Training, 38(2), pp. 171–185. Available at: https://psycnet.apa.org/record/2001-09102-006 (Accessed: 16 May 2026).
Cambridge Dictionary (2019). RAPPORT | meaning in the Cambridge English Dictionary. [online] Cambridge.org. Available at: https://dictionary.cambridge.org/dictionary/english/rapport.
Eysenck, H.J. (1952) ‘The effects of psychotherapy: an evaluation’, Journal of Consulting Psychology, 16(5), pp. 319–324
societyforpsychotherapy.org. (n.d.). Conclusions and Recommendations of the Interdivisional (APA Divisions 12 & 29) Task Force on Evidence-Based Therapy Relationships | Society for the Advancement of Psychotherapy. [online] Available at: https://societyforpsychotherapy.org/evidence-based-therapy-relationships/.
Strupp, H. H. (2001). Implications of the empirically supported treatment movement for psychoanalysis. Psychotherapy: Theory, Research, Practice, Training, 38(4), 424–429.
About Debbie Waller
Blog Author Debbie Waller is a hypnotherapist, supervisor, and trainer with more than twenty years of experience. As well as having a busy client practice, she runs Yorkshire Hypnotherapy Training and writes books and articles for therapists who want to deepen their knowledge and develop effective practice.
Disclaimer
The information and ideas shared on this blog are based on the author’s professional experience, research, and training. They are intended for educational purposes and to support reflection and professional development. Therapists should always apply their own professional judgment and consider the needs of individual clients when using any techniques or suggestions discussed here.
While every effort is made to ensure the information is accurate and helpful, no responsibility can be accepted for any loss, damage, or difficulties arising from the use or misuse of material contained in these articles.
