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Building rapport and trust through therapeutic communication

online Clinical Mental Health Counseling program

Every healthcare professional will agree that patient rapport is of the utmost importance. A positive rapport can help patients feel cared for and listened to, and it helps to improve outcomes. One of the best ways to build this rapport with people through mental health counseling is to follow therapeutic communication strategies.

But what is patient rapport, and how can you build it using therapeutic communication? This guide explores both concepts and suggests ways mental health counselors can build supportive caregiver relationships with their patients,

What is patient rapport?

Patient rapport refers to how someone communicates with a caregiver or healthcare professional. Rapport is a broad term, but it typically revolves around ease of communication. For instance, does a patient feel comfortable and confident sharing information with a caregiver or counselor?

Patients rely on a healthy rapport with their counselors to feel safe and supported. In many cases, people may be struggling to handle traumatic experiences and require friendly, gentle support. Essentially, patients always need to be able to trust the professionals they work with.

As you might imagine, rapport is crucial to building healthy relationships between mental health counselors and patients in both directions. With a healthy rapport, counselors can better understand the problems their patients face and determine how to support their needs more closely.

Learning how to build patient rapport, alongside the technicalities of mental health counseling, is critical for long-term success as a counselor.

As part of an online Clinical Mental Health Counseling program through a reputable institution such as American International College, budding counselors will learn how to build relationships with patients and treat them effectively. Combining 100% online coursework with in-person placements, the online MA in Clinical Mental Health Counseling program offers a fantastic gateway for professionals interested in extending that extra support to people. Students study various topics, including crisis intervention, counseling theories and techniques and multicultural and social bases of behavior.  

What is therapeutic communication?

Therapeutic communication is a term that refers to various rapport-building techniques that promote the mental, emotional and physical health of patients.

To help their patients, counselors need to support and encourage while also maintaining a professional distance. So, counselors and nurses refer to therapeutic communication methods to encourage patients to work on their problems and remain open to discussion.

For example, they might use open-ended questions, repetition or even silence to encourage patients to talk and share more during one-to-one sessions.

That said, therapeutic communication involves more than just talking. It also involves noticing the patients’ physical needs and being able to read between the lines. This is an important skill to learn and is vital for any nurse, counselor or other healthcare professional as it helps to build trust while keeping the patient-caregiver relationship strictly professional.

Ways you can use therapeutic communication to build rapport and trust

It’s easy to assume that “just being open” or giving people room to speak is enough to build rapport in therapy. However, therapeutic communication is a little more nuanced, especially when it concerns mental health matters.

Here are some of the most effective ways counselors use therapeutic communication to build rapport and help instill trust in their patients:

Active listening

One of the best ways to help patients to open up is simply by giving them the space and time to come forward and talk. However, when they do talk, it is imperative that they feel someone is hearing them. That is where active listening comes in.

Active listening relies on more than just nodding your head occasionally and agreeing with statements. Active listening involves paying attention to both verbal and non-verbal communication. Ideally, most of the talking in a therapeutic session — particularly about mental health — should come from the patient. Counselors can show patients they genuinely care by giving them the floor to air what they want to say, and only making suggestions if and when appropriate.

Sometimes, all a patient wants or needs is to be heard. That means taking a genuine interest in what they have to say and following up with questions and clarifications, rather than simply telling them “how it should be”.

In some situations, it may not seem as though what patients discuss is relevant to the matter at hand, but even irrelevant information can often hide important details. For example, counselors may gain extra insight into how the patient thinks, how they process what happens around them and who they have in their lives to depend on.

Recognizing patient behavior

Although we all rely on what people say verbally, body language often says much more. For example, counselors may notice that a patient looks more tired than usual, or particularly anxious.

Perhaps they’re playing with their clothes, fiddling with fingers and thumbs or tapping their legs. Simply noticing these kinds of behaviors and acknowledging them can help to shape the way counselors communicate. For example, depending on the body language on display, they will know whether to press a specific issue or to ease off on a topic.

Noticing these behaviors and more can also help counselors note other symptoms that had perhaps not been discussed or noticed beforehand, which may enable them to provide a more accurate or beneficial treatment plan.

Not all patients will be willing to share information verbally, so reading physical language is an important part of therapeutic communication. Trained counselors can take note of certain cues and use them to help shape the conversation, influencing rapport and building trust.

Clarifying what patients say

The communication between patients and counselors must always be clear. Sometimes, simply asking the patient to clarify their meaning can make a huge difference. For instance, a counselor would ask a patient to be a little more precise in how they describe what they experience and the problems they face.

Having more details on hand, naturally, supports professionals in better understanding the patient, their needs, and whether treatment is effective. It is also a great way of showing the patient that you care, are listening and want to help.

By asking follow-up questions, counselors show the people they treat that they genuinely want to help. They are not merely leaping into quick fixes or ideas by force. This communication standard fosters trust and helps counselors to build an even greater understanding of who they’re working with.

Offering hope and empathy

Therapy can be scary, which is why counselors should always lead therapeutic communication from a human perspective — to focus on the patient’s journey, not necessarily the eventual outcomes of their sessions.

Although maintaining a healthy distance between a counselor and their patient is of the utmost importance, it is just as important for professionals to be there for their charges in any way possible. Patients need to feel that they can reach out and explore any issues.

For example, offering hope can go a long way. Reminding patients of their strength, being positive, and offering positive feedback when appropriate can make all the difference to people in difficult situations. Naturally, counselors should be truthful and remain ethical at all times.

A counselor might take the opportunity to tell a patient that they have the right to feel certain emotions or that they understand why they might be upset. Empathy is an important facet of therapeutic communication, as it drives a want to care for others. However, a counselor must avoid making assumptions or using phrases such as “I understand how you feel” as it’s impossible to completely understand how anyone feels!

Instead, it’s wise for counselors to use language and careful moments to tell patients they have the right to feel what they feel and that they have a safe space to discuss what’s on their minds.

Letting patients choose topics

Counselors should, ideally, use broad openings in conversations to allow patients to choose topics that matter to them. Overall, it is usually best to keep things general rather than trying to force them to speak about a specific topic. The more general a counselor acts when leading conversations, the more likely patients will follow certain helpful trains of thought.

For example, a counselor could merely ask: “What are you thinking about right now?” or “What would you like to talk about today?” Both phrases can help guide people to what they need to discuss. It also shows patients they are in control of the conversation and can discuss whatever they need to, rather than participating in a session they feel powerless in.

Of course, not all patients feel comfortable choosing topics or taking the lead, so it’s up to the counselor to spot moments where they need to offer a helping hand. If patients do not want to talk at first, they could benefit from a highly specific question or two — even if it requires something as simple as a “yes” or “no” answer.

Even if patients don’t want to grab control of a conversation right away, one of the hallmarks of effective therapeutic communication in mental health counseling is to give the patient as much power as they want or need. Over time, a counselor will learn how to gauge how much individual people demand.

Accepting what patients have to say

There are no right or wrong answers in any counseling or therapy sessions, so it’s wise for counselors, instead of addressing areas where a patient might have made a factual mistake or said something that would otherwise need correcting, to use questions to ask why a patient might think something or believe in a specific line of thought.

This is another great way for counselors to get to the source of what might be driving their patients’ thought patterns. At the same time, the patient feels validated and supported knowing that their counselor isn’t judging them outwardly on what they have to say.

Reducing bias and prejudice on the part of the counselor is a reliable way to build rapport, trust and confidence. A patient worried about what therapists might have to say about their beliefs might feel closed off.

However, when given the time to speak and explore their thoughts — with the view that nothing gets discussed outside of a therapist’s office — patients can provide counselors with useful information that can help support a helpful diagnosis and/or treatment plan.

By accepting what patients have to say and building rapport by giving them space, counselors can help people help themselves. Sometimes, it might simply be a case of a patient finally getting the chance to vent and release years of worries and grief.

Counseling relies on rapport

Without rapport, counseling can only be so effective. When genuine, rapport can help the conversation flow freely and encourage people to discuss complex and intense subject matters. For many people, simply talking about a problem can be enough to reach a breakthrough.

Rapport helps both the counselor and the patient. For counselors, it’s a useful tool to help them understand some of the more complex mental health concerns people suffer with. For example, building a healthy professional relationship can help practitioners learn more about how post-traumatic stress disorder affects veterans or how postpartum depression affects new mothers.

Establishing a relationship is key

Ultimately, counselors are driven by a desire to help other people. Without that desire, there is no rapport. Mental health specialists learn to build rapport through their education and long into their regular practice.

While it’s certainly important for mental health counselors to have technical knowledge, it’s arguably just as important to be able to build healthy communicative relationships with patients. After all, we are all people at varying stages of life — and it’s important to keep that humanity at the heart of mental health practice.

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