When we first learned about therapy and the importance of a good therapeutic alliance, our attention was directed toward a small but unwavering group of principles that were understood to be critical in fostering this kind of connection. We were taught to demonstrate to our clients empathy, confidentiality, and unconditional support so that clients could tell we were compassionate and safe to talk with and, presumably, feel good about trying therapy. Basically, we chased them. 

As therapists, we generally think of rapport as something built over time, and that it is the time together that really consolidates the therapeutic relationship. We’re surprised though when suddenly, after weeks of pleasant-ish conversation, the kid drops out of therapy. There’s no traction in pleasant. And rapport needs traction to grow, not time. And traction comes from engagement/respect.

That’s why “rapport-building techniques” don’t make sense to me. I understand true rapport between therapists and their teenage clients as having developed after the teen has decided that there is something of value in relating to the therapist. The value can be anything that matters enough to the teen that s/he continues engaging — it could be anything from finding the therapist someone comfortable to talk with or finding the therapist entertaining; it doesn’t matter.

Once teenage clients decide that they like what they see, they then may start engaging more intently and openly. That’s why I consider the idea of rapport leading to engagement as backwards. I think of rapport as kicking in after there’s been a connection; my conception of it includes a quality of resiliency and durability that is not necessarily part of therapist/client engagement.

Or I don’t know. Maybe it’s all just semantics. I guess the important thing is that you have a way of beginning to talk with your teen clients that doesn’t involve asking them three dozen questions (and certainly doesn’t focus on “treatment goals”) and instead allows the most riveting, intriguing parts of your personality to come forward so that the kids sitting in your office actually want to talk with you! Now that changes everything — very positively so — about both the relationship the two of you form and the therapy you co-craft and, subsequently, the ability of the therapy to leave impressions on the hearts and minds of your young clients.

— Janet Sasson Edgette