Rapport

Therapy is based on the therapist developing a relationship with the client. Rapport has been described as an ideal version of this relationship between the therapist and client. The importance of the therapeutic relationship is accepted by most theoretical approaches. In some approaches, such as existential, person-centered, and Gestalt, the personal relationship is a crucial determinant of treatment outcomes, in contrast to other approaches, such as rational emotive behavior therapy, cognitive-behavior therapy, and behavior therapy, which, although they do not ignore the relationship, do not give it central importance. Developing this relationship requires honesty, sincerity, acceptance, understanding, and spontaneity. According to the literature, the relationship between the therapist and client is the key factor in client change, and the Rogerian core conditions of listening, [Page 403]reflecting, and clarification of feelings are fundamental to the development of a therapeutic relationship.

Rapport is characterized by openness, honesty, freedom for clients to be themselves, and a sense of comfort and acceptance. The development of this relationship can be influenced by many factors. One of these factors is the perception by the client of the therapist's association with an agency/organization that does not appear to have the client's best interests at heart. Another factor is the manner in which the client approaches therapy. If the client approaches therapy because she or he needs to talk about something and feels that talking to a therapist will be helpful, rapport will be easier to establish than when the client is unwilling to be in therapy but has been compelled to be there, such as in court-mandated therapy. Additional factors that affect the development of rapport are the client's initial impression of the therapist and the therapist's office, the therapist's response to the client challenging the therapist, and the extent to which the therapist is attuned to the client's feelings and able to communicate an understanding of the client in the initial session.

Historically, the use of microskills such as attending and listening, influencing, focusing, selective attention, and confrontation has been emphasized for the development of rapport between therapist and client. However, this expectation of the development of rapport through the use of these microskills is considered by many to be a European American concept and may not lead to rapport development with individuals who belong to minority cultures. There are several reasons for this.

Individuals from minority cultures may have different expectations of what the therapist can do for them and the goals of therapy. The client may define the therapist role very differently—as a medicine man, as a physician, and so forth—and the therapist needs to understand the client's definition in order to work with him or her.

Clients also may have different expectations from the initial therapeutic contact. Whereas European Americans may be comfortable with information collection being the focus of the first session to help the therapist in identifying and treating the problem, clients from diverse groups may view the same therapist as being technically and culturally incompetent. Thus, the therapist should not give the client the impression that a lot of information will be needed to understand the problem, and the presenting problem should be emphasized. The first session should focus on identifying the problem the client considers essential, providing concrete recommendations that will help the client problem solve, and establishing therapist credibility.

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