A large proportion of the psycho-social treatment experience consists of interaction between client and therapist/counsellor/practitioner/key worker, or whatever title such people operate under, between client and those workers operating in teams and between client and the service as a whole. It is about establishing a positive, productive relationship with successive clients – all of whom are individuals. The context doesn’t matter. Know-how and technical competence come a distant second in importance to this essential skill.

The quality of the therapeutic relationship is one of the few variables in psycho-social treatment for which there is good supportive evidence. More evidence has emerged to emphasise how important is the ability to build sound relationships with clients. The US study,* brought to us through the excellent Findings service, indicates that the clients of 1 in 6 therapists actually ended up with worse symptoms.

Raising standards to avoid such eventualities is what lies behind the mission of the Centre for Addiction Treatment Studies. Students are helped in the critical business of developing effective relationships.

A former patient of Clouds House, a well qualified health worker in the NHS told me that in all his wide experience of healthcare facilities he had never been anywhere where people were treated with such respect. I was pleased to hear such a review, naturally, but I wanted to know what that had done for him where his treatment was concerned. His answer: “It meant I didn’t have to think about you guys (the service and its staff). I could focus on what I needed to do.” Simple but profound.

Nick Barton
CEO, Action on Addiction

*Therapist Effectiveness: Implications for accountability and patient care. Kraus D.R., Catonguay L., Boswell J.F., et al. Psychotherapy Research 2011