No matter what level of education you possess, if you cannot create a genuine relationship with a client, then you will not be an effective clinician.

If we, as clinicians, do not genuinely care about our clients, our clients will not learn to care about themselves. The addictions field has been a blessing in my life and I have been rather successful due to my ability to form a strong therapeutic bond with each and every patient. If I were to adopt a superior attitude with my patients, I would never be able to form the bond necessary for effective treatment and recovery. I must remember that I am, most importantly, a human being with the goal of helping another human being.
Many times I have worked with colleagues who felt and acted as if they were superior to or better than the clients they treat, and patients’ reactions and responses to these counselors were neither positive nor healthy. I’ve never understood the reason for this behavior; I can only assume it is the clinician’s own “stuff” that they have not effectively worked on. I have confronted this behavior and attempted to change it, often failing in my attempts.
As clinicians, I believe we need to look inside and gain insight into our behaviors with our clients, and re-examine our reasons for working in this field. We need to evaluate our own needs — why we feel the need to be superior; why we need to be rigid and control our clients; why we need to demand things of our clients; and most importantly, whether we genuinely care for our clients’ well-being. After all, there are many other jobs out there if you truly do not have your heart in this profession. It’s better to move on then to continue working in this field without passion for helping the clients.
There is so much research out there that tells us the therapeutic relationship is vital in treatment outcomes, and yet I continue to see counselors treating clients in the absence of a strong therapeutic alliance. Even if you are an expert in theory, technique or research, if you cannot develop a strong therapeutic bond, then the clinical effectiveness of your treatment is, at best, questionable. The foundation of therapy or counseling is a strong therapeutic working alliance, and there is plenty of research that confirms this.
To address this issue I recommend that as a counselor you:
• Continue to monitor their thoughts, feelings, and behaviors regarding the therapeutic relationship.
• Continue to work on your own personal growth through 12-step recovery, personal therapy, retreats, etc.
• Review and continue to practice the basics of counseling therapy, such as rapport, trust, empathy, positive regard, etc.
• Examine your true reason for being in the addictions field. Do you care? Are you non-judgmental in your approach? Are you in it to feel powerful, controlling, or superior?
• Be a real human being with your patients!
I have entered this field because I am a recovering alcoholic and addict that want to help others to enjoy a better way of life. My one and only priority is the patient. I hope that all clinicians reading this will take an in-depth look at themselves, and share this with other clinicians. After all, our purpose is to help others enter recovery and leave behind the destruction and despair of addiction.

Richard Singer MA, CAC, has worked with a variety of populations including addicted law enforcement professionals and physicians, and is currently employed by the Cayman Islands Government as a therapist. 

This article is published in Counselor,The Magazine for Addiction Professionals, October 2005, v.6, n.5, pp.26.

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