This Is What’s Hurting Your Therapeutic Alliance With Clients

I was recently asked to serve on a panel discussing strategies for building therapeutic alliances with clients.

In preparation, I spoke with some of the administrative (non-clinical) leaders of my local therapist referral network. They noted that they’ve observed a recent dip in client retention among their partner therapists, and they wondered if I had any insight on causes for the decline. 

As I reflected on this conversation, I wondered how much therapist exhaustion and burnout was playing a role in impacting client retention.

I considered my own experience with burnout several years ago, and what I view as the causes of it.

Most people think that stress causes burnout, but that’s only one piece of the puzzle.

Not everyone who has a stressful job experiences burnout. 

We often think of people experiencing burnout as being disengaged or jaded, and while this can be an indicator, it’s not always the case.

When I personally experienced burnout, I actually became overly engaged. I kept taking on more clients and responsibilities.

The more I studied burnout and spoke to other helping professionals about their experience, the more I realized I wasn’t unique in this behavior. 

At the risk of stating the obvious, taking on more responsibilities when you’re already overwhelmed is exhausting and unsustainable.

When we get to a place of fatigue, we tend to resort to our unhelpful “default settings” that don’t always serve us or our clients best.

As a result, it can negatively impact the relationship with our clients and hurt the therapeutic alliance we’ve built with the people we support. 

4 Common Therapist Default Settings and How to Beat Them

Here are some of the default settings common among helping professionals.

If you find yourself falling into any of these traps, also share some suggestions for getting out of them.

Default Setting #1: Having Trouble Saying No

I already alluded to this one, but it bears repeating. Many helping professionals are drawn to their profession because of a desire to support other people in some way—but as a result, some have trouble setting healthy boundaries. We’ve all heard the classic “put on your oxygen mask first” metaphor for caregivers needing to ensure their needs are met to best care for other people. Yet, when times are tough, it’s easy to default back to saying “yes” to whatever requests come our way. 

How to Beat It: Don’t Respond Right Away

If you find yourself falling into this pattern and it’s difficult for you to say no, there’s a pretty simple adjustment you can make when you get asked to do something.

Rather than saying “yes” or “no” right away, make your new default statement something like “Let me see if my calendar will allow that. I’ll get back to you soon either way.”

This allows you more time to think about if your “yes” is a genuine yes, or simply a default yes.

If you don’t actually have the bandwidth or time for the request, you can respond to the person asking with a firm—but polite—”no.” 

Default Setting #2: Gathering Too Much Information

Let’s be clear: information gathering is generally a good thing, but like any good thing it’s possible to get too much of it.

This can happen with matters not related to work, such as looking into COVID-19 pandemic stats, or getting caught in the 24-hour news cycle when something tragic is happening in another area of the world. It can also happen with work related issues, such as getting immersed in researching a methodology or diagnosis. 

Many of us spent years in school studying our subject and our careers continuing our professional development and growth—and that’s important in helping professions.

Where the default setting becomes problematic is when we’re searching for an answer or solution as a method for gaining control over something that’s likely not in our control.

How to Beat It: Acknowledge What Is and Is Not in Your Control

Examine what’s driving your quest for more knowledge.

If it’s curiosity and love of learning, then by all means proceed.

But, if it’s anxiety-driven, you probably want to back off.

If you’re having trouble noticing the difference, see if you feel energized or depleted when you are in the middle of it. Often, trying to grasp control over the uncontrollable has the opposite effect that what we hoped it would.

Default Setting #3: Feeling Overly-Responsible

The way this shows up in me causes me some embarrassment, because I recognize how ego-driven it is.

When I was in the thick of experiencing my burnout, I truly believed that people wouldn’t be okay if I took time off, and that I was letting everyone down.

Upon reflection, while I’m sure my 14 week mental health leave inconvenienced some people to some degree, the world kept spinning on its axis without my help. 

Alternatively, if I had kept going at the pace I was, my career in general (and my personal relationships) would have been in real jeopardy.

This default setting still shows up when I tell a client my caseload is full while still wondering if I could move things around to make the space to help them.

How to Beat It: Let Go, Even Just a Little

Just because we’re capable of something, doesn’t mean that we need to take it on.

You’re special and what you do matters, but you can’t possibly take on everything that you’re qualified to do. It’s a basic supply and demand issue.

When can you refer out and give others a chance to use and develop their skills?
Finding small areas to give up some control can go a long way to protecting your own well-being.

Default Setting #4: Procrastination

This one doesn’t quite fit with the rest, but I think it’s still worth mentioning.

My default setting of procrastination usually comes in the form of putting off administrative tasks—the elements that are mostly invisible to my clients and colleagues, such as case note writing, billing, and organizing my desk.

When I put these items off, they become invisible energy drainers that pull my focus away from the primary elements of my job and even spill over into my personal life.

How to Beat It: Systematize

Consider which administrative and billing tasks can be automated or at least made easier.

Instead of repeatedly writing the same emails, I save email drafts for common responses and then personalize them as appropriate.

I’ve shifted my note taking system to reduce work during my time between sessions.

Additionally, I know many practitioners who hire office help or virtual assistants to manage the parts of private practice that don’t require clinical knowledge.

Try to make these tasks habitual, so you don’t have the chance to procrastinate on them.

Shifting away from our default settings can be difficult.

When we’re making this shift, the best thing we can give ourselves is the time and space to acknowledge what’s happening.

Through recognizing and naming your own default settings, you’re in a better position to do something about them.

And, as a result, you can take better care of yourself and be more present and engaged with the people you’re trying to support.

Over time, this shift may help repair your therapeutic alliance with clients.

Beat Your Default Settings With SimplePractice

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