I am counting my many blessings this Thanksgiving, and also feeling kind of sad. I sometimes get happy holidays texts from teens that I saw in art therapy, and today I heard from a former client who is not doing so well. She’s an amazing girl, very dear to me, and we have a lot of history together.

In psychology jargon, our relationship would be described as a strong therapeutic alliance. The term describes a relationship between therapist and client in which a sense of safety, trust, and common therapeutic goals is present. It has been said that a strong therapeutic alliance predicts better outcomes in therapy. But I say that a strong therapeutic alliance IS the therapy, and that therapy can’t happen without it. How much a client feels you care always trumps factors such as treatment method.

And so, a deep relationship led to a long Thanksgiving Day conversation with someone that I haven’t seen in a year and a half but care deeply about. And I am thankful for that.

Below is some artwork by kids depicting the therapeutic alliance. I’m the one with the purple hair and glasses.


This child shows how the sun and rain help a flower to bloom (the yellow arrow from the sun to the flower is hard to see, easier if you click to enlarge). What I love about this picture is the blue arrow, her awareness of how important the relationship is to me, too, how our relationship is a circle, and not at all one-sided.

flowers and sun

Flowers are a common metaphor in pictures about relationships.


Cheers! The clinical term may be therapeutic alliance, but often the word friendship better describes it.

friendship juice