How Therapists Can Build Trust Over the Phone
Research shows that clients with substance use disorders (SUDs) who enjoy a good rapport with their therapist are more motivated to take an active role in their plan of treatment and stay engaged in recovery. Similarly, when families of clients in substance abuse treatment have a higher level of trust in their loved one’s therapist and the therapeutic process, they, too, take more initiative in their recovery—which only improves their loved one’s treatment outcomes.
When you’re serving clients in a drug or alcohol treatment center, though, much of this work is done in person, through group and individual therapies. With families, in contrast, the rapport-building largely happens over the phone. (Telephone-administered therapy is considered telehealth in some states. This article will take the same stance, with the recognition that “telehealth” also employs a broader range of technologies in meeting people’s health needs.)
Building Rapport With SUD-Affected Families Over the Phone – Key Elements of Trust
In addition to building rapport with the clients who come through the doors of a rehab facility, therapists also need to build rapport with clients’ families. However, in a great majority of cases, clients’ families live out of state. They cannot meet in person with their loved one’s primary therapist, and as an accommodation, receive a weekly phone call from the therapist instead.
In this context, the family contact does not get a CPT code. They should never be treated as patients, and it is important to maintain this critical distinction at all times. This means that the therapist can only offer general and non-specific answers to family inquiries. Otherwise, the therapist could be guilty of practicing across state lines without the appropriate state license.
Knowing how to build rapport nevertheless remains crucial in these over-the-phone interactions. That can consist of the following key elements of trust-building on the part of the therapist:
- Signing of proper releases of information by the client – Contacting the family should only happen after the client has given their signed permission.
- Immediate contact with the family as soon as the client is admitted to treatment (assuming the client has signed a “Release of Information” form) – Trust and rapport are much easier to establish when families feel included in the therapeutic process from day one of their loved one’s treatment. In contrast, families who aren’t updated about their loved one’s progress or other issues are going to feel disconnected and distrustful. It’s thus critically important to demonstrate accessibility from the very beginning so that the first seeds of trust and connection can begin to take root.
- Letting the family know upon first contact that you will be calling them weekly to provide updates on their loved one’s progress—and then following through with these weekly phone calls. Building rapport takes time to develop. Over time, though, through these faithful weekly installments of love and connection from a therapist who keeps their word (by calling each week as promised), love and connection can grow and flower. On the other hand, it may go without saying that you can’t have a rapport with a therapist who says they will call you but then doesn’t.
- Inviting families to share their goals and concerns – In a first phone call with a family member, spend a lot of time inviting them to share any questions or concerns and any goals they have for their loved one. This process is a helpful way of both engaging the family but also meeting them where they are. In some cases, the goals that a family shares can then inform a client’s plan of treatment, serving as helpful benchmarks by which to measure the client’s progress.
- Active listening – The “active listening” that therapists are taught to apply is even more crucial over the telephone. Active listening conveys that you value the person on the other end of the line. This can involve paraphrasing back to the family member what they are telling us and asking whether you heard them correctly. It can also involve an acknowledgment of the emotions they are experiencing, based on what they are sharing. Taking notes on these goals and sending the family a copy is another way of building rapport. When a family member feels genuinely listened to on a phone call, they are better able to trust that you have both their and their loved one’s best interests in mind.
- Keeping the focus on the client but also encouraging the family – Families naturally want to know how their loved one is doing, so give them brief updates—for example, “April is having a good day,” or “Bob is not attending groups.” Out of concern for client privacy and confidentiality, you should avoid getting into clinical details. Still, these brief updates go a long way in providing families with greater peace of mind, including better preparation for when their loved one returns home. Encouraging family members in their own recovery and praising their efforts to heal is also key.
- Offering in-person therapy that is feasible for out-of-state families – Consider also giving families the option of participating in an intensive weekend workshop that addresses the family dynamics of addiction and that equips clients and with tools for how to relate to one another in healthier ways. This option makes it possible for families to build rapport with their loved one in an in-person therapeutic context that is feasible (as a one-time weekend offering rather than a weekly onsite meeting).
When the above elements are in place, trust and rapport are more achievable—even over the phone with a stranger you’ve never met.
Anna Ciulla is the Vice President of Clinical and Medical Services at Beach House Center for Recovery. Anna is passionate about helping clients with substance use and co-occurring disorders. She has nearly 20 years of industry experience and uses a variety of methods to help clients achieve successful long-term recovery.