Maintaining Good Working Relationships with Our Clients: The Importance of Rupture and Repair
Maintaining Good Working Relationships with Our Clients: The Importance of Rupture and Repair
In any therapeutic or clinical setting, the strength of the relationship between practitioner and client is central to effective outcomes. Whether in neuropsychology, counselling, or rehabilitation, a trusting and respectful rapport forms the foundation for meaningful progress. However, even the most constructive relationships can experience strain. Misunderstandings, mismatched expectations, or emotional reactions can lead to what is known as a rupture in the working alliance. Importantly, how these ruptures are addressed—and ultimately repaired—can significantly strengthen the therapeutic relationship and lead to deeper, more resilient collaboration.
Understanding Rupture
A rupture doesn’t necessarily mean conflict or overt disagreement. It might manifest subtly—a client becoming disengaged, expressing frustration, or not attending appointments. Sometimes, a practitioner may inadvertently say something that is misunderstood or triggers a sensitive emotional response. These moments, while uncomfortable, are not signs of failure. Rather, they are opportunities for reflection, clarification, and growth.
Where clients may be coping with cognitive changes, emotional distress, or identity shifts following a neurological diagnosis, relationships are often emotionally charged. Clients may feel vulnerable, misunderstood, or overwhelmed. Acknowledging these feelings is critical. When a rupture occurs, it is essential that the clinician responds with curiosity and openness, not defensiveness.
The Process of Repair
Repair involves re-establishing trust, often by creating space for honest conversation. This might mean the practitioner acknowledging something they missed or misunderstood, or inviting the client to express how they felt about a certain interaction. Repair is not about assigning blame—it’s about understanding what went wrong and working collaboratively to move forward.
One of the most powerful aspects of rupture and repair is that it models healthy relational behaviour. Many clients may not have experienced this kind of respectful, empathic conflict resolution before. Seeing that difficult moments can be worked through—not avoided or ignored—can itself be therapeutic.
At an organisational level, fostering good working relationships with clients also involves consistency, transparency, and reliability. Setting clear expectations, following through on commitments, and being responsive to feedback all contribute to a strong foundation. However, it is also vital to recognise that rupture and repair are natural parts of any long-term therapeutic journey. They do not signal breakdown; rather, they reflect the dynamic, evolving nature of human relationships.
It’s also worth noting that repair takes emotional maturity and clinical skill. It requires practitioners to be reflective, humble, and able to tolerate discomfort in the service of the client’s wellbeing. Supervision and team support are essential in helping clinicians navigate these moments effectively and ethically.
Our Approach
At The London Neurocognitive Clinic, we believe that the strength of our relationships with clients is at the heart of everything we do. We are committed to building trust through openness, compassion, and professionalism. When ruptures occur—as they sometimes do—we see them not as setbacks but as opportunities for deepening understanding and reinforcing the therapeutic alliance. Through active listening and collaborative repair, we aim to support our clients in feeling truly seen, heard, and valued throughout their journey with us.
