New approaches for creating the therapeutic alliance: solution-focused interviewing, motivational interviewing, and...

Probably one of the most important skills learned as a medical student and as a psychiatry resident is building the therapeutic alliance. Knowing how to navigate the tricky complexities and subtle nuances of establishing a therapeutic alliance--especially in the initial encounter--is, arguably, the most critical skill clinicians possess, whether seeing a patient for a single interview or for long-term therapy. This article reviews the theory behind the therapeutic alliance and, more importantly, explores three new approaches to establishing it effectively: (1) solution-focused interviewing, (2) motivational interviewing, and (3) the medication interest model designed to improve medication adherence.