The therapeutic relationship

This content relates to the following topics:

Part of Inquiry into the quality of general practice in England

There is evidence that a good-quality therapeutic relationship improves both patient satisfaction and professional fulfilment, saves time, and increases compliance with prescribed medication. Yet the subtle and intangible elements that underpin a strong therapeutic relationship are difficult to define and to measure.

Related document: Measuring quality in the therapeutic relationship

What did we explore?

To inform its work, the Inquiry commissioned a discussion paper on the importance of the therapeutic relationship to the overall quality of general practice care. Measuring quality in the therapeutic relationship assesses what a good-quality therapeutic relationship looks like, how it can be measured, and what GPs can do to stimulate and maintain it.

The paper's authors are Trisha Greenhalgh, Professor of Primary Health Care, Queen Mary, University of London, and Iona Heath, GP and President of the Royal College of General Practitioners.

What have we learnt about the therapeutic relationship?

Aspects of general practice care that underpin a good-quality therapeutic relationship were discussed as part of Inquiry events in February 2010 with participants including GPs, practice nurses, NHS executives, health academics and patient representatives.

Key issues raised for debate include:

  • Whether a strong therapeutic relationship requires continuity of access to a particular GP.
  • Whether 'modern' general practice – including larger practices, an increased reliance on information technologies and greater specialisation of the GP role – is undermining the therapeutic relationship.
  • Whether or not the doctor/patient relationship at an individual level lends itself to quantitative measurement.

What's your view?

During the inquiry, we asked for your opinions on this care dimension. You can read the comments submitted below.

Related content


Marcia Martins

Comment date
16 June 2010
The therapeutic alliance and relationship is primordial to fosted health. GPs are put under pressure to focus on quantity over quality of care. The levels of discourse involved in the therapeutic relationship also account for cultural differences and cultural sensitivity. Please read Prof. Petruska Clarkson's seminal book: The Therapeutic Relationship
Best wishes

Dianne Aslett

Comment date
25 June 2010
Well, I really value my GP and his wider practice as from what I have gathered my doctors' practice has a very positive and helpful regard for those of us with mental health issues. However, it seems to me that since I present with mental health issues in quite a significant way, my mental health Trust and the local Social Service quality and degree of input is unhelpfully disproportionate. These GPs are very conscientious and skilled in supporting this patient group. But, many workers in mental health are not, in my view, sufficiently insightful or dedicated in their work, and this inevitably has a knock-on effect in terms of pressure on GP surgeries.