Information provided in the “Ask the Doctors” column is not meant to take the place of individual consultation with a qualified health care provider. See your health care provider to discuss specific questions about your health, medication and treatment plan.

Question: What is a therapeutic alliance and how can I form one with my doctor?

Ellen Frank, Ph.D.: A therapeutic alliance is a productive relationship between a health care provider and the person receiving treatment. In a good therapeutic relationship, both the care provider and the consumer must be active participants in developing and carrying out a treatment plan.

How can you begin building a therapeutic alliance with your health care provider?

Educate Yourself About Your Illness Learn as much as you can about the symptoms of your illness and how they affect your daily life. Read DBSA’s web site and brochures for accurate, up-to-date information. If you have questions about your illness, ask your health care provider. Recognizing your symptoms, tracking them, and reporting them to your care providers can give them the information they need to best treat you. You may have once thought that mood swings, anxiety, risky behavior, suicidal thoughts and other symptoms were just part of your personality. Your health care providers can help you separate your true identity from your symptoms by helping you see how your illness affects your behavior. Be open with them about behaviors you want to change and set goals for making those changes.

Educate Yourself About Your Treatment People who understand their illness, symptoms, treatments and side effects are more likely to stick with treatment. The more involved you are in your treatment, the less likely you are to become discouraged or feel hopeless. Be honest with your health care provider regarding your concerns about your illness and its treatments. Ask questions. Find out what to expect from treatment and when. That way you won’t be surprised by medication side effects and you won’t have unrealistic expectations about how quickly treatments work. Ask your provider to help you set wellness goals and check your progress regularly. Whenever possible, educate your family and involve them in treatment. They can play a positive role in helping you reach wellness. They can help you spot symptoms, track behaviors and gain perspective. They can also give encouraging feedback and help you make a plan to cope with crises.

Work Toward Wellness If remission is the goal of treatment, it needs to be understood as more than just the absence of the worst symptoms. It is a return to a productive, quality life. Remission is also about a healthy lifestyle, which includes regular sleep, healthy eating and avoidance of alcohol, drugs and risky behavior. Be sure your health care provider knows what wellness means to you. Depression and bipolar disorder present many challenges. Sometimes it can be difficult to feel comfortable with a health care provider or bring up your needs. Write down your concerns and bring them with you to your appointments. Doctors like to know they have answered all of someone’s questions. Your list helps them do that. Bring a supportive friend if it helps. Know that your health care providers are there to help you. Seek a second opinion if you feel you need one. Know that you deserve the best possible care and the best possible chance at wellness and a full life.