As a counsellor, I have consistently grappled with what facilitates change in people. Despite our extensive training in models, interventions, and theory, I find the therapeutic relationship remains central to change. In my alcohol and other drugs (AOD) practice, even as I integrate Acceptance and Commitment Therapy (ACT) and process-based approaches and techniques, I keep returning to the importance of the therapeutic relationship as the foundation for transformation.

For many clients, the therapeutic relationship is not just background: it is often the main intervention. The complexity of addiction and comorbid challenges such as grief, trauma, shame and isolation frequently mask underlying relational pain. This reinforces my central argument: the relationship itself often drives significant changes. There is a paradox here, in that relationships can do both harm and heal, and counselling occupies a position directly placed within this tension.

Historically, the helping professions have significantly differed from their current forms. Earlier models regularly operated within paternalistic frameworks, with expertise primarily residing with the clinician. Over time, counselling has shifted towards working together, autonomy and person-centred practice. The work of Rogers (1957) marked a pivotal moment within this evolution. Rogers asserted that empathy, congruence and unconditional positive regard are not secondary aspects of therapy, though essential conditions for growth and change. His work challenged the notion that healing is exclusively the result of expertise, instead proposing that interpersonal connection itself has therapeutic value.

I often consider whether Rogers was engaged in more than the development of a therapeutic model. Perhaps he was facilitating a transition in counselling from an expert-driven to a more human-centred approach. This shift remains highly relevant today. Regardless of whether we employ ACT, CBT, narrative therapy, or trauma-informed approaches, it is evident that techniques seldom function independently of the therapeutic relationship. Techniques, evidence, and training are important, yet relationships frequently determine whether interventions are effective or even possible.

In my time managing an AOD rehabilitation facility and as a counsellor, I have observed a considerable distinction in how clients recall their counselling experiences. As clinicians, we often remember formulations, treatment plans, interventions, outcomes measures and conceptual concepts. In contrast, our clients tend to remember specific moments: feeling heard, not being judged, being believed, and having someone remain present when difficult emotions emerge. I think there is something very important in that.

Many clients who enter counselling have spent years adapting to difficult environments. Issues such as hypervigilance, avoidance, emotional suppression, dissociation, people-pleasing, aggression, withdrawal and substance use problems often develop for understandable reasons. These responses are often adaptive within the contexts from which they arise. When clients enter counselling, we ask them to trust us, which is a significant request.

Within ACT, I frequently discuss psychological flexibility and the importance of supporting individuals to remain present with difficult experiences, while reconnecting with their values and meaningful action. However, I have increasingly come to believe that such flexibility rarely develops in isolation. Often, individuals become willing to approach pain because another person remains present with them during the process.

This pattern is particularly evident in addiction work. Many people entering AOD services expect to be judged before they have even said a word. They anticipate criticism, assumptions, attempts to control their behaviour, or being seen only through the lens of their substance use rather than as a whole person. Some have spent years being stigmatised by health services, the justice system, their families, employers or, at times, even previous helping professionals. By the time they arrive in counselling, they are often not wondering, can this counsellor help me? They are wondering, Is this another person who is going to judge me?

Perhaps this is where the therapeutic relationship becomes so important. It does not promise rescue or quick solutions. It does not rely on advice or persuasion. Instead, it offers something many clients have experienced all too rarely: another human being who is willing to sit with them, listen without judgement and remain present, even when difficult emotions emerge.

I have often seen clients arrive for their first session guarded and cautious. Their answers are brief, eye contact is limited, and there is a sense that they are waiting to see whether counselling will be any different from what has come before. Then, several sessions later, something shifts. They begin talking about experiences they have never shared, not because I have discovered a new intervention, but because trust has slowly developed. Looking back, it is often the relationship—not a particular technique—that created the conditions for change.

At the same time, I think it is important not to romanticise the therapeutic relationship. Relationships are not automatically safe simply because they occur within a counselling room. The history of the helping professions includes examples of boundary violations, misuse of power, exploitation, coercive practices and ethical failures. Counselling is not immune from these realities. If anything, recognising the importance of the therapeutic relationship places an even greater ethical responsibility on the counsellor. Many clients have learnt, through painful experience, that trust can be costly. When they choose to trust us, they are taking a significant risk. That trust should never be assumed. It is something that must be earned through consistency, authenticity, humility, respect and ethical practice. Not rescue. Not fixing. Not advice giving. Simply someone willing to sit beside them without turning away. For most of my clients, this is unfamiliar; at the same time, it is important not to romanticise the therapeutic relationship. Relationships are not inherently safe simply because they occur within counselling settings. The history of the helping professions includes instances of boundary violations, misuse of power, exploitation, coercive practices, and ethical failures. Counselling is not exempt from these realities. In fact, the significance of the relationship amplifies our responsibility.

Therapeutic relationships contain inherent power differences. Clients often arrive in vulnerable states. They may disclose experiences they have never spoken aloud before. They may place enormous trust in us. That trust carries responsibility.

As counsellors, we must consistently reflect on rescue dynamics, dependency, countertransference, over-identification, self-disclosure, saviour narratives, emotional exhaustion, and the temptation to "perform empathy". The latter warrants particular attention. Contemporary counselling can create pressure to appear perpetually empathic, regulated, and available. However, authentic therapeutic presence is not a performance, and clients often can tell the difference.

The therapeutic relationship also includes relational challenges. Along with misunderstandings, disconnection happens, and expectations differ. Sometimes we miss something important. Increasingly, I have come to see these challenges, not necessarily as failure, but as part of the relationship itself. Perhaps the question is not whether relational challenges occur, but rather how they occur. Perhaps the question is whether repair occurs.

Another area on which I keep reflecting is the value of lived experience. Those who know my story are aware that I spent 32 years in the Army and have suffered my own challenges with mental health and a serious addiction. Over recent years, lived experience has gained increasing recognition across the fields of mental health, trauma, addiction and recovery. I believe that this change has strengthened our profession. When deliberately integrated, lived experiences can inspire hope, reduce shame, build connection and challenge customary authority dynamics. In my work, clients often share that they feel authentically understood or less alone, something that can be profoundly meaningful.

However, I also believe that lived experience requires reflection and prudence. Importantly, my own lived experience does not make me an expert in another person’s story. Mutual experience does not necessarily equal shared meaning. Two individuals may have experienced addiction, trauma, military service, grief, recovery, or loss, yet possess entirely different narratives. Risks arise when similarity leads to assumption, when the practitioner's story overshadows the client's, or when unresolved experiences influence the therapeutic space.

In my view, lived experience is most impactful when it has been thoroughly reflected upon, integrated, and utilised in the service of the client rather than the practitioner. The client must always remain central.

Telehealth has transformed counselling across Australia, improving access for rural and remote communities. I now work for Amity Community Services in Darwin, supporting people with behavioural concerns, including alcohol, other drugs, and gambling-related harm. After moving back to Queensland, I now see my clients via telehealth. Like many counsellors, I was initially sceptical about whether a genuine therapeutic relationship could develop through telehealth. I worried that something important would be lost without being in the same room. However, my experience has changed that view. I have seen clients open up about deeply personal experiences, sit with difficult emotions and describe feeling genuinely heard and understood, despite us never meeting face to face. This has led me to reflect on what really creates a therapeutic relationship. While being physically present certainly has value, I have come to believe that clients respond less to where we are sitting and more to how we show up. It is our consistency, authenticity, empathy and willingness to remain present that build trust, reminding me that the relationship itself is not confined to a counselling room.

Presence translates through digital mediums, empathy remains complex, and administrative duties shape our client engagement. As artificial intelligence also enters the field of therapy. I ask myself: How do we preserve humanity in procedural systems as well as ensure that the therapeutic relationship stays central as counselling evolves?

These questions may matter because the therapeutic relationship remains one of the few places where people are able to genuinely be themselves, without the need to perform, defend, justify or hide. This is crucial to its healing potential.

However, relationships alone are insufficient. They must be accompanied by ethics, reflection, boundaries, supervision, humility, and ongoing self-examination.

As counsellors, the therapeutic relationship is not just a tool; it is our most significant tool and our greatest responsibility, at the heart of all meaningful change.

As our profession continues evolving through technology, lived experience integration, neuroscience, changing service systems, and emerging therapeutic models, I find myself returning to the same question I started with: what helps people change?

I am not convinced people change because they were perfectly analysed. For me, people change because they experienced a relationship that made change feel possible.

Will Duncan has over 32 years of military service with the Royal Australian Navy and Australian Army. In addition to his professional experience, Will’s personal journey with mental health and addiction gives him a compassionate and practical understanding of the challenges individuals encounter during recovery and change.

He has several years of experience in the Alcohol and Other Drugs (AOD) sector, including managing a residential rehabilitation service and providing counselling to individuals facing substance use and complex life challenges. His approach combines practical experience with evidence-based therapeutic frameworks to support meaningful, lasting change.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103. https://doi.org/10.1037/h0045357