From a Distance: Establishing, Developing, and Deepening the Therapeutic Alliance


  • C. Cutler Dozier Jr. University of St. Thomas
  • Kari L. Fletcher University of St. Thomas


therapeutic alliance, telehealth, computer mediated communication, COVID-19, psychotherapy


We describe challenges when developing a therapeutic alliance—the dynamic and collaborative relational bond developed between therapist and client in a virtual environment during COVID-19. We offer adaptive strategies that can be used when establishing, developing, and deepening the therapeutic alliance when working virtually. Using a case study, individual vignettes illustrate the importance of establishing, developing, and deepening a therapeutic alliance. We introduce reflection and consultation adaptive strategies that may be effective when working virtually with clients. We also offer additional recommendations for strengthening clinical experiences while working with clients in a virtual environment.

Author Biographies

C. Cutler Dozier Jr., University of St. Thomas

I am a second-year graduate student in the MSW Program at the University of St. Thomas currently interning at my clinical practicum as an outpatient psychotherapist.


Kari L. Fletcher, University of St. Thomas

I am an associate professor and coordinator of the Area of Emphasis in Military Practice in the School of Social Work. I teach graduate-level clinical practice courses and currently serve as the MSW program director. My scholarship agenda focuses primarily around working with military-connected populations, assessing and developing curriculum, and using technology within education.




How to Cite

Dozier Jr., C. C., & Fletcher, K. (2023). From a Distance: Establishing, Developing, and Deepening the Therapeutic Alliance. Reflections: Narratives of Professional Helping, 29(1), 111–120. Retrieved from