Building an effective therapeutic alliance: competence, trustworthiness, and caring.

Patient counseling and pharmaceutical care require much more than the provision of information. They require a commitment on the part of the pharmacist to the well-being of the patient. They also require the formation of a therapeutic alliance. Patients are not likely to tell pharmacists about problems they have in managing their drug therapy if they believe they will be judged or scolded for nonadherence. Patients must feel safe enough to present problems or ask questions. In responding to how patients manage their illnesses and interpret the pharmacists' instructions, pharmacists must treat each patient as unique. Pharmacists must develop a flexible system of response. What is comforting to one patient might be frightening to another. By developing a flexible system of response, pharmacists will be able to treat patients more effectively. There are no right or wrong answers, only those that work. A pharmacist's basic understanding and true desire to care for the patient will increase the number of successful responses.