Relationship vs. Techniques?

This article is about the 70% to 30% rule of what creates success in Bodywork Sessions: 

    • 30 % of the outcome of our sessions are the result of the techniques we are using 
    • And 70 % are the outcome come from the setting and the relationship between client and therapist – the so called therapeutic alliance. 


This is true independently of the type of treatment we are offering: 

  • Wellness Treatments, centered around relaxation and wellbeing
  • Clinical Treatments, centered around the reduction of symptoms, pain and problems
  • Holistic Treatments, centered around ‘Being Fully Human’ – custom tailored to the needs of each client, ranging from causal recovery to personal growth. 

Which factors influence the success of our Sessions?

The factors that contribute the most to the outcome of our session – creating up to 70 % of the success – are commonly called the “soft-skills”, like 

  • establishing trust in the setting and competency of the therapist 
  • nourishing a strong therapeutic relationship (alliance) 
  • supporting the feeling of safety in the client that they are seen and taken serious by the therapist

Yes, our techniques, tools and treatment are also important, since 30% of the session outcome are determined by the impact of our technique

  • the structural work on the body
  • the precision of our work – whether hands-on or in the questions we ask
  • the clarity of our clinical reasoning and the fit of treatment approaches we are choosing

But if we forget the important 70 percent of a treatment, we do not establish a strong relationship and then try to make up for that with our “very well done Bodywork”… then we are working a self created Sisyphean Task. 

The Research behind this Principle:

With this 70-30-rule we are trying to lend simple words to a phenomenon that has been studied in Physiotherapy, Osteopathy and Psychotherapy for many decades. 

Dozens of studies and meta-studies undertaken by researchers who were determined to prove once and for all that “my approach is the best” came to the conclusion that statistically speaking there is no measurable difference between Approach A or B, Technique X or Y. 

But what these studies showed over and over again, was that the difference in communication and the quality of the relationship during the studies (how comfortable the participants felt, how the researcher communicated the exercises…) had an impact that was 3-12 (!!!) times as large as the different techniques that were used. 

The 70-30 Rule emphasizes this difference and asks us to learn how we can make sure that the 70 % of the treatment derived from the relationship are working for us.  

A practical example:

Imagine you are having a massage. 
The woman at the desk shows you the room for your treatment and tells you that you can already take your clothes of while you are waiting. 
Now you are laying there, in a white room, naked, with your face in the tight opening of the leather massage table.
It is a bit chilly and after 5 minutes an unknown person enters the room. She starts touching you on your shoulder, massaging with the words “You can relax now”. 

This could be a scene from an Alien abduction – and is unfortunately also happening often in Physiotherapy and Massage Salons. 

Without bad intentions but as the logical conclusion of the mechanistic treatment approaches that are often taught in these fields. When we follow them, we are often not in real connection with the people we are treating, but following the rules and techniques of the approach we have learned. 

Additionally there is a lack of Resources and Tools for bodyworkers to create this interpersonal space that is so important to nourish trust, safety and sustainable change. 

We can be perfect with our massage-tools and try our hardest – if the setting we created and the relationship with the client are not good it is almost impossible to sustainably support healing and growth in clients.  

If 70 % of the setting do not fit we cannot make up for that in the remaining 30 %. 

  • For Wellness-Treatment: It is very difficult to let go of my tension if I do not feel held and safe – no matter the techniques the therapist uses. 
  • For Clinical Treatments: It is very improbably that clients will make a new experience with us and then integrate it in their own time, if we do not have a clear agreement with them, based on intrinsic motivation of the Client and openness towards our approach.
  • For Holistic Treatments – especially Trauma- and Somatic Therapy: we need the relationship even more – but more about this in our next Newsletter. 

The Good News: We can learn this

  • We can build these skills. We can learn how to create a clear setting WITH our clients so that the 70 % of the treatment are working FOR us – the client and the therapist: 

This includes abilities, like:

  • Preparing the Space – Paying attention to temperature, decoration, setup of the space 
  • Leading a professional Consultation – Establishing contact and clarifying wishes, based on body language, clear questions and simple verbal tools 
  • Custom tailoring the treatment based on the wishes, resources and problems of the client – how we connect with them, what qualities of touch and what techniques we use
  • And deepening the relationship during the treatment – hands-on and based on simple communication tools 

We will deepen these topics in the next few weeks, offering simple tools you can use right away. Here are some you can already use: