Each therapeutic relationship begins with an orientation phase, where clients seek help and test the parameters of the relationship. The orientation phase ends and transitions to the working phase when clients identify problems to work on. A long orientation phase can be frustrating to both the client and nurse, as work cannot begin until this phase is completed. This chapter summarizes a qualitative study that explored factors that influence the movement of the therapeutic relationship from the orientation phase to the working phase. Interviews with clients and nurses during the evolution of therapeutic and non-therapeutic relationships, as well as videotapes of nurse–client interactions, informed the study. Clients described their perspectives of supporting factors, such as the perceived attitude of the nurse, the nature of the planned therapeutic sessions, and events that happened between sessions, as well as hindering factors, such as the unavailability of the nurse or client, a sense of distance/inequity, differences in realities/values, and mutual withdrawal. Implications for nursing theory and practice are discussed.