This chapter addresses the therapeutic alliance as it is practiced in HR therapy. Although a therapeutic alliance is common to most if not all therapies, it is of particular importance when working with clients who have had trauma. Because there are potential difficulties and dangers when conducting therapy with this population, the therapeutic alliance is discussed in this text. This chapter is by no means comprehensive, but it does acknowledge and address some of the common issues. It is divided into three sections: (1) building and monitoring rapport, (2) the impact of breaking rules, policies and agreements, and (3) dealing with other challenges to the relationship such as resistance, transference and counter-transference, and vicarious traumatization.