In essays submitted as part of the application process for O&P master’s degree programs, most prospective students passionately describe their motivations for choosing the profession. They usually include descriptions of times they have had strong emotional responses when witnessing patients’ dramatic functional improvements. Experienced clinicians often describe similar situations when asked why they chose O&P as a career or why they continue to enjoy their jobs many years after making that decision. Prospective students and experienced clinicians alike recognize the impact of our services, and gain meaning and enjoyment from a personal connection with patients. Is it possible that, in addition to being a benefit of the work we do, a personal connection with patients can also have a positive effect on our patients’ functional status? This article describes the concept of a therapeutic alliance, makes comparisons between the alliance formed in psychotherapy and in O&P care, describes research studies related to how this alliance affects health outcomes, describes a common instrument used to assess the alliance, and highlights the importance of communication strategies in establishing and maintaining this alliance.