The FIRA Assessment
The Fuente Interpersonal Relationship Assessment is a novel clinical tool for characterizing the emotional atmosphere of the therapy relationship — developed for clinical reflection, supervision, and research.
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Overview ·
Background ·
How It Works ·
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When to Use ·
Research ·
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What Is the FIRA?
Most existing instruments for assessing the therapy relationship share a common premise: they ask whether the relationship is conducive to therapeutic outcome, and produce a quantitative measure of how helpful it might be to the patient. While this approach has its place, it leaves many qualitative nuances unattended.
The FIRA takes a different route. Rather than benchmarking the therapy relationship against an outcome measure, it uses archetypal situations that may manifest in the consulting room and inquires about both the patient's and the therapist's sense of the atmosphere between them. From a selection of 24 archetypal descriptors, both sides can characterize the mood in the room.
In doing so, the FIRA enables clinicians to do three things:
Support therapist self-reflection. Finding the right words to describe one's experience of the therapeutic relationship is not universally practiced. Psychoanalytically oriented practitioners refer to transference and countertransference reactions, but even this group will rarely emphasize the atmosphere between themselves and the patient — the qualitative aspects of the relationship per se.
Gauge shared experience. The FIRA helps the clinician assess the extent to which the patient shares their experience of the therapeutic rapport. The expectation is not that both parties will produce identical results when treatment is progressing well. Rather, discrepancies indicated in the FIRA can help deepen mutual understanding and reveal underlying emotional dynamics that have not yet been addressed on a conscious level.
Surface difficult relational experiences. The patient — or the therapist — may have found specific situations in the clinical setting uncomfortable or unsettling: reminders of traumatic events, hurtful relational patterns, or difficult feelings such as guilt, regret, and shame. The FIRA can bring these challenges to light where they might otherwise have been missed.
Rather than seeing a relationship as something two people did to one another, I began to see a relationship as a field that both people engaged and which moved and molded their processes, both individually and together. Nathan Schwartz-Salant
The Therapy Relationship as a "Third Area"
The FIRA's design is grounded in a particular understanding of the therapy relationship: that it constitutes something more than the sum of its two participants. Drawing on the work of Jungian analyst Nathan Schwartz-Salant, the FIRA treats the relationship between therapist and patient as an "interactive field" — a shared, liminal space with unique characteristics in which transformational processes can unfold.
This notion of the relationship as a "third entity" — distinct from either participant taken individually — finds a striking parallel in the concept of the astrological composite, as developed by psychoanalyst and astrologer Liz Greene. Her characterization of the composite captures the archetypal qualities of the space between two people and treats the relationship itself as an independent entity with its own character. Both Schwartz-Salant and Greene regard this "third area" as the domain in which personal transformation can take place — for both parties involved.
These theoretical perspectives form the foundation of the study underlying the FIRA. By applying archetypal principles drawn from this framework, the FIRA makes it possible to characterize the specific atmosphere of a therapy relationship in a nuanced, qualitative manner — without reducing it to a single score or an outcome prediction.
How the FIRA Works
The FIRA presents 12 archetypal clinical situations. For each one, patient and therapist independently identify the response that best captures the atmosphere they associate with that kind of moment in the consulting room.
The 12 Situations
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1
Lively Exchange
When therapist and patient engage in animated back-and-forth
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2
Important Values
When discussing what matters most to the patient
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3
Playful Banter
Moments of humor and lighthearted exchange
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4
Family
Conversations about the patient's family of origin or current family
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5
Daily Life
Hobbies, children, and the texture of everyday experience
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6
Work & Career
Talk about the patient's professional life
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7
Important Relationships
Focus on the patient's significant personal relationships
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8
Intimacy & Sexuality
When these topics arise in the session
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9
New Ideas
Exploring new perspectives or ways of thinking together
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10
Life Goals
What the patient wants to achieve in life
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11
Ideals & Aspirations
The values and standards the patient holds themselves to
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12
Religion & Spirituality
When these dimensions of experience enter the conversation
The 24 Response Options
For each situation, 24 response options are available, organized in two columns. The left column reflects a more positive experience of the atmosphere; the right reflects a more challenging one. Neither is preferable from a clinical standpoint: responses from the challenging side can be particularly informative, pointing to areas that merit closer attention in the therapeutic work.
The full set of 24 options is included in the downloadable questionnaire.
Scoring and the Distribution Matrix
The 24 options are organized according to four archetypal temperament categories — choleric, melancholic, sanguine, and phlegmatic — with three positive and three challenging expressions per category. Once completed, the responses are tallied and mapped into a distribution matrix, giving the clinician an overview of the predominant archetypal qualities in the relationship. This is not a diagnostic score: it is a qualitative profile that becomes especially meaningful when the patient's results are placed side by side with the therapist's. All scoring is done by the clinician — for both their own questionnaire and the patient's.
FIRA-P, FIRA-T, and FIRA-C
The FIRA is available in three parallel versions, each adapted to a specific perspective and clinical context.
Patient Version
Asks the patient to describe how they experience the relationship with their clinician. All 12 situations are formulated from the patient's vantage point.
Therapist Version
Asks the therapist to capture their own experience of the relationship with the patient. Structurally identical to FIRA-P; wording reflects the clinician's perspective throughout.
Couples Version
Adapted for use with couples. Supports partners in understanding each other's experience of their shared relationship — the emotional atmosphere between them, their differing approaches to life, and relational patterns that may otherwise go unspoken.
The clinical value of the FIRA emerges most fully when patient and therapist versions are used in combination. Comparing the two sets of responses immediately reveals the degree to which the two experiences of the shared relationship overlap or diverge. Such discrepancies are to be expected and do not indicate a problematic rapport — on the contrary, they can be highly instructive, pointing to areas that merit closer exploration in the work.
In cases where the FIRA results suggest that a patient experienced certain situations in a distressing way — perhaps evoking memories of past trauma or unmet emotional needs — a carefully timed discussion of the results can help bring those areas to the surface. The therapist's own FIRA profile can be equally revealing: it supports the effort to identify personal blind spots and areas of countertransference that might otherwise remain below the surface of conscious awareness.
When to Use the FIRA
The FIRA is best suited for ongoing therapies in which a solid rapport has already been established. A minimum number of sessions is required for both patient and therapist to have developed a realistic, experience-based sense of each other and of the relationship between them. While not all 12 situations need to have occurred before the questionnaire is completed, both parties should be in a position to imaginatively place themselves in the scenarios described.
The FIRA is well suited for patients who are in touch with their emotional experience, willing to reflect on the therapy relationship in some depth, and engaged in a treatment of sufficient duration. It is not appropriate for short-term or highly structured therapeutic formats, nor for patients who are not yet in a position to register, remember, and reflect on their emotional states in the clinical setting.
Repeated use of the FIRA over the course of a longer treatment can be particularly valuable: it mirrors changes in the relationship that have taken place and underlines the therapeutic work that has been achieved.
The Research Behind the FIRA
The FIRA was introduced in Thomas de la Fuente's Magister's thesis, completed in August 2025 at Sigmund Freud Privatuniversität Wien in Vienna, Austria. The study reviews nine established instruments for assessing the therapy relationship — among them the Helping Alliance Questionnaire (HAQ), the Working Alliance Inventory (WAI), the Agnew Relationship Measure (ARM), and the Scale to Assess the Therapeutic Relationship (STAR) — and demonstrates the limitations of their predominantly quantitative orientation.
Drawing on the theoretical work of Nathan Schwartz-Salant and the concept of the astrological composite as developed by Liz Greene, the thesis then introduces the FIRA as a novel qualitative approach to characterizing the therapy relationship. Any use of the FIRA in clinical practice or academic research is warmly welcomed.
Questionnaires
All versions of the FIRA questionnaire are available for free. Current version is v. 0.6.
How to Use the FIRA
The FIRA is designed to be straightforward to administer. The following four steps outline a typical deployment in an ongoing therapy.
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1
Complete independently
Patient and therapist each fill in their respective questionnaire separately and without prior discussion — FIRA-P for the patient, FIRA-T for the therapist. Both cover the same 12 archetypal situations, each from their own vantage point. The patient may complete the questionnaire in the waiting room or at home between sessions.
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2
Score and map
The clinician scores both questionnaires, tallying responses by the four temperament categories — choleric, melancholic, sanguine, and phlegmatic — and transferring the totals into the distribution matrix on the final page. No specialist software is required; the scoring sheet is included in the questionnaire itself.
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3
Compare the profiles
Patient's and therapist's results are placed side by side. Areas of convergence and divergence become visible immediately — a first orientation for where the two experiences of the relationship align and where they differ. Items with notably contrasting responses are worth singling out for closer attention.
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4
Explore in the session
When the moment feels right, the clinician introduces the findings into the therapeutic conversation. Discrepancies can become an entry point for exploring what has gone unspoken; shared responses offer confirmation and grounding. The FIRA does not prescribe what to do with its results — it opens terrain that might not otherwise have been found.