You make it sound like the therapist did her a favor by changing her normal behavior in response to Sarah's needs. That's her freaking job. If she can't muster up any warmth, what is the point? Stuck with her... well gee she is getting paid to do that. It's not like some act of charity. Actions, words, empathic face… it all matters. The client is paying to be treated well, and in a way that serves them not the therapist.

Maybe the central issue here is that people need authentic relationships in order to not feel so alone and to feel valued. Therapy promises this and plays around with it, but simply cannot deliver for the most part, and instead gives people a contrived, half-assed approximation that clearly leaves some people in terrible distress. Is that so bloody hard to grasp?