1/ Every day, I see therapy trainees trying to provide a substitute relationship for patients who have no meaningful relationships in their lives.

That is not psychotherapy. That is a perversion of therapy. It is demoralizing for therapists & offers no lasting help for patients.

2/ If something about the person has been getting in the way of forming & keeping relationships, meaningful psychotherapy focusses on understanding what's been getting in the way—and helping them to change so that more meaningful connections become possible.

3/ If this does not become a focus of therapy—then what does? What else could therapist & patient possibly accomplish that would make a more meaningful & lasting difference in the patient's life?

The purpose of psychotherapy is psychological change.