Active ingredients of the therapeutic relationship that promote client change: A research perspective

Abstract

A good relationship between client and therapist is, at the very least, considered to be the base from which all therapeutic work takes place. This circumscribed view of the therapeutic relationship is often taken by cognitive and behavioural therapists and is described as ``professional skills'' in the most widely used instrument for assessing therapist competence in cognitive and behavioural therapy (CBT) (Cognitive Therapy Scale; Young & Beck, 1988). For other psychotherapy schools, the therapeutic relationship is seen as one of the main therapeutic tools for achieving client change (Luborsky, 1994; Klerman, Weissman, Rounsville, & Chevron, 1984). Whatever therapeutic processes are involved in the client±therapist relationship, research has consistently shown a signi®cant association between this relationship and outcome. For example, Norcross (2002) summarised the literature on predictors of outcome in psychotherapy and stated that 15% of outcome is due to expectancy effects, 15% to techniques, 30% to ``common factors'' which primarily involve the therapeutic relationship, and 40% to extratherapeutic change.