Real Relationship In Psychotherapy Research Articles

Attachment Theory as a Guide to Understanding and Working With Transference and the Real Relationship in Psychotherapy

Recent decades have witnessed an extraordinary amount of conceptual and empirical work on attachment theory in psychology and psychotherapy. Attachment theory is discussed in the present article as a way of understanding and fostering therapeutic work with 2 other key relationship constructs that have been theorized to be elements of all psychotherapies: client transference and the real relationship existing between the therapist and patient. Fundamental features of attachment, transference, and the real relationship are summarized. Particular emphasis is given to the role of the therapist as a secure base and a safe haven within the real relationship, and to the patient's internal working model as it relates to transference. A case of long-term psychodynamic psychotherapy conducted by the first author is presented to illuminate the 3 main constructs. The case demonstrates both the usefulness of attachment theory and the fact that any single theory cannot explain all of the complex features of a given treatment.

Review of The real relationship in psychotherapy: The hidden foundation of change.

Review of The real relationship in psychotherapy: The hidden foundation of change.

The real relationship in psychotherapy: Relationships to adult attachments, working alliance, transference, and therapy outcome.

The purpose of this study was to understand how the real relationship (RR) relates to important process and outcome variables from both the clients' and therapists' perspectives. Using a sample of 31 therapist/client dyads at a university counseling center, the authors examined the RR at the 3rd session of therapy and at termination. The results revealed that client adult attachment avoidance was negatively correlated with client RR, while client adult attachment anxiety was uncorrelated. Therapists' ratings of negative transference were negatively correlated with therapist-rated RR and were uncorrelated with client-rated RR. Hierarchical linear modeling analyses were conducted to predict postintervention outcome from client and therapist perceptions of the RR. Therapists' ratings of the RR accounted for a significant amount of variance in client posttreatment symptoms while controlling pretreatment symptoms. Client-rated RR total scores and client and therapist 3rd-session alliance scores were not significant predictors of postsymptom ratings. Implications of the usefulness of measuring the RR in psychotherapy are discussed, as are recommendations for future study.

Correlates of the real relationship in psychotherapy: A study of dyads

This study examined several theoretical propositions regarding the role of the real relationship using a sample of 59 psychotherapy dyads. As hypothesized, positive associations were evident between therapist ratings of the real relationship and their ratings of the working alliance and client progress; negative associations were found between therapist ratings of the real relationship and attachment avoidance. For clients, significant and hypothesized associations were found between ratings of the real relationship and secure attachment to therapists as well as their perceptions of therapist empathy. Regression analyses showed that client ratings of the real relationship were significantly associated with their ratings of progress in treatment above and beyond their ratings of the working alliance, therapist empathy, and attachment.

Measuring the Real Relationship in Psychotherapy: Initial Validation of the Therapist Form.

The development and initial validation of a therapist-rated measure of the real relationship in psycho-therapy (the Real Relationship Inventory—Therapist Form [RRI–T]) is reported. Using a sample ( n 80) of practicing psychotherapists and on the basis of prior theory, the authors developed a 24-itemmeasure consisting of 2 subscales (Realism and Genuineness) and a total score. This 24-item version andother measures used for validation were completed by 79 additional practicing therapists and 51counseling graduate students ( n 130). The RRI–T was found to have high reliability and sound initialvalidity. As theorized, the RRI–T correlated significantly with measures of working alliance, sessionoutcome (depth and smoothness), client intellectual and emotional insight, and client negative transfer-ence. Discriminant validity was supported by a nonsignificant relation to social desirability.Keywords: real relationship, therapist measure, therapeutic relationship, validation