The real relationship is a component of the therapeutic relationship. The therapeutic relationship consists of three elements: the therapeutic alliance or working alliance, a dynamic process of transference-countertransference, and a personal or real relationship. Although there has been a wide range of attention given to the therapeutic alliance and transference aspects at the core of the therapeutic process, less has been devoted to understanding the real/personal relationship. According to Charles J. Gelso of the Department of Psychology at the University of Maryland, “The working alliance may be seen as reflecting the work collaboration between therapist and client, whereas the real relationship is the personal, non-work element of all relationships.” The distinction between the two relationships prompted Geslo to explore how the real relationship affected treatment outcome in a sample of 42 clients undergoing brief therapy.
Geslo evaluated the real relationships between the clients and their therapists at the beginning of treatment, one session into treatment, and at the conclusion of the four sessions of therapy and found that the subjectivity of the relationship was directly related to treatment outcome. Specifically, Geslo found that clients who perceived their real relationships with their therapists as trusting, respectful, and strong from the beginning of treatment had better outcomes than those who perceived it as weak. Additionally, the average of the perceptions taken at three different times seemed to predict treatment outcome. However, Geslo also discovered that the therapists’ perceptions of the relationship did not impact outcome.
This finding was interesting because even though the client and therapist perceptions had independent effects on treatment outcome, for the participants with positive outcomes, both perceptions tended to converge toward treatment completion. Geslo realizes that his findings should be considered in light of the fact that the therapists were from university counseling centers only and that the outcomes in this study were based only on brief psychotherapy. Future work should look at how the real relationship affects treatment outcome in longer courses and with a more diverse participant sample in hopes of gaining insight into ways to strengthen the real relationship when it is weak.
Gelso, C. J., Kivlighan, D. M., Jr., Busa-Knepp, J., Spiegel, E. B., Ain, S., Hummel, A. M., et al. (2012). The unfolding of the real relationship and the outcome of brief psychotherapy. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0029838
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