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Does Genuineness Influence Therapeutic Outcome More than Working Alliance?

The working alliance, a dimension of the therapeutic relationship between a therapist and client, has been shown to be an important predictor of treatment outcome. But the real relationship, the personal relationship between the client and therapist consisting of genuineness (G) and realism, may provide a more accurate forecast of treatment outcome. “Genuineness may be seen as the participants’ degree of authenticity with each other, whereas the realism element implies experiences and perceptions that ‘befit the other,’ rather than inaccurate or distorted perceptions that may be because of earlier unresolved conflicts,” said Gianluca Lo Coco of the Department of Psychology at the University of Palermo in Italy. “The real relationship component of the overall therapeutic relationship is thought to exist from the first moment of contact between therapist and client, and it has been theorized to be a part of all relationships in general, and therapeutic relationships in particular.”

To determine which dimension of the therapeutic relationship, real relationship, or working alliance predicted treatment outcome more accurately, Lo Coco evaluated 50 Italian clients before and after brief therapy. “A central finding was that, from the clients’ perspective, both the G element of the real relationship and the Bond scale of the working alliance were found to relate significantly to treatment outcome when these variables were measured early in treatment,” said Lo Coco. “However, neither the therapist-rated real relationship nor the therapist-rated working alliance, when measured early in treatment, was significantly associated with outcome.”

Lo Coco believes that these results demonstrate the importance of the real relationship. “When viewed in conjunction with already existing research on the real relationship, it seems clear that the psychotherapist ought to pay close attention to the personal or real relationship that is developing between him or her and the patient.” Lo Coco added, “Perhaps the major ways include for the therapists to be genuinely themselves within the confines of their theoretical orientations and to seek to grasp the reality of their patients in ways that are not contaminated by countertransference conflicts.”

Lo Coco, Gianluca, Salvatore Gullo, Claudia Prestano, and Charles J. Gelso. “Relation of the Real Relationship and the Working Alliance to the Outcome of Brief Psychotherapy.”Psychotherapy 48.4 (2011): 359-67. Print.

© Copyright 2011 by By John Smith. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Gregg

    December 28th, 2011 at 5:37 AM

    Some people are going to naturally shy away from a close and personal relationship with his therapist. This is not going to feel right to them, and if they feel like this is developing then this may cause them to be reluctant in sharing their feelings with him.

  • shayne d

    December 29th, 2011 at 5:45 AM

    you have to be able to work with someone if they are going to influence your life for the better

  • Greg.B

    December 30th, 2011 at 8:49 AM

    If there’s no genuineness between a therapist and a client then their working alliance will suffer too.Because an alliance is formed between two allies and to be an ally there needs to be genuineness.

    Genuineness is like a plan based on which the foundation(alliance) is laid and the construction (treatment) occurs and the end result is a beautiful monument (recovery).

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