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21 - Psychotherapy Relationships

Published online by Cambridge University Press:  10 January 2025

By
John C. Norcross  and
Christie P. Karpiak
Edited by
Stephen Hupp  and
David F. Tolin
Stephen Hupp
Affiliation:
Southern Illinois University, Edwardsville
David F. Tolin
Affiliation:
Institute of Living
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Summary

The therapeutic relationship constitutes the heart and soul of the enterprise. Second only to the patient’s contribution, the relationship is the most powerful predictor of, and contributor to, outcome. Its effectiveness cuts across theoretical orientations (transtheoretical) and largely across client problems (transdiagnostic). This chapter reviews evidence-based psychotherapy relationships, primarily with adults in individual treatment. We begin by defining terms and summarizing the meta-analytic evidence on effective relationship behaviors or components (what works). That is followed by a summary of ineffective or discredited relationship behaviors (what does not work). We advance therapeutic and training practices based on this research evidence. The chapter finishes with multiple caveats, concluding thoughts, and useful resources.

Keywords

psychotherapy relationshiptherapy relationshipevidence-based therapy relationshipsevidence-based practicetherapeutic alliancerupture repairclient feedbackemotional expressionscience-based therapy
Type
Chapter
Information
Science-Based Therapy
Raising the Bar for Empirically Supported Treatments
 , pp. 381 - 398
Publisher: Cambridge University Press
Print publication year: 2025

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References

Useful Resources

Norcross, J. C., & Lambert, M. J. (Eds.). (2018). Evidence-based psychotherapy relationship III (special issue). Psychotherapy, 55(4), 303–537.

Norcross, J. C., & Lambert, M. J. (Eds.). (2019). Psychotherapy relationships that work. Volume 1: Evidence-based therapist contributions (3rd ed.). Oxford University Press.

Norcross, J. C., & Wampold, B. E. (2019). (Eds.). Psychotherapy relationships that work. Volume 2: Evidence-based responsiveness (3rd ed.). Oxford University Press.

Norcross, J. C., & Karpiak, C. P. (2023). Relationship factors. In Miller, S. D., Chow, D., Malins, S., & Hubble, M. A. (Eds.), Field guide to better results: Individualizing a deliberate practice. American Psychological Association.

Society for the Advancement of Psychotherapy (APA Division of Psychotherapy). (2020). Teaching and learning evidence-based relationships: Interviews with the experts. societyforpsychotherapy.org/teaching-learning-evidence-based-relationships.

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