This article meta-analytically reviews the research on the association between therapist positive regard (PR) and treatment outcome. The history of the construct of unconditional PR in client-centered theory and the efforts to clearly operationalize and measure this construct are reviewed. Several clinical examples are presented. The updated meta-analysis, which features expanded inclusion criteria and a larger number of studies (k ϭ 64) than previous analyses, yielded a small positive association between PR and treatment outcome, g ϭ .28. To control for the repeated use of data sets and study samples within the database, a multilevel meta-analysis was adopted that indicated a stronger relation between PR and clinical outcome (g ϭ 0.36). These analyses support PR's standing as a significant component of the therapy relationship that leads to improved clinical outcomes. The article concludes with limitations of the research, patient contributions, diversity considerations, and recommendations for using PR in practice. Clinical Impact StatementQuestion: This article addresses the following question: Aggregated over multiple studies over several decades, what association emerges between the therapist's provision of positive regard and therapeutic outcome? Findings: The findings of the meta-analysis conducted indicate that there is a small but positive relation between these variables and that no demographic or therapy-related variable significantly affects this association. Meaning: These findings suggest the importance of providing positive regard to one's patients; affirming patients may serve many valuable functions and, at a minimum, "sets the stage" for other mutative interventions. Next Steps: Research is needed to determine what specific forms of positive regard, including verbal and nonverbal expressions, have which kinds of effects for which kinds of patients at which points in therapy.

This chapter meta-analytically reviews the research on the association between therapist positive regard and treatment outcome. The history of the construct of unconditional positive regard in client-centered theory, as well as the efforts to operationalize and measure this construct, are reviewed. Several clinical examples are presented. The meta-analysis, which features 64 studies, yielded a small positive association between positive regard and treatment outcome, g = 0.28. To control for the repeated use of data sets and study samples within the database, a multilevel meta-analysis was adopted that indicated a stronger relation between positive regard and clinical outcome, g = 0.36. These analyses support positive regard’s standing as a significant component of the therapy relationship that leads to improved clinical outcomes. The chapter concludes with limitations of the research, patient contributions, diversity considerations, and practice recommendations.

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The primary aim of this study was to assess and compare the perceptions of clients (N = 540) in 4 different psychotherapies (psychodynamic, cognitive behavior therapy [CBT], existential/humanistic, and eclectic) regarding the extent and type of positive regard (PR) they have received in their therapy and the type of PR they regard as most affirming. PR was assessed via an online survey with the Level of Regard scale of the Barrett-Lennard Relationship Inventory (BLRI-PR), the Psychotherapist Expression of Positive Regard-Affirming scale (PEPR-A), and the Psychotherapist Expression of Positive Regard-Likely scale (PEPR-L). Regression analyses that included multiple patient, therapist, and therapy-related variables indicated that, when measured by the BLRI-PR, being in psychodynamic therapy versus CBT was associated with higher client ratings of their overall receipt of PR. However, when PR was assessed via PEPR-L and PEPR-A, clients in CBT, relative to those in psychodynamic and eclectic therapies, had higher scores on several indices of specific dimensions of PR, including one that assessed the degree of supportive/caring statements. In addition, results indicated that, in general, clients with higher scores on the Working Alliance Inventory, specifically the Task and Bond dimensions, perceived their therapists as providing higher degrees of PR. Discussion of these results focuses on the complexity involved in determining which forms of PR work best for which kinds of clients in which kinds of psychotherapy.

The history of authenticity in psychoanalysis is as old as analysis itself, but the analyst's authenticity in particular has become an increasingly important area of focus in recent decades. This article traces the development of conceptions of analytic authenticity and proposes that the analyst's spontaneous verbalization of his or her unformulated experience in session can be a potent force in the course of an analysis. We acknowledge that although analytic authenticity can be a challenging ideal for the analyst to strive for, it contains the power to transform the experience of the patient and the analyst, as well as the meaning of their work together. Whether it comes in the form of an insight-oriented comment or a simple acknowledgment of things as they seem to be, a therapist's willingness to speak aloud something that has lost its language is a powerful clinical phenomenon that transcends theoretical orientation and modality.

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there are moments, we imagine, in every therapist's work with virtually all their clients, in which they are moved to express their deep-seated care or support for that client. it may be a verbal or nonverbal expression, solicited or not, expanded upon or not, explicitly acknowledged by their client or not. "that was brave of you." "i do care about you." "you're handling those situations so much better now." "i'm proud of you." "you're a good person." or perhaps a smile, a laugh, or several (affirming) nods of the head. All are means of expressing positive regard for one's client. Carl rogers's remark to gloria in that famous filmed therapy session (shostrom, 1965)-"you look to me like a pretty good daughter"-may be criticized as excessively personal and even seductive (daniels, 2014), but there can be little doubt that rogers meant it as an affirmation of gloria's basic worth.it is possible to conceptualize the therapist's provision of positive regard in a rather straightforward manner, one consistent with rogers's original

The world needs a sense of worth, and it will achieve it only by its people feeling that they are worthwhile.