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

Abstract

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.

Client concealment and disclosure of secrets in outpatient psychotherapy

“…Testretest reliability has been demonstrated to be .88 for genuineness, .84 for realism, and .87 for the total score. The RRI is positively related to ratings of the working alliance (r = .79) and therapist ratings of the real relationship (r = .60) and negatively related to client avoidant attachment (r = -.40) (Kelley et al, 2010, Marmarosh, Gelso, Markin, Majors, Mallery, & Choi, 2009). This study used a 12-item version of the measure that was first used in Hill et al (2013), which consists of the 12 items believed to best encompass the theoretical components of the measure.…”

The Relationship: How It Works

“…Academic scholarship has shown support that receiving "doses" of connectedness based on experiencing the real relationship does improve psychological well-being. The therapist's perception of the real relationship has been shown to predict the reduction of patient posttreatment symptoms, indicating that the real relationship can provide positive outcomes within psychotherapy (Marmarosh et al 2009). In addition, patientrated genuineness of the real relationship and therapeutic bond were related to improved outcomes in a brief therapy intervention (Lo Coco et al 2011).…”

The unfolding of the real relationship and the outcome of brief psychotherapy.

“…Like the present study, Marmarosh et al (2009) andLo Coco et al (2011) assessed outcome at the end of treatment. Fuertes et al (2007) and Ain and Gelso (2011), however, studied what was termed progress because all of their participants were at different points in their treatment when the strength of the real relationship and "outcome" were assessed.…”