Saturday, December 31, 2011 - Does Genuineness Influence Therapeutic Outcome More than Working Alliance?

One of the things that has proven true over the years is that the relationship between a client and therapist (the working alliance) is more important than the therapeutic approach being employed. This new study looks at the element of genuineness (the "real" relationship) between the client and therapist as the crucial element in the working alliance.

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Does Genuineness Influence Therapeutic Outcome More than Working Alliance?

December 27th, 2011

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.
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