What’s therapeutic about the therapeutic relationship? A hypothesis for practice informed by perceptual control theory
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Abstract Evidence clearly suggests that the therapeutic relationship is important to successful outcomes in psychotherapy. It is less clear as to why this might be the case. Throughout the literature, various factors such as warmth, empathy, compassion, unconditional positive regard, and openness are identified as key. The way in which factors such as warmth and empathy bring about an amelioration of psychological distress, however, is not entirely obvious. We suggest that one possible mechanism through which these factors become important is by helping to create an environment where clients can examine their problems freely. Furthermore, we propose that when the therapeutic relationship is therapeutic, clients feel comfortable to consider whatever comes into their mind; with any filtering or evaluating happening after the ideas have been expressed, and not before. Psychological processes identified as maintaining psychological distress (e.g. thought suppression, avoidance, rumination) block this capacity. Our suggestion is that as internal experiences are being examined, the client has an opportunity to become aware of facets of the problem that were previously unattended to; and to continue this process outside therapy. Through this awareness-raising process the client's problem can be reorganized via intrinsic learning processes to achieve a more contented state of mind.
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A therapeutic relationship is not necessary for effective psychological intervention.
“Therefore, e.g., Carey et al. (100), point out that while a therapeutic relationship might be a key component of effective psychological intervention (they go as far as to suggest that “it might be sufficient” for achieving the positive therapeutic effect; p. 48), it is not necessary.”
From Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence (2023) · cites this paper as [100]
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- Authors
- Carey, T. A., Kelly, R. E., Mansell, W., & Tai, S. J.
- Affiliations
- Flinders University (AU)
- University of Manchester (GB)
- Corresponding author
- Carey, Timothy A.
- Venue
- The Cognitive Behaviour Therapist
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-05-08
- Volume
- 5
- Issue
- 2-3
- Pages
- 47-59
- ISSN
- 1754-470X (ISSN-L)
- OpenAlex
- W2169631639
- Semantic Scholar
- 5e58e50099b476d37d1988c3431bb30dcee1eab2
- Cited by
- 37
- References
- 27
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 1 · 2014: 8 · 2013: 1
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Cognitive Behaviour Therapist (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- therapeutic relationship, perceptual control theory, psychotherapy mechanisms, empathy, warmth, unconditional positive regard, thought suppression, rumination, avoidance, awareness raising, psychological distress
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