Update On Therapy Partners

On my website is the page entitled Therapy Partners . This update is meant to provide the most extensive and current evidence on the importance of therapist and patient's becoming therapy partners. For the third time, the American Psychological Association Division of Psychotherapy commissioned a task force to explore  the empirically supported impact of the psychotherapy relationship on treatment outcome. This third iteration was intended to update the task force's findings and to present the best available evidence. The evidence was first presented in a 2018 Special Issue of the Psychotherapy journal in the form of 16 articles. This same material was also more recently reviewed in an article in the Monitor on Psychology (Deangelis, 2019).

The editors, Lambert and Norcross (2018) of the Special Issue adopted Gelso and Carter's (1985, 1994) operational definition of the relationship: "The therapeutic relationship is the feelings and attitudes that the therapist and the client have toward one another, and the manner in which these are expressed" (p. 304). They explained that the emphasis on the therapeutic relationship did not mean to imply that therapeutic techniques do not matter. Indeed, they recognized that there is a complex interaction between the relationship and techniques. However, in this exploration of therapeutic variables, the relationship was the focus. This focus seemed very likely to be productive.

Indeed, this focus did prove to be productive in teasing out which elements of the patient-therapist relationship contribute most to the quality of the treatment. Among the contributors identified by Deangelis (2019) and Norcross and Lambert (2018) were the following that  I think are most important in my work:

1) Mutuality - The patient and therapist must see themselves as equal partners with different roles to play. The therapist is not the director and the patient is not a passive recipient.

2) Collaboration - The patient and therapist work together to to set goals and change them as the process of therapy evolves.

3) Responsiveness - The therapist sees the patient as a unique individual and responds in kind. Therapy is, therefore, is not formulaic.

4) Feedback - Feedback about how the therapy and the relationship are going is offered by both parties and used by them.

5) Repairing Ruptures - If the relationship runs into trouble, both parties need to acknowledge it and try to fix it.

6) Termination - Therapy should be ended after open discussion and mutual agreement. The discussion might best include closure about the progress made and perhaps also about what might have been left undone.

Such factors as those just listed above supported the overall conclusion that the patient-psychologist relationship matters a a great deal. Moreover, the quality of this relationship is at least as important, if not more important, to therapeutic success as the therapist's treatment methods. Norcross and Lambert (2018) concluded, "Both clinical experience and research findings underscore that the therapy relationship accounts for as much, and probably more, of the outcome variance as particular treatment methods" (p. 307). Deangelis (2019) agreed with them and said, "A good relationship, the research finds, is essential to helping  the client connect with, remain in,  and get the most from therapy" (p.38). In other words, regardless of the theory and associated techniques used in the treatment, the therapy partnership is a potent contributor to good therapy.


Deangelis, T. (2019). Better relationships with patients lead to better outcomes. Monitor on Psychology, 50(10), 38-43.

Norcross, J.C., & Lambert, M.J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-315. http://dx.doi.org/10.1037/pst0...

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