Therapeutic Relationship Through the Lenses of the Real Relationship, Therapeutic Alliance and Attachment to the Therapist: In Search of a Synthesis

Abstract

Aim

There is an overlap in psychotherapy research and clinical applications between these three views of the therapeutic relationship: the real relationship, the therapeutic alliance and attachment theory.

Objective

This study aimed to provide a synthesis by exploring this overlap in the client's perspective on the therapeutic relationship.

Method

The sample included 373 adult clients of individual therapy. An exploratory principal components analysis was conducted.

Results

Parallel analysis revealed a five-component structure generating a final solution explaining 47% of the variance. These components seem to illustrate different clients' needs and views about the relationship and how the therapist might perceive the relationship and their interactions. It presents dimensions such as the need for security in the therapist, the need to be cared for by the therapist, the fear of being genuine to the therapist, working on the goals of therapy and the need for more contact and expanding the therapeutic relationship beyond the boundaries that can be relevant for assessment, clinical decision-making and responding to a client's core needs.

Conclusion

This theoretical perspective may be useful beyond a specific relational construct, stressing the transtheoretical potential of clients' core needs towards the relationship and better preparing therapists to be more responsive to them.