Perceptions of psychotherapy when therapists focus on the therapy relationship or other relationships

Talking about the present-moment quality of a therapy relationship-sometimes termed immediacy or working in the here and now-has been recommended as a technique to enhance the therapeutic alliance and treatment outcome. The aim of the present study was to compare perceptions of therapy when the discussion was of the client's relationship with the therapist or with someone else.

In the study, undergraduate participants were presented with an audio recording of a therapist and client discussing their relationship and another recording in which the discussion was of the client's relationship with someone else. For approximately half the participants, the relationships discussed were both positive; for the other participants, both relationships were problematic. After listening to each recording, participants rated the therapeutic bond and treatment credibility.

Results revealed that the effect of discussing the therapy relationship depended on the relationship valence: When the valence was positive, participants rated the therapeutic bond and treatment credibility higher for discussions of the therapy relationship; when the valence was negative, ratings were higher for discussions of an outside relationship.

These findings suggest that focusing the therapy discussion on the therapeutic relationship may be more helpful when the relationship is positive than when it is negative.