Re: Therapeutic Relationship and Content

• The Case of Gary III - Life in a malevolent world. by Jim Pretzer, 10/25/97
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    • Therapeutic Relationship and Content by Patricia A. Doherty, 12/16/97
      
      

The discussions regarding the importance of the therapeutic relationship almost make it sound like the content of the therapy session is of only minimal importance. Cognitive Therapy certainly emphasizes the importance of the therapeutic relationship as a precondition for effective therapy (see the discussion of the importance of the therapeutic alliance in the Cognitive Therapy Forum) but we would argue that a good therapeutic relationship is only the beginning of what therapy can offer.

There are some clients and some problems where a good therapeutic relationship is all that is needed for effective therapy. However, there are many clients and many problems where a therepeutic relationship alone will accomplish little.

For example, consider Gary's compulsive checking (checking faucets and light switches, checking for errors in his work). This may not have been the major focus of therapy, but it presented a significant problem for Gary at times. Our therapeutic relationship produced no improvement in this symptom until he and I addressed some dysfunctional cognitions which contributed to the problem and I coached him through applying "Exposure and Response-Prevention" (a standard cognitive-behavioral treatment for compulsions). There is good reason to believe that the therapeutic relationship alone would have been ineffective with this problem and to believe that the intervention technique would have been ineffective (due to non-compliance) if it had been applied without a good therapeutic relationship. Both relationship and content are important.

• Yes Relationship and Content are Important by Patricia A. Doherty, 1/5/98