Development of a psychotherapy process prototype for the Real Relationship.

OBJECTIVE

The Real Relationship (RR) describes the aspect of the psychotherapy relationship that is based on a genuine connection and a realistic view between patient and therapist. In the current study, we aimed to develop a Psychotherapy Process Q-set (PQS) prototype of the RR to facilitate post-hoc assessment of the RR in psychotherapy session recordings. We also aimed to measure the association between the RR-PQS and current PQS measures of theoretical treatment principles and the working alliance.

METHOD

We developed an RR-PQS prototype based on ratings of an ideal RR session by eight RR experts. We assessed the associations between the RR-PQS and existing cognitive behavioral and psychodynamic process prototypes, and seven PQS items known to predict the working alliance.

RESULTS

RR experts agreed on the ideal RR session ratings to a high degree (ICC = 0.89). The RR-PQS was moderately related to both cognitive behavioral ( = 0.66,  < 0.01), and psychodynamic prototypes ( = 0.56,  < 0.01). PQS items predictive of the working alliance were characteristic of the RR-PQS.

CONCLUSION

The RR-PQS prototype appears to behave in theoretically predicted ways and may be a valid measure of the RR.