Therapeutic relationships in cognitive behavioral therapy: Theory and recent research

In the context of Cognitive Behavior Therapy (CBT) the work of Aaron T. Beck and colleagues placed an emphasis on the therapeutic relationship as “necessary” for change (Beck et al., 1979). The therapeutic relationship in CBT requires adaptation and variation for each client, where empathic understanding and effective interpersonal style are central in assessments of therapist skill in CBT (see Psychotherapy Research, 13(2)). There is also an expectation that the therapist will tailor relationship elements, such as the degree and type of empathy, for each therapeutic interaction. Such adjustments are based on the evolving cognitive case conceptualization and facilitate client engagement with techniques. Such adjustments can also directly facilitate change in cognitions, such as pervasive beliefs about others that have their origins in early life development and attachments. Therefore, every technique in CBT exists within the relationship context and can be facilitated or adversely affected by the therapist’s responses to the client. CBT Specific Relationship Elements