Being real in therapy

Therapeutic realness occurs when therapists express their feelings, thoughts, and desires directly to their clients, even when doing so comes with risk. Previous nonclinical research indicates that realness is a core feature of the more general concept of authenticity/genuineness/congruence. In this article, we examined therapeutic realness in a sample of 691 therapist participants who reported on their typical experiences in therapy. Therapeutic realness was correlated with age and clinical experience and was higher in the treatment of individuals as opposed to couples, families, or groups, and in the use of process-oriented as opposed to cognitive–behavioral therapy techniques. Therapeutic realness was associated with the real relationship, therapy presence, and working alliance. These results suggest that therapeutic realness might play an important role in psychotherapy and point to important directions for future research.