Secularising the therapeutic relationship in cognitive behavioural therapy
Giovanni Ruggiero, Gabriele Caselli, Sandra Sassaroli
This paper critically reviews scientific literature regarding the concepts of «therapeutic relationship»,
«therapeutic alliance» and «shared case formulation», linking the first to the relational developments
of the psychodynamic paradigm, the third to the functional and procedural developments of the
cognitive behavioural paradigm, and the second to a trans-theoretical operational concept. This critical
examination holds that only the third one is compatible with a consistent and promising development
of the cognitive-behavioural psychotherapeutic paradigm, while the first one leads to two incompatible
and unpromising outcomes: either an aspecific definition of psychotherapeutic relationship as a
decisive aspect present in every therapeutic change, which reduces psychotherapy to a placebo effect
and a sterile eclecticism, or to a specific definition which must accept being honestly presented in
terms of promise of theoretically founded increased efficacy without surreptitiously using any concepts
related to an aspecific definition of therapeutic relationship present in any therapy and capable of
making them all homogeneously effective and equivalent.
Keywords
Therapeutic relationship, Therapeutic alliance, Shared case formulation,
Psychotherapeutic change.
