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Concluding CommentsIn this article, we have presented a way tothink about the roles of technique and the rela-tionship in the therapeutic change process from adifferent perspective than is typically considered.Specifically, we have suggested that techniqueand the relationship serve to facilitate generalprinciples that are the keys to the change process,including the facilitation of expectations thattherapy will help, the establishment of an optimaltherapeutic alliance, offering feedback that canhelp increase awareness, the encouragement ofcorrective experiences, and an emphasis on con-tinued reality testing. As noted earlier, these ideashave been presented before (Goldfried, 1980),and have even been extended. For example, Beut-ler, Consoli, and Lane (2005) have attempted tospecify client variables that need to be consideredin any intervention, such as whether or not aclient will be receptive to a directive or nondi-rective approach to intervention. Further researchis needed to help us better understand the param-eters associated with the role of technique andrelationship in fostering the general change prin-ciples. For example, questions need to be ad-dressed about how different components of thetherapeutic alliance (e.g., client-therapist bond,agreement on goals, and agreement about meth-ods) are related to change, and how this may varyas a function of such variables as nature of theclinical problem, client characteristics, and typeof technique. However, these ideas have not yetbecome part of mainstream thinking, and withthis article, we hope to move the research agendafurther in that direction.Fortunately, there are others who share ourgoals. In a critique of the current randomizedclinicaltrialapproachtotherapyresearch,Westen,Morrison,andThompson-Brenner(2004) argued, among other things, that it is notpossible to delineate exactly what needs to bedone therapeutically when working with certainclinical problems (e.g., depression). To follow amanual that clearly specifies exactly what thetherapist needs to do provides constraints on clin-ical judgment—often to the detriment of thera-peutic success (Castonguay et al., 1996; Henry,Goldfried and Davila428
Strupp, Butler, Schacht, & Binder, 1993; Roth &Fonagy, 1996). At the other extreme, to provideno clinical guidelines leaves us where psycho-therapy research was a half century ago, whenstill in its infancy. Rather than studying compet-ing theory-based treatment interventions whosespecifications leave no room for clinical judg-ment, Westen and his colleagues recommend thatwe shift our research approach and study concep-tions and principles of change. Moreover, shiftingthe research focus in this way would also impact ontraining, and would open the door to more collab-oration and integration between relationship-basedand technique-based orientations.