Congruence or genuineness is a relational quality that has been highly prized throughout the history of psychotherapy, but of diminished research interest in recent years. This chapter defines and provides examples of this attribute of the therapy relationship and present an original meta-analytic review of the empirical literature showing its relation to improvement. Moderators of the association between congruence and treatment outcome are examined, and limitations of the extant research are discussed as well. In closing, this chapter advances several therapist practices that are likely to foster congruence and thus improve psychotherapy outcomes.
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