Relational Therapy

What is relational therapy?

Relational therapy puts the way you relate to others at the centre of the work. It looks at how past relationships shape the ones you have now.

Much of this happens between you and your therapist. What goes on between you, here and now, can show how you relate to other people.

You talk about your life, as in any therapy. You also talk about how it feels to be in the room together.

It is not the same as relationship therapy. That works with a couple or a family together. If you and a partner want help together, our couples therapy page is the place to start.

Sources: UKCP: approaches, BACP: types of therapy

Where it comes from

One root is in psychoanalysis. In 1983, Jay Greenberg and Stephen Mitchell set Freud's model against one in which relationships come first. Mitchell drew these ideas together in a 1988 book.

Today the word is used across many kinds of therapy. One UK network of relational therapists has members from many schools. They include humanistic, Jungian and gestalt therapists.

From person-centred therapy, Dave Mearns and Mick Cooper wrote about relational depth in 2005. They describe it as deep contact between two people. Each person is fully real with the other.

Sources: Greenberg & Mitchell 1983, Mitchell 1988, Loewenthal 2014, Relational School: about, Mearns & Cooper 2005

How it works

Your therapist pays close attention to what happens between you, as it happens. Talking about your bond in the moment is called immediacy.

For example, your therapist might ask whether you feel angry with them right now. They may also share, with care, something of what they feel.

Sometimes the bond itself runs into trouble. Researchers call this a rupture: a disagreement about goals or tasks, or a strain in your bond. UK counselling guidance calls mending a rupture a vital part of therapy.

If something your therapist says lands badly, you can tell them. Talking it through together is part of the work.

Sources: BACP: therapy relationships, Eubanks et al. 2018, Relational School: about, UKCP: approaches

What sessions look like

The UK Council for Psychotherapy says sessions typically last 50 minutes. Most often, people see their therapist once a week, at the same time.

Therapy can be short or long term. Some continues for two years or more. Many therapists work online or by phone.

Early sessions are a chance to see how it feels to work together. That feeling is something you can talk about too.

Source: UKCP: FAQs

How it differs from psychodynamic therapy

Both approaches look at how past relationships shape the present. The difference is in how the therapist takes part.

In psychodynamic therapy, your therapist tries to keep their own personality out of the picture. You can then project feelings about important people in your life onto them.

The psychoanalyst Lewis Aron called the relational view a two-person psychology. In the older view, he wrote, transference happened inside the patient's mind, not between two people.

Some relational psychoanalysts see open talk about the bond as a way to sort out ruptures.

Sources: UKCP: approaches, Aron 1990, BACP: therapy relationships

Who it may suit

Relational therapy may suit you if you:

• Notice the same things happening in your relationships
• Find it hard to trust people, or to let them close
• Have tried therapy before and felt kept at a distance
• Want a therapist who talks openly about what happens between you
• Would rather explore than follow a set programme

It may suit you less if you want a structured course with practical tasks. By contrast, cognitive behavioural therapy focuses on current problems and practical solutions.

Source: BACP: types of therapy

Finding a relational therapist

Relational therapists train in many schools. Ask any therapist what they trained in, and how they work with the relationship.

Anyone in the UK can call themselves a psychotherapist or a counsellor. The NHS says to check that a private therapist is on a register accredited by the Professional Standards Authority.

UKCP and BACP both keep accredited registers.

Sources: Relational School: about, Loewenthal 2014, Lally & Naulls 2025, NHS: talking therapies, PSA: UKCP, PSA: BACP

The evidence

A 2018 review pooled 295 studies of the working relationship between clients and therapists. A stronger working bond went with better results, in many kinds of therapy.

Another 2018 review looked at ruptures. Across 11 studies, mending a rupture went with better results for clients. Training therapists in rupture repair showed no clear link to results.

Neither review tested relational therapy itself. They looked at the working bond in many kinds of therapy.

A short form, brief relational therapy, has been tested in trials. In one, for adults with personality disorders, it did as well as two other short therapies. Fewer people dropped out of it.

A small pilot study tried it with people whose first therapy was not going well. Its authors said the findings were early. We found no trial of open-ended relational therapy.

NICE does not mention relational therapy in its guidance on depression or generalised anxiety. NHS Talking Therapies does not list it.

NICE does ask professionals to help build a trusting relationship with people who have depression. It also lists the option to change professional if the relationship is not working.

If you are weighing up a few options, our guide to the different approaches sets them side by side.

Sources: Flückiger et al. 2018, Eubanks et al. 2018, Muran et al. 2005, Safran et al. 2005, NICE NG222, NICE CG113, NHS England: talking therapies manual