The quality of the counseling relationship has consistently been found to have the most significant impact on successful client outcome. Yet the definition and critical components of a quality counseling relationship remain in question. This article is a systematic review of studies of the counseling relationship intended to identify the present empirical understanding of this essential element of counseling. Using the multidimensional model proposed by Gelso & Carter, empirical support for the "real, " "unreal, " and "working alliance" elements of the relationship are summarized. Studies investigating the interactional nature of the counseling relationship are also reported. In addition, implications of a potential "paradigm" shift in thinking of the counseling relationship are discussed in regard to the development of theoretical models and future research agendas. In particular, the authors outline how the adoption of a social constructivist perspective would change the focus of the theoretical models and systematic research.
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