Bruce Wampold
Director of the Research Institute, Modum Bad Psychiatric Center, Vikersund, Norway & Emeritus Professor of Counseling Psychology, University of Wisconsin

The role of the therapeutic relationship in the placebo effect

Ultrasocial species have evolved to heal socially. For example, bees and ants have social healing processes analogous to endogenous healing mechanisms of single organisms. As social organisms, it is not surprising that human civilizations have been been characterized by socially mediated healing practices. Humans have evolved to be influenced by conspecifics, particularly those who are trusted and who are believed to have the expertise to be of assistance. Clearly, socially sanctioned healers have appeared in civilizations to provide health benefits. Therefore, it is not surprising that the therapeutic relationship is an important aspect of medical and psychosocial healing practices and that the relationship is intimately involved in the placebo response. Strictly speaking a placebo response can be elicited without a relationship, but as expected interactions with a healer are responsible for much of observed placebo effects. Evidence for the importance of the relationship from placebo studies, psychopharmacology, and psychotherapy is presented. Implications for clinical practice and research are discussed.


Bruce E. Wampold Ph.D., ABPP, is Director of the Research Institute at Modum Bad Psychiatric Center in Vikersund, Norway, Emeritus Professor of Counseling Psychology at the University of Wisconsin—Madison, and Chief Scientist, Theravue.com. He is a Fellow of the American Psychological Association (Divisions 12, 17, 29, 45), is Board Certified in Counseling Psychology by the American Board of Professional Psychology, and is the recipient of the 2007 Distinguished Professional Contributions to Applied Research Award from the American Psychological Association. Currently his work, summarized in The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (with Z. Imel, Routledge, 2015), involves understanding psychotherapy from empirical, historical, and anthropological perspectives.