Imagine sitting face to face with your first client. What is the best thing to do or say? What if you open your mouth and say the wrong thing?

This is an appropriately daunting image because you want to do the best for your client and the stakes are high. Minimally, a therapist must aim to do no harm, but how is one to exert a positive influence? One common response among students is to seek technical guidance in the form of a treatment manual. There are published lists of empirically-supported treatments (e.g., Nathan & Gorman, 2002) that identify the relevant treatment manuals and it makes sense to find the manual that matches the client's problem and to begin therapy. Furthermore, this seems reasonable because the practice is scientific, in that you can base your clinical decisions on the empirical literature. Other students respond to the challenge of exerting a positive influence upon clients by seeking to focus on the therapeutic relationship. Once again, this is not an unscientific strategy since there is a substantial literature identifying aspects of the therapeutic process beneficial to outcomes (e.g., Beutler et al., 2004; Orlinsky et al., 2004). This approach has a long history with Frank (1973) suggesting that psychotherapy is an encounter between a demoralized client and a therapist aiming to energize the client.