The real relationship is the genuine person-to-person connection between the therapist and client, which is distinguished from the aspect of the therapeutic relationship that is colored by transference and countertransference. This chapter represents the first (to our knowledge) scholarly consideration of the real relationship in the delivery of cognitive behavioral therapy (CBT). We describe ways in which the real relationship can facilitate engagement in CBT, as well as its role in the effective delivery of CBT strategies such as cognitive restructuring, core belief modification, behavioral activation, and exposure. We propose specific directions for future research on the interface of the real relationship and the effective delivery of CBT.