This article provides meta-analyses of the relation between goal consensus and collaboration and individual psychotherapy outcome using studies published in English between 1978 and June 2017. Inclusion criteria involved (a) a measure of psychotherapy outcome, (b) a measure of goal consensus and/or collaboration, (c) a group design, (d) adult patients (aged 18 years or older), and (e) a reported effect or statistic that could be converted to an effect size. For the 54 studies (N = 7,278) of goal consensus and outcome, the result was r = .24 (95% confidence interval [CI] [.19, .28]) or d = .49, representing a medium effect. For the 53 studies (N = 5,286) of patient–therapist collaboration and outcome, the result was r = .29 (95% CI [.24, .34]) or d = .61, another medium effect. In all, 21 studies (N = 2,081) of therapist collaboration and outcome yielded an omnibus effect of .26 (95% CI [.18, .35]) or d = .54. Results suggest patient–therapist goal consensus and collaboration enhance psychotherapy outcome. The article concludes with research limitations, diversity considerations, and therapeutic practices. Limitations of the studies included a dearth of diverse samples, assessment of goal consensus and/or collaboration at a single time during treatment, failure to relate measures to outcome, and analyses that do not permit causal conclusions. Research suggests that therapists seek input from patients to form and effect treatment goals and plans, provide patients with regular feedback, and seek their involvement throughout therapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)