This study investigates whether placebo effects can be separated into three components—assessment and observation, therapeutic ritual (placebo treatment), and a supportive patient-practitioner relationship—and then combined to produce incremental clinical improvement in patients with irritable bowel syndrome (IBS). The study is a six-week, single-blind, three-arm randomized controlled trial conducted at an academic medical center. Two hundred sixty-two adults diagnosed with IBS and scoring ≥150 on the symptom severity scale were randomized to one of three groups: a waiting list (observation), placebo acupuncture alone, or placebo acupuncture with an augmented patient-practitioner relationship. The primary outcomes were global improvement scale scores, adequate relief of symptoms, symptom severity, and quality of life. Results showed that the augmented group had significantly better outcomes than the limited and waiting list groups, with the augmented group reporting the highest proportion of moderate to substantial improvement. The study concludes that non-specific effects can produce statistically and clinically significant outcomes, and the patient-practitioner relationship is the most robust component.This study investigates whether placebo effects can be separated into three components—assessment and observation, therapeutic ritual (placebo treatment), and a supportive patient-practitioner relationship—and then combined to produce incremental clinical improvement in patients with irritable bowel syndrome (IBS). The study is a six-week, single-blind, three-arm randomized controlled trial conducted at an academic medical center. Two hundred sixty-two adults diagnosed with IBS and scoring ≥150 on the symptom severity scale were randomized to one of three groups: a waiting list (observation), placebo acupuncture alone, or placebo acupuncture with an augmented patient-practitioner relationship. The primary outcomes were global improvement scale scores, adequate relief of symptoms, symptom severity, and quality of life. Results showed that the augmented group had significantly better outcomes than the limited and waiting list groups, with the augmented group reporting the highest proportion of moderate to substantial improvement. The study concludes that non-specific effects can produce statistically and clinically significant outcomes, and the patient-practitioner relationship is the most robust component.