Client attendance measures in counselling psychology trainees

Abstract

Counselling supervisors and educators have yet to reach a consensus about standard measures for evaluating the performance of graduate student therapists. Compared to self‐reports and rater judgements, client attendance records provide low‐inference behavioural data partially reflective of clients’ engagement with therapists. This naturalistic study evaluates client attendance data using archival records of 92 doctoral students in beginning and advanced counselling practica who produced data for 771 clients, 3,949 scheduled sessions and 3,186 attended sessions. Providing evidence of the sample representativeness for clinicians, results indicated that the mean number of sessions attended per client for student therapists (5.65) was very similar to that reported in the literature for outpatient therapists (<6). As expected because of structural differences in client assignment, beginning and advanced students evidenced statistically significant differences on attendance variables such as number of clients and scheduled sessions. In contrast, attendance ratios were equivalent across counsellor experience, suggesting that these individual difference variables could be useful for evaluation of therapist competencies related to client engagement.

Effectiveness of videoconferencing psychotherapy delivered by novice clinicians in a training clinic.

“…For the same months in 2019, when care was delivered in-person only, attendance across psychotherapy appointments was 80.4%. Notably, this rate of attendance is lower than video- and audio-based telehealth appointments but was similar to or slightly higher than appointment attendance cited for training clinics elsewhere (Meier, 2021). Further, the attrition rate of 5% for the current data is better than other literature evaluating training clinics, such as one clinic with a 7% dropout rate over an 8 year period (Öst et al, 2012).…”

“…Prepandemic literature has demonstrated a number of factors that can impact client attendance to psychotherapy appointments, and thus impact treatment outcome. Meier (2021) found that attendance across scheduled appointments in a training clinic was approximately 80%, although differences in attendance were noted based on clinician training level. Of note, a typical treatment episode was relatively short, approximately five sessions, and clinics providing longer-term care may find different trends.…”

Ceiling effects indicate a possible threshold structure for working alliance.

“…The co-occurrence of these important therapeutic events and processes suggests the existence of an early therapeutic environment . Across treatment type and problem areas, clients attend an average of approximately five sessions (Meier, 2021); many clients drop out of therapy early, at about the same time the alliance forms or fails to form (Sharf et al, 2010; Tryon & Kane, 1993). Similarly, measurements of client distress indicate that distress decreases substantially in early sessions (Meier et al, 2015), although other research finds that clients who remain in therapy longer begin with more distress than those who drop out (Owen et al, 2016).…”

Exploring Art Therapy in Helping Profession

“…It is also evident that specialised training is necessary to improve the cultural competency of helping professionals, as highlighted by Costa & Dewaele (2019), who call attention to the lack of training that therapists and counsellors receive in effectively treating clients. This is echoe by (Meier, 2021) who stated that helping professionals from all theoretical backgrounds should possess the fundamental ability of involving clients and promoting attendance, demonstrating the necessity of client engagement strategies training for the establishment of successful therapeutic relationships. As an addition, in order to help people achieve optimal well-being in terms of physical, mental, social, emotional, and intellectual aspects, helping professions working in this field must change laws and regulations, vocational training, and practices (Mollaoğlu et al, 2022).…”