Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors

Abstract

Client engagement has been associated with positive psychotherapeutic outcomes, yet it is relatively undertheorized. The aims of this review were to establish how client engagement with psychotherapeutic interventions targeting psychological or behavioral change has been operationally defined and assessed, and the associated client characteristics, therapist characteristic, and treatment factors. Seventy-nine studies were selected for review, revealing inconsistent definitions and assessments of engagement and a broad array of client characteristics and treatment factors investigated. Attendance was frequently used as a proxy for engagement, but may not be reliable. Participation or involvement in conjunction with homework compliance which reflects clients' efforts within and between sessions may more reliably reflect engagement. The findings of associations between client characteristics and engagement variables were equivocal, although clients' capacities to address their problems tended to be positively associated with engagement. Nearly all therapist characteristics, particularly therapists' interpersonal skills, and most treatment factors, particularly strengths-based approaches and the therapeutic relationship, were positively associated with engagement. A theory of engagement is needed that characterizes the function and inter-relations of variables across different psychotherapeutic settings.

Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective

“…However the correlational design of these studies is unable to determine whether the core conditions have any causal relationship with treatment outcomes [30]. Even if the core conditions do not directly cause beneficial outcomes, our findings suggest therapist qualities may have an indirect influence on treatment outcomes, by increasing intervention engagement [31]. …”

Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

“…Bakker and Rickard (2017) detail how app engagement may be more useful than raw usage to consider for this relationship, as usage can be influenced by a high rate of general phone use, procrastination, boredom, emotion-focused coping, or anxiety. Measuring app engagement in terms of quality rather than quantity is similar to measuring client engagement or therapeutic relationship in psychotherapy, which is predictive of treatment outcomes (Holdsworth, Bowen, Brown, & Howat, 2014;Kazantzis, Cronin, Norton, Lai, & Hofmann, 2015). Measuring app engagement in terms of quality rather than quantity is similar to measuring client engagement or therapeutic relationship in psychotherapy, which is predictive of treatment outcomes (Holdsworth, Bowen, Brown, & Howat, 2014;Kazantzis, Cronin, Norton, Lai, & Hofmann, 2015).…”

Cuestionario de Estilo Personal del Terapeuta: análisis factorial confirmatorio de modelos rivales con psicoterapeutas argentinos

“…Entre ellas, la empatía (quizás la más importante), entrenamiento clínico, años de experiencia, respeto por el paciente, ciertas conductas no verbales, optimismo, sentido del humor, capacidad de auto cuestionarse, habilidades interpersonales y estilo terapéutico (Elliot et al, 2011;Heinonen et al, 2013;Holdsworth, Bowen, Brown, y Howat, 2014;Watson, Steckley, y McMullen, 2014).…”