Clients' Perceptions of the Therapeutic Process

Abstract

Recently researchers in the family therapy field have encouraged a focus on aspects of therapy common across all models that are important to therapeutic change. The purpose of this study was to build on the "common factors" literature by exploring clients' perspectives of what was useful to their therapeutic experience. Quantitative and qualitative measures were used to collect data from 41 clients who participated in therapy at a university-based family therapy clinic. Quantitative results indicated that therapeutic relationship, client motivation, extratherapeutic factors, and hope and expectancy accounted for 49% of the variance of clients' perception of change and 73% of the variance of clients' perceptions of therapy helpfulness. Qualitative results indicated the therapeutic relationship to be the most helpful aspect of clients' therapeutic experience.

Clients’ Relational Conceptions of Conjoint Couple and Family Therapy Quality: A Grounded Formal Theory

“…Clients’ pretherapy reflections can include a degree of hopefulness about their prospects for coming to therapy with convictions that their lives will be better by the end of treatment (Ward et al., 2007). They also can envision specific outcomes such as therapy helping them to create closer relationships or to making sense of things in their lives (Stanbridge, Burbach, Lucas, & Carter, 2003).…”

“…Once in therapy, clients reported the sessions to be a safe haven of comfort and hope where they could experience a respectful and relaxed atmosphere in which to converse (Allen & St. George, 2001; Newfield et al., 1990). Those clients expressing a positive experience with therapy had a tendency to use words such as supportive, unbiased, nonjudgmental, warmth, feeling accepted, engaged, context for change, collaborative, comfortable, caring, involvement, trust, and understanding (Howe, 1996; Odell, Butler, & Dielman, 2005; Schäfer, 2008; Singer, 2005; Smetana & Bigner, 2005; Smith, Yoshioka, & Winton, 1993; Stanbridge et al., 2003; Ward et al., 2007; Young & Cooper, 2008). Of critical importance to some clients was having a regularly scheduled session where they could (a) interact with each other differently, (b) limit the influence of their everyday problems (Bischoff & McBride, 1996; Ward et al., 2007; Wark, 1994b), and (c) focus on relationships (Bowman & Fine, 2000).…”

“…Over the last 20 years, there have been a significant number of published studies in which the experiences of clients in marriage and family therapy have been investigated to discover what works in therapy from their points of view (e.g., Allen & St. George, 2001; Bischoff & McBride, 1996; Bowman & Fine, 2000; Howe, 1996; Kuehl, Newfield, & Joanning, 1990; McWey, 2008; Strickland‐Clark, Campbell, & Dallos, 2000; Ward, Linville, & Rosen, 2007). Although there have been a number of systematic reviews (Petticrew & Roberts, 2006) of the effectiveness literature in marriage and family therapy (e.g., Pinsof & Wynne, 1995; Sprenkle, 2002) and of clients’ experiences in individual counseling (Elliott, 2008), there has not been a comparable review of the research literature presenting clients’ experiences of their conjoint clinical treatment as couples or families.…”

“…For many clients, therapists were crucial in helping them to experience a positive therapy environment (Ma, 2000; Ward et al., 2007).…”

Counselling Aboriginal peoples: A thematic study of counselling experiences.

“…Furthermore, the act of seeking help from another, who is not a friend or acquaintance, can be quite an embarrassing experience for the client (Goldin & Bordan, 1999). In general, researchers have found that the therapeutic relationship between counsellor and client is the best predictor of a positive outcome (Smith, Thomas, & Jackson, 2004), and the most helpful aspect of clients' therapeutic experience (Ward, Linville, & Rosen, 2007).…”