Therapist and client: Two views of the process and outcome of psychotherapy.

Kaschak, Ellyn

doi:10.1037/0735-7028.9.2.271

Cited by 22 publications

(13 citation statements)

References 11 publications

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“…That is, the therapists were more modest in evaluating the impact of their responses, suggesting that they may have applied more stringent standards in evaluating the therapy process (cf. Kaschak, 1978) or that clients may have been reluctant to criticize their therapists. each pair's agreement.…”

Section: Discussionmentioning

confidence: 99%

“…Studies using the Barrett-Lennard Relationship Inventory typically show weak correlations between client and therapist perceptions (Gurman, 1977;Lacrosse, 1977). Therapists and clients also appear to attribute client change to different aspects of the therapy relationship (Kaschak, 1978). However, studies examining client and therapist perceptions of the impact of single therapy sessions find moderate agreement (Mintz et al, 1973; Orlinsky & Howard, 1975;Stiles, 1980) The present study investigates agreement of client and therapist perceptions at the level of the individual therapist response.…”

mentioning

confidence: 99%

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Dual perspectives: Clients' and therapists' perceptions of therapist responses*

Caskey

Barker

Elliott³

1984

British J Clinic Psychol

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This study compares clients' and therapists' perceptions of individual therapist responses. Three segments of four responses each were sampled from early, middle, and late in actual therapy sessions with 16 client-therapist pairs. Using interpersonal process recall, both therapists and clients independently described their perceptions of the therapist's response intentions in their own session. They also rated the impact of therapist responses according to four variables, including response helpfulness and therapist empathy. Client-therapist agreements on intentions and impacts were computed using indices of both covariation and mean difference. Clients' and therapists' response-by-response reports of therapist intention were positively associated, but their average ratings for the session were not. On the other hand, their response-by-response ratings of impact were not associated, but their average ratings of helpfulness and affective impact were. Correlates of agreement were also studied. Contrary to expectations, length of therapeutic relationship was not correlated with client-therapist agreement: in fact, there was a trend toward lower agreement for client-therapist pairs of longer duration. Therapist experience also did not predict client-therapist agreement.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Dual perspectives: Clients' and therapists' perceptions of therapist responses*

Caskey

Barker

Elliott³

1984

British J Clinic Psychol

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“…Even where there is agreement about the characteristics of good outcome, it may not be easy to measure. Clients and therapists may differ in their evaluation of a particular treatment outcome (Kaschak, 1978;Margolis, Sorensen, & Galano, 1977). The inability to show difference in outcome as a result of difference in quality may not mean that the treatment is ineffective only that the standards used to measure outcome are inconsistent.…”

Section: Effects On Qualitymentioning

confidence: 99%

Reviewing professional practice: Implications for the mental health consumer.

Simon¹,

Rosenberg²

1982

Professional Psychology

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Cost containment and quality control are the major purposes of professional practice review (PR). PR appears to more effectively control utilization of services than cost per unit. PR may increase quality of service by establishing a better data base for evaluating treatment and outcome. Quality and cost, however, are interrelated. Optimal quality may raise cost of care. Although PR may decrease costs and increase quality, it may also infringe on the privacy of the clients and narrow their freedom in choosing a provider. Consumers need to be involved to make sure that PR addresses issues of importance to them, such as humaneness of treatment and control of poorly prepared providers.This article discusses some ways in which professional practice review (PR) may affect the consumer of mental health services. PR is used as a generic term for any method that systematically scrutinizes health care, including peer review, quality assurance, medical audit, professional services accounting, Professional Standards Review Organizations (PSROs), Professional Standards Review Committees (PSRCs), utilization review, and claims review. These approaches differ in whether they emphasize cost containment or quality of care; in whether the review is conducted prospectively, concurrently, or retrospectively; and to what extent nonhealth providers participate in the process. However, all of these approaches may be labeled PR.PR standards may be established descriptively or prescriptively. Descriptive standards, alsd called "empirical" or "statistical," are typically used in insurance claims review when determining whether a given practice is "usual, customary, and reasonable" (UCR). Since a descriptive standard "depends upon average clinical practice," an activity may meet the standard "and yet still be below what most persons would agree is minimally adequate" (Zusman & Ross, 1969, p< 353). Professors who grade on a curve are familiar with this phenomenon. In addition, the standards are usually determined on a local rather than on a national basis. As a result consumers living in one area may receive care that is considered inadequate or overpriced in another. Prescriptive standards, also called "clinical," "a priori," or "normative," avoid the relativism of descriptive standards because they are based on the judgment of a select group of experts. This doesjiot necessarily mean, however, that prescriptive standards will lead to more effective or less costly care. In the absence of validating research, such standards may merely reflect the practice prejudices of the experts. Even if valid, prescriptive standards may lead to therapeutic overkill and needless expense (Institute of Medicine, 1974). Effects on CostMuch of PR's impetus in the last decade has come from the desire to control the cost of health services. A crucial question then is, Will PR save consumers money? The experience of one California clinic may provide an answer (Kazanjian, 1982;

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“…However, the original Haan and Livson study is still being cited today, perhaps because the need to validate personal experience that sex bias in psychotherapy exists is so strong that researchers feel almost compelled to demonstrate it empirically. Even feminist researchers, however, fail to find the effect they seek (Billingsley, 1977;Gomes & Abramowitz, 1976;Kaschak, 1978). The inability to validate one's personal experiences is frustrating.…”

Section: Sex Bias In Psychotherapymentioning

confidence: 99%

A Decade of Feminist Influence on Psychotherapy

Brodsky

1980

Psychology of Women Quarterly

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The last decade has seen some major impacts of feminism on the institution of psychotherapy regarding theories, treatment techniques, and assessment instruments. The changes in attitudes toward women as therapists and as clients have reflected the general advances of the women's movement in that women clients are more likely to seek women therapists and to receive treatments specifically developed for crises affecting women such as rape, pregnancy and domestic violence. The difficulties in designing empirical studies to demonstrate bias in psychotherapy have resulted in a confusing state of the art because only the higher-order interactions have consistently been significant. Attempts of some women to resist changes brought about by the women's movement and the apathy and levity of others have also presented problems in the path of progress. However, movement toward the long-range goal is encouraging when one compares the writing on women and psychotherapy in recent professional journals with examples from the 1960s.In 1963, as the first female clinical psychology intern in the U.S. Army, I was assigned a 40-year-old woman client who refused to accept m e as her therapist because I was younger than she, and a woman. She was convinced that she was assigned to the lowly female intern because her husband was only a sergeant. Her parting words as w e aborted our tenuous relationship were something like, "I'm a difficult case, honey. It's not your fault. I hope someday you'll be another Joyce Brothers." O n the other hand, recently a woman client peeked into m y office after leaving our initial session and commented, "You know,

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Therapist and client: Two views of the process and outcome of psychotherapy.

Cited by 22 publications

References 11 publications

Dual perspectives: Clients' and therapists' perceptions of therapist responses*

Dual perspectives: Clients' and therapists' perceptions of therapist responses*

Reviewing professional practice: Implications for the mental health consumer.

A Decade of Feminist Influence on Psychotherapy

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