The structure of client language and drinking outcomes in project match.

Client language during Motivational Interviewing interventions is an important predictor of drinking outcomes, but there are inconsistencies in the literature regarding what aspects of client language are most predictive. We characterized the structure of client language by factor analyzing frequency counts of several categories of client speech. The results provide limited support for a model proposed by Miller et al. (2006) and Amrhein et al. (2003) but with some important differences. While Amrhein et al. (2003) found that only increasing strength in client commitment language predicted behavior change, the current study revealed that client language preparatory to commitment predicted drinking outcomes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Using client feedback in psychotherapy training: An analysis of its influence on supervision and counselor self-efficacy.

Tracking client outcome and the therapeutic relationship across treatment (i.e., client feedback) has become a recommended practice for clinicians. This study investigated whether the utility of this practice would extend to trainees if the data gained from clients was provided to their supervisor for use within supervision. Trainees (N = 28) were assigned to a continuous feedback condition or no-feedback condition for 1 academic year. Results indicated that trainees in both conditions demonstrated better client outcomes at the end of their practicum training than at the beginning, but those in the feedback condition improved more. However, those in the feedback condition did not rate the supervisory alliance or satisfaction with the supervision process differently. The relationship between counselor self-efficacy and outcome was stronger for trainees in the feedback condition than for those in the no-feedback condition, perhaps indicating that feedback may facilitate a more accurate assessment of one’s skills. Implications of how counseling self-efficacy, the supervisory alliance, and satisfaction with supervision are related to effective supervision are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived counselor characteristics, client expectations, and client satisfaction with counseling.

Examined (a) the relationship between perceived counselor expertness, attractiveness, and trustworthiness and client satisfaction; (b) the relationships between specific client expectations on perceived counselor characteristics and client satisfaction; and (c) the effects of actual counselor experience level on perceived counselor characteristics and client satisfaction. The 55 counselors who participated in the study were either beginning or advancing practicum students, doctoral-level interns, or PhD counselors; clients were 72 students who sought help at a university counseling center. Clients completed an Expectations About Counseling (EAC) questionnaire before entering counseling, as well as the Counseling Evaluation Inventory (CEI) and Counselor Rating Form (CRF) after several weeks of counseling. CRF and CEI were correlated, but EAC scores were not strongly related to the CEI or CRF scores. Actual counselor experience level did not differentially affect CEI or CRF scores. Findings are discussed in terms of several variables (e.g., legitimate power, source variables, and client satisfaction) that may differentially affect the influence process over time. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Female counselor–client dyads: Effects of counselor age, client marital status, and intimacy level of presenting problem on perceptions of counselors.

Explored the impact of counselor age, level of intimacy of clients' presenting problems, and client marital status on perception of counselors and the counseling relationship with 48 married females (mean age 21.9 yrs) and 48 unmarried females (mean age 26.3 yrs). Ss viewed a series of 3 videotapes, which were counterbalanced for level of intimacy of client's presenting problems and depicted initial interviews between young female clients and either younger or older female counselors. After viewing each individual vignette, Ss completed a counselor rating form, a client satisfaction form, and manipulation checks for presenting problem intimacy and counselor age. Overall, differences in presenting problems and counselor age were perceived as intended. Ss' marital status was unrelated to any measures. Counselors were judged as most expert, attractive, and trustworthy when dealing with presenting problems that were least intimate. Ss anticipated greater satisfaction with younger rather than older counselors only for the least intimate presenting problem. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors related to client return rate following intake.

Examined the relationship of client sex, intake counselor sex and experience level, and the sex of the counselor to whom the client was referred to the percentages of clients returning for counseling following an intake interview. In addition, the effect on return rate of referral to another counselor vs continuation with the counselor seen at intake was examined. Results from 67 male and 74 female counseling center clients and 25 regular counseling staff indicate that clients of both sexes were significantly less likely to return when initially interviewed by male rather than female intake counselors. Further, clients referred by male intake counselors to other male counselors were significantly less likely to return than were clients seen by and/or referred to female counselors. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical attractiveness: Interactive effects of counselor and client on counseling processes.

192 college students, selected on the basis of their scores on an attractiveness battery, assumed the role of a client having social skill problems during 3 counseling sessions. Exp I was a factorial design in which the major variables were counselor's physical attractiveness, client's physical attractiveness, and sex of client. Exp II studied the interaction between physical attractiveness of the counselor and client's susceptibility to attractiveness as determinants of outcome. In both experiments, Ss roleplayed a client who interacted with a female counselor. The counselor's physical attractiveness had a major impact on her perceived therapeutic effectiveness and the client's expectancies about future success, irrespective of the client's physical attractiveness or sex. Male clients generally attributed a higher level of skill to the female counselor than did female clients. When the counselor was unattractive, clients who were more susceptible to attractiveness perceived her as less skillful than clients who were less susceptible to attractiveness. Physical attractiveness of the counselor accounted for over 50% of the variance in perceived effectiveness and future expectancy measures in both experiments. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving the effects of psychotherapy: The use of early identification of treatment and problem-solving strategies in routine practice.

Client-focused research systems have been developed to monitor and provide feedback information about clients' progress in psychotherapy as a method of enhancing outcome for those who are predicted to be treatment failures. In the current study, the authors examined whether feedback regarding client progress and the use of clinical support tools (CSTs) affected client outcome and number of sessions attended. Results showed that clients in the feedback plus CST group stayed in therapy longer and had superior outcomes. Nearly twice as many clients in the feedback plus CST group achieved clinically significant or reliable change, and fewer were classified as deteriorated by the time treatment ended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergence in client and counselor recall of important session events.

The authors examined convergence of clients' and counselors' recall of important session events by comparing client and counselor Critical Incident Questionnaires (CIQs) from 27 counseling dyads. In addition, clients reported interpersonal problems before and after counseling. Trained judges rated matched pairs of CIQs for similarity of change mechanisms and content. Individual growth modeling was conducted with the Hierarchical Linear Model program. Results showed that (a) convergence of client and counselor recall of important therapeutic events increased linearly over time, and (b) increasing convergence was related to counseling outcomes, as measured by a decrease in interpersonal problems. Implications for counseling practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation of the effects of client sex and presenting problem in referral from intake.

Examined the extent to which client sex and presenting problem were related to the sex of the counselor to whom the client was referred for individual counseling. Data were collected from the files of 142 counseling center clients seen initially by an intake counselor and then referred for individual counseling; the 25 intake counselors, 14 male and 11 female, were the center's professional staff and maintained regular client loads as well as sharing intake responsibilities with other staff members. Results indicate a predominance of same-sex referrals regardless of client sex, sex of the intake counselor, or the client's presenting problem. While intake counselors were more likely to keep clients of their own sex for continued individual counseling, the tendency to make same-sex referrals was most evident when clients were referred to other counselors. The results suggest that sex is a salient factor in the assignment of clients to counselors and that further study of the conditions under which same-sex vs opposite-sex counselor–client pairings lead to differentially effective counseling outcomes is needed. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of client preference and expectancy upon the initial interview.

Used a 2 * 3 design with 10 Ss per cell to show how initial counseling interview process and outcome are affected by (a) assigning clients to either more preferred or less preferred counselors; (b) giving clients either positive, nonexistent, or negative expectancy inductions regarding their counselor assignments; and (c) congruence and incongruence between clients' expectations and experiences. Process and outcome were assessed using client and counselor self-report measures and audiotape segment ratings. More preferred assignment conditions received more favorable tape ratings than did less preferred assignment conditions. Positive or no-expectancy conditions revealed a more favorable counseling outcome than did negative expectancy conditions. Most Ss showed increased preferences for counselors seen despite congruence or incongruence between their expectations and experiences. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of failure to meet client preference in a counseling interview analogue.

The hypothesis that failure to meet client preference for high- or low-directive counselor style would adversely affect interpersonal process was tested with 48 undergraduates in a counseling intervention analog oriented around students' actual problems. Students with strongly stated preferences for high- or low-directive counselors were randomly assigned to a counselor whose style was congruent or incongruent with their preference. The Therapist Behavior Scale was used to assess counselor directiveness. Dependent variables included 3 speech and 2 satisfaction measures. The data do not support the hypothesis. There was no evidence that failure to meet client preference adversely affected interview process. Clients of high-directive counselors expressed significantly greater satisfaction with the client–counselor relationship, spent only about 50% as much time per utterance, responded significantly more quickly, and exhibited less silence time while they held the floor than did clients of low-directive counselors. Results suggest that recent interest in ascertaining and meeting client preference may not be relevant to the quality of the interpersonal process. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strength of commitment language in motivational interviewing and gambling outcomes.

The purpose of the present study was to examine the mechanisms by which the motivational interview (MI) is an effective treatment for pathological gambling. Forty MIs with pathological gamblers were transcribed and coded for language content and strength of expression. As hypothesized, participants who expressed stronger commitment to change their gambling behavior during the MI exhibited better gambling outcomes over 12 months than did those who expressed weaker commitment or no commitment to change their gambling behavior during the MI. Contrary to expectation, commitment strength in the latter part of the MI was not a stronger predictor of gambling outcome. Expression of desire, ability, need, reasons, and readiness for change were not predictive of outcome. Ability and readiness were associated with commitment. This study has important implications for clinical monitoring of client treatment success and for improving the MI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of counselor identification of client problem description to continuance in a behavioral weight loss program.

I investigated the relation of counselor ability to articulate salient information to continuance in a weight loss program in two studies. In the first, clients (N?=?39) were asked questions regarding their weight loss problems, and counselors were asked to predict client responses. A higher proportion of accurate predictions occurred for clients who later completed the program than for those who dropped out. Within the completer group, there was greater weight loss in cases that had been accurately predicted than in those that had not. The second study was identical to the first except for program duration, which was eight sessions for the first and six sessions for the second (N?=?41 clients). The results of the second study replicated those of the first with regard to continuance but not outcome. I discuss the relevance of the results to similar research done with different client populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of a sex-fair counselor and her client.

Investigated the effects of sex-fair counseling on 18 male and 21 female undergraduates' perceptions of (a) a female counselor, (b) a same-sex client, and (c) their own attitudes. The experimental design was a 2?×?2 factorial in which a female or a male client discussed traditional or nontraditional career plans with the counselor. The only significant findings regarding perceptions of the counselor were that women anticipated that they would feel more comfortable with the counselor who facilitated nontraditional career exploration than did men. Women tended to evaluate traditional and nontraditional clients similarly, whereas men evaluated the traditional client more favorably regarding academic achievement. Ss' own attitudes regarding occupational choice did not differ significantly between the 2 types of counseling, although the nontraditional condition did seem to result in greater flexibility among women. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor and client personality as determinants of counselor expectancy effects.

78 students enrolled in summer-session college courses were randomly assigned to serve either as counselors or as clients for a 20-min, role-played peer counseling session. Ss completed a battery of standardized personality measures, including the Personality Research Form. Each counselor interacted with 2 clients. Prior to the sessions, the counselor was led to believe that one of the clients was especially introverted and that the other client was especially extraverted. Dependent measures were based on clients' change scores on a mood adjective rating scale administered before and after the peer counseling sessions. Analyses showed that counselors who were more successful at biasing their clients in the direction of their expectancies (a) scored higher on measures of dogmatism, nurturance, and social recognition; (b) scored lower on impulsivity; and (c) were more likely to be female. Clients who were more susceptible to counselor bias scored higher on the Self-Monitoring Scale, its Other-Directedness subscale, and social recognition. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential client attractiveness in a counseling analogue.

Investigated the effects of variations in conceptual complexity level of counselor and client on counselor attraction to the client. 40 counselor trainees (characterized as having either high or low conceptual level—Paragraph Completion Test) in 2 groups rated the attractiveness of clients following each of 2 counseling analog tasks in which the client was depicted as exhibiting high or low conceptual level. Results of a 2?×?2 analysis of variance (Counseling Complexity?×?Analog Complexity) indicated only that the more complex clients were more attractive across both levels of counselor complexity. Results are discussed in terms of 2 models of interpersonal attraction and the implication for socioeconomic status, as it relates to conceptual level, as a factor in counselor–client role constraints. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Initial client expectancies in time-limited counseling.

Assessed the effects of (a) whether counseling was time-limited (12 sessions), (b) the interaction of time limits with the chronicity of the client's problem, and (c) the rationale given for time limits (time limits effective/appropriate vs a long waiting list) on the initial expectancies of clients. 80 female college students were asked to place themselves into the role of a client they saw interacting with a counselor on film. Pre- and postfilm written material manipulated the independent variables. Results show that Ss in the chronic (vs acute) problem condition had the most negative expectancies for the counseling relationship and outcome when the counseling was time-limited (vs unlimited). While the rationale for time limits did not affect the primary dependent variables, post hoc analyses of Ss' essay responses indicated that the waiting-list rationale stimulated more negative expectancies than the time-limits-effective/appropriate rationale. Contrary to predictions, time did not affect Ss' expectancies for client activity and responsibility and for counselor activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive style and counselor–client compatibility on client growth.

Tests of 2 cognitive style dimensions (serialism–holism and field dependence–independence; measured by the Gandlemuller Test and the Group Embedded Figures Test, respectively) were administered to 60 counselor trainees in graduate clinical and counseling psychology programs and 60 volunteer clients drawn from a university-level applied psychology course. 32 counselor–client pairs matched or mismatched on the 2 dimensions were formed. Counselor and client pairs engaged in 2 50-min therapy sessions that focused on client self-enhancement. In independent rating sessions, matching effects for field dependence–independence were obtained in clients' subjective ratings of improvement in self-exploration skills and in clients' and counselors' subjective ratings of the ease of relating with each other. Implications and applications for achieving maximum counselor–client compatibility in a person–environment interaction model are discussed. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of a client pretherapy orientation videotape.

Examined the effects of a videotaped psychotherapy orientation on clients' response to therapy, knowledge about therapy, utilization of services, and satisfaction with services and on therapist ratings of client attractiveness. 62 psychotherapy clients (mean age 29 yrs) at an urban community mental health center were randomly assigned to an oriented group, which viewed a pretherapy orientation videotape at admission, or to a control group. 14 therapists participated. The 11-min videotape described the relationship between client and therapist, encouraged clients to attend appointments, and stated that, although progress is rarely immediate, most clients find that therapy can lead to a reduction in anxiety and depression. Clients and therapists completed questionnaire and rating scales at intake and at 1-mo follow-up. It was found that oriented clients were able to understand and recall the information in the videotape, and the oriented group showed a greater decrease in self-reported symptoms than the control group after 1 mo. Client feedback regarding the videotape was favorable. In general, the 2 groups did not differ in their satisfaction with services, service utilization, or therapist ratings of client symptoms and functioning. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social cognitive variables in the prediction of client motivation and attrition.

Applied A. Bandura's (1986) social cognitive theory to the prediction of client motivation and attrition from counseling. 139 university counseling center clients completed a measure of self-efficacy regarding their ability to negotiate counseling tasks, along with measures of counseling-related outcome expectations, perceived motivation, problem distress level, state anxiety, and self-esteem. Results indicated that (1) self-efficacy and outcome expectations each explained unique variation in motivation, beyond client and counselor background variables; (2) self-efficacy and motivation each contributed to the prediction of client return status after an intake interview; and (3) self-efficacy did not relate to global self-esteem or to state anxiety at the intake session. These results suggest that social cognitive theory may help illuminate the process whereby clients commit to counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)