“…Studies examining the affective dimension or quality of participation have used assessments based almost entirely on providers' perspectives (Littell et al, 2001), including workers' ratings of client cooperation in family preservation services (McCroskey & Meezan, 1997), levels of participation in structured family support programs (Wagner, Spiker, Gerlach-Downie, & Hernandez, 2000), or group leaders' observations of engagement among individual group members in therapy (Wagner, Spiker, Gerlach-Downie, & Hernandez, 2000;MacGowan, 1997). In some studies, observations of affect have been combined with behavioral measures (Alexander & Hewgarty, 2001;Plasse, 2000).…”