Positive regard and psychotherapy outcome: A meta-analytic review.

Abstract

This article meta-analytically reviews the research on the association between therapist positive regard (PR) and treatment outcome. The history of the construct of unconditional PR in client-centered theory and the efforts to clearly operationalize and measure this construct are reviewed. Several clinical examples are presented. The updated meta-analysis, which features expanded inclusion criteria and a larger number of studies (k ϭ 64) than previous analyses, yielded a small positive association between PR and treatment outcome, g ϭ .28. To control for the repeated use of data sets and study samples within the database, a multilevel meta-analysis was adopted that indicated a stronger relation between PR and clinical outcome (g ϭ 0.36). These analyses support PR's standing as a significant component of the therapy relationship that leads to improved clinical outcomes. The article concludes with limitations of the research, patient contributions, diversity considerations, and recommendations for using PR in practice. Clinical Impact StatementQuestion: This article addresses the following question: Aggregated over multiple studies over several decades, what association emerges between the therapist's provision of positive regard and therapeutic outcome? Findings: The findings of the meta-analysis conducted indicate that there is a small but positive relation between these variables and that no demographic or therapy-related variable significantly affects this association. Meaning: These findings suggest the importance of providing positive regard to one's patients; affirming patients may serve many valuable functions and, at a minimum, "sets the stage" for other mutative interventions. Next Steps: Research is needed to determine what specific forms of positive regard, including verbal and nonverbal expressions, have which kinds of effects for which kinds of patients at which points in therapy.

Personal therapy and the personal therapist

“…Several meta-analyses and reviews have stressed the importance of empathy (Elliott et al, 2018) and related qualities, including positive regard (Farber et al, 2018), interpersonal skills (Wampold, 2017), genuineness (Kolden et al, 2018), and feedback (Norcross, 2002;Lambert et al, 2018). The meta-analyses (Elliott et al, 2018;Kolden et al, 2018;Farber et al, 2018;Tryon et al, 2018) discussed below consist mainly of cross-sectional studies. This is an important shortcoming, since psychotherapy is an ongoing process that requires repeated measures.…”

“…Recent meta-analyses have related empathy (Elliott et al, 2018), congruence/genuineness (Kolden et al, 2018), positive regard (Farber et al, 2018), and goal consensus and collaboration (Tryon et al, 2018) to treatment outcome. Other therapist characteristics that may influence treatment outcomes were self-disclosure and immediacy (Hill et al, 2018), countertransference management (Hayes et al, 2018), and therapist and client emotional expression (Peluso & Freund, 2018).…”

“…The conceptualization of positive regard has varied in psychotherapy research. However, the consensus is that positive regard refers to the therapist's ability to support the patient (Farber et al, 2018). The definition of positive regard includes elements of respect, validation, nonpossessive warmth, affirmation, prizing, and support (Farber et al, 2018).…”

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“…Several recent articles have highlighted the importance of psychotherapy process variables and the beneficial impact of a strong therapeutic relationship (e.g., Farber et al 2018;Fluckiger et al 2018). These articles help to document the research support for well-known psychotherapy process issues, such as positive regard for the client (Farber et al 2018), mutuality in session (Cornelius-White et al 2018), client insight (Jennissen et al 2018), and therapist genuineness (Kolden et al 2018). Although these core process variables were emphasized many years ago, recent research has documented their impact of treatment outcome.…”

“…Journal of Psychotherapy Integration, 28 (3), 348-366. Farber, B., Suzuki, J., & Lynch, D. (2018). Positive regard and psychotherapy outcome: A meta-analytic review.…”