Psychotherapist advice, suggestions, recommendations: A research review.

Abstract

Psychotherapists provide at least some advice, suggestions, and recommendations (ASR) in most treatment approaches. We define ASR, offer clinical examples, and review the research evidence for the immediate insession, immediate delayed, and intermediate effects of ASR, as well as for the moderators of these effects in individual psychotherapy. In seven studies with 327 clients and 131 therapists, we found evidence of neutral immediate in-session outcomes (e.g., client experiencing levels), neutral immediate delayed outcomes (e.g., client-rated helpfulness during postsession videotape reviews), and positive intermediate outcomes (e.g., implementation of recommendations as rated in subsequent sessions) for ASR. These differences may be related to methodological variations in studies in addition to the different timing of the outcome measurement. In terms of moderators, there is some evidence that the working alliance, client collaboration prior to the ASR, content of the ASR, and therapist and client attachment styles moderate the effects of immediate in-session outcomes, and that type, difficulty, and therapist influence moderate the effects of intermediate outcomes of ASR. We conclude with research limitations, training implications, and therapeutic practices related to ASR. Clinical Impact StatementQuestion: Although most therapists at least occasionally offer advice, suggestions, and recommendations, the research on this topic is minimal. We sought to examine the evidence for whether therapists should provide advice, suggestions, and recommendations to clients. Findings: On average, clients decrease their level of collaboration (i.e., engagement) immediately after therapists give advice, suggestions, and recommendations (ASR), although they seem to profit from more directive forms of ASR when asked to remember and record them after sessions. Meaning: Therapists are advised to have a good working alliance before giving ASR. Next Steps: More research is needed about markers for when therapists should provide advice, suggestions, and recommendation and about therapist and client variables that influence the use and effectiveness of these skills.

Towards a Culturally Sensitive Model of Therapeutic Alliance: Exploring the Role of Filipino Values and Shared Realities

“…Furthermore, there may be doubt or trust regarding the therapy or therapist (Rosenzweig et al, 1996). Likewise, therapists may either perceive that their clients need or do not need treatment (Hill et al, 2023), and this may also be further compounded by their doubt or trust toward their clients regarding commitment to therapy (Crits-Christoph et al, 2019).…”