The effect of client choice of therapist on therapy outcome

Abstract

This study compared the therapeutic progress of three randomly assigned groups (n = 14 in each group) of community mental health center clients: (a) clients who viewed a slide/sound presentation about all available therapists and chose their own therapist; (b) clients who viewed the presentation and were assigned to a therapist by the center's clinical director; (c) clients who were assigned to a therapist by the clinical director without seeing the presentation. There were no significant differences among the three groups in their initial reaction to the clinic, number of therapy sessions, type of termination, severity of presenting problems, General Well-Being Schedule scores, Current Adjustment Rating Scale scores, or therapist's satisfaction with therapy. Further analysis revealed that three out of four clients had improved significantly as a result of therapy. It was concluded that in the absence of research evidence demonstrating the efficacy of client choice on therapy outcome, support for the notion of client choice must be based solely on social, ethical, and legal considerations.

Students' expressed and actual preferences for counsellor race and sex

“…This incongruence between expressed and actual preferences is likely to account for many of the inconsistencies present in the literature. The findings of Manthei's (1982) study, carried out in a clinical setting, suggested that there may be a distinction between preference and choice. This study, carried out in analogue form, confirms and indeed emphasizes the need to differentiate between the two.…”

“…Items were suggested by other research (Manthei, 1982;Netzky, Davidson & Crunkleton, 1982) and the counselling literature in general. Items could be categorised as one of three types: (a) quality of the relationship items (e.g., Looks like the kind of person who will listen to me; Treats me with respect; Accepts me as I am); (b) physical and cultural similarity items (e.g., Is the same race as I am; Is attractive; Is the same sex as I am); (c) directive and non-directive aspects of counselling style items (e.g., Is able to help me figure out what to do; Will push me into doing what I ought to do; Tells me what to do).…”

“…As early as 1956, however, Koile and Bird warned that what clients say they prefer might not necessarily match what they would do when given an actual choice. Thompson and Cimbolic (1978) alluded to this same issue, and Manthei, Vitalo and Ivey (1982) reported that when asked directly about their preferences for counsellor race and sex, clients rated these qualities as unimportant. However, actual choice of counsellor seemed to contradict these low rankings, especially in the case of counsellor race.…”

An empirical investigation of customer satisfaction with health care services

“…For example, Glassman and Glassman (1981) found that women used personal experience and peer recommendations to select a physician, and patient satisfaction was determined primarily by physiciancontrolled factors such as providing sufficient relevant information about what to expect during pregnancy and offering continuity of care. Manthei et al (1982) manipulated patients' choice of health care providers in a community mental health center and then measured patient satisfaction. Surprisingly, the subjects did A 2 Â 2 full factorial between subjects experimental design was used to examine how three elements of the health care experience (patients' freedom to choose a physician; patients receiving their preferred physician; health care outcome) impacted on patient satisfaction with health care service.…”

Sex differences in college students' preferences for an ideal psychotherapist.

“…Furthermore, the preference type being honored (i.e., treatment, role, or psychotherapist characteristic) did not moderate either finding, suggesting that all types, when aggregated statistically, appear to have a consistent association with treatment dropout and outcome. However, only three studies in this meta-analysis specifically focused on the effect of preference match for psychotherapist characteristics (Manthei, Vitalo, & Ivey, 1982;Proctor & Rosen, 1981;ZIotnick, Elkin, & Shea, 1998), and none demonstrated an effect individually. Thus, although it may be that an effect is present, as suggested in the meta-analysis with the larger aggregated sample, additional research is needed to establish more definitely whether accommodating clients' preference for psychotherapist characteristics is associated with better treatment process and outcome.…”