Therapist goals, patient aims and patient satisfaction in psychotherapy

Abstract

PROBLEMThe goals and wants of the participants in psychotherapy are potentially significant factors in the therapeutic exchange. The goals that a therapist sets with a particular patient can be considered indices of the direction in which he seeks to influence the experience of the patient. What the patient says she wants from therapy might be expected to influence what she reports receiving. This study explored the therapeutic perspectives of patients and therapists by determining the cluster dimensions of therapist goals, patient wants, and patient satisfactions, and investigated the influence and interaction of the intention factors on the satisfactions patients reported receiving from psychotherapy. While the patient's satisfaction with on-going therapy is hardly a criterion of ultimate success, it does represent the partial fulfillment of those personal needs which lead a person to seek therapy and undoubtedly influences the maintenance of the therapeutic relationship. PROCEDUREThe patients and therapists in the present sampIe were drawn from the Katherine Wright Mental Health Clinic, a private, urban, psychiatric outpatient. clinic predominantly serving female patients.2 The 28 patients were all women, mostly between the ages of 20 and 28 years; 82% were not currently married, and almost all were employed. On the whole, these women were well educated; 86% had completed high school and 61% had had some college. A little less than half of the sample were the eldest and one-quarter were the youngest child of predominately large, middle to lower class families. Half of the women had had previous psychotherapy.Nine of the 16 therapists treating these patients were psychiatrists, 3 were psychologists, and 4 psychiatric social workers; 9 were male and 7 female. As a group, the therapists had a median of 6 years experience in the practice of psychotherapy and could be considered dynamic-eclectic in orientation.Immediately following each hour of psychotherapy and as a regular part of the clinic routine, both clients and therapists completed their respective form of the Therapy Session Report questionnaire. These essentially parallel questionnaires were developed by Orlinsky and Howard(s) to survey the therapeutic experiences of patients and therapists. The specific scales in these instruments utilized in the present research were those which measured the therapist's report of his therapeutic goals, the patient's report of her purposes or wants, and the patient's report of her satisfactions. Each of the 28 patient-therapist pairs reported their experiences during a segment of treatment. The mean number of sessions in a segment was 14 (range = 7-25). For approximately half of the sample, the research period covered the first 3 to 6 months of therapy.' In all, more than 400 jointly reported hours of psychotherapy provided the data for the present analyses. 'An extended version of this article was submitted to Loyola University, Chicago as partisl fulfillment of tbe requirements for the degree of Doctor of Phloeoph . Th...

Outpatient Requests, Initial Sessions and Attrition

“…Similarly, it is no surprise that feeling as though one's feelings are understood enhances continuance, as patient perceived "accurate empathy" has been associated with a variety of positive outcome measures [28]. The final significant factor, satisfaction with the initial visit, also has previous research validation for its positive role in compliance measures, including clinic attendance [5,23,. As in other studies of short term therapy, most patients in this study indicated high satisfaction [29,30].…”

“…With few exceptions, however, the specific relationship of patient requests and adherence behavior has not been carefully evaluated [ 13,[18][19][20][21][22][23][24][25] . This paper examines the association between patients' requests, outcome of initial sessions and return for further therapy.…”

A Controlled Trial of Goal Setting for Long-Term Community Psychiatric Patients

“…In psychotherapy studies, it has been shown that the therapists' convictions and direction can influence the therapeutic outcome. 19 Other studies have shown that greater perceived involvement led to greater patient satisfaction.f This field requires further investigation, particularly with the chronic patient, to determine the correct balance between perceived and actual involvement in goal setting.…”

Clients and therapists evaluate clinical services

“…In order to place the client's ratings in perspective, the therapist was asked to answer the same three questions from his own point of view. Past research (Strupp, Fox, & Lesser, 1969;Hill, 1969;Feifel & Eells, 1963)led us to expect only modest correlations between answers of clients and their therapists. Also, the two face a somewhat different task.…”