Cognitive Therapy and Research

, Volume 16, Issue 3, pp 269–281 | Cite as

When clients don't progress: Influences on and explanations for lack of therapeutic progress

  • Philip C. Kendall
  • David Kipnis
  • Laura Otto-Salaj


Three hundred and fifteen psychotherapists responded to a survey and provided information about clients who had failed to make progress in individual treatment. It was found that criteria for defining failure to progress varied with therapy orientation, and that social—cognitive factors, over the severity of patient symptoms, often guided therapists evaluations of client functioning. Preliminary estimates were that an average of 11% of each therapist's caseload were not making progress, and that the majority of therapists who were continuing to treat these clients had not developed alternative treatment plans. Both pragmatic and ethical concerns suggest the need for developing guidelines and criteria for use in determining when clients are failing to make sufficient progress and in providing recommendations for how such cases should be managed.

Key words

treatment outcomes influences on therapeutic progress therapists attributions for client failure to progress therapy progress 


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Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Philip C. Kendall
    • 1
  • David Kipnis
    • 1
  • Laura Otto-Salaj
    • 1
  1. 1.Department of PsychologyTemple UniversityPhiladelphiaUSA

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