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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
Article

Abstract

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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References

  1. Barbrack, C. R. (1985). Negative outcomes in behavior therapy. In D. T. Mays and G. M. Frank (Eds.),Negative outcomes in psychotherapy and what to do about it. New York: Wiley.Google Scholar
  2. Brickman, P., Rabinowitz, V. C., Karuza, J., Coates, D., Cohn, E., & Kidder, L. (1982). Models of helping and coping.American Psychologist, 37, 368–384.Google Scholar
  3. Foa, E., & Emmelkamp, P. (1983).Failures in behavior therapy. New York: Wiley.Google Scholar
  4. Keith-Spiegel, P., & Koocher, G. P. (1985).Ethics in psychology. Hillsdale, NJ: Erlbaum.Google Scholar
  5. Kendall, P. C., Vitousek, K. B., & Kane, M. (1991). Thought and action in psychotherapy: Cognitive-behavioral approaches. In M. Hersen, A. Kazdin, & A. Bellack (Eds.),Clinical psychology handbook. (Second Edition) (pp. 596–626) New York: Pergamon Press.Google Scholar
  6. Kipnis, D. (1976).The powerholders. Chicago: University of Chicago Press.Google Scholar
  7. Kipnis, D., Hansen, F., & Fallon, A. (1989).Therapy and control: The metamorphic effects of power. Paper presented at the first annual meeting of the American psychological Society, Arlington, VA.Google Scholar
  8. Kottler, J. A., & Blau, D. S. (1989).The imperfect therapist. San Francisco, Jossey-Bass.Google Scholar
  9. Mays, D. T., & Frank, G. M. (1985). Negative outcomes: Historical context and definitional issues. In D. T. Mays and G. M. Frank (Eds.),Negative outcomes in psychotherapy and what to do about it. New York: Springer.Google Scholar
  10. McGovern, M. P., Newman, F. L., & Kopta, S. M. (1986). Meta-theoretical assumptions and psychotherapy orientation: Clinician attributions of patient's problem causality and responsibility for treatment outcome.Journal of Consulting and Clinical Psychology, 54, 478–481.Google Scholar
  11. Mitchell, T. R., & Wood, R. E. (1980). Supervisors' responses to subordinate poor performance: A test of an attributional model.Organizational Performance and Human Behavior, 25, 123–138.Google Scholar
  12. Ross, L. (1977). The intuitive psychologist and his short-comings: Distortions in the attribution process. In L. Berkowitz (Ed.),Advances in experimental social psychology (Vol. 10, Chap. 5). New York: Academic Press.Google Scholar
  13. Weiner, B. (1980).Human motivation. New York: Holt, Rinehart, and Winston.Google Scholar

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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