Skip to main content

The Client's Theory of Change: Consulting the Client in the Integrative Process

Abstract

This article casts a critical eye upon the integration literature and asserts that, as in psychotherapy in general, the client has been woefully left out of the therapeutic process. An alternative that privileges the client's voice as the source of wisdom and solution is presented. It is proposed that conducting therapy within the context of the client's own theory of change offers ways of integrating multiple therapy perspectives. An argument is made for not only recasting the client as the star of the drama of therapy, but also giving the heroic client directorial control of the action as it unfolds.

This is a preview of subscription content, access via your institution.

References

  • Asay, T., & Lambert, M. (1999). The empirical case for the common factors in therapy. In M. Hubble, B. Duncan, & S. Miller (Eds.), The heart and soul of change. Washington, DC: American Psychological Association.

    Google Scholar 

  • Atkinson, D., Worthington, R., Dana, D., & Good, G. (1991). Etiology beliefs, preferences for counseling orientations, and counseling effectiveness. Journal of Counseling Psychology, 38, 258–264.

    Google Scholar 

  • Bachelor, A., & Horvath, A. (1999). The therapeutic relationship. In M. Hubble, B. Duncan, & S. Miller (Eds.), The heart and soul of change. Washington, DC: American Psychological Association.

    Google Scholar 

  • Beutler L., & Clarkin, J. (1990). Sytematic treatment selection: Toward targeted therapeutic interventions. New York: Brunner/Mazel.

    Google Scholar 

  • Blatt, S. (1992). The differential effect of psychotherapy and psychoanalysis with anaclitic and introjective patients: TheMenninger Psychotherapy Research Project revisited. Journal of the American Psychoanalytic Association, 40, 691–724.

    Google Scholar 

  • Blatt, S. J., Zuroff, D. C., Quinlan, D. M., & Pilkonis, P. (1996). Interpersonal factors in brief treatment of depression: Further analyses of the NIMH Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 64, 162–171.

    Google Scholar 

  • Brickman, P., Rabinowitz, V., Karuza, J., Coates, D., Cohn, E., & Kidder, L. (1982). Models of helping and coping. American Psychologist, 37, 368–384.

    Google Scholar 

  • Claiborn, C., Ward, S., & Strong, S. (1981). Effects of congruence between counselor interpretations and client beliefs. Journal of Counseling Psychology, 28, 101–109.

    Google Scholar 

  • Conoley, C. W., Ivey, D., Conoley, J. C., Scheel, M., & Bishop, R. (1992). Enhancing consulta tion by matching the consultee's perspectives. Journal of Counseling Development, 69, 546–549.

    Google Scholar 

  • Crane, R. D., Griffin, W., & Hill, R. D. (1986). Influence of therapist skills on client perceptions of marriage and family therapy outcome: Implications for supervision. Journal of Marital and Family Therapy, 12, 91–96.

    Google Scholar 

  • Davison, G. C., & Neale, J. M. (1986). Abnormal psychology. New York: Wiley.

    Google Scholar 

  • Duncan, B., Hubble, M., & Miller, S. (1997). Psychotherapy with “Impossible” cases: Efficient treatment of therapy veterans. New York: Norton.

    Google Scholar 

  • Duncan, B., & Miller, S. (2000). The heroic client: Client directed, outcome informed therapy. San Francisco: Jossey-Bass.

    Google Scholar 

  • Duncan, B., & Moynihan, D. (1994). Applying outcome research: Intentional utilization of the client's frame of reference. Psychotherapy, 31, 294–301.

    Google Scholar 

  • Duncan, B., Solovey, A., & Rusk, G. (1992). Changing the rules: A Client-directed approach. New York: Guilford Press.

    Google Scholar 

  • Duncan, B., Sparks, J., & Miller, S. (2000). Recasting the therapeutic drama: A client directed, outcome informed approach. In F. Datillio & L. Bevilacqua (Eds.), Comparative treatments in couples relationships. New York: Springer

    Google Scholar 

  • Elliott, S. N., Witt, J. C., Galvin, G., & Peterson, R. (1984). Acceptability of behavior interventions: Factors that influence teachers' decisions. Journal of School Psychology, 22, 353–360.

    Google Scholar 

  • Erickson, M. (1980). The nature of hypnosis and suggestion: The collected papers of Milton H. Erickson on hypnosis (Vol. 1). New York: Irvington.

    Google Scholar 

  • Erickson, M. H., & Rossi, E. L. (1979). Hypnotherapy: An exploratory casebook. New York: Irvington.

    Google Scholar 

  • Fisch, R., Weakland, J., & Segal, L. (1982). The tactics of change: Doing therapy briefly. San Francisco: Jossey-Bass.

    Google Scholar 

  • Frank, J. D. (1995). Psychotherapy as rhetoric: Some implications. Clinical Psychology: Science and Practice, 2, 90–93.

    Google Scholar 

  • Frank, J. D., & Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy (3rd ed.). Baltimore, MD: John Hopkins University Press.

    Google Scholar 

  • Gaston, L. (1990). The concept of the alliance and its role in psychotherapy. Psychotherapy, 27, 143–152.

    Google Scholar 

  • Gold, J. R. (1994). When the patient does the integrating: Lessons for theory and practice. Journal of Psychotherapy Integration, 4, 133–158.

    Google Scholar 

  • Goldfried, M., & Wolfe, B. (1998). Toward amore clinically valid approach to therapy research. American Psychologist, 66, 143–150.

    Google Scholar 

  • Goolishian, H., & Anderson, H. (1987). Language systems and therapy: An evolving idea. Psychotherapy, 24, 529–538.

    Google Scholar 

  • Hayes, J., & Wall, T. (1998). What influences clinicians' responsibility attributions? The role of problem type, theoretical orientation, and client attribution. Journal of Social and Clinical Psychology, 17, 69–74.

    Google Scholar 

  • Held, B. S. (1991). The process/content distinction in psychotherapy revisited. Psychotherapy, 28, 207–217.

    Google Scholar 

  • Hester, R., Miller, W., Delaney, H., & Meyers, R. (1990, November). Effectiveness of the Community Reinforcement Approach. Paper presented at the 24th annual meeting of the Association for the Advancement of Behavior Therapy, San Francisco, California.

  • Hoch, P. (1955). Aims and limitations of psychotherapy. American Journal of Psychiatry, 112, 321–327.

    Google Scholar 

  • Hubble, M., Duncan, B., & Miller, S. (1999). The heart and soul of change: What works in therapy. Washington, DC: American Psychological Association.

    Google Scholar 

  • Kazdin, A. E. (1980). Acceptability of alternative treatments for deviant child behavior. Journal of Applied Behavior Analysis, 13, 259–273.

    Google Scholar 

  • Kelly, G. (1955). The psychology of personal constructs. New York: Norton.

    Google Scholar 

  • Kohut, H., Stepansky, P., & Goldberg, A. (1984). How does analyses cure? Chicago: University of Chicago Press.

    Google Scholar 

  • Krupnick, J. L., Sotsky, S. M., Simmens, S., Moyher, J., Elkin, I., Watkins, J., & Pilkonis, P. A. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Project. Journal of Consulting and Clinical Psychology, 64, 532–539.

    Google Scholar 

  • Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94–129). New York: Basic Books.

    Google Scholar 

  • Lazarus, A. (1992). Multimodal theapy: Technical eclecticism with minimal integration. In J. Norcross and M. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 231–263). New York: Basic Books.

    Google Scholar 

  • Lazarus, A. (1993). Tailoring the therapeutic relationship, or being an authentic chameleon. Psychotherapy, 30, 404–407.

    Google Scholar 

  • Luborsky, L., Singer, B., & Luborsky, L. (1975). Comparative studies of psychotherapies: Is it true that “everyone has won and all must have prizes”? Archives of General Psychiatry, 32, 995–1008.

    Google Scholar 

  • Martin, J. (1988). A proposal for researching possible relationships between scientific theories and the personal theories of counselors and clients. Journal of Counseling and Development, 66, 261–265.

    Google Scholar 

  • Miller, S. D., Duncan, M. A., & Hubble, M. A. (1997). Escape from Babel: Toward a unifying language for psychotherapy practice. New York: Norton.

    Google Scholar 

  • Norcross, J. (1997). Emerging breakthroughs in psychotherapy integration: Three predictions and one fantasy. Psychotherapy, 34, 86–90.

    Google Scholar 

  • Norcross, J., & Goldfried, M. (Eds.) (1992). Handbook of psychotherapy integration. New York: Basic Books.

    Google Scholar 

  • Norcross, J., & Beutler, L. (1997). Determining the relationship of choice in brief therapy. In J. N. Butcher (Ed.), Personality assessment in managed health care: A practitioner's guide. New York: Oxford University Press.

    Google Scholar 

  • Reimers, T. M., Wacker, D. P., Cooper, L. J., & De Raad, A. O. (1992). Acceptability of behavioral treatments for children: Analog and naturalistic evaluations by parents. School Psychology Review, 21, 628–643.

    Google Scholar 

  • Safran, S., Heimberg, R., & Juster, H. (1997). Client's expectancies and their relationship to pretreatment symptomatology and outcome of cognitive-behavioral group treatment for social phobia. Journal of Consulting and Clinical Psychology, 65, 694–698.

    Google Scholar 

  • Saltzman, N., & Norcross, J. (Eds.) (1990). Therapy wars: Contention and convergence in differing clinical approaches. San Francisco: Jossey-Bass.

    Google Scholar 

  • Scheel, M., Conoley, C., & Ivey, D. (1998). Assessing client positions as a technique for increasing the acceptability of marriage therapy interventions. American Journal of Family Therapy, 26, 203–214.

    Google Scholar 

  • Tallman, K., & Bohart, A. (1999). The client as a common factor. In M. Hubble, B. Duncan, & S. Miller, (Eds.), The heart and soul of change. Washington, DC: American Psychological Association.

    Google Scholar 

  • Torrey, E. (1972). The mind game. New York: Emerson Hall.

    Google Scholar 

  • Tracey, T. (1988). Relationship of responsibility attribution congruence to psychotherapy outcome. Journal of Social and Clinical Psychology, 7, 131–146.

    Google Scholar 

  • Wampold, B. E. (1997). Methodological problems in identifying efficacious psychotherapies. Psychotherapy Research, 7, 21–44.

    Google Scholar 

  • Watzlawick, P., Weakland, J., & Fisch, R. (1974). Change: Problem formation and problem resolution. New York: Norton.

    Google Scholar 

  • Webster's collegiate dictionary (10th ed.). (1993). New York: Merriam Webster.

  • Wile, D. (1977). Ideological conflicts between clients and psychotherapists. American Journal of Psychotherapy, 37, 437–449.

    Google Scholar 

  • Wilford, J. (1986). The riddle of the dinosaur. New York: Knopf.

    Google Scholar 

  • Witt, J. C., & Elliott, S. N. (1985). Acceptability of classroom interventions strategies. In T. Kratochwill (Ed.), Advances in school psychology (pp. 251–288). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Worthington, R., & Atkinson, D. (1996). Effects of perceived etiology attribution similarity on client ratings of counselor credibility. Journal of Counseling Psychology, 43, 423–429.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Duncan, B.L., Miller, S.D. The Client's Theory of Change: Consulting the Client in the Integrative Process. Journal of Psychotherapy Integration 10, 169–187 (2000). https://doi.org/10.1023/A:1009448200244

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1009448200244

  • client's theory
  • theory of change
  • integration
  • common factors
  • client directed