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Agreement between therapists and clients in evaluating therapy and its outcomes: Literature review

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Abstract

This paper reviews 41 studies published since the 1950s that deal with agreement between therapists and their clients in their evaluation of problems, process, and outcomes of therapy. The results indicate that there is great variability in the extent to which clients and therapists agree in evaluating various dimensions of therapy. The extent of agreement reported depended primarily on how agreement was measured. Future research should standardize the definition and measurement of client-therapist agreement. Studies should be conducted to test the different hypotheses about reasons for agreement and disagreement and to help understand the meaning of client-therapist agreement in the therapeutic context.

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References

  • Anteby, U. (1987).The evaluations of treatment and outcomes by clients who were in contact with family service agencies. Unpublished master's thesis, Haifa University, Haifa. (In Hebrew)

    Google Scholar 

  • Bachelor, A. (1987). The counselling evaluation inventory and the counselor rating form: Their relation to perceived improvement and to each other.Psychological Reports, 61, 567–575.

    PubMed  Google Scholar 

  • Ballard, R. G., & Mudd, E. H. (1957). Some theoretical and practical problems in evaluating effectiveness of counseling.Social Casework, 38, 533–538.

    Google Scholar 

  • Berzins, J. I., Bednar, R. L., & Severy, L. J. (1975). The problem of intersource consensus in measuring therapeutic outcomes: New data and multivariate perspectives.Journal of Abnormal Psychology, 84, 10–19.

    Google Scholar 

  • Blain, G. B., & McArthur, C. C. (1958). What happened in therapy as seen by the patient and his psychiatrist.Journal of Nervous and Metal Disease, 127, 344–350.

    Google Scholar 

  • Board, F. A. (1959). Patient's and physician's judgment of outcome of psychotherapy in an outpatient clinic.Archives of General Psychiatry, 1, 185–196.

    PubMed  Google Scholar 

  • Bond, G., Bloch, S., & Yalom, I. D. (1979). The evaluation of a “Target Problem” approach to outcome measurement.Psychotherapy: Theory, Research & Practice, 61, 48–54.

    Google Scholar 

  • Campbell, J. A. (1990). Ability of practitioners to estimate client acceptance of single-subject evaluation procedures.Social Work, 35, 9–14.

    PubMed  Google Scholar 

  • Carr, J. E., & Whittenbaugh, Z. J. (1969). Source of disagreement in the perception of psychotherapy outcomes.Journal of Clinical Psychology, 25, 16–21.

    PubMed  Google Scholar 

  • Caskey, N. H., Barker, C., & Elliot, R. (1984). Dual perspectives: Clients' and therapists' perceptions of therapist responses.Journal of Clinical Psychology, 23, 281–290.

    Google Scholar 

  • Cohen, J. (1960). A coefficient of agreement for nominal scales.Educational and Psychological Measurement, 10, 37–46.

    Google Scholar 

  • Cooley, E. J., & Lajoy, R. (1980). Therapeutic relationship and improvement as perceived by clients and therapists.Journal of Clinical Psychology, 36, 562–570.

    PubMed  Google Scholar 

  • Dill-Standiford, T. J., Stiles, W. B., & Rorer, L. G. (1988). Counselor-client agreement on session impact.Journal of Counseling Psychology, 35, 47–55.

    Google Scholar 

  • Dormaar, M., Dijkman, C. I. M., & de Vries, M. W. (1989). Consensus in patient-therapist interactions: A measure of the therapeutic relationship to outcome.Psychotherapy and Psychosomatics, 51, 69–76.

    PubMed  Google Scholar 

  • Farran, C. J., Carr, V., & Maxson, E. (1988). Goal related behaviors in short-term psychiatric hospitalization.Archives of Psychiatric Nursing, 2, 159–164.

    PubMed  Google Scholar 

  • Farrell, A. D., Stiles Camplain, P., &, McCullough, L. (1987). Identification of target complaints by computer interview: Evaluation of the computerized assessment system for psychotherapy evaluation and research.Journal of Consulting and Clinical Psycholog), 55, 691–700.

    Google Scholar 

  • Feifel, H., & Eells, J. (1963). Patients and therapists assess the same psychotherapy.Journal of Consulting Psychology, 27, 310–318.

    PubMed  Google Scholar 

  • Fiester, A. R. (1979). Goal attainment and satisfaction scores for CMHC clientsAmerican Journal of Community Psychology, 7, 181–188.

    PubMed  Google Scholar 

  • Garfield, S. L., Prager, R. A., & Bergin, A. E. (1971). Evaluation of outcome in psychotherapy.Journal of Consulting and Clinical Psychology, 37, 307–313.

    PubMed  Google Scholar 

  • Gomez, E., & Becker, R. E. (1985). Comparisons between the perceptions of human service workers and Chicano clients.Social Thought, 11, 40–48.

    Google Scholar 

  • Green, B. L., Gleser, G. C., Stone, W. N., & Seifert, R. F. (1975). Relationships among diverse measures of psychotherapy outcome.Journal of Consulting and Clinical Psychology, 43, 689–699.

    PubMed  Google Scholar 

  • Harty, M., & Horwitz, L. (1976). Therapeutic outcome as rated by patients, therapists and judges.Archives of General Psychiatry, 33, 957–961.

    PubMed  Google Scholar 

  • Heine, R. W. (1957). A comparison of patients' reports on psychotherapeutic experience with psychoanalytic, nondirective and Adlerian therapists.American Journal of Psychotherapy, 7, 16–23.

    Google Scholar 

  • Horenstein, D., Houston, K. B., & Holmes, D. S. (1973). Clients', therapists' and judges' evaluation of psychotherapy.Journal of Counseling Psychology, 20, 149–153.

    Google Scholar 

  • Kaschak, E. (1978). Therapist and client: Two views of the process and outcome of psychotherapy.Professional Psychology, 9, 271–277.

    Google Scholar 

  • Kokotovic, A. M., & Tracey, T. J. (1987). Premature termination at a university counseling center.Journal of Counseling Psychology, 34, 80–82.

    Google Scholar 

  • LaCrosse, M. B. (1977). Comparative perceptions of counselor behavior: A replication and extension.Journal of Counseling Psychology, 24, 464–471.

    Google Scholar 

  • Lambert, H. J. (Ed.). (1983).The assessment of psychotherapy outcome. New York: John Wiley.

    Google Scholar 

  • Malluccio, A. N. (1979).Learning from clients-interpersonal helping, as viewed by clients and social workers. New York: The Free Press.

    Google Scholar 

  • Marmar, C. R., Gaston, L., Gallagher, D., & Thompson, L. W. (1989). Alliance and outcome in latelife depression.Journal of Nervous and Mental Disease, 177, 464–472.

    PubMed  Google Scholar 

  • Marziali, E. (1984). Three viewpoints of the therapeutic alliance-Similarities, differences and associations with psychotherapy outcome.Journal of Nervous and Mental Disease, 172, 417–423.

    PubMed  Google Scholar 

  • Marziali, E., & Alexander, L. (1991). The power of the therapeutic relationship.American Journal of Orthopsychiatry, 61, 383–391.

    PubMed  Google Scholar 

  • Mayer, J. E., & Timms, N. (1969). Clash in perspective between worker and client.Social Casework, 50, 32–40.

    Google Scholar 

  • Mintz, J., Auerbach, A. H., Luborsky, L., & Johnson, M. (1973). Patient's therapist's and observers' views of psychotherapy: A ‘Rashomon’ experience or a reasonable consensus?British Journal of Medical Psychology, 46, 83–89.

    PubMed  Google Scholar 

  • Mutchler, E., & Rosen, A. (1979).The Social Welfare Forum. Evaluation of treatment outcome by client and social worker. New York: Columbia University Press.

    Google Scholar 

  • Overton, A. (1960). Taking help from our clients.Social Work, 5, 42–50.

    Google Scholar 

  • Peake, T. H. (1979). Therapist-patient agreement and outcome in group therapy.Journal of Clinical Psychology, 35, 637–646.

    PubMed  Google Scholar 

  • Porat, E. (1987).Differences between group members and group leaders in the evaluation of groups for bereaved parents. Unpublished master's thesis, Tel Aviv University, Tel Aviv. (In Hebrew)

    Google Scholar 

  • Prager, E. H. (1980).A client-developed measure of self-assessment in mental health. Unpublished doctoral thesis, School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH.

    Google Scholar 

  • Prager, E. H. (1982). Involvement of consumers in the evaluation of treatment in a day care center: A report on a pilot study.Society and Welfare, 4, 255–261. (In Hebrew)

    Google Scholar 

  • Rubenstein, H., & Bloch, M. H. (1978). Helping clients who are poor: Worker and client perceptions of problems, activities and outcomes.Social Service Review, 52, 69–84.

    Google Scholar 

  • Saltzman, C., Luetgert, M. J., Roth, C. H., Greaser, J. J., & Howard, L. (1976). Formation of therapeutic relationship: Experiences during the initial phase of psychotherapy as predictors of treatment duration and outcome.Journal of Consulting and Clinical Psychology, 44, 546–555.

    PubMed  Google Scholar 

  • Schwartz, A. J., & Bernard, H. S. (1981). Comparison of patient and therapist evaluation of time-limited psychotherapy.Psychotherapy: Theory, Research & Practice, 18, 101–108.

    Google Scholar 

  • Sirles, E. A. (1982). Client-counselor agreement on problem and change.Social Casework, 63, 348–353.

    Google Scholar 

  • Stiles, W. B. (1980). Measurement of the impact of psychotherapy sessions.Journal of Consulting and Clinical Psychology, 48, 176–185.

    PubMed  Google Scholar 

  • Stiles, W. B., & Snow, J. S. (1984). Counseling session impact as viewed by novice counselors and their clients.Journal of Counseling Psychology, 31, 3–12.

    Google Scholar 

  • Storrow, H. A. (1960). The measurement of outcome in psychotherapy.Archives of General Psychiatry, 2, 142–146.

    PubMed  Google Scholar 

  • Strupp, H. H., Wallach, M. S., & Wogan, M. (1964). Psychotherapy experience in retrospect: Questionnaire survey of former patients and their therapists.Psychological Monographs: General and Applied, 78, 1–37.

    Google Scholar 

  • Weiss, I. (1992).Agreement between clients' and therapists' retrospective evaluations of treatment and outcomes. Unpublished master's thesis, Tel-Aviv University, Tel-Aviv. (In Hebrew)

    Google Scholar 

  • Zaslove, M. O., Ungerleider, T. J., & Fuller, M. C. (1966). How psychiatric hospitalization helps: Patient views vs. staff views.Journal of Nervous and Mental Disease, 142, 568–575.

    PubMed  Google Scholar 

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Correspondence to Idit Weiss M.S.W..

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Weiss, I., Rabinowitz, J. & Spiro, S. Agreement between therapists and clients in evaluating therapy and its outcomes: Literature review. Adm Policy Ment Health 23, 493–511 (1996). https://doi.org/10.1007/BF02108686

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