Development of a system for categorizing client reactions to therapist interventions.

Abstract

We developed a measure of client reactions to therapist interventions. The 21 categories of the measure were divided into 14 positive and 7 negative reactions, which differed significantly from each other on client helpfulness ratings. Preliminary validity data indicated that therapist were related to client reactions more for successful cases than unsuccessful cases, pretreatment symptomatology was highly predictive of which reactions the clients reported, there were some predictable changes in reactions across time in treatment, and within-case correlations of reactions with client-rated session depth and smoothness indicated some similarities across cases. We discuss the case-specific nature of client reactions, methodological issues, and the need for greater therapist awareness of client reactions. Covert feelings undoubtedly influence a client's behavior in therapy. Rice and Greenberg (1984) noted that people in therapy are goal-setting beings who actively construe the task and situation and act in terms of their goals and construals. Clients will respond differentially to the same interventions depending on how they perceive the situation and in terms of their own goals and intentions (p. 13).