Abstract
Psychotherapy is a generally effective form of mental health treatment, yet difficulties with engagement continue to plague the field. Poor outcomes, including premature termination, are more likely to be achieved by poorly motivated clients (Prochaska & DiClemente, 1992) and highly distressed individuals and couples (Tambling & Johnson, 2008). This study examined links between motivation to change, initial levels of distress, referral source, and pressure to attend therapy in an archival sample of 587 people who attended therapy. Results indicated a relationship between distress and motivation and between the perceived pressure felt by a client and motivation to change.
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