Client Perceptions of Psychotherapists: An Analogue Study

Abstract

In the last decade, an impressive body of empirical evidence has accumulated which strongly suggests that psychotherapy outcome is a function of the levels of therapeutic conditions expressed by the therapist during the course of therapy. The empirically established role of these "levels of therapeutic conditions" (LTC) in determining process movement and therapy outcome suggested that they deserved and demanded systematic investigation in their own right as dependent variables. The primary concern of this investigation, then, was to determine whether LTC varied in its expression across therapists, and its perception across clients. It was hypothesized that psychotherapeutic orientation and client interpersonal style interact in determining client perceptions of psychotherapists. The experimental design developed for this study was a modification of Strupp's (1962) analogue procedure. Measures of interpersonal style-using Schutz's FIRO-B (1966)--were gathered from 378 college students at the University of Maryland. Approximately a week later, the Ss were randomly assigned to view one of the films in the film series Three Approaches to Psychotherapy. Immediately after viewing the film, the Ss were instructed to complete Barrett-Lennard's Relationship-Inventory in regards to how they would perceive the therapists if they were working with him as a client. The data were analyzed by means of analysis of variance procedures. The design was a 3 x 3 x 2 factorial analysis of variance (three therapeutic orientations x three client interpersonal styles x client sex). The first order interaction between therapists and clients was not significant (p <.240). However, the second order interaction (therapeutic orientation x client interpersonal style x client sex) did approach significance (p < .065), indicating that the first order therapist x client interaction was differential by sex. Subsequent analyses of variance were performed separately for males and females. For females, the therapist x client interaction was significant (p < .05), but this interaction was not significant for the male data. In discussing these results, two points were emphasized: (1) Those therapist behaviors which were perceived as facilitative and favorable by some clients, were not necessarily perceived as such by other clients; (2) The sources of variance in client perceptions were not as attributable to either therapist or client effects by themselves, as they were attributable to the interactive, system effects of the therapist-client dyads. Furthermore, the differential interaction effects between therapist and client variables and client sex were discussed in the context of sex-roles as conventionally defined at a societal level. Finally, the psychotherapeutic and research implications of the study, and its limitations, were considered.