PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS: ATTACHMENT STYLE, OUTCOME EXPECTATIONS, NEED FOR THERAPY, SESSION DURATION, AND THERAPIST HELPING SKILLS IN INTAKE SESSIONS

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2011

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The present study investigated client attachment style, outcome expectations, need for therapy, intake duration and therapist helping skills associated with psychotherapy engagement. Intake sessions of 16 adults (8 non-engagers, i.e., post-intake dropouts; 8 engagers, i.e., clients who attended at least 8 sessions) in individual long-term therapy were divided into thirds (beginning, middle, and end of session). Statistical controls for therapist verbal activity level and clients nested within therapists were employed for helping skills analyses. With non-engagers, compared to engagers, therapists used more approval-reassurance in the beginning third of intake sessions, but marginally more reflections of feeling and marginally less information about the helping process in the last third of intakes. Non-engagers had higher pre-therapy anxious attachment and pre-therapy self-rated need for therapy than engagers. In sum, non-engagers versus engagers differed with therapist helping skills, client attachment style, and client need for therapy, but not intake duration or client outcome expectations.

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