Relationship of client participation to psychotherapy

Ruth A. Nelson, Thomas D. Borkovec

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Dimensions of client participation in psychotherapy were assessed to investigate whether participation is unidimensional or multidimensional, stable over therapy, and/or related to measures of psychotherapy outcome. Participation dimensions included compliance with scheduling (lateness, rescheduling, no-show) and with homework assignments (completion of a daily diary and relaxation home-practice), reported acceptance of the credibility of therapy rationale, satisfaction with global and specific aspects of therapy, expectation of personal improvement in anxiety symptomatology, self-rated engagement in therapy activities, and reported judgments about therapist characteristics and relationship qualities. Outcome measures included assessor ratings, daily client self-report of anxiety severity, and questionnaire measures. Subjects were 30 clients participating in a 12-session generalized anxiety disorder comparative treatment study in which they received progressive relaxation training plus either cognitive therapy or nondirective therapy. Across clients in both treatment groups, behavioral compliance measures were poorly intercorrelated and unrelated to the other participation measures. Canonical correlation of participation variables with change on pre-post outcome measures showed a significant relationship between some participation variables representing satisfaction with specific aspects of therapy and the therapeutic relationship and improvement in daily level of subjective anxiety.

Original languageEnglish (US)
Pages (from-to)155-162
Number of pages8
JournalJournal of Behavior Therapy and Experimental Psychiatry
Issue number2
StatePublished - Jun 1989

All Science Journal Classification (ASJC) codes

  • Experimental and Cognitive Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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