Prof. Mick Cooper leads first major interview study into client preferences in psychotherapy

• Monday, March 13, 2023

The study, which sought to explore client perspectives and experiences in psychotherapy, found that assessing and accommodating clients' preference positively affected how most clients felt about the relationship with their therapists.

Typically, clients wanted leadership, challenge, and input from their psychotherapist, and an affirming style. However, most importantly, client perspectives were varied and nuanced, highlighting the value of talking to clients about what works for them in therapy.

Participants were 13 UK-based clients who completed up to 24 sessions of ‘pluralistic’ psychotherapy at our therapy research clinic at the University of Roehampton London. At the end of their therapy, clients were asked semi-structured interview questions about how they found the preference work. Answers were analysed as a team, via a ‘consensual qualitive research’ (CQR) method, thus ensuring the results were not one person’s interpretation of qualitative data.

The data shows a nuanced picture which highlights the need for ongoing communication between client and therapist. Generally, most clients liked being asked about their preferences because it helped develop the relationship between client and therapist: clients felt safer, more trusting, and more listened to by the therapist. Conversely, however, some clients did not find it helpful to be asked about their preferences; and others found it useful when the therapist took approaches that were counter to their preferences. For some their preferences changed over time, though many kept the same preferences throughout therapy.

‘The research holds important implications for practice’, says Prof. Mick Cooper. ‘Generally, it seems asking clients about what they want and prefer in therapy is helpful, particularly in building up the therapeutic relationship. But it also needs to be sensitive to the individual client. If clients don’t feel that they have any preferences or don’t want to talk about them, therapists shouldn’t try and force it. At the same time, however, clients may be reluctant to spontaneously state what they want and need, so having some strategies for inviting clients to state their preferences is generally a helpful thing.’

You can read the full study here, plus a blog post by Prof. Cooper here.

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