International Journal of Psychology and Psychological Therapy

Volume 12 Num. 2 - June 2012


Session quality, task adjustment, and effectiveness of therapeutic sessions

Volume 12 Num. 2 - June 2012 - Pages 245-260


Esteban Ezama , Yolanda Fontanil , Yolanda Alonso


Against the backdrop of studies of therapeutic alliance and unspecific factors in psychotherapy, this paper explores the relationship between the kind of help that clients obtain in therapeutic sessions and its results. Data was obtained by means of a clinical questionnaire in which clients expressed, session by session, their priorities regarding therapeutic tasks, their satisfaction with each session and their assessment of the achieved outcomes. The statistical analysis of 679 questionnaires showed that, contrary to expectations, the therapist?s adjustment to the client?s requests improves neither satisfaction nor perceived outcome. The better predictor of both is the amount of help the client feels he or she has received during the session, regardless of the client?s priorities. Of the nine different kinds of therapeutic tasks considered in the study, help understanding what is happening correlates the most with both satisfaction and improvement, independently of whether the client prioritized this. This article discusses the kinds of assistance that achieve therapeutic goals and calls into question the value of adjusting sessions to the client?s demand. The concept of conformity instead of adjustment is proposed.

Key words:

working alliance, therapeutic tasks, therapeutic outcome, psychotherapy

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