Activity preferences in psychotherapy: What do patients want and how does this relate to outcomes and alliance?

Mick Cooper, Biljana Van Rijn, Evi Chryssafidou, William B Stiles

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This study aimed to investigate (a) what clients’ within-treatment activity preferences were; (b) whether match between preferences and psychotherapy approach predicted outcomes and alliance; (c) whether scores on preference dimensions, per se, predicted outcomes and alliance. Participants were 470 clients engaging in one of five approaches with trainee psychotherapists. We used the Cooper–Norcross Inventory of Preferences to identify clients’ within-treatment activity preferences; and multilevel modelling to examine the relationship between these preferences—and match on these preferences—to outcomes and alliance. Clients had an overall preference for therapist directiveness and emotional intensity. We found no evidence of a preference matching effect. Clients who expressed a desire for focused challenge over warm support showed greater progress. Client preferences for focused challenge may be indicative of their readiness to change and indicate a positive prognosis. Further research should directly observe therapeutic practices and assess a range of client variables. 
© 2021, Taylor & Francis. The attached document (embargoed until 11/02/2022) is an author produced version of a paper published in COUNSELLING PSYCHOLOGY QUARTERLY uploaded in accordance with the publisher’s self-archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
Original languageEnglish
Pages (from-to)503-526
Number of pages24
JournalCounselling Psychology Quarterly
Issue number3
Publication statusPublished - 11 Feb 2022


  • Aptitude-treatment interaction research, Cognitive Behavior Therapy, Depression, Experiential/Existential/Humanistic Psychotherapy, Treatment preferences, Guided self-help
  • alliance
  • process research
  • experiential/existential/humanistic psychotherapy
  • integrative treatment models
  • preferences

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