Stages of change and psychotherapy outcomes: A review and meta-analysis

2018 ◽  
Vol 74 (11) ◽  
pp. 1964-1979 ◽  
Author(s):  
Paul Krebs ◽  
John C. Norcross ◽  
Joseph M. Nicholson ◽  
James O. Prochaska
Author(s):  
Paul Krebs ◽  
John C. Norcross ◽  
Joseph M. Nicholson ◽  
James O. Prochaska

The transtheoretical model and the stages of change are often used to adapt treatment to the individual client. This chapter aims to review the stages of change and popular measures of change readiness in psychotherapy and to conduct a meta-analysis of the relation between readiness measures and psychotherapy outcomes. This chapter reports data from 76 studies, encompassing 25,917 patients. Moderate-sized effects (d =.41) were found for the association between stages and psychotherapy success. Outcomes were a function of pretreatment stage of change; that is, the farther a patient is along the stages, the better the treatment outcomes. The chapter concludes with limitations of the research, diversity considerations, and therapeutic practices for stage matching in psychotherapy specifically and behavioral health more generally.


Author(s):  
Joshua K. Swift ◽  
Jennifer L. Callahan ◽  
Mick Cooper ◽  
Susannah R. Parkin

Client preferences in psychotherapy reflect specific conditions and activities that clients desire in their treatment, with increasing evidence pointing to preference accommodation as facilitating psychotherapy outcomes. This updated meta-analysis establishes the magnitude of the effect of client preference accommodation in psychotherapy. Based on data from 53 studies and over 16,000 clients, preference accommodation was associated with fewer treatment dropouts (odds ratio = 1.79) and more positive treatment outcomes (d = .28). The chapter provides case examples of preference accommodation, limitations of the research, diversity considerations, and practice recommendations for working with client preferences.


Author(s):  
Jeffrey A. Hayes ◽  
Charles J. Gelso ◽  
D. Martin Kivlighan ◽  
Simon B. Goldberg

This chapter reviews the history and definition of countertransference, as well as empirical research on countertransference, its management, and the relation of both to psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (r = –.16, d = –.33, k = 14 studies, N = 973). A second meta-analysis supported the notion that countertransference management factors attenuate countertransference reactions (r = –.27, d = –.55, k = 13 studies, N = 1,065). The final meta-analysis revealed that successful countertransference management is related to better therapy outcomes (r = .39, d = .84, k = 9 studies, N = 392 participants). The authors conclude by summarizing the limitations of the research base, noting diversity considerations, and highlighting the therapeutic practices predicated on research.


2019 ◽  
Vol 64 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Leonardo Essado Rios ◽  
Álex Moreira Herval ◽  
Raquel Conceição Ferreira ◽  
Maria do Carmo Matias Freire

Author(s):  
Gregory G. Kolden ◽  
Chia-Chiang Wang ◽  
Sara B. Austin ◽  
Yunling Chang ◽  
Marjorie H. Klein

Congruence or genuineness is a relationship element with an extensive and important history within psychotherapy. Congruence is an aspect of the therapy relationship with two facets, one intrapersonal and one interpersonal. This chapter defines and provides clinical examples of congruence. It presents an original meta-analysis of its relation with psychotherapy improvement. Analysis of 21 studies, representing 1,192 patients, resulted in a weighted aggregate effect size (r) of .23 or an estimated d of .46. In closing, the chapter addresses patient contributions, limitations of the extant research, diversity considerations, and therapeutic practices that might promote congruence and improve psychotherapy outcomes.


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