PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

differ in their confidence about overcoming their problems and have satisfying lives prior
to the intake session. Although, on average, non-engagers were less hopeful than
engagers, the differences at a medium effect size did not reach statistical significance.
With a larger sample size and greater statistical power, this effect may have reached
statistical significance.
Conclusions
Overall, the patterns of helping skills (more approval-reassurance with non-
engagers than engagers at the beginning of sessions, somewhat more reflections of
feeling but somewhat less information about the process of helping with non-engagers
than engagers at the end of sessions), the finding that non-engagers were higher in
anxious attachment style than engagers, and the finding that non-engagers reported a
higher need for therapy prior to therapy, provide evidence that intake sessions differ with
engagers compared to non-engagers. The non-engagers may have elicited more approval-
reassurance from their therapists at the beginning of the session due to verbal or
nonverbal signs of anxiety about forming a new therapeutic relationship, and/or signs that
they are desperate for help. Such non-engagers may have been more focused on obtaining
immediate help from their therapists at the end of the session than the less-anxiously-
attached, less-desperate continuers, and thus elicited somewhat more reflections of
feeling and somewhat less information about the helping process at the end of the
session. Strikingly, the attachment style findings were similar to that of Marmarosh et al.
(2009), in which dropouts were also more anxiously attached than engagers.
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