PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Tryon (1989b) investigated the engagement of clients for more than one session in relation to counselor understanding of, preparation for, and education of clients, and duration of the initial interview. In addition, the study investigated the differences between professionals and practicum trainees in the percentage of clients who returned for therapy after the intake session. The study was conducted in a university counseling center. Counselors were 4 practicum trainees (2 male, 2 female) and 5 professional psychologists (2 male, 3 female). Clients were 238 college student clients (154 women, 84 men). After the initial interview, clients and counselors each completed a questionnaire investigating the therapists’ understanding of, preparation for, and teaching of the client. In addition, duration of the intake session was recorded by the receptionist from the time the client entered the interview room to when s/he left the room. Results indicated that the professionals had significantly more clients returning for therapy after the initial intake session, χ 2 (1, N = 300) = 5.20, p < .03. On average, professionals engaged 52% of their clients, whereas practicum trainees engaged 39% of their clients. The professional female counselors were the highest engaging therapists (they had EQs of over 60%, while all other therapists, both professional and practicum, had EQs below 50%). Practicum counselors were more likely to engage clients who had been helped at the counseling center before, χ 2 (1 df, n = 173) = 5.68, p < .02. Professionals were just as likely to engage clients seeking help for the first time as they were to engage clients who had been to the center previously, χ 2 (1 df, n = 127) = 2.36, ns. Results also indicated that therapists perceived themselves as teaching engaged clients more than nonengaged clients, F(1, 255) = 16.11, p < .001. Engagement interviews (about 52 minutes on average) lasted longer than non-engagement interviews (about 40 minutes on average), 21
F(1, 261) = 40.64, p < .001. Limitations of the study include the small sample of therapists, that the client sample was limited to university students (the results may not apply to non-university-student populations) in a medium-sized private university counseling center, and that no effect-size information was reported. Tryon (1990) investigated the relation of client and counselor evaluations of the initial intake interview to client engagement (i.e. client return for another session). The study was conducted in a university counseling center. At the end of the initial session, 5 professionals (3 female, 2 male), 5 practicum trainees (3 female, 2 male), and their 290 college student clients (187 female, 103 male) completed the depth and smoothness indexes of the Session Evaluation Questionnaire (SEQ; Stiles, 1980). Clients also completed the Client Satisfaction Questionnaire (CSQ; Larsen, Attkisson, Hargreaves, & Nguyen, 1979), and counselors completed items from the Pre-Counseling Assessment Blank (PCAB; Gelso & Johnson, 1983). In addition, the duration of the intake interview was determined. Significantly more clients returned for counseling after the intake session when they had longer intake interviews [F(1, 237) =10.63, p < .002], deeper interviews [as rated by both client and counselor; F(1, 237) = 7.33, p < .008 for clients, F(1, 237) = 33.88, p < .001 for counselors], greater client-rated satisfaction [F(1, 237) = 6.61, p < .02], greater counselor-rated severity of problems [i.e., disturbance, F(1, 237) = 6.81, p < .01], and greater counselor-rated motivation [F(1, 237) = 17.69, p < .001]. Limitations include the small therapist sample and the restriction of the client sample to college students, so the results may not apply to non-college student clients. Another limitation was that no effect size information was reported. 22
Page 1 and 2: ABSTRACT Title of Document: PSYCHOT
Page 3 and 4: PSYCHOTHERAPY ENGAGERS VERSUS NON-E
Page 5 and 6: Table of Contents List of Tables ..
Page 7 and 8: Last Third of the Intake: Helping S
Page 9 and 10: List of Figures Figure 1: Approval-
Page 11 and 12: therapists (Hill & Lent, 2006), tha
Page 13 and 14: third of the intake) and types of t
Page 15 and 16: “completed treatment” - from a
Page 17 and 18: ange on the OQ-45.2 when beginning
Page 19 and 20: Wierzbicki and Pekarik (1993) condu
Page 21 and 22: Enabling factors or barriers refer
Page 23 and 24: MI evaluation were statistically si
Page 25 and 26: later dropout (Barrett et al., 2008
Page 27 and 28: male) at a university counseling ce
Page 29: = 12.3, p < .001, and lower rates o
Page 33 and 34: clinic in a medium-sized Midwestern
Page 35 and 36: Summary. In summary, there are seve
Page 37 and 38: quality of the technique (e.g., app
Page 39 and 40: therapist behaviors which may be be
Page 41 and 42: of the three judges. Based on an ex
Page 43 and 44: theoretical orientation. Furthermor
Page 45 and 46: occur after closed questions, and I
Page 47 and 48: Elliott’s (1985) system used in t
Page 49 and 50: 8 women who were interviewed to det
Page 51 and 52: lasted 20 minutes for each type, tr
Page 53 and 54: corresponded to similar categories
Page 55 and 56: does not provide restatements, refl
Page 57 and 58: presenting concerns, psychosocial h
Page 59 and 60: counselors was reported. Minimal fa
Page 61 and 62: (1991); and Tryon (2003). At the en
Page 63 and 64: counselor’s emphasis from gatheri
Page 65 and 66: composed of volunteer undergraduate
Page 67 and 68: Table 3 Tryon (2003) Mean Number an
Page 69 and 70: therapy service at the university (
Page 71 and 72: treatment outcome (which means the
Page 73 and 74: Chapter 3: Statement of the Problem
Page 75 and 76: engagement, and f) a definition of
Page 77 and 78: the intake session, and about 4% wi
Page 79 and 80: Research Question 9: Do proportions
Page 81 and 82:
Chapter 4: Method The present study
Page 83 and 84:
Indian and Portuguese; aged 20-28,
Page 85 and 86:
or abandoned by romantic partners.
Page 87 and 88:
Intake sessions. When clients arriv
Page 89 and 90:
unitizer had a unit in a meaningful
Page 91 and 92:
Table 4 Proportions of Helping Skil
Page 93 and 94:
Table 6 Proportions of Helping Skil
Page 95 and 96:
to the last third of the session, a
Page 97 and 98:
second to last third, F(1, 3858) =
Page 99 and 100:
Estimated Likelihood (%) 12 10 8 6
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significant, F(1, 3856) = 3.95, p =
Page 103 and 104:
Research Question 7: Do proportions
Page 105 and 106:
Page 107 and 108:
Research Question 10: Do proportion
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Client Avoidant Attachment Scale Av
Page 115 and 116:
Client Outcome Expectations How con
Page 117 and 118:
minimal encouragers since the 2009
Page 119 and 120:
In contrast, information about the
Page 121 and 122:
duration. This null finding diverge
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Limitations Although the present st
Page 125 and 126:
for need for therapy and “How con
Page 127 and 128:
Appendix A: Preliminary Tests of Th
Page 129 and 130:
Barrett, M., Chua, W., Crits-Christ
Page 131 and 132:
Dodd, J. (1970). A retrospective an
Page 133 and 134:
Hampton-Robb, S., Qualls, R. C., &
Page 135 and 136:
Hill, C. E. (2009). Helping skills:
Page 137 and 138:
Johansson, H., & Eklund, M. (2005).
Page 139 and 140:
Ligiero, D. P., & Gelso, C. J. (200
Page 141 and 142:
Pekarik, G. (1983). Follow-up adjus
Page 143 and 144:
Stiles, W. B. (1978). Verbal respon
Page 145:
Willer, J. (2009). The beginning ps
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PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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