PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

Chapter 3: Statement of the Problem
Understanding differences between engagers and non-engagers in terms of
therapist helping skills may help therapists reduce the occurrence of client non-
engagement in psychotherapy. Since helping skills training is an integral part of the
training of novice therapists (Hill & Lent, 2006), it may also be of interest to those
training novice therapists to know what therapist helping skills are associated with client
engagement in therapy. In the existing literature, however, very few researchers have
examined patterns of therapist helping skills used in therapy sessions for engagers versus
non-engagers. Thus, further research on therapist helping skills in relation to client
engagement in therapy is an important avenue of investigation.
There is thus far only one study examining therapist helping skills in relation to
engagement. Results of the Tryon (2003) study indicated that intake sessions for clients
who dropped out before attending the first therapy session contained less information-
giving and more minimal encouragers from the therapist than would be expected by
chance compared to that of clients who returned for a subsequent session.
Tryon (2003) also found statistically significant differences regarding the timing
of therapist verbal interventions. For engagers (compared to non-engagers), the number
of closed questions decreased, whereas the number of information-giving statements
increased as the session progressed. For non-engagers, in contrast, the amount of closed
questions increased and then decreased; information-giving showed the inverse pattern
(initial decrease then later increase).
Although the findings of Tryon (2003) are a valuable and stimulating starting
point for investigating the relationship between client engagement in therapy and
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