PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

engagement, and f) a definition of ‘engager’ in which clients must have attended at least
8 sessions of therapy (indicating greater “buy-in” than if they attended just one
subsequent session after the intake). The most widely used content analysis system in
counseling psychology research (Hill, Nutt, & Jackson, 1994), the Helping Skills System
(HSS; Hill, 2009), was used in the present study to classify helping skills categories.
Since minimal empirical evidence exists on the study of helping skills and
engagement, I pose research questions rather than hypotheses on the relationship between
helping skills and engagement. Originally, I proposed two research questions for the
present study: 1) Do therapists use different proportions of skills in intake sessions with
clients who continue versus those who drop out?, and 2) Does the proportion of therapist
skills change over thirds of intake sessions for dropouts compared to continuers?
However, to be more descriptive of the data, I accordingly re-formatted the original
research questions into nine research questions so that each skill occurring at least 1% of
the time had its own research question. In addition, to be more precise in my
terminology, I use the terms ‘engager,’ and ‘non-engager,’ instead of ‘dropouts’ and
‘continuers.’
These nine research questions are presented and briefly discussed below.
Research Question 1: Do proportions of therapist approval-reassurance differ across
time (1 st , 2 nd , and 3 rd thirds of intake sessions) and condition (engager versus non-
engager)?
Hill (1978) found that approval-reassurance was on average used 5 to 6% for each
third of the intake; Hill found no difference in the use of approval reassurance across
thirds of the intake (see Table 1 in Chapter 2). Lonborg et al. (1991) found that average
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