Therapist directives: use and outcomes in China

We examined relationships among the use of therapist directives, client implementation of directives, and outcome for 43 Chinese therapists and their 96 Chinese clients at a university counseling center in mid-China. The results showed that most directives reported by both therapists and clients asked clients to act on or think about intrapersonal or interpersonal issues. Chinese therapists reported giving fewer, but clients reported receiving a similar number of directives than was found in Scheel et al.'s (1999) American sample. Client-rated fit, difficulty, and therapist influence did not predict client implementation directly, nor did implementation predict client-rated outcome directly. Instead, quantity and acceptability of directives interacted in influencing client implementation and use of directives facilitated client-rated outcome through strengthening working alliance.