Dual perspectives: clients' and therapists' perceptions of therapist responses

This study compares clients' and therapists' perceptions of individual therapist responses. Three segments of four responses each were sampled from early, middle, and late in actual therapy sessions with 16 client-therapist pairs. Using interpersonal process recall, both therapists and clients independently described their perceptions of the therapist's response intentions in their own session. They also rated the impact of therapist responses according to four variables, including response helpfulness and therapist empathy. Client-therapist agreements on intentions and impacts were computed using indices of both covariation and mean difference. Clients' and therapists' response-by-response reports of therapist intention were positively associated, but their average ratings for the session were not. On the other hand, their response-by-response ratings of impact were not associated, but their average ratings of helpfulness and affective impact were. Correlates of agreement were also studied. Contrary to expectations, length of therapeutic relationship was not correlated with client-therapist agreement: in fact, there was a trend toward lower agreement for client-therapist pairs of longer duration. Therapist experience also did not predict client-therapist agreement.