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Updated: Sep 9, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 17, 2011
Therapeutic relationship and improvement as perceived by clients and therapists
Abstract:
Therapeutic relationship as perceived by clients (N = 54) and therapists (N = 8) At a community mental health clinic was rated on Lorr's (1965) five main factors: Understanding, Accepting, Accepting, Critical, Independence-Encouraging, and Authoritarian (directive). These perceptions were correlated with client and therapist ratings of improvement. In addition, discrepancies between client and therapist ratings of the relationship were correlated with outcome measures. Findings indicated that client perceptions of therapists as Understanding and Accepting were correlated most highly with self-reported improvement. Therapists self-perception of Independence-Encouraging was correlated most highly with client-rated improvement, while therapists' self-perception of Accepting and Understanding was correlated most highly with therapist-rated improvement. Differences between client and therapist ratings of the Understanding and Accepting qualities of the therapeutic relationship showed the highest negative correlations with both client and therapist improvement ratings. Implications for therapeutic and research strategies are discussed.
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