Description

Therapists rely on their clinical expertise in evaluating the effectiveness of therapy throughout the treatment process. The author details many experience-near aspects of the therapy process that she recommends therapists focus on in assessing whether their clinical understanding and interventions are having the desired effect, and if not, how they can adjust and tailor them to improve the treatment experience for their clients. There are many challenges for therapist as well as clients, who are simultaneously evaluating the benefit they are receiving, in attempting to evaluate an ongoing treatment process. For some clients, therapy progresses in a relatively straightforward manner, while for others it can include periods of significant setbacks and even dissatisfaction. For these and other reasons articulated, it can be hard to distinguish effective from ineffective treatment using the yardsticks of short-term progress and client satisfaction making stable change over time a more reliable indicator to use. Reflection by therapists on whether they are stably responding from their therapeutic caregiving ideals and motives or unintentionally or inadvertently responding, at times, out of personal feelings, interests, needs, or agendas, is central to evaluating an ongoing therapy process and consistent with the ethical principles of beneficence and nonmaleficence. Genuinely beneficial psychological treatment of any modality requires that the therapist have a stable capacity to remain therapeutic and regulate their personal motives so as not to take the therapy process off course in unproductive ways. The author supplies concrete suggestions for making that crucial distinction. Problems therapists identify through reflection, can deepen and strengthen the therapeutic relationship when therapists are able to respond by reexamining and reordering the balance between their personal and caregiving motives and by seeking consultation where appropriate. The author describes additional important aspects of an ongoing treatment process to consider and offers helpful yardsticks for determining whether treatment is working as intended and desired. Examples are: (1) whether there is expectable symptom improvement; 2) when setbacks occur, how to distinguish clients’ negative reactions to a beneficial therapeutic process from clients’ negative reactions to inaccurate or unhelpful therapeutic responses; and (3) the important distinction between essential developmental involvement in the therapeutic relationship and client dependency.

Learning Objectives

By the end of the reading program, participants will be able to:

1. Describe how therapists can evaluate the quality of the therapeutic process by reflecting on whether their responses to the client are being regulated by their therapeutic caregiving motives or their personal motives
2. Describe how therapists can better understand and respond to clients when they are backsliding or making erratic progress
3. Describe how therapists can determine when a client’s report of symptom improvement is or is not an accurate/reliable indicator of progress in therapy
4. Describe how to understand and assess when clients are truly independent