Therapists Are Not In Agreement As To Their Goals
Results: The analyses showed that even though patients judged by their therapists to have depression and anxiety problems were higher than other patients, about half of the patients reported such problems when the therapists did not, and vice versa. An agreement was not linked to a better alliance or a better outcome. Nearly one in four clients (23%) said their therapy had no goal. Sirles, E. A. (1982). Client-advisor agreement on the problem and change. Social Casework, 63, 348-353. The lack of clarity of objectives was strongly related to clients` opinions on the quality of the therapeutic alliance. In particular, a greater lack of clarity of purpose was associated with a weaker agreement between the client and the therapist on the treatment goals and task dimensions of the Working Alliance Inventory, as well as a lesser connection with the therapist. Clients with a greater lack of clarity about goals also had a higher level of psychological stress and more problems in interpersonal relationships and functions.
It`s not surprising – it`s hard to imagine how it can be anything but worrisome for a client not knowing exactly where your therapy is going and where you are. Stiles, W.B., &Snow, J. S. (1984). Impact of the board meeting, as seen by novice consultants and their clients. Journal of Counseling Psychology, 31, 3-12. Compared to the Goal Clarity Scale, the perceived lack of clarity of goals by clients who reported that goals were set at the beginning of their treatment was significantly lower. Objective: A common understanding of the patient`s symptoms and problems is considered by most theories to be an essential aspect of therapy collaboration, which likely influences the alliance and outcome. However, the empirical basis for this argument is not solid. Several studies have found weak links between a common view of the patient`s problems and outcome. The objective of this study was to analyse whether consistency in understanding the patient`s depression and anxiety problems was important for the alliance and outcome. As we have already written, goals are one of the three critical elements that together form the therapeutic alliance that was first articulated by Edward Bordin.
With the tasks of therapy and the client-therapist bond, goals represent perhaps seven times more of the variance in therapeutic outcomes than the therapeutic model itself. Keywords: agreement on problems; Alliance; outcome research; therapeutic cooperation. Weiss, I., Rabinowitz, J. &Spiro, S. Agreement between therapists and clients when evaluating therapy and its results: Bibliographic review. Adm Policy Ment Health 23, 493-511 (1996). doi.org/10.1007/BF02108686 Therapeutic Alliance: The therapeutic alliance was measured with the Client`s Working Alliance Inventory (WAI-12), which measures the degree of consistency between client and therapist on treatment tasks and treatment goals (i.e. destination consensus) and the strength of the link between them.
The lack of clarity of goals was significantly higher when initial treatment goals were discussed less frequently during treatment, and more broadly when treatment progress was not assessed regularly. Target Clarity Scale: An 11-part version of a scale designed to test clients` perception of target clarity in their therapy, rated on a 7-point Likert scale. Examples of questions are „I know what the focus of my treatment is“; „I find it difficult to indicate what the desired outcome of my treatment is“; or „The goal of treatment tends to change from time to time.“ Peake, T. . . .