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Client preferences in psychotherapy reflect specific conditions and activities that clients desire in their treatment, with increasing evidence pointing to preference accommodation as facilitating psychotherapy outcomes. This updated meta‐analysis establishes the magnitude of the effect of client preference accommodation in psychotherapy. Based on data from 53 studies and over 16,000 clients, preference accommodation was associated with fewer treatment dropouts (OR = 1.79) and more positive treatment outcomes (d = 0.28) than providing client with a nonpreferred treatment or psychotherapy condition. The preference effect was moderated by study design, timing and type of outcome measurement, and client diagnosis. It was not moderated by year of publication, treatment duration, preference type, treatment options, client age, client gender, client ethnicity, or client years of education. The authors provide a case example of preference accommodation and practice recommendations for working with client preferences. [ABSTRACT FROM AUTHOR]

The purpose of this study was to bridge the methodologies of significant events and micro-process research to gain a better understanding of clients' perceptions of helpful and hindering events in psychotherapy. A total of 16 clients were asked to review a recent psychotherapy session and, while watching, complete a moment-by-moment rating of helpful/hindrance using a dial rating system. They were also asked to describe the most helpful and hindering segments that were rated as such. The moment-by-moment ratings suggest that clients perceive a significant amount of variability within a single session. The qualitative results suggest that clients perceive both specific treatment and common factors techniques as being helpful. Further, some of the same therapist actions were rated as both helpful and hindering, but they differed in the timing and the client's experience of feeling heard and understood versus judged or given advice that was not perceived as relevant to them. These results have important implications for clinical practice. [ABSTRACT FROM AUTHOR]

Clients are frequently recognized as perhaps having the largest impact on the eventual success or failure of treatment; however, researchers and clinicians alike often give inadequate attention to clients' perspectives on psychotherapy processes and outcomes. Researchers who do examine client variables in psychotherapy often conduct research about the client rather than from the client. The purpose of this article is to introduce a special issue focused on the client's perspective in psychotherapy. Specifically, the articles in this issue present case studies and quantitative and qualitative research that seek to (a) demonstrate how to tailor interventions according to the client's perspective and (b) identify common themes in clients' perspectives about their experiences in psychotherapy. [ABSTRACT FROM AUTHOR]