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Abstract

Despite efforts to identify best counseling approaches, evidence suggests that client variables are a more potent source of outcome. Two separate samples of adult clients were tested using cross-sectional designs. Study 1 used an Internet sample (N = 224) and Study 2 used a university counseling training center sample (N = 159). Hierarchical multiple regression analyses revealed that four client constructs (i.e., presenting problem, security needs, life role satisfaction, and support network) accounted for 52% and 63% of the variance in client symptom levels for Study 1 and Study 2, respectively. The pragmatic use of the findings are discussed.

Keywords

adults assessment change counseling outcome quantitative

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References

Alexopoulos

G. S.

Meyers

B. S.

Young

R. C.

Kakuma

Feder

Einhorn

Rosendahl

(1996). Recovery in geriatric depression. Archives of General Psychiatry, 53, 305–312.

Anastasi

Urbina

(1997). Psychological testing. (7th ed.). Prentice Hall, NJ: Simon & Schuster.

Baker

T. D.

(2003). Welcome to Counseling Surveys.org [Computer software]. Retrieved October 25, 2004, from http://www.counselingsurveys.org/counselors/

Beck

A. T.

Ward

C. H.

Mendelson

Mock

Erbaugh

(1961). An inventory for measuring depression. Archives of General Psychology, 4, 53–63.

Beutler

L. E.

Clarkin

J. F.

Bongar

(2000). Guidelines for the systematic treatment of the depressed patient. New York, NY: Oxford University Press.

Billings

A. G.

Moos

R. H.

(1985). Life stressors and social resources affect posttreatment outcomes among depressed patients. Journal of Abnormal Psychology, 94, 140–153.

Blazer

D. G.

Hughes

D. C.

(1991). Subjective social support and depressive symptoms in major depression: Separate phenomena or epiphenomena. Journal of Psychiatric Research, 25, 191–203.

Blustein

D. L.

(2008). The role of work in psychological health and well-being: A conceptual, historical, and public policy perspective. American Psychologist, 63, 228–240.

Boles

S. M.

Joshi

Grella

Wellisch

(2005). Childhood sexual abuse patterns, psychosocial correlates, and treatment outcomes among adults in drug abuse treatment. Journal of Child Sexual Abuse, 14, 39–55.

10.

Bosworth

H. B.

Hays

J. C.

George

L. K.

Steffens

D. C.

(2002). Psychosocial and clinical predictors of unipolar depression outcome in older adults. International Journal of Geriatric Psychiatry, 17, 238–246.

11.

Bowen

A. M.

Daniel

C. M.

Williams

M. L.

Baird

G. L.

(2008). Identifying multiple submissions in internet research: Preserving data integrity. AIDS & Behavior, 12, 964–973.

12.

Bradley

L. J.

Sexton

T. L.

Smith

H. B.

(2005). The American Counseling Association Practice Research Network (ACA-PRN): A new research tool. Journal of Counseling & Development, 83, 488–491.

13.

Brogan

M. M.

Prochaska

J. O.

Prochaska

J. M.

(1999). Predicting termination and continuation status in psychotherapy using the transtheoretical model. Psychotherapy, 36, 105–113.

14.

Chambless

D. L.

Steketee

(1999). Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic outpatients. Journal of Consulting and Clinical Psychology, 67, 658–665.

15.

Chambless

D. L.

Tran

G. Q.

Glass

C. R.

(1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11, 221–240.

16.

Clarkin

J. F.

Levy

K. N.

(2004). The influence of client variables on psychotherapy. In Lambert

M. J.

(Ed.), Bergin & Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 194–226). New York, NY: John Wiley.

17.

Cohen

(1992). A power primer. Psychological Bulletin, 112, 155–159.

18.

Cohen

Wills

T. A.

(1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.

19.

Connolly Gibbons

M. B.

Crits-Christoph

de la Cruz

Barber

J. P.

Siqueland

Gladis

(2003). Pretreatment expectations, interpersonal functioning, and symptoms in the prediction of the therapeutic alliance across supportive-expressive psychotherapy and cognitive therapy. Psychotherapy Research, 13, 59–76.

20.

Cukor

McGinn

L. K.

(2006). History of child abuse and severity of adult depression: The mediating role of cognitive schema. Journal of Child Sexual Abuse, 15, 19–34.

21.

Derogatis

L. R.

(1983). The SCL-90: Administration, scoring, and procedures for the SCL-90. Baltimore, MD: Clinical Psychometric Research.

22.

Diener

Suh

E. M.

Lucas

R. E.

Smith

H. L.

(1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 76–302.

23.

Division 12 Task Force. (1995). Training in and dissemination of empirically-validated psychological treatments: Report and recommendations. The Clinical Psychologist, 48, 3–23.

24.

Garfield

S. L.

(1994). Research on client variables in psychotherapy. In Bergin

A. E.

Garfield

S. L.

(Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 190–228). New York, NY: John Wiley.

25.

George

Blazer

D. G.

Hughes

D. C.

Fowler

(1989). Social support and the outcome of major depression. British Journal of Psychiatry, 154, 478–485.

26.

Gleaves

D. H.

Eberenz

K. P.

(1994). Sexual abuse histories among treatment-resistant bulimia nervosa patients. International Journal of Eating Disorders, 15, 227–231.

27.

Heppner

P. P.

Wampold

B. E.

Kivlighan

D. M.

(2008). Research design in counseling. (3rd ed.). Belmont, CA: Thomson Brooks/Cole.

28.

Hoberman

H. M.

Lewinsohn

P. M.

Tilson

(1988). Group treatment of depression: Individual predictors of outcome. Journal of Consulting and Clinical Psychology, 36, 393–398.

29.

Hooley

J. M.

Teasdale

J. D.

(1989). Predictors of relapse in unipolar depressives: Expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology, 98, 229–235.

30.

Howard

K. I.

Kopta

S. M.

Krause

M. S.

Orlinsky

D. E.

(1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159–164.

31.

Jahoda

(1982). Employment and unemployment. Cambridge, England: Cambridge University Press.

32.

Kadera

S. W.

Lambert

M. J.

Andrews

A. A.

(1996). How much therapy is really enough: A session-by-session analysis of the psychotherapy dose-effect relationship. Psychotherapy: Research and Practice, 5, 132–151.

33.

Kendall

P. C.

Holmbeck

Verduin

(2004). Methodology, design, and evaluation in psychotherapy research. In Lambert

M. J.

(Ed.), Bergin & Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 16–43). New York, NY: John Wiley.

34.

Lambert

M. J.

(1992). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In Norcross

J. C.

Goldfried

M. R.

(Eds.), Handbook of psychotherapy integration (pp. 94–129). New York, NY: Basic Books.

35.

Lambert

M. J.

Anderson

E. M.

(1996). Assessment for the time-limited psychotherapies. Annual Review of Psychiatry, 15, 23–42.

36.

Lambert

M. J.

Hansen

N. B.

Umpress

Lunnen

Okiishi

Burlingame

G. M.

(2003). Administration and scoring manual for the Outcome Questionnaire (OQ-45.2). Stevenson, MD: American Professional Credentialing Services LLC.

37.

Lambert

M. J.

Ogles

B. M.

(2004). The efficacy and effectiveness of psychotherapy. In Lambert

M. J.

(Ed.), Bergin & Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 139–193). New York, NY: John Wiley.

38.

Landerman

George

Campbell

R. T.

Blazer

D. G.

(1989). Alternative models of the stress buffering hypothesis. American Journal of Community Psychology, 17, 625–642.

39.

Luborsky

Crits-Christoph

Mintz

Auerbach

(1988). Who will benefit from psychotherapy? Predicting therapeutic outcomes. New York, NY: Basic Books.

40.

Mallinckrodt

(2000). Attachment, social competencies, social support, and interpersonal process in psychotherapy. Psychotherapy Research, 10, 239–266.

41.

McConnaughy

E. N.

DiClemente

C. C.

Prochaska

J. O.

Velicer

W. F.

(1989). Stages of change in psychotherapy: A follow-up report. Psychotherapy, 26, 494–503.

42.

McConnaughy

E. N.

Prochaska

J. O.

Velicer

W. F.

(1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research and Practice, 20, 368–375.

43.

McKee-Ryan

F. M.

Song

Wanberg

C. R.

Kinicki

A. J.

(2005). Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology, 90, 53–76.

44.

Meyer

Pilkonis

P. A.

Krupnick

J. L.

Egan

M. K.

Simmens

S. J.

Sotsky

S. M.

(2002). Treatment expectancies, patient alliance, and outcome further analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 70, 1051–1055.

45.

Moos

R. H.

(1990). Depressed outpatients' life contexts, amount of treatment, and treatment outcome. The Journal of Nervous and Mental Disease, 178, 105–112.

46.

Ogles

B. M.

Lambert

M. J.

Fields

S. A.

(2002). Essentials of outcome assessment. New York, NY: John Wiley.

47.

Paul

K. I.

Moser

(2009). Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 74, 264–282.

48.

Petry

N. M.

Tennen

Affleck

(2000). Stalking the elusive client variable in psychotherapy research. In Snyder

C. R.

Ingram

R. E.

(Eds.), Handbook of psychological change: Psychotherapy processes and practices for the 21st century (pp. 88–108). New York, NY: John Wiley.

49.

Pierce

G. R.

Sarason

I. G.

Sarason

B. R.

(1991). General and relationship-based perceptions of social support: Are two constructs better than one?. Journal of Personality and Social Psychology, 61, 1028–1039.

50.

Prochaska

J. O.

(1999). How do people change, and how can we change to help many more people? In Hubble

M. A.

Duncan

B. L.

Miller

S. D.

(Eds.), The heart and soul of change: What works in therapy (pp. 227–255). Washington, DC: American Psychological Association.

51.

Prochaska

J. O.

Norcross

Fowler

Follick

Abrams

(1992). Attendance and outcome in a worksite weight control program: Processes and stages of change as process and predictor variables. Addictive Behaviors, 17, 35–45.

52.

Project MATCH Research Group. (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58, 7–29.

53.

Reips

U.-D.

(2002). Standards for Internet-based experimenting. Experimental Psychology, 49, 243–256.

54.

Renshaw

K. D.

Chambless

D. L.

Steketee

(2003). Perceived criticism predicts severity of anxiety symptoms after behavioral treatment in patients with obsessive-compulsive disorder and panic disorder with agoraphobia. Journal of Clinical Psychology, 59, 411–421.

55.

Roehrle

Strouse

(2008). Influence of social support on success of therapeutic interventions: A meta-analytic review. Psychotherapy Theory, Research, Practice, Training, 45, 464–476.

56.

Sherbourne

C. D.

Hays

R. D.

Wells

K. B.

(1995). Personal and psychosocial risk factors for physical and mental health outcomes and course of depression among depressed patients. Journal of Consulting and Clinical Psychology, 63, 345–355.

57.

Snyder

C. R.

Michael

S. T.

Cheavens

J. S.

(1999). Hope as a psychotherapeutic foundation of common factors, placebos, and expectancies. In Hubble

M. A.

Duncan

B. L.

Miller

S. D.

(Eds.), The heart and soul of change: What works in therapy (pp. 179–200). Washington, DC: American Psychological Association.

58.

Sotsky

S. M.

Glass

D. R.

Shea

T. M.

Pilkonis

P. A.

Collins

J. F.

Elkin

Moyer

(1991). Patient predictors of response to psychotherapy and pharmacotherapy: Findings in the NIMH treatment of depression collaborative research program. American Journal of Psychiatry, 148, 997–1008.

59.

Spielberger

C. D.

Gorsuch

R. L.

Lushene

R. E.

(1970). The State-Trait anxiety inventory self-evaluation questionnaire. Palo Alto, CA: Consulting Psychologists Press.

60.

Steinmetz

J. L.

Lewinsohn

P. M.

Antonuccio

D. O.

(1983). Prediction of individual outcome in a group intervention for depression. Journal of Consulting and Clinical Psychology, 51, 331–337.

61.

Ware

J. E.

(1999). SF-36 health survey. In Maruish

M. E.

(Ed.), The use of psychological testing for treatment planning and outcomes assessment (2nd ed., pp. 1227–1246). Mahwah, NJ: Lawrence Erlbaum.

62.

Ware

J. E.

Kosinski

Keller

S. D.

(1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

63.

Ware

J. E.

Kosinski

Turner-Bowker

D. M.

Gandek

(2002). How to score version 2 of the SF-12 health survey: With a supplement documenting version 1. Lincoln, RI: Quality Metric.

64.

Warr

P. B.

(1987). Work, unemployment and mental health. Oxford, England: Clarendon.

65.

Weissman

M. M.

Bothwell

(1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111–1115.

Brief Client Self-Report Predictors of Psychological Distress

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