INFLUENTIAL CLIENT FACTORS: UNDERSTANDING AND ORGANIZING THERAPISTSâ PERCEPTIONS OF CLIENT FACTORS THAT INFLUENCE REPORTED OUTCOME OF THERAPY

Researchers and clinicians report that they think the client is the most influentialcomponent in determining the outcome of therapy. Although a variety of studies have examinedthe impact of various client factors on the outcome of couple therapy, this research is notcohesive and produces inconsistent results. The purpose of this multi-method study is to presenta sense of the range and depth of client factors that influence the outcome of couple therapy.The use of qualitative and quantitative methods allowed the data to build on existing researchwhile expanding the range of client factors considered. Data were gathered using a dynamic,web-based survey which assigned participants to discuss a case of successful or unsuccessfulcouple therapy. Participants provided their own descriptions of influential client characteristics.Participants also rated how important they thought several literature-based client factors were.Quantitative data analysis utilized descriptive statistics, principal components analysis, andlogistic regression. Qualitative data were analyzed in two stages, using content analysis. Resultsindicated that couples can be conceptualized by five arenas of couple focus; these arenasaccurately predicted whether participants were discussing a successful or unsuccessful case ofcouple therapy 85.9% of the time. Regarding individual client characteristics, in general, clientswhose couple therapy was successful tended to be open to each other and committed to therelationship and to therapy. Unsuccessful couple therapy tended to focus on a greater number ofindividual issues. Couple dynamics characteristics differed according to outcome groups;participants described four types of couple dynamics that influenced couple therapy to beunsuccessful. Data showed that many client factors influenced the outcome of couple therapy,and that uncommon client characteristics could be vital to the outcome of some cases.Participants described a clientâs life events as impacting the outcome of couple therapy byincreasing one personâs vulnerability to his or her partner. If the partner acted in a way thatcreated a sense of connection or support, this contributed to successful couple therapy. Theresults are presented in connection to previous research, when possible. Finally, implications fortheory, research, and clinical work with couples are discussed.