Advanced Relational Interventions, Emotional Arousal, The Real Relationship, and Single Session Outcome

Abstract

This study examined relationships among client-perceived session factors (self-reported emotional experience and judgments about the extent to which the therapist utilized process interventions), therapist-perceived session factors (judgments about extent to which clients experienced emotions, and self-reported use of process), the real relationship from client perspective, and client-reported session outcome. Specifically, the study attempted to determine the relative importance of client and therapist factors in predicting the real relationship, and explored the possibility of therapist-reported use of process contributing additional variance above and beyond variance contributed by client factors in predictions of the real relationship. The study also explored whether the real relationship mediated the relationship between client-perceived factors and outcome. Forty client-therapist dyads at 10 university/college counseling centers completed measures assessing factors within one therapy session. Measures for therapists included reported use of process and perceived client emotional arousal. Measures for clients included reported emotional arousal, perceived therapist use of process, strength of the real relationship, and session outcome. Despite positive correlations between client-reported session factors (emotional arousal and therapist use of process) and the real relationship, client reports were not found to be more important than therapist variables in predicting client-reported real relationship. Therapist-reported use of process did not add significant variance above and beyond client variables in predicting client-reported real relationship. Mixed results were found regarding clients’ perception of the real relationship as a mediator on the relationship between client-reported emotional expression and client-reported outcome, as well as the relationship between client-perceived therapist use of process and client-reported outcome. Implications for future research and study limitations are discussed.