Clients as consultants: Understanding what consumers find helpful in therapy

Beth L. Giurelli (1999)

This paper describes a research project which sought to understand, from the perspective of the consumer, what clients find to be helpful in therapy. The paper begins by situating the researcher in order to render transparent the context and values behind the study. The empirical research on client preferences and expectations is reviewed, methodological problems are discussed, and the dominant discourse concerning the expert stance of the researcher and clinician is examined. Theoretical and practical tenets underlying narrative therapy and consumerism are explored in light of their non-expert stance; and a need to move to more collaborative practices in both therapy and research is established. The research utilized a survey methodology in which accountability practices are brought into the research arena within the context of a group private practice. Analyses of the results include a detailed understanding of what clients found to be most helpful in therapy. Main findings indicate that consumers find therapist feedback, a solution-focus to therapy, and practical steps which clients can proactively implement to be most helpful. Additional findings indicate that therapist reassurance, objectivity, communication, listening skills, flexibility and understanding are helpful. Major differences by session number were not found. The results represent the combined voices of 73 consumer consultants to the therapy process.