Client Preferences in Psychotherapy: A North American Survey

Abstract Psychotherapy researchers have provided an expanding base of evidence that psychotherapy is effective in attenuating numerous psychological problems. Despite the extensive research demonstrating that talking can heal, it is still not precisely clear how it does so. The healing effect of psychotherapy has been attributed to two broad categories of interventions, the common factors and the specific factors. The common factors consist of all therapist actions or attitudes that promote a communicative relationship in which the client feels safe, understood, and validated. These factors are indeed common to all research-based psychotherapies, and any therapy modality that implements these factors tends to be effective. In contrast, specific factors are the interventions specific to therapeutic modalities. Despite extensive research into the specific factors of many therapies, the common factors were found to be at least as important in the therapy efficacy of all major therapeutic approaches. Given their role in therapy outcome, it would be beneficial to determine which common factors play the greatest role in therapy efficacy. Since most common factors are therapist attributes, this study explored which therapist attributes are preferred by clients. An online survey was conducted using a sample of 1011 North Americans who were questioned about their preferences. Psychotherapy clients preferred psychotherapists with empathic and emotional attributes, in addition to therapists with knowledge of neuroscience, personality psychology, and physiology. However, some groups, particularly those traditionally marginalized, seem to be even more sensitive to common factors, requiring therapists who are exceptionally empathic and able to sympathize with clients.