TPC-Journal-V2-Issue3

The Professional Counselor \Volume 2, Issue 3 209 Empirical Research on Participant Perceptions in Counseling Historically, researchers examined the counseling process from the lens of the counselor, however more recently many researchers have studied client perceptions of counseling (Bowman & Marshall, 2000; Henkelman & Paulson, 2006; Paulson et al., 2001), and some researchers have explored the counseling process more holistically by eliciting client and counselor perceptions and by comparing these perceptions (Llewelyn, 1988). Martin and Stelmaczonek (1988) found, through post-session interviews for eight- or fourteen-session treatment, that clients and counselors identified the same occurrences as most important in counseling, and were only slightly different in their ranking of these occurrences. The most important occurrences for both clients and counselors were the expression of insight, providing personally revealing and significant material about self or interpersonal relationships, the expression of new ways of being or behaving either in session or outside of session, and the description and exploration of feelings. These occurrences are listed in order of importance for clients; the order differs for counselors in that the final two occurrences are reversed in rank. Lietaer and Neirinck (1986) conducted a study of client and counselor perceptions of client-centered/experiential counseling, using a post session questionnaire of open-ended questions, finding that clients perceive the therapeutic relationship as more helpful than counselors do. Clients specifically report a safe therapeutic relationship with an empathic, accepting, and involved counselor as helpful in counseling. Clients and counselors agree that self- exploration and experiential insight were the most important aspects in their counseling sessions, with some degree of difference in emphasis. Llewelyn (1988) and Lietaer (1992) both examined helpful and unhelpful, or hindering, events in counseling. Llewelyn (1988) utilized post-session questionnaires, and termination of therapy questionnaires, while Lietaer (1992) asked clients and counselors, through post-session open-ended questions, to write their perceptions and experiences of what was helpful and hindering in sessions. Llewelyn (1988) found that clients most often reported reassurance or relief, and problem solving as helpful, while Lietaer found that clients, twice as often as counselors, identified the counseling relationship as helpful. Counselors, on the other hand, most often reported events where clients gained cognitive and affective insight as helpful (Llewelyn, 1988), and self-exploration (Lietaer, 1992). As for unhelpful, or hindering events, clients in Llewelyn’s study reported events related to disappointment as unhelpful, whereas events related to misdirection were unhelpful for counselors. Counselors in Lietaer’s study identified lack of empathy, avoidance of the here-and-now of the relationship, lack of congruence, and a “flight to rationality” in both themselves and clients as hindering events in session. Clients identified either too much or too little happening in session as hindering. Clients and counselors agreed that useless self-exploration and resistance were hindering in session (Lietaer, 1992). Notably, Lietaer (1992) discovered that many participants, twice as many clients than counselors, chose not to answer the question of what is hindering in session. This finding may indicate that clients experience fewer hindering occurrences in session than counselors, or it may support the idea that clients are hesitant to criticize counselors, which has been reported by Elliott and James (1989) and Thompson and Hill (1991). Relatedly, Sells et al. (1996) interviewed clients and counselors on effective and ineffective moments over the course of counseling. Clients identified goal setting, rapport and counselor empathic qualities as important. Clients identified the following as ineffective in counseling: when counselors have their own agenda, when counselors do not understand or address the problem, unclear goals and direction, and lack of continuity of sessions. Effective moments from the counselors’ perspective resulted in one theme, specific therapist techniques that were beneficial to the client, which includes techniques such as contracting, finding solutions or exceptions to the problem, reframing, and unbalancing. In a group interview, all counselors expressed surprise that clients did not identify therapist techniques as important in counseling. Like clients, counselors also identified unclear goals and direction as ineffective. Overall, Sells et al. (1996) found that clients emphasize the counseling alliance more, while counselors emphasize techniques.