Title page for ETD etd-05102010-165141

Type of Document Dissertation
Author Perkins, Susan Nadine
Author's Email Address sperkins.research@gmail.com
URN etd-05102010-165141
Title Influential Client Factors: Understanding and Organizing Therapists' Perceptions Of client Factors That Influence Reported Outcome of Therapy
Degree PhD
Department Human Development
Advisory Committee
Advisor Name Title
Piercy, Fred P. Committee Chair
Blow, Adrian J. Committee Member
Dolbin-MacNab, Megan L. Committee Member
Doolittle, Peter E. Committee Member
  • common factors
  • client factors
  • therapy
  • outcomes
Date of Defense 2010-04-29
Availability unrestricted
Researchers and clinicians report that they think the client is the most influential

component in determining the outcome of therapy. Although a variety of studies have examined

the impact of various client factors on the outcome of couple therapy, this research is not

cohesive and produces inconsistent results. The purpose of this multi-method study is to present

a 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 research

while 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 unsuccessful

couple 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, and

logistic regression. Qualitative data were analyzed in two stages, using content analysis. Results

indicated that couples can be conceptualized by five arenas of couple focus; these arenas

accurately predicted whether participants were discussing a successful or unsuccessful case of

couple therapy 85.9% of the time. Regarding individual client characteristics, in general, clients

whose couple therapy was successful tended to be open to each other and committed to the

relationship and to therapy. Unsuccessful couple therapy tended to focus on a greater number of

individual issues. Couple dynamics characteristics differed according to outcome groups;

participants described four types of couple dynamics that influenced couple therapy to be

unsuccessful. 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 client’s life events as impacting the outcome of couple therapy by

increasing one person’s vulnerability to his or her partner. If the partner acted in a way that

created a sense of connection or support, this contributed to successful couple therapy. The

results are presented in connection to previous research, when possible. Finally, implications for

theory, research, and clinical work with couples are discussed.

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