Psychotherapy is often evaluated by the changes in symptoms that clients experience. But what other benefits do clients themselves see and rate as important? An analysis of all available studies that have looked at this topic has been published by Michaela Ladmanová and her team at the Centre for Psychotherapy Research in one of the most prestigious scientific journals in the field - The Lancet Psychiatry. This meta-analysis provides insights into what clients identify as the most important outcomes of psychotherapy.
Michaela’s meta-analysis was co-authored by Tomáš Řiháček and Klára Jonášová from INPSY/Center for Psychotherapy Research. The author team also included researchers from Masaryk University, University of Dublin, Charles University and University of Strathclyde. The aim was to summarise findings from qualitative studies on how clients evaluate the outcomes of psychotherapy that they themselves consider important. The study provides the first comprehensive overview of the changes perceived by clients following psychotherapy, across different therapeutic approaches.
The author team analysed an admirable 177 qualitative studies from 24 countries, involving 2908 clients aged 18 to 95. Clients were asked about their experiences of psychotherapy and the changes they attributed to the therapeutic process. The data were processed using meta-analysis, which divided the results into 60 categories, further divided into 10 specific groups, which related, for example, to clients' relational and social functioning, their emotional functioning, self-knowledge, attitudes toward themselves, changes in symptoms, and overall mental well-being.
Change in symptoms after therapy is not the only benefit. Other things are also important for clients
According to research, what did psychotherapy bring to clients?
- Self-knowledge and cognitive processing: deeper self-knowledge, insight into their mental processes, a more optimistic view of themselves and their lives
- Attitude towards self: greater self-acceptance, self-compassion, self-esteem and self-confidence, enhanced sense of self-empowerment and emancipation, clearer personal values and goals
- Relational and social functioning: improved attitudes towards relationships, greater empathy and assertiveness, better communication skills and deeper connections with loved ones
- Mental resilience: learning new strategies for coping with stress, emotional regulation and better self-care
- Emotional functioning: better understanding of emotions, better emotional regulation and resilience, greater openness to emotional experiences, acceptance of emotions and greater comfort in expressing them
- Behaviour change: elimination of harmful behaviour patterns, engagement in meaningful activities and better functioning in daily life
- Changing symptoms and problems: reducing anxiety, depression, somatic difficulties and finding solutions to personal problems
- General well-being: a feeling of greater happiness, peace, gratitude and renewed vitality.
- Acceptance of life: mindfulness, reduced need for control and acceptance of reality as it is
The results of the meta-analysis suggest that although symptom change is undoubtedly important, it represents only a slice of what psychotherapy brings to clients. The study therefore highlights the need to extend traditional ways of assessing psychotherapy outcomes to include aspects that clients themselves consider important. This approach may help to better understand how psychotherapy affects clients' lives and to better set goals for therapeutic practice.
Recommended citation:
Ladmanová, M., Řiháček, T., Timulak, L., Jonášová, K., Kubantová, B., Mikoška, P., Polakovská, L., & Elliott, R. (2024). Client-identified outcomes of individual psychotherapy: a qualitative meta-analysis. The Lancet Psychiatry. https://doi.org/10.1016/s2215-0366(24)00356-0
