Psychotherapy Clients’ Recalled Treatment Experiences: A Survey of Perceived Evidence-Based Practice Elements

Background: Common evidence-based practice (EBPs) elements can be observed across cognitive-behavioral therapy (CBT) manuals for commonly occurring disorders. Example EBP elements include exposure, cognitive restructuring, teaching active coping skills (e.g., relaxation), enhancing positive affect, and facilitating a positive working alliance. It is unclear if EBP elements are frequently delivered or prioritized in routine psychotherapy. Also, little is known about the prevalence or pervasiveness of EBP elements from the routine clients’ perspective. Objective: The objective of this study was to assess psychotherapy clients’ self-reported retrospective treatment experiences with regard to common EBP elements. Method: Participants (N = 592) were consenting university undergraduate students who received course credit. Eligibility: (a) 18 years of age or older, and (b) have current or previous experience with psychotherapy or counseling. The sample was mostly female (58.1%) and Caucasian (54.4%), with a mean age of 19.04 years (SD=2.44). Eligible participants were invited to access a web-based survey that included (a) diverse measures of current symptoms and functioning; (b) an item assessing the problem domain(s) of focus during their therapy; and (c) the presence/absence of 8 potential EBP elements and the extent to which they were discussed during/were a focus of their psychotherapy. Results: Overall, routine psychotherapy clients recalled receiving a variety of EBP elements, the most common being a focus on positive emotions. The presence or absence of a recalled EBP element was, in some cases, associated with endorsement of a specific problem domain. The recall of receiving an EBP element was not consistently related to better current functioning. Implications: Future research should continue to focus on clients’ experience of psychotherapy elements, including what was/is most and least helpful to assist in the refinement and implementation of EBPs