The impact of accommodating client preference in psychotherapy: A meta-analysis

J Clin Psychol. 2018 Nov;74(11):1924-1937. doi: 10.1002/jclp.22680. Epub 2018 Aug 8.


Client preferences in psychotherapy reflect specific conditions and activities that clients desire in their treatment, with increasing evidence pointing to preference accommodation as facilitating psychotherapy outcomes. This updated meta-analysis establishes the magnitude of the effect of client preference accommodation in psychotherapy. Based on data from 53 studies and over 16,000 clients, preference accommodation was associated with fewer treatment dropouts (OR = 1.79) and more positive treatment outcomes (d = 0.28) than providing client with a nonpreferred treatment or psychotherapy condition. The preference effect was moderated by study design, timing and type of outcome measurement, and client diagnosis. It was not moderated by year of publication, treatment duration, preference type, treatment options, client age, client gender, client ethnicity, or client years of education. The authors provide a case example of preference accommodation and practice recommendations for working with client preferences.

Keywords: client; matching; meta-analysis; preferences; psychotherapy; psychotherapy outcome; psychotherapy relationship.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Black or African American / psychology
  • Culture
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Humans
  • Individuality*
  • Male
  • Outcome and Process Assessment, Health Care
  • Patient Dropouts / psychology
  • Patient Preference*
  • Professional-Patient Relations*
  • Psychotherapy / methods*
  • Treatment Outcome