How clients choose their psychotherapist: influences on selecting and staying with a therapist

This study considered how a client chooses a psychotherapist/psychologist working in private practice. This research emerged from a desire to enable clients to make more informed choices in relation to entering psychotherapy. It considered two research questions: How do clients choose their psychotherapist? What impact does the choice of therapist have over whether or not to stay in therapy? Ten male and female participants were interviewed in semi-structured interviews and transcripts were analysed using grounded theory. A three-stage model was developed, which emphasised the relational processes underlying the influences on client’s choice of therapist and decision to remain in therapy. At the initial stage of the process, prior to meeting a therapist, clients gathered information, formed expectations, and considered practical matters such as the therapist’s location and cost. At the stage of first meeting the therapist, clients took into account aspects of the therapy setting, the information provided by the therapist, as well as their own assessment of the quality of the relationship they experienced at this first meeting. Once clients had begun working with a psychotherapist, they appeared to continually balance the gains made against the cost and convenience of the therapy whilst also continuing to assess the quality of the relationship. This ultimately had an impact on whether or not they stayed in therapy. Findings highlighted the considerable lack of clarity for clients in locating reliable sources of information about therapy and how to make the best choice of therapist. Limitations of the research were discussed and some suggestions for areas of future research were suggested. Implications for therapeutic practice include the provision of more detailed information for clients prior to beginning therapy and also at first meeting in order to demystify therapy, to enable better informed consent, and to potentially reduce client dropout rates.