The impact of accommodating client preference in psychotherapy: a meta-analysis
Abstract
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.
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Taking patients preferences into account has been associated with higher completion of treatment, and higher improvement in clinical outcomes.
“Taking patients preferences into account has been associated with higher completion of treatment, and higher improvement in clinical outcomes (Lindhiem et al., 2014; Swift et al., 2018).”
From Effects of patient-driven iCBT for anxiety in routine primary care and the relation between increased experience of empowerment and outcome: A randomized controlled trial (2021) · cites this paper as Swift et al., 2018
Offering more tailored provider recommendations, based upon factors such as client's mental health history, therapy provider expertise, and logistical needs and preferences, could help to mitigate dropout rates.
“Offering more tailored provider recommendations, based upon factors such as client’s mental health history, therapy provider expertise, and the logistical needs and preferences (location or care delivery format) could help to mitigate these dropout rates.14”
From Using Machine Learning to Match Clients and Therapy Providers: Evaluating Clinical Quality and Cost of Care (2025) · cites this paper as [14]
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“However, several meta-analyses in adults have indicated that adapting therapy to patient preferences reduces dropout (29–31).”
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“This may be because patients’ likelihood to persevere with an agreed course of treatment could be more strongly related to other aspects of the therapist-patient process, such as the working alliance (Sharf et al., 2010) or preference accommodation (Swift et al., 2018).”
Understanding non-response in psychotherapy: A meta-synthesis
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Analyzing Psychotherapy on Twitter: An 11-Year Analysis of Tweets From Major U.S. Media Outlets
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Search Strategies for [Systematic] Literature Reviews
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You Can Lead an Adolescent to Mindfulness, but You Can’t Make Them Mindful
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“Accommodating individual preference in psycho-therapy also strongly predicts completion rates and positive outcomes (Swift et al., 2018).”
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“…the need for further research into whether VR-CBTp can be optimized in its delivery to enhance efficacy, and it highlights the need to consider other factors such as cognitive interventions 44 , therapeutic alliance 45 and patient preferences 46 , all of which may influence treatment outcomes.”
Szuhany, K. L., Adhikari, S., Chen, A., Lubin, R. E., Jennings, E. L. M., Rassaby, M. M., Eakley, R., Brown, M. L., Suzuki, R. R., Barthel, A. L., et al. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.07.008 · Cited by 9 · see citing works
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“Although standardized protocols can be helpful for counselors’ practice, we also know that forcing inflexible treatment protocols onto clients can be problematic as well (Swift et al., 2018).”
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“The reflective analysis may foster the accommodation of clients’ perspectives and their agency (Swift et al. 2018).”
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“Formally, preferences refer to activities, treatments, or therapist qualities that clients want or hope to experience during therapy (Swift et al., 2018).”
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A re‐introduction of the psychodynamic approach to the standard clinical psychology curriculum
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Awareness of and attitudes toward CBT, DBT, and ACT in an acute psychiatric sample
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Cooper-Norcross Tercih Envanteri Türkçe Uyarlaması : Bir Geçerlik ve Güvenirlik Çalışması
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Assessing Patient Preferences: Examination of the German Cooper-Norcross Inventory of Preferences
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“Previous research has demonstrated that considering patients’ treatment preferences can improve treatment outcomes (Le et al., 2018; Swift et al., 2018; Delevry and Le, 2019; Windle et al., 2020).”
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“Moreover, most studies in both reviews investigated treatment preferences, with 21 of the studies in the review by Windle et al. (2020) comparing medication to therapy and Swift et al. (2018) noting the small number of studies investigating finer-grained preference types.”
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Kutá, B., Novák, L., Žídková, R., Fürstová, J., Maliňáková, K., de Winter, A. F., & Hušek, V. (2025) · JMIR Mental Health · doi:10.2196/82642 · Cited by 9 · see citing works
“This leverages one of the primary benefits of DMHIs, which is the personalization of treatment, especially using machine learning [18], potentially leading to greater positive outcomes and lower dropout rates [11,19].”
- Authors
- Swift, J. K., Callahan, J. L., Cooper, M., & Parkin, S. R.
- Affiliations
- Idaho State University (US)
- University of North Texas (US)
- University of Roehampton (GB)
- Corresponding author
- Swift, Joshua K.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2018-08-08
- Volume
- 74
- Issue
- 11
- Pages
- 1924-1937
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2887258972
- Cited by
- 279
- References
- 20
- Citations by year
- 2026: 37 · 2025: 40 · 2024: 44 · 2023: 48 · 2022: 42 · 2021: 31 · 2020: 19 · 2019: 17 · 2018: 1
- FWCI
- 19.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- psychotherapy outcome, treatment discontinuation, consumer preferences, treatment options
- MeSH terms
- Adult, Black or African American, Culture, Depressive Disorder, Humans, Individuality, Male, Outcome and Process Assessment, Health Care, Patient Dropouts, Professional-Patient Relations, Psychotherapy, Treatment Outcome, Patient Preference
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