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

Swift, Joshua K., Callahan, Jennifer L., Cooper, Mick, Parkin, Susannah R.·2018·Journal of Clinical Psychology

DOI 10.1002/jclp.22680

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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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“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).”
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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.”
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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).”
Background
Acceptability of the ‘Crisis Toolbox’: a skills-based intervention delivered in a Crisis Resolution and Home Treatment Team during COVID-19
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“The reflective analysis may foster the accommodation of clients’ perspectives and their agency (Swift et al. 2018).”
Background
Rapid transition from in‐person to videoconferencing psychotherapy in a counselor training clinic: A safety and feasibility study during the COVID‐19 pandemic
Hall, S. B., Bartley, A. G., Wenk, J., Connor, A., Dugger, S. M., & Casazza, K. (2022) · Journal of Counseling & Development · doi:10.1002/jcad.12439 · Cited by 11
“Formally, preferences refer to activities, treatments, or therapist qualities that clients want or hope to experience during therapy (Swift et al., 2018).”
BackgroundInfluential
Using Machine Learning to Match Clients and Therapy Providers: Evaluating Clinical Quality and Cost of Care
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The Use of a Smartphone Application to Complete Therapeutic Homework in Cognitive-Behavioral Therapy for Gambling Disorder: a Pilot Study of Acceptability and Feasibility
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Cooper-Norcross Tercih Envanteri Türkçe Uyarlaması : Bir Geçerlik ve Güvenirlik Çalışması
Özer, Ö., & Yalçın, İ. (2020) · Anadolu Journal Of Educational Sciences International · doi:10.18039/ajesi.790673 · Cited by 8
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Does treatment preference affect outcome in a randomized trial of a mindfulness intervention versus cognitive behaviour therapy for social anxiety disorder?
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Assessing Patient Preferences: Examination of the German Cooper-Norcross Inventory of Preferences
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Which Trauma Treatment Suits me? Identification of Patients' Treatment Preferences for Posttraumatic Stress Disorder (PTSD)
Schwartzkopff, L., Gutermann, J., Steil, R., & Müller-Engelmann, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.694038 · Cited by 7
“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).”
Background
Client preferences, therapy activities and preference-activity match as predictors of therapy outcome
Jacobsen, C. F., Karstoft, K., Falkenström, F., Nielsen, J., Lunn, S., & Poulsen, S. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2353358 · Cited by 7
“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.”
Influential
Meta-analysis on the effects of client preferences on treatment satisfaction, completion, and clinical outcome: A 10-year update
Bennett, C. B., Toevs, E. K., Angus, A., Krawczak, R. A., Trentacosta, C. J., Jagadeesh, D., Tomlinson, C. S., & Lindhiem, O. J. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102644 · Cited by 11
Effectiveness of a Fully Automated Mobile Therapeutic Versus a General Chatbot in Reducing Depression and Anxiety and Improving Well-Being: Feasibility Randomized Controlled Trial
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 12
“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.
ORCID: Swift, Joshua K.
Callahan, Jennifer L.
Cooper, Mick
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
DOI: 10.1002/jclp.22680
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
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
Health Sciences › Medicine › Psychiatry and Mental health › 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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The impact of accommodating client preference in psychotherapy: a meta-analysis

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