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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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Crisis Line Use Among Undergraduate Men of Color: A Qualitative Inquiry
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“Similar to previous studies (e.g., Moore et al., 2023; Swift et al., 2018), participants emphasized greater trust in working with crisis line responders with similar social and cultural identities to themselves, highlighting the need for systematic efforts to recruit and retain crisis line…”
Psychometric Evaluation of the Cooper–Norcross Inventory of Preferences–Therapist Version
She, Z., Řiháček, T., Xu, J., Yang, W., Xu, D., Zhou, N., Ji, W., & Xi, J. (2022) · Assessment · doi:10.1177/10731911221118317 · Cited by 2
“The past two decades have witnessed a dramatic increase in research on preferences in psychotherapy in relation to therapeutic outcomes (Swift et al., 2018).”
BackgroundMethodInfluential
Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison
Fradley, M. F., Allison, M. K., Smith, M. K. S., Bossard, M., & Zielinski, M. J. (2023) · Violence Against Women · doi:10.1177/10778012231200480 · Cited by 2
“Multiple meta-analyses of patients ’ attitudes toward mental health interventions suggest that their perspectives on treatment have a signi ﬁ cant impact on engagement, dropout, and likelihood of clinical improvement (Swift & Callahan, 2009; Swift et al., 2018).”
Patients’ race/ethnicity in relation to their experiences of and attitudes toward therapist referral/assignment
Gaines, A. N., Constantino, M. J., Kmetz, H. M., & Boswell, J. F. (2023) · Cogent Mental Health · doi:10.1080/28324765.2023.2277920 · Cited by 2
“…even stronger beneficial effect for POC because they would know it is meeting a preference for using therapist performance data to inform referral/assignment (and it is established meta-analytically that meeting patient preferences is associated with better treat-ment outcomes; Swift et al., 2018).”
Psychotherapy Expectations and Preferences Among Black and White Undergraduate Women
Rodriguez, T. R., Woodling, C. M., O’Dell, C. C., Charles, N. E., Finn, J. A., & Anestis, J. C. (2024) · Journal of College Student Mental Health · doi:10.1080/28367138.2024.2303076 · Cited by 2
“Past research has found that unmet client expectations for psychotherapy are strongly related to premature termination of treatment – further highlighting the importance of discussing clients’ expectations prior to beginning therapy (Swift et al., 2018).”
People of color’s relative valuing of having therapist performance data inform the referral/assignment process
Constantino, M. J., Gaines, A. N., Hart, N. J., & Boswell, J. F. (2024) · Cogent Mental Health · doi:10.1080/28324765.2024.2305405 · Cited by 2
“Importantly, this would still be a form of evidence-informed personalization by way of meeting preferences (Swift et al., 2018).”
Influential
Responsiveness and Clinical Judgment as an Alternative to Drifting: A Narrative Update
Yonatan‐Leus, R., & Tishby, O. (2024) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-024-09638-6 · Cited by 2
“The measured patient preferences related to certain interventions, the type of treatment, and the choice of the therapist (Swift et al., 2018).”
A Scoping Review of Preferences of Men Who Experienced Sexual Assault: Implications for Adaptation of Trauma-Focused Cognitive Behavioral Therapies
Gamache, L., Dubé, L., & Belleville, G. (2025) · American Journal of Men s Health · doi:10.1177/15579883241260512 · Cited by 4
Motive-Oriented, Personalized, Internet-Based Interventions for Depression: Nonclinical Experimental Study
Bücker, L., Berger, T., Bruhns, A., & Westermann, S. (2022) · JMIR Formative Research · doi:10.2196/37287 · Cited by 3
“According to a recent meta-analysis, adapting psychotherapy to specific patient preferences is associated with fewer treatment dropouts and more positive treatment outcomes than providing a nonpreferred type or mode of treatment [25].”
Method
Critical thinking and its impact on therapeutic treatment outcomes: a critical examination
Williams, I. L., & Wright, D. E. (2019) · British Journal of Guidance and Counselling · doi:10.1080/03069885.2019.1580675 · Cited by 2
Modeling the Reduction of Attrition in Campus Mental Health Services: A Discrete Choice Conjoint Experiment
Cunningham, C. E., Rimas, H. L., Sivayoganathan, T., Stewart, B., Munn, C., Zipursky, R. B., Christensen, B. K., & Furimsky, I. (2020) · Emerging Adulthood · doi:10.1177/2167696820946894 · Cited by 3
“…of student-centered service planning is supported by systematic reviews suggesting that patients are more likely to enroll in, adhere to, and benefit from mental health services that are consistent with their preferences (Lindhiem et al., 2014; Swift & Callahan, 2009; Swift et al., 2018).”
Background
Evaluation of a decision aid for the treatment of depression among college students
Rogojanski, J., Zeifman, R. J., Antony, M. M., Walker, J. R., Monson, C. M., & and Mobilizing Minds Research Group (2020) · Journal of American College Health · doi:10.1080/07448481.2020.1817034 · Cited by 2
Patient Choice in Depression Psychotherapy: Outcomes of Patient-Preferred Therapy Versus Randomly Allocated Therapy
Kuzminskaite, E., Lemmens, L. H. J. M., van Bronswijk, S. C., Peeters, F. P. M. L., & Huibers, M. J. H. (2021) · American Journal of Psychotherapy · doi:10.1176/appi.apt.2020.2020.0042 · Cited by 7
Choice, voice and collaboration: using preference accommodation and feedback in trauma therapy
Mahon, D. (2021) · Mental Health and Social Inclusion · doi:10.1108/mhsi-06-2021-0032 · Cited by 3
A Proposed Stage Model of LGBTQ People’s Selection of and Engagement with Therapists
Leitch, J., & McGeough, B. L. (2023) · Families in Society The Journal of Contemporary Social Services · doi:10.1177/10443894221150667 · Cited by 2
“In some instances, the client may benefit from the therapist accommodating their treatment preferences (Swift et al., 2018).”
Background
Does involving patients in treatment decisions affect perceptions of treatments and therapists?
Pham, A. P., Berman, J. S., & Lewin, R. K. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1620368 · Cited by 2
Transcultural Considerations
Mahon, D. (2023) · Springer eBooks · doi:10.1007/978-3-031-18381-2_3 · Cited by 1
A Two-Phased Telehealth Model to Treat Post-Traumatic Stress Disorder in a Health Care Worker due to the COVID-19 Pandemic: A Case Report
Wang, C. C., & Difede, J. (2023) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2023.0326 · Cited by 1
“34,35 This case study reports on the first participant in this trial.”
Traumatherapie
Schwartzkopff, L., Gutermann, J., & Müller‐Engelmann, M. (2023) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000716 · Cited by 1
The mental health self‐direction scale: An abridged version and its sensitivity to change
de Haas, S. M. H., Janse, P. D., Tiemens, B. G., & Hutschemaekers, G. J. M. (2024) · Journal of Clinical Psychology · doi:10.1002/jclp.23686 · Cited by 1
Dealing with Diversity in Digital Psychological Interventions for Young People: A Structured Review
Jahedi, F., Henman, P. W. F., & Ryan, J. C. (2024) · ACI Open · doi:10.1055/s-0044-1788563 · Cited by 1
The nexus of poetics and psychotherapy: a neurobiological and substrative comparative analysis
Perkins, S. A., & Plisco, M. K. (2024) · Journal of Poetry Therapy · doi:10.1080/08893675.2024.2384469 · Cited by 1
“…advises that therapy is not effective with an individual client unless the approach of their therapist fits their “characteristics, culture, and preferences” (American Psychological Association, 2006, p. 273), a statement which is supported by research (Bohart & Wade, 2013; Swift et al., 2018).”
Should face-to-face in-person therapy be preserved for some clients with anxiety? Evaluation of Anxiety UK's psychological therapy services before and during the COVID-19 pandemic
Paton, L. W., Bee, P., Bosanquet, K., Bower, P., Fell, J., Gellatly, J. L., Lidbetter, N., Lukoseviciute, B., McMillan, D., Smithson, D., et al. (2024) · BJPsych Open · doi:10.1192/bjo.2024.738 · Cited by 1
“20 In this study we did not observe any differences in short-term outcomes across therapy delivery mode for anxiety-related conditions.”
Treatment preferences among Canadian military Veterans with chronic low back pain: Mixed-methods cross-sectional survey
Emary, P. C., Ciraco, C., DiDonato, J., Deschambault, B., Garas, A., Sprague, S., & Busse, J. W. (2024) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh-2023-0101 · Cited by 1
What About Our Physical Activity Preferences? Toward Their Incorporation Into Physical Activity Interventions
LaChance, D. J. (2025) · Journal of Physical Activity and Health · doi:10.1123/jpah.2024-0895 · Cited by 1
The Role of Treatment Methods in Evidence-based Psychological Practice
Høstmælingen, A. (2025) · Tidsskrift for Norsk psykologforening · doi:10.52734/arjo5645 · Cited by 1
Power, Interpersonal Trauma, and the Counseling Relationship: A Grounded Theory Analysis
Caputo, L. G. D., Storlie, C. A., Cureton, J. L., & Dyson, S. (2025) · Journal of Counseling & Development · doi:10.1002/jcad.70000 · Cited by 1
Mental health treatment preferences of sexual minority youth and young adults: Findings from three samples.
Eisenstadt, B. E., Chiaramonte, D. M., Ankrum, H., Bränström, R., Watson, R. J., & Pachankis, J. E. (2025) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000850 · Cited by 1
Expectations About Counseling-Brief (EAC-B) Form – Assessing Its Psychometric Properties for Use in Bangladesh
Hasan, M. I., & Haque, M. (2025) · Psychological Test Adaptation and Development · doi:10.1027/2698-1866/a000103 · Cited by 1
Beyond efficacy: Eliciting preference for face-to-face and digital psychological interventions among people with depression using discrete choice experiment
Auyeung, L., Mak, W. W. S., & Tsang, E. Z. (2025) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2025.100880 · Cited by 1
Psychotherapy dropout: a bibliometric analysis
Zhang, L., Swift, J. K., Wan, Y., Hu, J.-W., Zhang, X., Sun, X., Zhang, X., & Hou, Y. (2026) · Current Psychology · doi:10.1007/s12144-025-08690-2 · Cited by 1
“Furthermore, other noted strate - gies include respecting clients’ treatment preferences (Swift et al., 2018) and utilizing Routine Outcome Monitoring (ROM) and feedback to track progress and adjust treatment accordingly (Barkham et al., 2023).”
“The Natural Highs, the Opening Gate, the Stile to Another Somewhere…”. A Single Case Study of One Client's Experience of Walk and Talk Therapy
Revell, S., & McLeod, J. B. (2026) · Counselling and Psychotherapy Research · doi:10.1002/capr.70090 · Cited by 1
Trauma focused CBT or EMDR? Choosing a trauma-focused therapy and avoiding dropout in an NHS Talking Therapies for anxiety and depression service
Lohawala, N., McNulty, N., El-Ghaly, H., Leckstein, C., Baker, A., Ghani, M., O’Driscoll, M., Hendy, A. S., & Howells, S. (2026) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x26100737 · Cited by 1
“This is particularly important because, as the results on dropout suggest, avoiding a premature end to therapy is a key step towards a better outcome, and giving the client an open choice of therapies could be a helpful part of engagement A meta-analysis by Swift et al .”
Training, Recruiting, and Retaining African American Mental Health Professionals
Austin, J. T., & Austin, J. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-77131-7_9 · Cited by 1
Psicología positiva y terapia cognitivo conductual: Diseño, implementación y evaluación de un nuevo protocolo de intervención dirigido a personas que han vivido un evento estresante
Rincón, P., Vázquez, C., García, F. E., Rivera, C., & Bruna, B. (2022) · Ajayu Órgano de Difusión Científica del Departamento de Psicología UCBSP · doi:10.35319/ajayu.201114 · Cited by 1
“…serie de meta-análisis, identificar y tener en cuenta las preferencias de los consultantes es importante pues un acomodo de la terapia a dichas preferencias se asocia a un mejor resultado, menor abandono y una mejor alianza terapéutica (Swift, Callahan, Cooper y Parkin, 2018; Windle et al., 2019).”
Background
A practice‐based exploration of therapeutic change in a charitable, community‐based person‐centred counselling service using routine outcome measures of anxiety and depression. I: Statistical and clinically significant change
Young, J., Widdowson, M., & Tate, D. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12651 · Cited by 2
Integrativ terapi
Oddli, H. W., & Kjøs, P. (2023) · Tidsskrift for Norsk psykologforening · doi:10.52734/idvp596 · Cited by 1
“…et al., 2006; Krebs et al., 2018; Miller & Rose, 2009), agens (Bandura, 2006; Tallman & Bohart, 1999; Williams & Levitt, 2007), forventninger (Ahmed et al., 2012; Constantino et al., 2011; Frank & Frank, 1991), preferanser (Swift et al., 2018) og håp (Irving et al., 2004; Snyder et al., 1999).”
Low-Income Participants’ Preference Between Financial Incentives for Behavioral Goals vs Weight Loss Targets and Associations With Behavioral Goal Adherence
Adhiyaman, A., Jay, M. R., Chung, U. Y. R., Gronda, A., Tseng, C., Wylie‐Rosett, J., Wittleder, S., Wali, S., Ladapo, J. A., & Orstad, S. L. (2024) · American Journal of Health Promotion · doi:10.1177/08901171241254366 · Cited by 1
Rapid-Access Focused Treatment: Clinical Considerations for Brief Psychotherapy in Outpatient Psychiatry
Laird, C. W., & Dreier, A. S. (2024) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20230030 · Cited by 1
Using Patient Preferences to Customise Therapy
Tona, A. L., Brugnera, A., Stringo, J., & Cooper, M. (2024) · Springer eBooks · doi:10.1007/978-3-031-71904-2_24 · Cited by 1

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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