Client Engagement In Counseling: Questionnaire Development And Relevant Studies

In recent years, client engagement has gained much attention in theoretical and clinical field. But different investigators use different concepts and definitions, such as engagement, participation, involvement and adherence.These concepts are linking with each other and often used interchangeably, but they have different standpoints and applicability, too. Some researchers only pay attention to clients’objective behaviors, for example, session attendance, the opposite is dropout. Some researchers are more concerned about the performance of the clients during the counseling or psychotherapy process. Some researchers focus on the motivation behind client’s engagement, they want to find out why some clients can overcome difficulties and persisting on counseling. Although the definition of engagement varies from different treatment plans and objectives, they still have something in common. It is generally acknowledged that client engagement is a prerequisite for clients to benefit from counseling and psychotherapy, and stressed clients’ active cooperation and efforts.Many researchers are concerned about how to successfully make clients engagement into counseling and psychotherapy. However, due to the different terms and definitions and measurement of the client engagement, the related research results were difficult to unify. Because of the limitation of the measurement method, further evidence is still needed to verify the effect of client engagement on outcome, and explore how client engagement affects the change process.This paper considers that client engagement is a series of behaviors, refers to clients’ mental and behavioral process of engaging in counseling and psychotherapy and making unremitting efforts towards changes. Based on the concept and definitions in a clear, the first study was designed to compile the client engagement questionnaire, exploratory factor analysis and confirmatory factor analysis were used to validate a five-component construction of client engagement, these 5 dimensions are session attendance, intro-session involvement, inter-session reflection, inter-session actions and adherence to counseling, included 22 items. Results showed that this questionnaire had good reliability and validity. The overall internal consistency reliability is 0.857, internal consistency reliability of each dimension ranged 0.609 to 0.836. Result showed good predictive validity and construct validity, too.The second study examined associations between different dimensions of client engagement and session outcome assessed by self-report among 142 clients, majority of whom are college students, as well as associations between different dimensions of clients’ initial engagement and treatment outcome assessed by continuous self-report among 38 college students. Findings both revealed significant associations between client engagement and session outcome, client engagement and treatment outcome. However, the correlation coefficients between session attendance and session outcome, clients’ arousal and client engagement were not significant. Regression analysis showed that the correlation between client engagement and treatment outcome may be expressed in inverse U-shape curve. Clients who had the lowest level of the engagement obtained a moderate treatment outcome; for clients who had middle level of engagement, the worst of outcome were obtained; clients with the highest level of engagement had the best treatment outcome. On the whole, it is proved that the client engagement had an important influence on the outcome, yet this relationship was influenced by other factors.