Professional-Patient Relations

The present study evaluated affective, relational, and emotional behaviors associated with symptom reduction and clinical outcomes in psychotherapy. It relied on 36 therapist-client dyads and assessed client symptoms using the Counseling Center Assessment of Psychological Symptoms (CCAPS-34) as the progress monitoring and outcome assessment tool used by university counseling centers before every psychotherapy session. The research examined the first administration scores and the last administration scores of the CCCAPS to determine the level of clinical improvement. The researcher used the revised Specific Affect Coding System (SPAFF) to code the therapist and client interactions throughout the entire first psychotherapy session. The results revealed significant effects between the affective exchanges in the therapeutic relationship of both the therapist and the client on clinical outcomes. The researcher employed multivariate statistics with appropriate univariate follow-up procedures to determine group differences between SPAFF codes on the symptom outcome groups and CCAPS subscales. The researcher also used path analysis following Actor Partner Independence Model assumptions (Kenny et al., 2020) to examine the interdependent emotional dynamics between therapist and client on client symptom outcomes, and these revealed significant effects between SPAFF scores observed in the first session on client outcomes at the termination of therapy. The results add to the current research literature, highlighting patterns of significant affective behaviors in the first psychotherapy session on client outcomes. The study reveals that the first session cannot be minimized, as it has a greater impact on client outcomes than previously believed. The conclusion also outlines the study’s implications for clinical practice, graduate training, and research.