Content area
Full Text
One parameter of the treatment planning process that needs more attention is the expected duration of counseling. Mental health counselors should be prepared to discuss with new clients both the typical duration of counseling and the rate of change that commonly occurs throughout counseling. Mental health counselors should be aware that most of their clients will attend only a few sessions before discontinuing, and they should plan counseling services accordingly. Furthermore, researchers have found that most client improvement occurs within the first few sessions, with diminishing returns as counseling continues, and discontinuation tends to occur when clients reach a level of improvement that they, but perhaps not their counselors, consider to be satisfactory. The purpose of this article is to describe how research on the base rate of counseling and the trajectory of client change can enhance the treatment planning process for both clients and counselors.
Clinical mental health counselors need to consider a number of contextual factors in developing a treatment plan for a new client, such as the nature of the presenting problem, client expectations, cultural considerations, and recommended intervention strategies (e.g., Reichenberg & Seligman, 2016). One treatment planning issue that deserves more attention is the expected duration of counseling services (Hansen, Lambert, & Forman, 2002; Vasquez, Bingham, & Barnett, 2008), an issue of importance for both clients and mental health counselors (Draper, Jennings, Baron, Erdur, & Shankar, 2002). New clients need at least a general idea as to the likely duration of counseling and rate of client improvement, so they can make informed decisions about participating in an experience that can be costly in terms of both financial and personal resources (Barrett, Chua, Crits-Christoph, Gibbons, & Thompson, 2008; Hansen et al., 2002). Likewise, mental health counselors need to understand these same phenomena, so they can recommend treatment strategies congruent with a client's expected level of commitment to the counseling process. For example, a treatment plan for a client who expects to complete 20 counseling sessions will likely be very different from a treatment plan for a client who expects to attend only three.
Unfortunately, the counseling literature, including counseling textbooks, does not provide mental health counselors with a great deal of information about either the typical duration of counseling or the...