Are client- and therapist-identified significant events related to outcome?: a systematic review

ABSTRACT

The significant events paradigm in psychotherapy research assumes that some parts of the psychotherapy process play a more important role in achieving desired outcomes than others. The goal of this study was to assess whether this assumption is tenable in the light of existing research. A systematic review of 13 empirical studies which strived to establish a link between client-/therapist-identified significant events (SEs) and psychotherapy outcome was conducted. Whereas only sporadic associations were found between specific SE types and psychotherapy outcome, the match between client- and therapist-identified SEs predicted outcome. Furthermore, SEs tend to have higher specificity, emotional and information-processing quality, and a more direct focus on clients’ main issues. Finally, the process of resolution of these issues could be tracked in SE descriptions. Although studies connecting SEs with psychotherapy outcome are relatively scarce, the evidence lends support to the assumption that SEs really matter.

KEYWORDS:

• Significant events
• important events
• helpful events
• hindering events
• psychotherapy outcome
• psychotherapeutic change

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Czech Science Foundation [grant number GA18-08512S].

Notes on contributors

Hana Pivolusková

Hana Pivolusková is a psychologist and psychotherapist. She was a postgraduate student at the Department of Psychology, Faculty of Social Studies, Masaryk University, Brno at the time of the study. Her research interests include process-outcome research and evidence-based psychotherapy.

Tomáš Řiháček

Tomáš Řiháček is a psychologist and psychotherapist. He works as an Associate Professor at the Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, where he teaches several research- and methodology-oriented courses. His research interests include psychotherapy in psychosomatics, assessment of psychotherapeutic change, psychotherapist development, and psychotherapy integration.

Michal Čevelíček

Michal Čevelíček is a psychologist. He works as a researcher at the Department of Psychology, Faculty of Social Studies, Masaryk University, Brno. His research interests include qualitative methodology, psychotherapy and psychosomatics, psychotherapy integration, psychotherapy case formulation, and evidence-based psychotherapy case study.

Lucia Ukropová

Lucia Ukropová is a psychologist and psychotherapist working in the area of mental health care and welfare. She was a postgraduate student at the Department of Psychology, Faculty of Social Studies, Masaryk University, Brno at the time of the study. Her research interests include psychotherapy process and evidence-based psychotherapy case study.