Research convincingly shows that the use of client feedback in an ongoing treatment (monitoring)
has positive effects on treatment outcome. However, it is largely unknown how and
under which circumstances monitoring works. In the present exploratory study, we had two
aims: a) to identify factors influencing the use of monitoring by clinicians, and b) to identify
processes initiated by monitoring. Fourteen clinicians were extensively interviewed on their
monitoring experiences. Content analysis revealed that client and work setting factors had
predominantly negative effects on the use of monitoring. A positive attitude, sufficient time,
training and support affected monitoring use positively. Clinicians reported increased (self-)
reflection and insight in therapeutic processes, leading to better attuned therapeutic interventions.
Alliance tensions and ruptures are identified and targeted earlier in treatment, and
therapeutic tasks and goals are clarified or explained more explicitly. Sometimes, client feedback
has negative effects on clinicians’ self-esteem, undermining the quality of the working
alliance. In this study, monitoring shows to be a promising approach to improve the quality
of therapy, but only if certain basic conditions are taken into account.
monitoring, helping and disturbing factors, influencing factors
The tPeP (Journal Person-centered experiential Psychotherapy) is the scientific journal for Dutch and Flemish psychotherapists, psychologists, and psychiatrists, that work from, or are interested in a client-centered perspective.
