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The therapeutic process holds both majesty and mystery for its participants. Client knowledge about the process ranges from total unfamiliarity with and/or misinformation about therapy—and what to expect of it—to the unique sophistication of the client who has entered into episodic therapy with several therapists. Given that individuals bring the sum of their past experiences as well as their current state into the therapeutic process, it is appropriate to assume that client expectations, behaviors, and outcomes vary due to these and many other factors, such as temperament, early learning about relationships, capacity to trust, experience of trauma, current stress level, and cultural mores.

How, then, do therapists proceed to create a therapeutic alliance that allows the maximum gain for their clients? What client attitudes and behaviors mediate the outcome of successful therapy? How does the therapist accommodate these issues when inviting a relationship, determining a course of therapeutic action, or approaching a problem area? The American Psychological Association Division 29 Task Force on Empirically Supported Therapy Relationships has compiled information on client characteristics within the therapy relationship that have been shown to enhance therapeutic outcome. This entry addresses some of these factors.

Meaning-Making and Attribution

The term first impression generally denotes an individual's immediate sense and understanding of an encounter with a specific person or situation. Individuals may use many different pieces of information as evidence for making quick judgments about others that may become lasting beliefs. Researchers have suggested that humans have a unique ability to judge personality traits and complex social characteristics—such as dominance, hierarchy, warmth, fear, and threat—from their first impression of individuals they meet or see in a photograph.

The client's assessment of the personal character of the therapist, including the therapist's physical appearance and dress, professional reputation, assumed ethnicity, and gender, is influenced by the innumerable experiences the client has synthesized over his or her lifetime. Such impressions often lead to permanent judgments and emotional reactions to others, particularly those perceived to be in positions of authority or power. There is little a therapist can do to change clients' past experiences and how these experiences affect their relationships to the therapist and the experience of counseling. Therapists accept that some issues may be projected onto the therapist and create a distorted view of the interactions between client and therapist. Therapists then work to provide a way in which clients may be able to recognize their distortions when the distortions are pointed out by the therapist in a respectful, well-timed, and appropriate manner.

Different schools of therapy have different labels for these projective phenomena: transference and countertransference, products of early learning, personal schemas, or projective identification. The client's attribution of specific positive and negative qualities to the therapist and therapeutic process allows the therapist to understand how the client views the world and to provide corrective emotional experiences through addressing the appropriateness and validity of the client's ascriptions. It also provides a platform for therapists to evaluate themselves and their own attributions and biases through self-reflection, supervision, or their own psychotherapy.

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