Counseling Process/Outcome

Counseling process refers to events, characteristics, or conditions that occur during or as a result of the interaction between counselor and client. The therapeutic relationship that develops during counseling sessions is an example of counseling process; completing homework outside of session also constitutes an event that fits within counseling process. Process can refer to what the counselor does with the client as well as how change occurs within the client. In contrast, counseling outcome refers to the results or effects of counseling. Outcomes are those phenomena that change in the client as a direct or indirect result of counseling. Presumably, process influences outcome, although research has been unsuccessful at demonstrating consistent links between measures of process and measures of outcomes.

Measurement of counseling process and outcome has been one of the most vexing tasks in the history of counseling and psychotherapy research. One of the key problems in process and outcome measurement is that while hundreds of process and outcome measures have been created, no consensus exists about what measures or how these measures should be employed in practice or research. Researchers refer to this as the units of measurement issue: With any particular client, or in any particular study, what should be measured? Process researchers have investigated such variables as the amount of talking by counselors or clients, counselor competence, therapist adherence to a role or treatment manual, client experiencing of affect, the strength of the therapeutic bond, client defensiveness or resistance, severity of client problem(s), and language use. As researchers have noted, process clearly signifies many different things.

The remainder of this entry discusses how psychological tests are typically evaluated, describes and evaluates a representative sample of counseling process and outcome measures, and then discusses future directions for research about process and outcome measures.