Associations Between Client Characteristics and Perceptions of the Importance of Implementation Quality in Decisions to Join and Stay Involved in Socioemotionally-Focused Group Therapy

INTRODUCTION: Although the majority of research on process indicators of implementation quality (IQ) focuses on individual psychotherapy (Norcross, 2002), these factors may be equally relevant for community-based programs aimed at preventing socioemotional problems. In prior work, we advanced the conceptualization of five aspects of IQ (therapeutic alliance, group dynamics, cultural competence, social validity, and treatment engagement), which are thought to enhance intervention effects (Fixsen et al., 2005). Though therapist characteristics have been linked to these process variables, client characteristics are rarely investigated (Grencavage & Norcross, 1990). In this analogue study, we hypothesized that client characteristics would be associated with client perceptions of the importance of these process variables when deciding to join and stay involved in group therapy.

METHOD: Participants were young adults recruited from a Midwestern university to complete an online survey (N = 184; ages 18 to 49, M = 23.49, SD = 5.60; 85.3% female; 82.1% white). Five-factor personality scores, ability to self-regulate, interpersonal style, and externalizing/internalizing symptoms were self-reported. Participants also rated their perceptions of how important high-quality implementation (across all five aspects of IQ) would be in their decision to join and stay involved in group therapy; a composite IQ score was utilized.

RESULTS: Participants who were more Agreeable (r = .41, p < .001), Conscientious (r = .19, p = .01), and Open (r = .17, p = .02), as well as better able to self-regulate (r = .39, p < .001), were more likely to perceive high-quality therapy processes as important. Participants endorsing interpersonal problems, including tendencies toward being domineering (r = -.30, p < .001), vindictive (r = -.32, p < .001), cold (r = -.30, p < .001), and socially avoidant (r = -.18, p = .01), and psychopathology, including aggression (r = -.20, p = .006) and depression (r = -.20, p = .006), were less likely to rate these processes as important.

CONCLUSIONS: In this analogue study, client characteristics were significantly associated with client perceptions that high-quality implementation would be important when considering joining and staying involved in group therapy. These findings suggest that individuals may perceive high-quality implementation differently, and that these process variables may not play as important a role for clients less likely to engage in adaptive social interactions. These findings have implications for dissemination and implementation researchers interested in tailoring interventions or in better understanding the match between existing interventions and target populations.