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date: 17 June 2019

Abstract and Keywords

Decades of research have demonstrated that psychotherapy is generally effective: symptoms change for the better and most clients feel and perform better after talk therapy (Lambert, 2013). In this chapter, we examine the relationship between number of therapy sessions and symptom change. We will focus on the primary claims of the two competing views of this relationship. The dose–effect (DE) model proposes that sessions are like doses; more session-doses cause more improvement. The good-enough-improvement (GEI) model proposes that clients persist in therapy until they improve enough to meet their goals; symptom change controls session attendance. We compare these competing models by examining patterns in the treatment we have provided at our counseling center. Our primary goal was to answer what we consider the most important question about session totals and symptom change: Do session totals cause symptom change, as proposed by the DE model, or is the reverse true: does symptom change control session totals, as proposed by the GEI model? At our counseling center both models fit the data. Greater session totals are associated with more improvement for some clients and other clients leave treatment when they improve enough to meet their treatment goals.

Keywords: psychotherapy, effectiveness, dose–response relationship, good-enough improvement relationship

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