Clients' Perceptions of Positive Regard Across Four Therapeutic Orientations

The primary aim of this study was to assess and compare the perceptions of clients (N = 540) in 4 different psychotherapies (psychodynamic, cognitive behavior therapy [CBT], existential/humanistic, and eclectic) regarding the extent and type of positive regard (PR) they have received in their therapy and the type of PR they regard as most affirming. PR was assessed via an online survey with the Level of Regard scale of the Barrett-Lennard Relationship Inventory (BLRI-PR), the Psychotherapist Expression of Positive Regard-Affirming scale (PEPR-A), and the Psychotherapist Expression of Positive Regard-Likely scale (PEPR-L). Regression analyses that included multiple patient, therapist, and therapy-related variables indicated that, when measured by the BLRI-PR, being in psychodynamic therapy versus CBT was associated with higher client ratings of their overall receipt of PR. However, when PR was assessed via PEPR-L and PEPR-A, clients in CBT, relative to those in psychodynamic and eclectic therapies, had higher scores on several indices of specific dimensions of PR, including one that assessed the degree of supportive/caring statements. In addition, results indicated that, in general, clients with higher scores on the Working Alliance Inventory, specifically the Task and Bond dimensions, perceived their therapists as providing higher degrees of PR. Discussion of these results focuses on the complexity involved in determining which forms of PR work best for which kinds of clients in which kinds of psychotherapy.