Client satisfaction: Consideration of correlates and response bias

The consideration of client satisfaction as a measure of clinical outcome is attractive, particularly for agency administrators, because of the apparent face validity of the construct as well as the relative feasibility of client-satisfaction studies. This study explored the relationship between client satisfaction and clinical as well as demographic variables among discharged clients in a small not-for-profit counseling center. Telephone interviews and mailed surveys were employed. Case-record information was used to determine the differences between those who responded to either method and those who could not be reached. Client satisfaction was found to be correlated with (a) client report of improved ability to handle problems, (b) whether client would recommend services to others, (c) whether the fee was considered fair, and (d) client and therapist ratings of global improvement. Therapists rated nonresponders as having shown less improvement in therapy, suggesting that those who were not reached were less satisfied and made less progress in treatment. Ways to improve validity of client satisfaction as well as increase response rates are offered.