Client preferences, therapy activities and preference-activity match as predictors of therapy outcome

Objective: This study investigated whether distinct types of psychotherapy activities, the client’s preference towards these activities prior to therapy, and the degree of match between client preferences and therapy activities, served as predictors of treatment outcomes. Methods: A total of 621 clients (M_age = 42 years, 71.7% female) received individual psychotherapy by 54 psychologists. Associations between activity preferences, therapy activities, and preference-activity match as predictors, and symptom change and treatment dropout as outcomes were analyzed using multilevel longitudinal and logistic modelling and polynomial regression models with response surface analysis. Results: No type of therapy activity or activity preference significantly predicted symptom change in therapy, while higher levels of inward orientation therapy activities predicted an increased risk of dropout. Moreover, matching and higher levels of inward orientation and affect expression activities predicted an increased risk of dropout, and matching and higher levels of outward orientation activities predicted a decreased risk of dropout. Finally, a preference-activity mismatch in affect suppression predicted an increased risk of dropout from therapy, both at higher and lower levels of affect suppression. Conclusion: Distinct types of therapy activity preferences may, especially when (mis)matched with similar levels of the same therapy activities, differentially predict particular dropout from therapy. Trial registration:ClinicalTrials.gov identifier: NCT05630560.