Exploring Client Satisfaction Among Psychotherapy Recipients

Abstract

Systematic practice of psychotherapy has been in Bangladesh for two decades. However, limited attention has been paid to study client’s perspective toward the service. The present study was aimed to understand client satisfaction by exploring and assessing its different components and associated, factors among psychotherapy recipients. This study was conducted following mixed method design. Firstly, a qualitative phenomenological study was conducted on six psychotherapy recipient’s to explore the construct and relevant facets and factors of client satisfaction through in-depth interview. Forty two factors of psychotherapy recipient’s satisfaction were found and categorized into five cluster of factors. Secondly, based on the findings of the qualitative study a scale to measure satisfaction and a set of tools to measure associated factors was devised. The scales included a 14-item client satisfaction scale and 44 minuscule tools (1- 6 items) to measure the associated factors. The client satisfaction scale possessed good criterion validity (r = -0.527 with single item thermometer scale on client satisfaction) and internal consistency (Cronbach's alpha = 0.899). Most (27) of the instruments developed for measuring factors of client satisfaction had good internal consistency reliability (Cronbach's alpha ranged from 0.505 to 0.892). Thirdly, a quantitative study was carried out on 249 psychotherapy recipient’s to identify the predictors of client satisfaction from the list of indigenously explored factors. Multiple regression analysis carried out using stepwise method to get a parsimonious model revealed ten significant predictors of client satisfaction which explain 62.5% variance in client satisfaction. Therapist’s empathy, appropriateness of therapeutic technique, and clients’ loyalty to therapy had the strongest influence on client satisfaction among the signification predictors. Other predictors of satisfaction were client’s education level, session fee, additional cost, catharsis, collaboration throughout the therapy, orienting the client toward therapy and client’s compliance. Regression model consists of four clusters of factors namely therapist, therapy, institutional and client factors. Taking into account these four clusters of factors is supposed to give a broader understanding about clients’ satisfaction toward psychotherapy. Moreover, the findings of qualitative and quantitative study suggested the importance of therapist and client factors cluster in understanding client satisfaction. Psychotherapist, researchers and psychotherapy service provider institution can use the newly developed client satisfaction and the other tools for measuring the factors to understand and design client friendly service. These tools may help researchers and service providers to monitor and develop the service quality as well as client satisfaction. Further research on service satisfaction especially in new area should consider using qualitative study to generate service recipients' experience laden context specific information. Further researches on psychotherapy recipient’s satisfaction including dropout, follow up and terminated clients along with ongoing clients would add a valuable new dimension of in psychotherapy satisfaction research.