Client-Directed Outcome-Informed Work: An Overview

Steven L. Proctor, Philip L. Herschman


Considerable research has amassed to support the contention that irrespective of specific treatment modality and in some instances, treatment provider or format, clients are likely to benefit from psychotherapy.  The psychotherapy literature appears to have shifted its focus from simply evaluating comparative treatments––and the resultant equivalence of outcome––to identifying the hypothesized underlying mechanisms or common factors found to account for client improvement.  An alternative perspective to the traditional philosophy of psychotherapy research and practice, in which researchers strive to delineate disparities between various treatment modalities and identify the most efficacious or effective for a given disorder, involves examining the commonalities.  The common factors perspective is the basis from which the Client-Directed Outcome-Informed (CDOI) approach was derived.  This paper presents a general overview of CDOI and reviews the empirical evidence supporting the relative contribution of the various factors responsible for client improvement.  CDOI may best be conceptualized as an underlying framework from which all clinicians, regardless of theoretical orientation or scientific discipline, may ascribe.  Implications for routine clinical practice are also described.

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