VISTAS articles are made available for historical reference only and are presented "as is." ACA does not guarantee or represent that the information is current, accurate or indicative of the original or intended quality. These materials are not maintained or updated and may contain outdated or incomplete information. Readers should exercise discretion and verify information independently before relying on it. We assume no responsibility for the use or interpretation of this content.

Article 42

Counseling Students’ Perceptions of Counseling Effectiveness

Adriean Mancillas

Download PDF

Within counseling effectiveness research, considerable importance has been placed on the factors that contribute to successful outcomes. Knowledge of the determinants of successful counseling is essential in order for counselors to improve therapeutic efficacy, for counselor educators to incorporate current research into instruction, and for counseling students to begin their training with the proper understanding of counseling procedures. However, studies have indicated that as a whole, counseling professionals underutilize research which can lead to erroneous conceptions of what makes counseling effective (Herman, 1993). Inaccurate perceptions of counselor competence have been demonstrated with counseling students (e.g., Yager, 1984), yet there is a lack of discussion in the literature regarding what these perceptions actually are, particularly in regard to what counseling students specifically believe contributes to effective counseling.

In order to better understand students’ perceptions and improve the education of counselors in training, the present study was conducted to assess the content and accuracy of students’ perceptions of counseling effectiveness and elucidate areas where further instruction, including research utilization, may be needed. This article presents a brief review of this study and the counseling outcome literature.

Based on extensive reviews of counseling outcome research, Lambert (1992) concluded that the counselor’s techniques account for only 15% of the total therapeutic outcome. Another 15% is attributable to expectancy and placebo effects, which relate to clients’ belief that their counseling will result in desired changes. The therapeutic relationship, interpersonal variables of the counselor, and core conditions of empathy, warmth, and positive regard, account for 30% of a positive counseling outcome. The greatest proportion, 40%, is estimated to be due to client variables, such as motivation and level of pathology.

Numerous studies have demonstrated the significance of the therapeutic relationship in determining effective counseling (e.g., Martin, Garske, & Davis, 2000). Moreover, the quality of the relationship is partially determined by the personal qualities of the counselor, which have been shown to be more important to clients than particular techniques or interventions (Lambert & Cattani-Thompson, 1996; Sperry, Carlson, & Kjos, 2003). Empathy, warmth, and positive regard are also interrelated with the therapeutic relationship and the counselor’s attributes. The client’s experience of feeling empathically understood has been shown to be a primary component of effective counseling and the best predictor of a successful outcome (Lambert & Barley, 2001; Lafferty, Beutler, & Crago, 1989).

An effective counselor not only conveys accurate empathy, but also recognizes whether the empathic responses will indeed be experienced as accurate by the client. Research has demonstrated that empathy increases when counselors modify their empathic response style to fit the client’s definition of helpful, empathic responses (Lambert & Barley, 2001); the ability to do so corresponds to counselor sensitivity to individual and cultural differences, which is also a determinant of a quality therapeutic relationship and effective counseling (Sperry et al., 2003).

A large portion of a positive counseling outcome is determined by the client (Lambert, 1992: Lambert & Barley, 2001; Lambert & Cattani-Thompson, 1996). The client’s level of pathology, motivation for change, expectations for treatment, coping skills, personal history, and other external resources all influence how effective the counseling experience will be (Lambert, 1992; Lambert & Cattani-Thompson, 1996). Clients clearly benefit by actively participating in the counseling process. The more collaborative, motivated, and engaged clients are, the more they tend to be involved, which results in effective counseling (Sperry et al., 2003).

There are several reasons why receiving personal counseling might increase a counselor’s effectiveness. For example, personal counseling could increase one’s emotional stability and ability to practice, and facilitate empathy for clients by experiencing their role (Macran, Stiles, & Smith, 1999). According to studies where counselors and therapists have been questioned about their personal counseling experiences, it is consistently reported that receiving personal counseling is beneficial and has an impact on one’s effectiveness as a counselor (Beck & Yager, 1988; Macran et al., 1999).

Method

To gain information about the specific perceptions counseling students hold about counseling effectiveness, 86 graduate students, ranging in age from 22 to 53 years, were selected from prepracticum courses and given a questionnaire which asked, “List the factors that you think are indicative of effective/ineffective counseling” and “Have you ever received personal counseling or therapy?” as well as “Do you think there is any relationship between having experienced one’s own personal counseling and being an effective counselor? Why or why not?”

Responses were content analyzed and organized into a coherent list. Multiple responses were then rank ordered according to frequency and combined into factors only when responses were synonymous. Finally, factors were extracted into thematic categories.

Results

A total of 559 and 347 factors were reported as indicative of effective and ineffective counseling, respectively. Three thematic categories of factors were revealed: client variables, counselor skills and competence, and counselor interpersonal attributes. Client variables received 1.25% of the total responses for effective counseling; specific factors included “strong family support,” “specific goals in treatment,” “client’s consistency to treatment,” and client attributes of being “willing,” “open,” “voluntary,” and “honest.” Client variables contributing to ineffective counseling comprised only .86 % of the total; reported factors were “resistance,” “impractical goals,” and “incorrect assumptions about treatment or the counselor.”

Counselor skills and competence comprised 41.1% and 36.3% of the total effective and ineffective counseling factors, respectively. This category included specific techniques, counselor training and knowledge, and any variables pertaining to the counselor’s management of the counseling process.

The majority of responses perceived for both effective and ineffective counseling regarded counselor interpersonal attributes, which comprised 57.6% of the total responses for effective counseling and 62.8% for ineffective counseling. This category included the counselor’s demeanor, personal characteristics, approach to counseling, and presence or lack of the core therapeutic conditions.

Due to a large number of overall responses, only those factors that received over 2% of the total for effective and ineffective counseling are presented here, although all factors reported were included in the totals and percentages. The following are the factors students most frequently perceived as being indicative of effective counseling, with percentages of total factors reported: good listening skills (12.5%), empathy/ acceptance/understanding (12.0%), nonjudgmental/objective/open-minded (6.1%), kindness/caring/warmth (5.9%), knowledge/training (5.2%), good attending skills (3.4%), honest/trustworthy (3.2%), and patient (2.3%).

The following are the factors students most frequently perceived as being indicative of ineffective counseling, and the percentages of total factors reported: judgmental/objective/close-minded (10.4%), uncaring/impersonal/cold (7.8%), poor listening skills (7.2%), rude/angry/hostile (6.3%), egotistical/arrogant (4.0%), culturally insensitive/prejudiced (3.7%), lack of knowledge/training (3.2%), inattentive (3.2%), impatient (2.6%), controlling/demanding (2.3%), inflexible/stubborn (2.3%), poor attending skills (2.3%), gives too much advice (2.0%), and pessimistic/negative attitude (2.0%).

Approximately half (48%) of the students had attended personal counseling. Regardless of having attended counseling, the majority (86%) believed that experiencing one’s own personal counseling was relevant to being an effective counselor.

Among the 86% of students who believed seeking personal counseling was important to being an effective counselor, 52% felt that it was necessary to experience the client’s role in order to have greater empathy for the client, 28% believed counseling would help resolve personal issues that may affect one’s objectivity and ability to effectively practice, and 20% felt that the observation of counseling strategies and practices by an experienced counselor would increase the effectiveness of counseling provided to future clients. A minority of the participants (10%) did not believe that experiencing one’s own personal counseling was relevant to being an effective counselor, with many simply commenting that they believed personal experience in counseling has nothing to do with effectiveness.

Discussion

The beginning counseling students in this study largely demonstrated accuracy in their perceptions of what contributes to counseling effectiveness, with one exception: students reported counselor interpersonal attributes most frequently in describing both effective and ineffective counseling, thereby placing the primary responsibility for outcome on the counselor. Conversely, students reported client variables least frequently as factors contributing to outcome; however, as research has shown, variables relating to the client contribute to outcome much more than the counselor (Lambert, 1992).

This result raises the question of why students reported so few client variables and relatively so numerous counselor variables as indicative of effective and ineffective counseling. One obvious possibility pertains to the students’ perspective of being counselors- in-training. Students may have placed undue influence on the counselor’s role simply because that is where their current focus is. Similarly, it is common for students to worry about competence and overly emphasize the impact of their own actions as beginning counselors. It is also possible that the words effective and ineffective contained in the stimulus prompts may have elicited a focus upon counselor factors as opposed to other variables that could affect outcome. It may be that if the stimulus question were reworded to say “List the factors that you think are indicative of an effective/ ineffective outcome,” a greater variety of factors, including client variables, might have been reported.

Further, students’ relative deemphasis of the client’s role in contributing to effective counseling may also be due to a lack of education about the importance of client variables as key determinants of outcome. If so, this finding suggests that these students are in need of further education regarding the client’s contribution to counseling and may exemplify the underutilization of research among counselors, counselor educators, and students that Herman (1993) discussed.

The results also indicated that the majority of students believed attending personal counseling is relevant to being an effective counselor, which is consistent with previous research on this topic. It is noteworthy that despite half of the students not having received counseling themselves, most believed that personal counseling would be an important factor for effectiveness.

Implications for Practice and Research

One implication from the present findings is the need for more research-based education regarding counseling outcome. If students are unaware of the client’s importance in determining outcome, then a further implication exists regarding counseling practice. It is clinically important for counselors to understand the role that clients have in determining their own outcome and to expect a corresponding degree of responsibility from them. Additionally, for beginning counselors who are typically preoccupied with competence concerns, it is beneficial for them to know that there are many therapeutic factors outside their control in determining effective counseling, and that outcome is not solely determined by their every action.

The reasons students provided as positive effects of receiving personal counseling suggest that any counselor in training would benefit from the experience, which is consistent with personal counseling requirements instituted by many programs nationwide. The students in this study were not required to attend personal counseling, and more asserted the importance of personal counseling than had actually attended. Underlying possibilities for this discrepancy between students’ apparent knowledge of the importance of personal counseling for counselors versus the lack of actually attending counseling may be due to fear of the unknown, a reluctance to personally examine one’s self, an internalized bias against seeking mental health care, or having to commit to the time and costs involved in regular counseling. Due to the beneficial impact personal counseling has been shown to have on counselor efficacy, it would be wise for counselor educators to strongly encourage students who are in programs where personal counseling is not a requirement to seek counseling on their own. In order to increase the likelihood of students attending, it may be necessary to educate students about the logistical and emotional processes of beginning counseling and assist them in finding resources (e.g., college counseling center or a low-fee clinic).

In order to examine the perceptions of beginning counseling students, it was necessary to purposely select this particular population to study, thus limiting the ability to generalize the findings to other counseling students. However, it should be noted that the particular sample was ethnically diverse, which may add to the degree to which the results may apply to other counseling students and programs. It is recommended that further research be conducted with graduate students from various counseling programs to determine if patterns of similar student perceptions exist.