Therapeutic Responsiveness

Abstract

Abstract: Therapeutic responsiveness (TR) encompasses the dynamic interaction between therapist and client, reflecting adjustments in behavior and interventions to meet individual needs, characteristics, and preferences. TR influences the therapeutic alliance, client engagement, and treatment outcomes. Despite evolving conceptualizations over time, a unified definition of TR remains elusive, hindering research and practice in psychotherapy. We aimed to explore how TR has been defined and studied in psychotherapy process research, identifying elements incorporated into its conceptualization and methodologies for its assessment. A systematic literature review was conducted across four databases using search terms related to the variables of interest (TR and the psychotherapy process). Thirty empirical studies were identified. The review revealed diverse methodologies and definitions of TR, with an emphasis on quantitative approaches. Four dimensions of TR emerged, highlighting its multidimensional nature: therapist and treatment responsiveness, relational responsiveness, and client responsiveness. Challenges in defining and assessing TR were evident, with studies often focusing on one dimension rather than embracing its complexity fully. A proposal for a ‘gold standard’ definition was presented, based on the different conceptualizations of TR mentioned in the various studies. Consolidating existing measures, developing new tools, and adopting multidimensional assessment approaches are recommended to advance our understanding of this complex construct. Recognizing TR’s multifaceted nature and addressing challenges in its definition and assessment are essential for informing responsive therapeutic interventions, with implications for therapist training and supervision.