Client implementation of therapist recommendations predicted by client perception of fit, difficulty of implementation, and therapist influence

This study examined the occurrence of therapist recommendations and client implementation of recommendations based on client perceptions of (a) fit, ( b) difficulties of implementation, and (c) therapist influence. Therapists (N = 27) volunteered to list any recommendations that occurred in a single session, and clients (N = 102) agreed to complete 2 measures of acceptabili ty and 1 measure of implementation concerning the primary recommendation. R esults indicated a high frequency of recommendations, with most sessions co ntaining multiple recommendations. Therapists provided 8 types of recommend ations; validation of internal experiences, reframing meanings, decision ma king, and social interactions were most frequent. Clients who returned tend ed to report a high level of implementation. Client perceptions of difficul ties and therapist influence were predictive of client-reported implementat ion.