Client deception in therapy is associated with worse therapeutic relationships and perceived therapeutic outcomes

Abstract

Objectives

In psychotherapy, clients and therapists work together to forge a path towards better mental health. Key to this process is genuine and honest communication. However, much previous research suggests that clients are not always fully truthful with their therapists. In this study, we make a preliminary examination of the relationship between client deception in therapy, the quality of the therapeutic relationship and therapeutic outcomes.

Methods

Participants who had been involved in psychotherapy completed a variety of measures that assessed their use of dishonesty in therapy. They also completed measures of the quality of the client–therapist relationship and measures of their perceived therapeutic outcomes. We hypothesised that client dishonesty would negatively correlate with the perceived quality of the therapeutic relationship and the therapeutic outcomes. Furthermore, we predicted that the quality of the therapeutic relationship would mediate the relationship between client dishonesty and perceived therapeutic outcomes.

Results

The results of correlation and mediation analyses supported these hypotheses. Client dishonesty was associated with poorer therapeutic relationships and worse perceived therapeutic outcomes. Additionally, therapeutic relationship quality partially mediated the relationship between client dishonesty and therapeutic outcomes.

Conclusions

This initial study provides important tentative insights into the possible negative correlates of client dishonesty in the therapeutic environment.