Advice, Suggestions, Recommendations

Abstract Psychotherapist advice, suggestions, and recommendations (ASR) occur in many psychotherapy sessions and most treatment approaches. This chapter defines ASR, provides clinical examples, and reviews the research evidence for the immediate in-session, immediate delayed, and intermediate effects of ASR, as well as for the moderators of these effects in individual psychotherapy. In seven studies with 327 clients and 131 therapists, evidence of neutral immediate in-session outcomes (e.g., client experiencing levels), neutral immediate delayed outcomes (e.g., client-rated helpfulness during post-session videotape reviews), and positive intermediate outcomes (e.g., implementation of recommendations as rated in subsequent sessions) was found for ASR. These differences may be related to methodological variations in studies, in addition to the different timing of the outcome measurement. In terms of moderators, there was evidence that the working alliance, client collaboration prior to the ASR, content of the ASR, and therapist and client attachment styles moderated the effects of immediate in-session outcomes and that type, difficulty, and therapist influence moderated the effects of intermediate outcomes of ASR. The chapter concludes with research limitations, diversity considerations, training implications, and therapeutic practices related to ASR.