Paradoxical outcomes in psychotherapy: Theoretical perspectives, research agenda and practice implications

Abstract

Client self-report symptom measures are widely used in counselling and psychotherapy research and practice to track client progress and evaluate outcome. A growing body of evidence indicates differences between self-report assessments and information collected through other sources. This paper considers a range of theoretical and empirical perspectives on this issue, including the concept of illusory mental health. Particular emphasis is given to the relevance of single-case research as a means of identifying different patterns of paradoxical outcome. Implications for practice and research are discussed.