A Social Exchange Approach to Explaining Satisfaction with Therapy

The present study examined the effect of Reward, Cost, Comparison Level, Comparison Level of Alternative, and Investment on Satisfaction and Commitment in therapy from the perspective of social exchange theory and the investment model. Relationship variables were assessed by 114 subjects for the beginning of therapy, the first few sessions: middle of therapy, when therapy was clearly underway and issues were being dealt with; and the end or last few sessions. Results confirmed that Satisfaction and Commitment were significantly predicted by greater Reward, lower Cost, and Comparison Level. Investment was consistently positively related to Commitment and not to Satisfaction. However, Comparison Level of Alternative was correlated with Satisfaction rather than Commitment. As hypothesized, Satisfaction and Commitment at the beginning of therapy were more highly correlated with Reward minus Cost than with Reward plus Cost, but for overall Satisfaction and Commitment, the strength of total Reward plus Cost as a predictor increased. Magnitude of Reward alone was a better predictor of Overall Evaluation than any other combination of variables. Finally, Satisfaction at the beginning of therapy was a significant predictor of Overall Evaluation indicating the influence of early evaluations in the therapy relationship.