Psychotherapists' Offices and Willingness to Disclose Information
Timothy Walker Swan
Mental health has increasingly become a significant issue in society at large, as for example 12-18% of college students on any given campus are reported to have attended at least one therapy session within their four years (Mowbray, 2006). The rate of therapeutic visits in society is still quite high, for that reason more emphasis should be placed on creating a healing setting that can significantly reduce anxiety levels, as well as increase perceived judgments of care (Ingham & Spencer, 1997). Essentially, there has been much more attention placed on the psychological consequences of architectural choices toward the physical health and well being of patients, therefore the factors of creating a healing setting deserve attention given their importance for both clients and therapists (For the purpose of this study, the literature review describing a welcoming and comfortable therapeutic setting is broken down into four concepts: A warm and socially attractive room, lighting, nature and windows, and an orderly and organized room.
Social Attractiveness & Warmth
A socially attractive room is one that has a variety of plants, rugs, and comfortable furniture, which have been shown to increase the amount of disclosed information among clients (Chaikin & Miller, 1976). Having a “soft” and generally warm room can increase the comfort and amount of disclosed information. Also, such a room can provide a safe environment that elevates patients’ comfort, the expectation of the therapist’s credibility, and the perceived quality of care. For this reason, among others, close to two thirds of therapists design their own office, as they desire to promote a feeling of acceptance, comfort, and welcomeness for their clients (Backhaus, 2008). Therefore, by creating a socially attractive room and a significant level of “warmth”, therapists hope to increase the amount of information the client will offer freely, which in turn benefits the counseling process as a whole.
Lighting
Even though lighting seems simple to control, it is surprising how many benefits appropriate lighting has on the client. For example, muted lighting has been shown to have many more positive effects than has bright and harsh lighting, therefore counseling settings should possess indirect lighting, as opposed to harsh florescent lighting, to increase positive effects such as decreased anxiety and stress levels within the client (Iwai, Churchill & Cummings, 1983). People prefer muted light or, preferably, natural light, which can be significant in increasing the client’s level of comfort and general well-being.
Nature
Nature is an essential factor in creating a comfortable environment, as it can provide diversity in monotonous environments such as healing and counseling settings (Kaplan & Kaplan, 1989). Humans have a natural affinity for nature, as people generally prefer places that contain nature because of its content and complexity (Kaplan & Kaplan, 1989). This preference was shown in a study by Kaplan, Kaplan & Went (1972), where participants claimed that they liked the least complex nature slide more than the most preferred urban slide. Nature is important to the general well-being of any individual, and is even a natural restorer of our human attention mechanism. Simply put, nature and the inclusion of natural elements in a healing environment is vital to improving the counseling setting. In a hospital, a view of nature visible from a window has been shown to benefit the patients because they tend to have fewer negative comments towards their treatment as well as a generally shorter stay in the healing setting (Ulrich, 1984). The ideal therapy office should be one that has windows and view of nature in order to present a professional appearance and increase the client’s comfort and perceived level of care.
Orderliness
Orderliness refers to the cleanliness and proper organization of an environment. Studies have shown that among clients, their ratings for therapists and their desirability for an office increase with softness and personalization, with a clear preference towards neatness and orderliness (Devlin & Nasar, 2012; Nasar & Devlin, 2011). This neatness may impact whether patients stay in therapy, as well as their perceived credibility of the therapist and the level of care they will receive, therefore therapists should avoid cramped and chaotic offices, as well as make sure that their offices are organized rather than cluttered and impersonal in order to increase the client’s comfort and reduce their stress levels (Bloom et.al, 1977).
Present Study
As shown in this research focusing on psychotherapist environments, there are many factors that can affect perceived quality of care as well as comfort and general well-being. However, there is significantly less focus on how the environment can affect an individual’s willingness to disclose personal information. Therefore, building upon this earlier research, the present study seeks to address this research question by using a within-subjects quasi-experimental design. The goal is to identify which environmental variables are most highly related to the likelihood to disclose information.
Hypotheses
The three hypotheses were organized and constructed based of the four concepts addressed within the background research concerning the beneficial aspects of a psychotherapists’ environment. First, it was hypothesized that rooms that include natural lighting from windows and a view of nature would be rated higher on willingness to disclose than would those rooms that lack these design choices. Second, it was predicted that rooms that possessed a sense of order would be rated higher on willingness to disclose. Finally, it was hypothesized that rooms with comfortable furniture and warmth would be rated higher on willingness to disclose information.
Method
Participants
The participants in this study were 85 students from a small liberal arts college situated in New England. There were 23 men and 62 women. The participants were between the ages of 18-22. Of the 85 participants, 50 of them had been to therapy (58.8%) whereas 35 had not been to therapy (41.2%). One problem was that some participants did not fully complete the online survey, leaving some of the images blank. The total participant count after the survey had been closed was 88, however this number had to be decreased to 85 after further analysis revealed that 3 people did not finish the survey.
Procedure
To recruit participants for this study, sign up sheets were given to introductory psychology classes at a small liberal arts college. Psychology students who indicated interest in the study were also recruited through email. When participants signed up, they were given an online survey completed using Surveymonkey.com. The survey began with an informed consent form. The survey’s format consisted of 15 images gathered from online sources. Each page of the survey consisted of two parts. There was an enlarged image, which was roughly 6 x 6 inches, of the psychotherapist’s office, and then participants were asked to complete one question for each image: “How willing would you be to disclose personal information to the psychiatrist belonging to this office?”
The participant answered this question on a rating scale from 1 being the least willing, 4 coded as neutral, and 7 being the most willing to disclose personal information. After completing all 15 images, the participant was asked to fill out demographic information, which consisted of gender, age, email address, if they had been to therapy before, and if so how many times they had been. Finally, upon completion of the survey, the participants were sent a debriefing form.
Results
The purpose of this study was to analyze the effect of qualities of a psychotherapist’s office environment on a client’s willingness to disclose personal information. To manage these ratings, dimensions were created using a principal components factor analysis with varimax rotation. This method produced four factors, with images 10 and 14 not loading at least .4 on a factor, which was the required criterion for this study. New meanings or “titles” were ascribed to each grouping based upon analysis of themes and common factors of the psychotherapists’ offices in each group. Table 1 below presents these four factors as well as their images’ subsequent loadings. Appendix C shows examples of the psychotherapist office images for each factor.
Table 1
Factor analysis of the rated images
Factor 1: View of Nature (18.39% of variance)
Image 1 .819
Image 8 .675
Image 9 .695
Image 15 .655
Factor 2: Natural Lighting & Warmth (16.31% of variance)
Image 5 .757
Image 6 .741
Image 7 .741
Factor 3: Orderliness (15.74% of variance)
Image 2 .495
Image 3 .804
Image 4 .676
Image 11 .707
Factor 4: Comfortable Furniture (13.17% of variance)
Image 12 .805
Image 13 .655
Table 2
Means and (standard deviations) for the four dimensions
Natural Lighting and Warmth 4.68(1.15)
View of Nature 4.22(1.15)
Comfortable Furniture 4.10(1.06)
Orderliness 3.95(1.15)
By dividing the images loaded on each factor by the total number of items in each factor, these four dimensions above could compared in further analyses. Table 2 presents the means and standard deviations of these factors.
To test if these four dimensions would deviate in terms of the degree of disclosure associated to each, six paired samples t-tests were conducted. The test comparing natural lighting and warmth with orderliness had a significant effect, t(84) = 3.16, p = .002. The test comparing natural lighting and warmth with a view of nature also had a significant effect, t(84) = 5.17, p < .001. The comparison of natural lighting and warmth with comfortable furniture showed a significant effect, t(84) = 3.69, p < .001. The test between a view of nature and comfortable furniture did not show a significant effect, t(84) = .795, p = .429. The comparison of comfortable furniture and orderliness also did not reveal a significant effect, t(84) = 1.13, p = .261. Finally, the test comparing a view of nature and orderliness was approaching a trend toward significance, t(84) = 1.78, p = .079.
Table 3
Results of MANOVA Test across Gender
Factor Male Female F(1,83) p
Natural Lighting & Warmth 4.85(1.03) 4.62(1.19) .712 .401
View of Nature 4.43(.833) 4.14(1.11) 1.29 .259
Orderliness 3.98(.926) 3.95(1.05) .015 .902
Comfortable Furniture 4.11(1.20) 4.10(1.01) .002 .963
To evaluate the possibility that willingness to disclose information based on these four dimensions differs across gender, a MANOVA was conducted. The fixed factor in this multivariate test was gender, while the dependent variables were the four factors generated using factor analysis: View of Nature, Natural Lighting and Warmth, Orderliness, and Comfortable Furniture. Results indicated no significant multivariate effect, Wilks’ Lambda = .980, F (4,80) = .399, p = .809. Examination of the univariate effects also did not show any significant findings (See Table 3).
To analyze if people with previous experience in therapy differed in their evaluation of the four factors that are related to disclosed information a second MANOVA was conducted. The fixed factor of this MANOVA was “experience in therapy,” while again the dependent variables were the four factors generated using factor analysis. Results indicated no significant multivariate effect, Wilks’ Lambda = .919, F(4,80) = 1.76, p = .146. Examination of the univariate effects showed no significant findings, however there was a trend toward significance for orderliness (See Table 4).
Table 4
Results of MANOVA Test across Experience with Therapy
Factor Exp. No Exp. F p
Natural Lighting & Warmth 4.63(1.11) 4.75(1.21) .219 .641
View of Nature 4.10(1.15) 4.40(.858 1.71 .195
Orderliness 4.13(.993) 3.71(1.01) 3.69 .058
Comfortable Furniture 4.22(1.03) 3.93(1.08) 1.57 .213
Discussion
Implications
The research question surrounding this study is the impact of certain environmental factors in a psychotherapist’s office that can increase an individual’s willingness to disclose information. The results in this study support the findings from earlier studies regarding the importance of natural lighting. Natural lighting and warmth was rated highest among the means of the 15 images, which confirms previous research describing how counseling settings that present indirect or natural lighting would provide more beneficial effects (Iwai, Churchill & Cummings, 1983). This research also fits well with the body of literature describing the importance of having views of nature within a counseling setting. This is due to the fact that providing a view of nature as well as general plant life can truly increase a client’s comfort and well-being within a counseling setting, therefore making them more likely to disclose personal information. Both orderliness and comfortable furniture showed a tendency toward creating a supportive environment, although not to the extent as did natural lighting and nature.
In terms of comparing the four factors across gender and experience of therapy, this study showed no significant differences for both MANOVA’s. There was a trend toward significance comparing orderliness for individuals who had experience with therapy or not. This seems to make sense, as people with experience in therapy may expect an elevated level of professionalism and orderliness from a practiced psychotherapist. The fact that there were no significance differences between men and women is actually a relevant finding, in that both men and women may respond positively to this environmental quality. The healing environment should be one in which everyone is able to feel comfortable, therefore this result is important in showing the role of orderliness in creating a “healing environment” beneficial to both men and women.
The overarching focus of this study was to explore which environmental factors should be emphasized when designing a psychotherapist’s office to produce positive effects. This study and others are important to demonstrate that there is a distinct working relationship between human beings and their environment, especially concerning the counseling setting and increased disclosed information. Counseling settings should be designed with emphasis placed on increasing natural lighting, producing a “soft” and “warm” environment. The room should be orderly and organized, because the environment plays a significant role in psychotherapeutic effects such as credibility, comfort, and willingness to disclose information (Bloom et Al., 1977). Ultimately, the environment should encourage clients to make choices regarding their care, most importantly their comfort and level of personal information they disclose.
Limitations and Future Directions
One of the clear limitations of this study was the lack of much gender variation in the sample. Unfortunately, the liberal arts college where the study was conducted has a strong female majority. This predominance of women was evident in this study, as there were significantly more women than men, which could possibly have skewed the data. One more limitation concerning the layout of the survey was that the question asking the participants to indicate how many times they had been to therapy resulted in many different answers. Examples included “Not many times” or “too many to count,” therefore some answers were unable to be coded into the data. This was rather unfortunate, as one further analysis would have been to compare longer vs. shorter experience in therapy to the four factors.
More focus should be placed on the extent of experience in therapy when considering future studies, as it would be helpful to see if length of therapy was related to the level of disclosure when looking at a psychotherapist’s office. Another way in which the results from this study could be expanded on is to create studies specifically focused on one of the four factors presented in the study. One example would be maintaining the organization of a room as the control factor, but changing the amount of nature that could be viewed in each picture by either adding plant life or opening the window blinds. This approach could test explicitly if the view of nature has a direct impact on willingness to disclose and see if it relates to the significant effects found in this study. The take away point from this study, as well as research concerning psychotherapy environments, is that focus should truly be placed on elevating the four factors tested to create an environment that not only enhances the impressions of the therapist, but also makes the client feel safe, comfortable, and willing to openly talk about personal conflicts and concerns (Backhaus, 2008).
References
Bloom, L. J., Weigel, R. G., & Trautt, G. M. (1977). Therapeugenic factors in Psychotherapy: Effects of office decor and subject-therapist sex pairing on the perception of credibility. Journal of Consulting and Clinical Psychology, 45, 867–873.
Chaikin, A. L., Derlega, V. J., & Miller, S. J. (1976). Effects of room environment on self-disclosure in a counseling analogue. Journal of Counseling Psychology, 479-481.
Devlin, A. S. (2008). Judging a book by its cover: Medical building facades and
judgments of care. Environment and Behavior, 40, 307-329. doi:10.1177/0013916507302242.
Ingham, B., & Spencer, C. (1997). Waiting for the dentist: Do comfortable chairs and soft lights really help reduce anxiety and improve the practice’s image? Health Psychology Update, 28, 17-20.
Iwai, S., Churchill, W., & Cummings , L. (1983). The physical characteristics of college and university counseling services. Journal of College Student Personnel, 24(1), 55-60.
Kaplan, S., Kaplan, R. & Wendt, J. S. (1972). Rated preference and complexity for natural and urban visual material. Perception and Psychophysics.12, 354-356.
Kaplan, R., & Kaplan, S. (1989). The Experience of Nature: A Psychological Perspective. New York: Cambridge University Press.
Mowbray, C.T., Lewandowski, L., Bybee, D., & Oyserman, D. (2004). Children of mothers diagnosed with serious mental illness: Problems and predictors of service use. Mental Health Services Research, 6, 167–183.
Nasar, J., & Devlin, A. S. (2011). Impressions of psychotherapists’ offices.
Journal of Counseling Psychology, 58, 310-320. doi: 10.1037/a002388.
Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 420-421.
Ulrich, R. S. (1981). Natural versus urban scenes: Some psychophysiological effects. Environment and Behavior, 13, 523-556.
Social Attractiveness & Warmth
A socially attractive room is one that has a variety of plants, rugs, and comfortable furniture, which have been shown to increase the amount of disclosed information among clients (Chaikin & Miller, 1976). Having a “soft” and generally warm room can increase the comfort and amount of disclosed information. Also, such a room can provide a safe environment that elevates patients’ comfort, the expectation of the therapist’s credibility, and the perceived quality of care. For this reason, among others, close to two thirds of therapists design their own office, as they desire to promote a feeling of acceptance, comfort, and welcomeness for their clients (Backhaus, 2008). Therefore, by creating a socially attractive room and a significant level of “warmth”, therapists hope to increase the amount of information the client will offer freely, which in turn benefits the counseling process as a whole.
Lighting
Even though lighting seems simple to control, it is surprising how many benefits appropriate lighting has on the client. For example, muted lighting has been shown to have many more positive effects than has bright and harsh lighting, therefore counseling settings should possess indirect lighting, as opposed to harsh florescent lighting, to increase positive effects such as decreased anxiety and stress levels within the client (Iwai, Churchill & Cummings, 1983). People prefer muted light or, preferably, natural light, which can be significant in increasing the client’s level of comfort and general well-being.
Nature
Nature is an essential factor in creating a comfortable environment, as it can provide diversity in monotonous environments such as healing and counseling settings (Kaplan & Kaplan, 1989). Humans have a natural affinity for nature, as people generally prefer places that contain nature because of its content and complexity (Kaplan & Kaplan, 1989). This preference was shown in a study by Kaplan, Kaplan & Went (1972), where participants claimed that they liked the least complex nature slide more than the most preferred urban slide. Nature is important to the general well-being of any individual, and is even a natural restorer of our human attention mechanism. Simply put, nature and the inclusion of natural elements in a healing environment is vital to improving the counseling setting. In a hospital, a view of nature visible from a window has been shown to benefit the patients because they tend to have fewer negative comments towards their treatment as well as a generally shorter stay in the healing setting (Ulrich, 1984). The ideal therapy office should be one that has windows and view of nature in order to present a professional appearance and increase the client’s comfort and perceived level of care.
Orderliness
Orderliness refers to the cleanliness and proper organization of an environment. Studies have shown that among clients, their ratings for therapists and their desirability for an office increase with softness and personalization, with a clear preference towards neatness and orderliness (Devlin & Nasar, 2012; Nasar & Devlin, 2011). This neatness may impact whether patients stay in therapy, as well as their perceived credibility of the therapist and the level of care they will receive, therefore therapists should avoid cramped and chaotic offices, as well as make sure that their offices are organized rather than cluttered and impersonal in order to increase the client’s comfort and reduce their stress levels (Bloom et.al, 1977).
Present Study
As shown in this research focusing on psychotherapist environments, there are many factors that can affect perceived quality of care as well as comfort and general well-being. However, there is significantly less focus on how the environment can affect an individual’s willingness to disclose personal information. Therefore, building upon this earlier research, the present study seeks to address this research question by using a within-subjects quasi-experimental design. The goal is to identify which environmental variables are most highly related to the likelihood to disclose information.
Hypotheses
The three hypotheses were organized and constructed based of the four concepts addressed within the background research concerning the beneficial aspects of a psychotherapists’ environment. First, it was hypothesized that rooms that include natural lighting from windows and a view of nature would be rated higher on willingness to disclose than would those rooms that lack these design choices. Second, it was predicted that rooms that possessed a sense of order would be rated higher on willingness to disclose. Finally, it was hypothesized that rooms with comfortable furniture and warmth would be rated higher on willingness to disclose information.
Method
Participants
The participants in this study were 85 students from a small liberal arts college situated in New England. There were 23 men and 62 women. The participants were between the ages of 18-22. Of the 85 participants, 50 of them had been to therapy (58.8%) whereas 35 had not been to therapy (41.2%). One problem was that some participants did not fully complete the online survey, leaving some of the images blank. The total participant count after the survey had been closed was 88, however this number had to be decreased to 85 after further analysis revealed that 3 people did not finish the survey.
Procedure
To recruit participants for this study, sign up sheets were given to introductory psychology classes at a small liberal arts college. Psychology students who indicated interest in the study were also recruited through email. When participants signed up, they were given an online survey completed using Surveymonkey.com. The survey began with an informed consent form. The survey’s format consisted of 15 images gathered from online sources. Each page of the survey consisted of two parts. There was an enlarged image, which was roughly 6 x 6 inches, of the psychotherapist’s office, and then participants were asked to complete one question for each image: “How willing would you be to disclose personal information to the psychiatrist belonging to this office?”
The participant answered this question on a rating scale from 1 being the least willing, 4 coded as neutral, and 7 being the most willing to disclose personal information. After completing all 15 images, the participant was asked to fill out demographic information, which consisted of gender, age, email address, if they had been to therapy before, and if so how many times they had been. Finally, upon completion of the survey, the participants were sent a debriefing form.
Results
The purpose of this study was to analyze the effect of qualities of a psychotherapist’s office environment on a client’s willingness to disclose personal information. To manage these ratings, dimensions were created using a principal components factor analysis with varimax rotation. This method produced four factors, with images 10 and 14 not loading at least .4 on a factor, which was the required criterion for this study. New meanings or “titles” were ascribed to each grouping based upon analysis of themes and common factors of the psychotherapists’ offices in each group. Table 1 below presents these four factors as well as their images’ subsequent loadings. Appendix C shows examples of the psychotherapist office images for each factor.
Table 1
Factor analysis of the rated images
Factor 1: View of Nature (18.39% of variance)
Image 1 .819
Image 8 .675
Image 9 .695
Image 15 .655
Factor 2: Natural Lighting & Warmth (16.31% of variance)
Image 5 .757
Image 6 .741
Image 7 .741
Factor 3: Orderliness (15.74% of variance)
Image 2 .495
Image 3 .804
Image 4 .676
Image 11 .707
Factor 4: Comfortable Furniture (13.17% of variance)
Image 12 .805
Image 13 .655
Table 2
Means and (standard deviations) for the four dimensions
Natural Lighting and Warmth 4.68(1.15)
View of Nature 4.22(1.15)
Comfortable Furniture 4.10(1.06)
Orderliness 3.95(1.15)
By dividing the images loaded on each factor by the total number of items in each factor, these four dimensions above could compared in further analyses. Table 2 presents the means and standard deviations of these factors.
To test if these four dimensions would deviate in terms of the degree of disclosure associated to each, six paired samples t-tests were conducted. The test comparing natural lighting and warmth with orderliness had a significant effect, t(84) = 3.16, p = .002. The test comparing natural lighting and warmth with a view of nature also had a significant effect, t(84) = 5.17, p < .001. The comparison of natural lighting and warmth with comfortable furniture showed a significant effect, t(84) = 3.69, p < .001. The test between a view of nature and comfortable furniture did not show a significant effect, t(84) = .795, p = .429. The comparison of comfortable furniture and orderliness also did not reveal a significant effect, t(84) = 1.13, p = .261. Finally, the test comparing a view of nature and orderliness was approaching a trend toward significance, t(84) = 1.78, p = .079.
Table 3
Results of MANOVA Test across Gender
Factor Male Female F(1,83) p
Natural Lighting & Warmth 4.85(1.03) 4.62(1.19) .712 .401
View of Nature 4.43(.833) 4.14(1.11) 1.29 .259
Orderliness 3.98(.926) 3.95(1.05) .015 .902
Comfortable Furniture 4.11(1.20) 4.10(1.01) .002 .963
To evaluate the possibility that willingness to disclose information based on these four dimensions differs across gender, a MANOVA was conducted. The fixed factor in this multivariate test was gender, while the dependent variables were the four factors generated using factor analysis: View of Nature, Natural Lighting and Warmth, Orderliness, and Comfortable Furniture. Results indicated no significant multivariate effect, Wilks’ Lambda = .980, F (4,80) = .399, p = .809. Examination of the univariate effects also did not show any significant findings (See Table 3).
To analyze if people with previous experience in therapy differed in their evaluation of the four factors that are related to disclosed information a second MANOVA was conducted. The fixed factor of this MANOVA was “experience in therapy,” while again the dependent variables were the four factors generated using factor analysis. Results indicated no significant multivariate effect, Wilks’ Lambda = .919, F(4,80) = 1.76, p = .146. Examination of the univariate effects showed no significant findings, however there was a trend toward significance for orderliness (See Table 4).
Table 4
Results of MANOVA Test across Experience with Therapy
Factor Exp. No Exp. F p
Natural Lighting & Warmth 4.63(1.11) 4.75(1.21) .219 .641
View of Nature 4.10(1.15) 4.40(.858 1.71 .195
Orderliness 4.13(.993) 3.71(1.01) 3.69 .058
Comfortable Furniture 4.22(1.03) 3.93(1.08) 1.57 .213
Discussion
Implications
The research question surrounding this study is the impact of certain environmental factors in a psychotherapist’s office that can increase an individual’s willingness to disclose information. The results in this study support the findings from earlier studies regarding the importance of natural lighting. Natural lighting and warmth was rated highest among the means of the 15 images, which confirms previous research describing how counseling settings that present indirect or natural lighting would provide more beneficial effects (Iwai, Churchill & Cummings, 1983). This research also fits well with the body of literature describing the importance of having views of nature within a counseling setting. This is due to the fact that providing a view of nature as well as general plant life can truly increase a client’s comfort and well-being within a counseling setting, therefore making them more likely to disclose personal information. Both orderliness and comfortable furniture showed a tendency toward creating a supportive environment, although not to the extent as did natural lighting and nature.
In terms of comparing the four factors across gender and experience of therapy, this study showed no significant differences for both MANOVA’s. There was a trend toward significance comparing orderliness for individuals who had experience with therapy or not. This seems to make sense, as people with experience in therapy may expect an elevated level of professionalism and orderliness from a practiced psychotherapist. The fact that there were no significance differences between men and women is actually a relevant finding, in that both men and women may respond positively to this environmental quality. The healing environment should be one in which everyone is able to feel comfortable, therefore this result is important in showing the role of orderliness in creating a “healing environment” beneficial to both men and women.
The overarching focus of this study was to explore which environmental factors should be emphasized when designing a psychotherapist’s office to produce positive effects. This study and others are important to demonstrate that there is a distinct working relationship between human beings and their environment, especially concerning the counseling setting and increased disclosed information. Counseling settings should be designed with emphasis placed on increasing natural lighting, producing a “soft” and “warm” environment. The room should be orderly and organized, because the environment plays a significant role in psychotherapeutic effects such as credibility, comfort, and willingness to disclose information (Bloom et Al., 1977). Ultimately, the environment should encourage clients to make choices regarding their care, most importantly their comfort and level of personal information they disclose.
Limitations and Future Directions
One of the clear limitations of this study was the lack of much gender variation in the sample. Unfortunately, the liberal arts college where the study was conducted has a strong female majority. This predominance of women was evident in this study, as there were significantly more women than men, which could possibly have skewed the data. One more limitation concerning the layout of the survey was that the question asking the participants to indicate how many times they had been to therapy resulted in many different answers. Examples included “Not many times” or “too many to count,” therefore some answers were unable to be coded into the data. This was rather unfortunate, as one further analysis would have been to compare longer vs. shorter experience in therapy to the four factors.
More focus should be placed on the extent of experience in therapy when considering future studies, as it would be helpful to see if length of therapy was related to the level of disclosure when looking at a psychotherapist’s office. Another way in which the results from this study could be expanded on is to create studies specifically focused on one of the four factors presented in the study. One example would be maintaining the organization of a room as the control factor, but changing the amount of nature that could be viewed in each picture by either adding plant life or opening the window blinds. This approach could test explicitly if the view of nature has a direct impact on willingness to disclose and see if it relates to the significant effects found in this study. The take away point from this study, as well as research concerning psychotherapy environments, is that focus should truly be placed on elevating the four factors tested to create an environment that not only enhances the impressions of the therapist, but also makes the client feel safe, comfortable, and willing to openly talk about personal conflicts and concerns (Backhaus, 2008).
References
Bloom, L. J., Weigel, R. G., & Trautt, G. M. (1977). Therapeugenic factors in Psychotherapy: Effects of office decor and subject-therapist sex pairing on the perception of credibility. Journal of Consulting and Clinical Psychology, 45, 867–873.
Chaikin, A. L., Derlega, V. J., & Miller, S. J. (1976). Effects of room environment on self-disclosure in a counseling analogue. Journal of Counseling Psychology, 479-481.
Devlin, A. S. (2008). Judging a book by its cover: Medical building facades and
judgments of care. Environment and Behavior, 40, 307-329. doi:10.1177/0013916507302242.
Ingham, B., & Spencer, C. (1997). Waiting for the dentist: Do comfortable chairs and soft lights really help reduce anxiety and improve the practice’s image? Health Psychology Update, 28, 17-20.
Iwai, S., Churchill, W., & Cummings , L. (1983). The physical characteristics of college and university counseling services. Journal of College Student Personnel, 24(1), 55-60.
Kaplan, S., Kaplan, R. & Wendt, J. S. (1972). Rated preference and complexity for natural and urban visual material. Perception and Psychophysics.12, 354-356.
Kaplan, R., & Kaplan, S. (1989). The Experience of Nature: A Psychological Perspective. New York: Cambridge University Press.
Mowbray, C.T., Lewandowski, L., Bybee, D., & Oyserman, D. (2004). Children of mothers diagnosed with serious mental illness: Problems and predictors of service use. Mental Health Services Research, 6, 167–183.
Nasar, J., & Devlin, A. S. (2011). Impressions of psychotherapists’ offices.
Journal of Counseling Psychology, 58, 310-320. doi: 10.1037/a002388.
Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 420-421.
Ulrich, R. S. (1981). Natural versus urban scenes: Some psychophysiological effects. Environment and Behavior, 13, 523-556.