Description

The Session Evaluation Questionnaire (SEQ-24) is a psychometric instrument designed to assess the quality, characteristics, and immediate emotional impact of individual and group psychotherapy or counseling sessions. The questionnaire evaluates the therapeutic experience from multiple perspectives, including the therapist, the client, and external observers or reviewers, allowing a comprehensive assessment of the psychotherapy process.

The SEQ-24 was developed by W. B. Stiles and was adapted into Greek by J. Nestoros and K. Zgantzouri. The Greek adaptation was based on the fourth edition of the original instrument and was developed for use within clinical and research settings.

The questionnaire is a brief self-report instrument that can be completed immediately after a therapy session. It consists of 24 Likert-type bipolar rating scales with seven response levels, where each item presents two opposite descriptive characteristics, such as “Helpful” versus “Unhelpful.” Participants evaluate both the characteristics of the session and their emotional state following completion of the therapeutic encounter.

The SEQ-24 assesses four central dimensions of psychotherapy experience. Depth refers to the level of engagement, significance, and intensity of the session. Smoothness evaluates the extent to which the session was experienced as comfortable, natural, and well-flowing. Positive Affect examines feelings of satisfaction, well-being, and positive emotional responses after the session. Arousal assesses the level of emotional activation or intensity experienced following the therapeutic interaction.

The instrument can be applied through immediate post-session assessment or through evaluation of recorded psychotherapy sessions using transcripts, audio recordings, or video recordings.

Data Analysis and Use

Data obtained through the SEQ-24 can be analyzed to examine the perceived effectiveness and experiential characteristics of psychotherapy sessions. The instrument provides quantitative information regarding how sessions are experienced by therapists, clients, and external evaluators.

Descriptive statistical analyses, including calculation of means, standard deviations, and score distributions, can be used to evaluate the overall quality and emotional impact of therapy sessions. Each of the four dimensions provides separate information regarding the depth, smoothness, positive emotional response, and activation associated with the session.

The SEQ-24 may be used in psychotherapy research to investigate therapeutic processes, compare different therapeutic approaches, examine therapist–client interactions, and evaluate factors associated with effective counseling or psychotherapy.

In clinical practice and supervision, the questionnaire may provide structured feedback regarding the therapeutic process and contribute to therapist training and professional development.

The Greek adaptation was evaluated using different groups of participants, including psychotherapy clients and therapists in clinical practice, psychology students trained in psychotherapy processes at the University of Crete, and external evaluators who assessed recorded therapy sessions from therapist and client perspectives.

Objective

The primary objective of the Session Evaluation Questionnaire (SEQ-24) is to evaluate the immediate impact and quality of psychotherapy or counseling sessions.

The instrument aims to assess two major aspects of the therapeutic experience. The first concerns the characteristics and quality of the session itself, including effectiveness, communication, achievement of goals, and completeness. The second concerns the emotional responses of participants after the session, including satisfaction, comfort, emotional tension, and activation.

By measuring these dimensions, the SEQ-24 contributes to a better understanding of psychotherapy processes and provides a quantitative approach for studying the relationship between session characteristics and therapeutic outcomes.

Structure and Content

The SEQ-24 consists of 24 bipolar rating scales, each evaluated on a seven-point response format. Participants indicate their position between two opposite characteristics describing either the therapy session or their emotional state after the session.

The questionnaire includes four main dimensions. The Depth dimension assesses the extent to which the session was experienced as meaningful, engaging, and psychologically intensive. The Smoothness dimension evaluates the ease, comfort, and overall flow of the therapeutic interaction. The Positive Affect dimension examines positive emotional responses, including satisfaction and feelings of well-being. The Arousal dimension measures emotional activation following the session.

The questionnaire may be completed by therapists, clients, or external observers, depending on the purpose of the assessment.

Scoring

Each dimension of the SEQ-24 is calculated through the mean score of the items associated with that dimension. All items are rated from 1 to 7, with higher scores indicating stronger expression of the corresponding characteristic.

Higher scores on Depth indicate greater therapeutic engagement and intensity. Higher scores on Smoothness indicate a more comfortable and effective session process. Higher scores on Positive Affect indicate stronger positive emotional responses following therapy. Higher scores on Arousal indicate greater emotional activation.

The scoring system allows researchers and clinicians to quantify different aspects of the therapeutic experience and compare evaluations between therapists, clients, and external observers.

Statistical Analysis

Statistical evaluation of the SEQ-24 may include descriptive statistics, reliability analysis, factor analysis, and comparative analyses between different evaluator groups.

The examination of dimension scores allows researchers to investigate differences in how therapy sessions are perceived by clients, therapists, and external reviewers. Repeated assessments across multiple sessions can also provide more stable estimates of the overall therapeutic experience.

The available information indicates that single-session evaluations may not fully represent the overall psychotherapy experience. More stable evaluation may be achieved through averaging scores across approximately 4–6 therapy sessions.

Validity

The SEQ-24 demonstrates evidence of validity through its theoretical foundation and empirical application in psychotherapy research.

The instrument shows internal consistency and content validity, as its items are directly related to important dimensions of psychotherapy session experience. The available information indicates that a fully equivalent Greek-language instrument was not available for direct criterion validity comparisons; therefore, future comparisons with similar measures in other languages could further strengthen evidence regarding validity.

The Greek adaptation process involved translation and adaptation procedures designed to preserve conceptual and linguistic equivalence with the original instrument.

Reliability

The SEQ-24 demonstrates strong reliability characteristics in the Greek adaptation.

Internal consistency coefficients measured through Cronbach’s alpha were reported as α = 0.94 for therapists, α = 0.89 for clients, α = 0.94 for external reviewers evaluating from the therapist perspective, and α = 0.94 for external reviewers evaluating from the client perspective.

These findings indicate excellent internal consistency across different evaluator groups and support the use of the instrument for research and clinical evaluation of psychotherapy sessions.

References

Nestoros, J. N., & Zgantzouri, K. A. (1999). Session Evaluation Questionnaire in psychotherapy research: Translation and adaptation into Greek (pp. 23–24). Paper presented at the 5th European Conference on Psychological Assessment, University of Patras.

Stiles, W. B. (1980). Measurement of the impact of psychotherapy sessions. Journal of Consulting and Clinical Psychology, 48(2), 176–185.

Zgantzouri, K. A. (2000). Psychotherapeutic Processes in Psychosis: The Formation of Delusional Ideas in Paranoid Schizophrenia and Schizoaffective Disorder. Unpublished Ph.D. Thesis, University of Crete.

Zgantzouri, K. A., & Nestoros, J. N. (1999). Session Evaluation Questionnaire: Greek translation and adaptation from Stiles’ (1980) SEQ. Laboratory of Clinical & Social Psychology, University of Crete.