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Although client participation is central to psychosocial interventions, most investigations conceptualize and measure participation in rather crude ways. This review suggests that essential elements of treatment participation are largely unknown, links between participation and outcomes are not clear, and most investigations of influences on within-treatment variations in participation are based on outdated causal models. Drawing on literature on health and mental health care, this article develops a comprehensive conceptual model of treatment participation. It proposes an agenda for future research aimed at understanding participation phenomena in various contexts.
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