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What clients tell us about psychotherapy. A qualitative study of change and its mechanisms

ARTICLEStinckens, Nele, Geys, Kimmi, Vos, Eline, Vrancken, Mieke, Smits, Dave, & Claes, Laurence - 53–1 (2015)

SUMMARY

Research has convincingly shown that psychotherapy is effective and clinically relevant.
However, a small minority of clients still deteriorates or quits prematurely. To date, little
attention has been given to the mechanisms underlying this positive or negative change.
In this article, we attempt to understand how and why therapy works by letting the clients
speak. It was noted that clients identified a wide array of helping events. Gaining insight was
seen as the most prominent change mechanism. Less spontaneous reference was given to
common helping factors, but these received more weight when such processes were offered
as possible answers. Although symptom reduction traditionally is proposed as an important
(and often only) indicator of change, clients seldom expressed or indicated this category
themselves.

KEYWORDS

therapeutic process, helping factors, qualitative change, change mechanisms, insight, common helping factors

The tPeP (Journal Person-centered experiential Psychotherapy) is the scientific journal for Dutch and Flemish psychotherapists, psychologists, and psychiatrists, that work from, or are interested in a client-centered perspective.