Exploration of session perceptions in the words of clients and therapists

This qualitative, baseline study collected information from clients and therapists about their perceptions of their first three sessions together. Four pairs of clients and therapists, matched on gender, participated in the study. Clients were adults seeking individual therapy for problems related to relationship issues and/or depression. Each participant provided a written document of their sessions, answered questionnaires about the helpfulness of their sessions together, and participated in semi-structured interviews following each session. Written notes and questionnaires were used as a springboard for discussion during interviews. Data were analyzed qualitatively regarding their perceptions of their sessions together. Themes related to the valued contributions participants made in a collaborative, conversational dialogue as part of helpful therapy.

Informed by constructivist and social constructionist principles, the methodology of this study supported a relationship with research participants that allowed them to elaborate and comment openly about their perceptions of their therapy experience. Building on previous literature that tended to rely on more close-ended, response limited opportunities, this study elicited detailed, descriptive information about perceptions of therapy by both clients and therapists. Results supported theoretical literature about therapy that is more collaborative and conversational (e.g., narrative and solution-focused) as helpful for client change.

In this study, clients and therapists similarly valued aspects of therapy that supported clients in an empowered, responsible role. Meaning-making was viewed as an important part of negotiating between therapist and client to find a fit that was most help4ful for client change towards a desired goal. A "friend"-like atmosphere was appreciated in which less hierarchy and a down-to-earth and relaxed style between therapist and client was facilitated. These aspects of their experiences provided more fertile ground for change.