A qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda.

Abstract

This article argues that psychotherapy practitioners and researchers should be informed by the substantive body of qualitative evidence that has been gathered to represent clients' own experiences of therapy. The current meta-analysis examined qualitative research studies analyzing clients' experiences within adult individual psychotherapy that appeared in English-language journals. This omnibus review integrates research from across psychotherapy approaches and qualitative methods, focusing on the cross-cutting question of how clients experience therapy. It utilized an innovative method in which 67 studies were subjected to a grounded theory meta-analysis in order to develop a hierarchy of data and then 42 additional studies were added into this hierarchy using a content meta-analytic method-summing to 109 studies in total. Findings highlight the critical psychotherapy experiences for clients, based upon robust findings across these research studies. Process-focused principles for practice are generated that can enrich therapists' understanding of their clients in key clinical decision-making moments. Based upon these findings, an agenda is suggested in which research is directed toward heightening therapists' understanding of clients and recognizing them as agents of change within sessions, supporting the client as self-healer paradigm. This research aims to improve therapists' sensitivity to clients' experiences and thus can expand therapists' attunement and intentionality in shaping interventions in accordance with whichever theoretical orientation is in use. The article advocates for the full integration of the qualitative literature in psychotherapy research in which variables are conceptualized in reference to an understanding of clients' experiences in sessions. (PsycINFO Database Record

The client's perspective on (experiences of) psychotherapy: A practice friendly review

“…Systematic reviews have recently been supplemented by qualitative meta‐analyses (Timulak, ), a method that has evolved in other disciplines such as nursing but is relatively new to psychotherapy research (e.g., Timulak, ; Timulak et al., ; Timulak & McElvaney, ). Most recently, Levitt, Pomerville, and Surace () performed a comprehensive qualitative meta‐analysis of clients’ experiences of psychotherapy based on findings from 109 qualitative studies on individual therapy (1,414 clients).…”

“…Levitt et al. () structured their findings around five clusters of client perceptions: (a) therapy as a process of change through structured curiosity and pattern identification; (b) the caring relationship that allows clients to benefit from therapy; (c) the therapist's professional credentials as a building block of trust as well as a source of client doubt regarding therapist authenticity; (d) the importance of collaboration and recognition of differences in the relationship; and (e) the importance of the client's agency and the need to accommodate therapy to fit the client's needs.…”

Understanding the client's perspective of helpful and hindering events in psychotherapy sessions: A micro‐process approach

“…In another, more recent review of the significant events research, Levitt and colleagues () summarized findings from over 100 qualitative studies. They concluded that there may be one core category that best summarizes clients’ experiences in psychotherapy: “Being known and cared for supports clients’ ability to agentically recognize obstructive experiential patterns and address unmet vulnerable needs” (p. 821).…”

Displaying agency problems at the outset of psychotherapy

“…The client's experience of loss of agency in his/her life has been conceptualized as a prime reason for seeking help from conversational therapy (Wahlström, 2006) and the participation of the client as an active agent is seen as prerequisite for the change process (Levitt, Pomerville, & Surace, 2016).…”