Clients' experience and understanding of change processes in cognitive analytic therapy

SECTION 1: LITERATURE REVIEW This paper reviews the qualitative literature exploring the experience of individual psychotherapy and counselling from the client's perspective. It considers the client's experience in three broad phases: pre-therapy feelings on becoming a client, the middle phase of therapy and the ending of therapy. It provides an updated synthesis of the available literature and presents a critique of that literature. The review demonstrates the rich diversity of experiences that are uncovered when exploring therapy from the clients' perspective. SECTION 11: RESEARCH REPORT This paper reports the findings of a qualitative study exploring clients' experiences and understanding of change processes in Cognitive Analytic Therapy (CAT). Using grounded theory methodology the study utilised a three stage design to develop a 'bottom up' theoretical model allowing for constant member validation. Within this process, a total of 15 end of therapy interviews were conducted with nine clients who had received a course of individual CAT. The core conceptual framework, 'doing with' emerged from the analysis and was conceptualised to represent clients' subjective experience of CAT. This framework subsumed four main inter-related themes each interacting and influencing the other; 'being with the therapist', 'keeping it real', 'understanding and feeling' and 'CAT tools'. SECTION III: CRITICAL APPRAISAL The first part of this paper presents a synopsis, with personal reflections, of the research process from its origins to write up. The second part discusses the main learning experiences gained from the study.