Helpful therapeutic processes: a pluralistic analysis of client activities, therapist activities and helpful effects

The purpose of this study was to undertake a pluralistic analysis of helpful processes in therapy, focusing on the specific client and therapist activities that can lead to helpful effects. Eleven clients took part in relationally-oriented therapy, and were asked to complete post-session evaluation forms, with qualitative data was analysed thematically. Process maps were developed to represent the multiplicity of change processes. Clients identified talking about their emotions and experiences as the principal helpful client activity; with therapist questioning, direction and relational qualities identified as the most helpful therapist contributions. The principal helpful effects of these activities were increased insight, along with completion of therapeutic tasks and changes in the client’s feelings. Process maps were developed to illustrate these pathways of change. The pluralistic method of analysis developed in this paper helps to disentangle different helpful therapeutic processes, and can be used to map out the multiplicity of change processes that may take place in therapy.