Expectations and experiences of psychological therapy from the client perspective: a qualitative study

Clients’ subjective expectations and experiences of psychological therapy are likely to influence engagement and outcomes. A better understanding from the client perspective of how client therapy expectations compare to experiences of therapy may highlight client information needs and improve therapist sensitivity and attunement. In this study, we interviewed ten clients who had recently completed individual therapy about their expectations and experiences of therapy. Interview data were thematically analysed in the template style. Three themes are presented: (1) Undertaking the hard work of therapy and developing personal agency; (2) Abandoning expectations about ‘roles’ to develop a relationship between imperfect individuals; (3) Applying and owning learning from therapy. This study provides useful information about participants’ experiences of psychological therapy from the client perspective, including how these experiences compared to their expectations of therapy, and how these expectations changed over time. These insights could inform the development of materials to ensure those referred to and awaiting therapy are well informed and prepared for the process of therapy, promoting improved client experiences of therapy and increased engagement with the therapy process.