Therapy Termination

Using consensual qualitative research (CQR), the researchers interviewed 12 clients about their experiences with therapy, most specifically their experiences with the termination of the therapy. The focus of the study was geared toward how clients experience therapy termination, how termination unfolds or is initiated, and how termination affects the therapeutic process and relationship. In cases with positive termination experiences, there was a generally positive effect of therapy on the client, the termination process and post-termination plans were premeditated, and clients felt more comfortable with their relationships and more confident in coping with problems. In cases with negative termination experiences, clients noted more negative elements of therapy (did not feel understood), the termination process was abrupt (often unplanned) and unilateral, and clients were upset with with their therapy experience and hesitant about seeking more therapy. This study truly shows how therapy termination can lead to long-lasting effects and opinions (both positive and negative) about therapy.


Citation: Knox, S., Adrians, N., Everson, E., Hess, S., Hill, C. E., & Crook-Lyon, R. (2011). Clients' perspectives on therapy termination. Psychotherapy Research, 21, 154-167.

Hitting the Wall

A case study was conducted on one client (Krista) and one therapist (P) in order to evaluate the changes in client interpersonal functioning as a result of psychotherapy. Before entering into therapy, Krista reported problems and concerns with her loneliness, lack of a romantic partner, inadequacy in social interactions, and anger towards others. In her 21 sessions with P, Krista told very animated stories about her emotions and behaviors toward her ex-boss, two of her housemates, and others; she even hit the wall to indicate her passion about certain events. After her therapy, client behaviors were coded by counseling psychology doctoral students. They found that, through the course of therapy, Krista felt less shame/guilt in all of her interactions and had a better sense of people's reactions (i.e. responding to others with less confusion and noticing that others complied with her less). In a post-therapy interview, Krista communicated that she had experienced a better sense of self and an increased freedom when expressing her emotions in a healthy and positive way.


Citation: Hill, C.E., Chui, H., Huang, T., Jackson, J., Liu, J., Spangler, P. (2011). Hitting the wall: A case study of interpersonal changes in psychotherapy. Counselling and Psychotherapy Research, 11(1), 34-42.

Attitudes about Psychotherapy

In order to qualitatively measure the influence of attachment style on attitudes toward psychotherapy, twelve (12) undergraduate students in introductory psychology classes were used as a sample size in a study conducted by six undergraduate students who were enrolled in an upper-level class on consensual qualitative research (CQR). Participants shared beliefs that, in psychotherapy, clients should be open, receptive, and motivated, therapists should listen, support, and advise the client, and the therapeutic relationship should be intimate. Through a series of interviews, the researchers found that participants who displayed an insecure attachment style were more skeptical of psychotherapy; these participants wanted a more professional client-therapist relationship, wanted the therapist to inquire more instead of disclosing personal information themselves, and thought of fewer therapeutic benefits in relation to their counterparts who displayed a secure attachment style. The study suggested that attitudes about psychotherapy need to be changed in order for the  therapy to have a greater impact.


Citation: Hill, C. E., Satterwhite, D. B., Larrimore, M. L., Mann, A. R., Johnson, V. C., Simon, R. E., Simpson, A. C., & Knox, S. (in preparation). Attitudes about psychotherapy: A qualitative study of introductory psychology students who have never been in psychotherapy and the influence of attachment style. Counselling and Psychotherapy Research, 1-12.