"You Feel They Have a Heart and are Not Afraid to Show it": A Qualitative Investigation of How Clients Experience the Therapeutic Relationship in Emotion-focused Therapy

Abstract

Objective: To explore how clients with depression and destructive self-criticism experience the therapeutic relationship in Emotion-focused Therapy (EFT) including helpful and hindering aspects. Methods: 18 clients who had completed treatment with EFT were interviewed using a semi-structured guide to explore their experiences of the relationship with their therapist during treatment. Transcripts were analyzed by use of a hermeneutic-phenomenological thematic analysis. Results: We identified four main themes: (1) Forming a trusting relationship, (2) Collaborating to find new ways to change painful feelings, (3) Alliance ruptures and needs for repair when working with distressing emotions, and (4) The relationship as a transformative experience. Conclusions: Participants described the importance of the establishment of trust in the relationship for them to open up to vulnerability and painful feelings. A close and secure relationship enabled participants to immerse themselves more fully in interventions designed to transform these distressing emotions, and provided important corrective experiences. However, some of the participants’ concerns in therapy were not always fully recognized or disclosed. Implications for clinical practice and research are discussed.