The client's helical path : a grounded theory of unsuccessful therapy experiences

Abstract

A grounded theory methodology, justified by the logic of methodical hermeneutics, was employed to guide both the collection and analysis of data produced from interviews with 11 psychotherapy clients who reported having unsuccessful experiences. Ultimately, I put forth the ‘‘Client’s Helical Path’’ as a theoretical model grounded in clients' unsuccessful therapy experiences. The theory subsumes four subcategories: three cyclically-related subcategory processes (Embarking, Evaluating, and Ending), and a fourth category (Familiarity) that provides a temporal/experiential dimension. Clients embark upon a course of therapy with certain expectations; they later evaluate their experience on the basis of these expectations, and then end therapy when they adjudicate it as not sufficiently successful. Clients' familiarity with the enterprise of therapy is enhanced with each successive therapy experience, and this familiarity implicates clients' subsequent expectations, evaluations, and endings. The theory contextualizes clients’ experiences of unsuccessful therapy at the level of the individual, rather at the level of the course of therapy, thereby providing an understanding for how past therapy experiences influence future ones. This feature of the theory represents a significant departure from and contribution to the existing psychotherapy research literature. I discuss the unique nature and utility of the theory, its overlap with existing empirical findings, as well as its limitations. I suggest directions for future research, and I provide multiple credibility checks.