What do people think works in psychotherapy: A qualitative and quantitative assessment of process expectations

Although the effectiveness of psychotherapy is well established, the debate regarding the active processes that produce a therapeutic change is still ongoing. An important question stemming from this debate is whether lay individuals might not themselves have a clear view regarding what works in a therapeutic process. In this study we aimed to address this question by investigating individuals' expectations of the active processes described in the current literature as important facilitators of change, using both qualitative and quantitative approaches. Participants (n = 174) were requested to describe what they viewed as the active processes that produce a therapeutic change in psychotherapy and to rank 7 active processes according to their perceived potency in producing change. The results of the qualitative analysis indicated that emotional and verbal expression was the most frequently identified theme. Quantitative analysis showed that participants ranked the ability to share sensitive contents openly and securely as the highest active process. These findings indicate that individuals view psychotherapy as potent primarily because of how it allows them to speak while attributing less weight to more established active processes such as the therapeutic relations. Implications and directions for future research are discussed.