LAUSR

Abstract Objective: This study explores processes and changes experienced by clients during and after successful naturalistic therapy conducted by experienced psychotherapists. A taxonomy of content is built and presented, before the prevalence, range, and variation of process— and change categories are explored. Method: Sixteen therapies showing reliable improvement (on OQ-45) at treatment termination and having complete follow-up data up to 3–4 years post therapy were selected for this study. Processes and changes were extracted from clients’ reports of important aspects during therapy and semi-structured interviews from termination and follow-up. A procedure allowing for description, organization, and quantification of this material was developed and followed. Results: The totality of processes and changes (36 categories) reported by clients under and after these therapies are described. The most prevalent of these were exploration and more understanding (from session reports); relational quality and ways of thinking/more understanding (from interviews at termination); therapy process continues and situational changes (from follow-up interviews). Conclusions: Findings suggest that the therapies in this privileged sample are operating through a broad range of processes and changes, with all clients appreciating material from a large share of categories.