Helpful aspects of pluralistic therapy for depression.

Aim The purpose of this study was to examine clients' perspectives regarding the helpful aspects of pluralistic therapy for depression. Method Thirty-nine clients received psychological treatment in a multi-site study exploring alternative interventions to standardised 'evidence-based' approaches. Eighteen of them consented to a face-to-face or telephone change interview at the end of their treatment. Change interviews aim to elicit clients' perspective regarding changes that they noticed during, and after, therapy and also the possible causes of these changes. Their descriptions were transcribed and analysed thematically using explicit coding of themes which were audited by the research team. Findings The data were categorised in three a priori domains consisting of specific themes. The first domain constitutes of client-originated helpful factors including clients' positive perspectives of therapy, clients' overall effort to change and clients' contribution in the decision-making process of therapy. Therapists were perceived as helpful when they were accepting and respectful, empathic, responding to clients' needs, making clients feel comfortable, challenging, empowering, using techniques, flexible and reassuring. Treatment outcomes such as change in perspectives, behaviour and response to problems as well as increased insight were also considered helpful factors of therapy. Conclusion These findings suggest that clients in pluralistic therapy are active agents of change and their willingness to engage with treatment is crucial. Helping clients feel comfortable by creating a safe therapeutic environment, challenging dysfunctional patterns associated with depression and empowering them to believe that change is possible through reassurance and non-intrusive guidance were considered beneficial. [ABSTRACT FROM AUTHOR]