Facilitating client change: principles based upon the experience of eminent psychotherapists

Eminent therapists across psychotherapy meta-orientations were asked to describe the processes by which they facilitate change in psychotherapy. A grounded theory analysis of these interviews was conducted. Safety within the psychotherapeutic relationship was identified as a central element in creating client change to the extent that in-session risk taking was important in that orientation. As well, common processes across orientation in structuring new awareness emerged as a core finding. Patterns were identified in how therapists balanced negotiating the client-therapist relationship while fostering new awareness. Principles based on therapists' common intentions are put forward to guide future research and psychotherapy integration efforts.