Client relationship incidents in early therapy: Doorways to collaborative engagement

The purpose of this study was to elaborate how clients understand the development of the alliance and to highlight aspects of the process particular to depressed clients working with experienced therapists. Fifteen participants described critical incidents in early therapy that influenced how they understood their working relationships with therapists. All incidents involved clients appraising what their therapists were doing. Through interviewer probing, participants were able to identify the importance of their own activity (disclosing and working with therapist input) as their collaboration in the incidents. Positive emotional responses were woven through the descriptions of the incidents. The research underscores how client understanding of collaboration might be accessed by researchers or clinicians and the potential importance of the interaction of client active exploration with positive emotions in understanding alliance development.