Understanding the processes involved in therapy are crucial to maximising its
benefits. This doctoral thesis explores two aspects of therapy which are crucial to the beginning and ending phases of therapy i.e. the formation of the therapeutic relationship and the experience of ending therapy. It is hoped that this contribution to the research base will provide clinicians with practical recommendations based on empirical evidence and prompt future research to investigate these topics further.

The first section of this thesis describes a metasynthesis of qualitative studies
exploring the formation of the therapeutic relationship from the client’s perspective. Findings highlight clients’ initial assessment of therapist characteristics to see whether they fit with their perceived needs. Displays of openness and respect from the therapist were found to facilitate the formation of the relationship and allow for a deep connection between client and therapist to be established.

The second section of this thesis presents a grounded theory study focusing on
therapists’ experiences of ending therapy with clients. The theory explains the processes that play a significant role in the ending experience (therapist context, therapeutic approach, level of connectedness, level of investment and therapist’s perceived responsibility) and how they impact on different types of therapy endings. Elements of the therapy were found to continue beyond the final session as therapists described learning from each ending experience which
served to influence their future work with clients.

The third section of this thesis comprises personal reflections on the process of
engaging in the thesis project. Specifically, this critical appraisal explores the difficulties experienced by the author in positioning herself within a consistent ontological and epistemological stance. The reflections offered in this section follow the developmental journey made by the author as a result of engaging in this project.