Qualities clients wish for in their therapists Henrik Littauer MD, Hal Sexton MD, PhD (Professor) and Rolf Wynn MD, PhD (Associate Professor) Psychiatric Research Centre of Northern Norway, University Hospital of Northern Norway, Tromsø, Norway Scand J Caring Sci; 2005; 19; 28–31 Qualities clients wish for in their therapists In this qualitative and phenomenological study we inter- viewed 36 clients following the second session of psycho- therapy. We asked the clients about which therapist qualities they felt were important with regard to the therapist–client alliance. A possible change of therapist was also discussed. Behaving in a confidence-inspiring and calm manner were seen as good therapist qualities that could promote the client–therapist alliance. It was seen as important that the therapist was prepared and had a plan for therapy. The clients felt it was vital that therapists were accepting and understanding. The clients also emphasized the importance of the therapist balancing attentive listen- ing with questioning and commenting. Many clients nee- ded two sessions before a good connection was established. A smaller group felt that they achieved a good or very good connection with their therapists immediately, while a minority of patients had not obtained a good connection with their therapists after two sessions. None of the clients wished to change therapist, and clients had few negative comments about the therapists. The findings underline the importance of the nonspecific and interpersonal aspects of therapists’ behaviour in the alliance-building process. Keywords: psychotherapy, alliance, phenomenology, interviews. Submitted 12 May 2004, Accepted 13 December 2004 Introduction In the Norwegian public psychiatric outpatient clinics, as it likely is in many countries, a large number of clients with nonpsychotic disorders are treated with brief psychother- apy. In most clinics therapists have backgrounds as psy- chologists, doctors, nurses and social workers (1). Their professional training is diverse, ranging from family- oriented to cognitive or psychodynamic. The need for some common general empirically based approaches and understandings is obvious. One central issue in all therapy is the client–therapist alliance. The early client-rated alliance has been shown to be a major predictor of treatment outcome (2, 3). It seems to be independent of diagnosis, therapist experience, age, pro- fession and therapeutic training (4), but dependent pri- marily upon nonspecific aspects of the client–therapist relationship (5, 6). The number of studies on the potentially alliance pro- moting therapist actions during the first psychotherapeutic sessions is limited to a few, mainly quantitative, studies. For this reason, we believed that the clients’ own views of which therapist qualities they regarded as important at the beginning of therapy, would be of interest. Method The study was carried out at the Psychiatric Outpatient Clinic at the University Hospital of Northern Norway, located in the city of Tromsø. The sample consisted of 36 newly referred clients (28 women and eight men), aged 21–60, with nonacute, nonpsychotic disorders, and no serious substance abuse. The therapists were nine women and four men, aged 30–52. Four were psychiatrists, five psychologists, two psychiatric nurses and two occupational therapists. They had an average of 5 years of experience. Five were primarily psychodynamically oriented while eight favoured an eclectic approach. The therapists and clients were not acquainted prior to the onset of the therapy. The study was approved by the regional medical ethics committee. Prior to the instigation of the study, each client had met with the researcher and signed an informed consent. The clients had been informed about the entire project, which, as part of a parallel quantita- tive study, also included a video recording of the two first sessions. The clients were told that after the first two sessions, we would interview them, and that there Correspondence to: Rolf Wynn, Psychiatric Research Centre of Northern Norway, University Hospital of Northern Norway, A ˚ sga ˚ rd N-9291 Tromsø, Norway. E-mail: rolf.wynn@unn.no 28 Ó 2005 Nordic College of Caring Sciences, Scand J Caring Sci; 2005; 19, 28–31