Objective: Evidence about the high burden of depression on society and the immediate environment of patients has accumulated over the past decades. Yet, empirical data about the impact of depression on the environment of psychotherapy are limited. The present study investigates the phenomenon of therapist responsiveness in the treatment of depression. Specifically, this qualitative study examines the influence of a client's severe depressive symptomatology on psychotherapists' immediate experience and reflections about interventions.
Method: The responses of 26 Flemish psychotherapists and counselors to a questionnaire with open questions and as part of a focus group were investigated by using Consensual Qualitative Research methodology.
Results: First, experiences with a negative valence were most common in the responses of the psychotherapists and counselors. A particular negative experience, a sense of "constriction", affecting the therapist's relational, cognitive, emotional, and bodily level of experiencing, was a predominant response. Second, most psychotherapists and counselors considered a therapeutic attitude of being present for the client and the different aspects in the client's experience to be crucial, although most of them experienced difficulty in maintaining an attitude of presence.
Conclusions: The results of this study suggest that exploration of the different aspects of the clients' experience and working with the self-split of the client might be essential in the psychotherapeutic treatment of depressive disorder.
Keywords: client characteristics; depression; therapeutic relationship; therapist response.