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Can I be helped? The prospects for change in me and my depression: A thematic analysis of pre-therapy expectations

Lewis, Daniel


Daniel Lewis


While clients’ expectations are understood to contribute significantly to outcomes in therapy, attempts to understand this contribution have been confusing, and there is a paucity of research on the subject for adults with depression seeking therapy. This is significant given that people with depression are less likely to seek help and have higher rates of pre-therapy attrition compared to people with other presentations. Moreover expectations for therapy are likely to play a role in clients’ early engagement in therapy, which is seen to be a critical phase for improvement. This research provides a qualitative account of the pre-therapy expectations of twelve adults who were on waiting lists to receive psychological therapy for depression. A thematic analysis was carried out on the data obtained from semi-structured interviews which explored participants’ experiences of depression and help-seeking, and their expectations for therapy. The first overarching theme, Therapy – A faint hope, explored the difficulty participants had with envisaging how, and having conviction that, therapy would help them. The overarching theme, Being helped to heal myself, describes how participants sought a sanctuary of acceptance in order to talk about and ultimately self-manage their problems. The final overarching theme, How to deal with my depression, highlights the way participants conceptualised solutions to their depression. A central theme about the prospect for change appears to be mediated by issues of identity, capability and responsibility. The study has implications for how mental health services and practitioners engage with people with depression, and how Counselling Psychology meets its wider obligations to marginalised groups.


Lewis, D. Can I be helped? The prospects for change in me and my depression: A thematic analysis of pre-therapy expectations. (Thesis). University of the West of England

Thesis Type Thesis
Keywords therapy expectations, depression, help-seeking, qualitative, common factors


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