Clients' experiences of psychotherapeutic interventions addressing trauma

Purpose: This systematic review aimed to evaluate and synthesise qualitative research on adult clients' experiences of psychotherapeutic interventions addressing trauma across multiple modalities.

Methods: Six databases (PsycINFO, MEDLINE, The Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and CINAHL) were systematically searched. Google Scholar and reference lists of included and other relevant reviews were also searched, and in total 37 studies met the inclusion criteria. Relevant data were extracted, quality assessed following the Critical Appraisal Skill Programme checklist, and data synthesised using thematic synthesis.

Results: The specific helpful factors and perceived impact of the interventions aligned with their theoretical bases. Certain factors were perceived to be helpful or challenging regardless of the modality used, such as relational factors between the client and the therapist, and within group settings. Towards the end of the interventions, feelings of ambivalence and emotional struggles which pervaded the process gradually resolved, as a majority of the clients expressed a sense of benefit from the whole experience. Most of the studies included in this review were published post-2020, underscoring research interest towards clients' psychotherapeutic experiences.

Conclusions: The review provides a comprehensive understanding of helpful and challenging factors of interventions addressing trauma, as perceived by clients. The analysis serves as a foundation for future intervention development. Also, it highlights the importance of therapist responsiveness and discussions with clients at various intervention stages to foster a sense of safety, prevent early drop-outs, and emphasise clients as agents of change in their therapeutic process.