Thomas Smith

Defense Date


Graduation Date



Immediate Access

Submission Type


Degree Name



Clinical Psychology


McAnulty College and Graduate School of Liberal Arts

Committee Chair

Roger Brooke

Committee Member

Constance Fischer

Committee Member

Jessie Goicoechea


qualitative research, psychotherapy research, client's perspective psychotherapy, long-term psychotherapy, depressive disorders, therapeutic relationship


Although there is sufficient evidence that psychodynamic therapy for depression is effective, there is no research documenting the qualities of experience in effective psychodynamic therapy for depression. To address this lack, this study aimed to investigate clients' experiences of both the helpful processes and the therapeutic effects of psychodynamic therapy for depression.

Letters, emails, and flyers were distributed and advertisements placed through psychological associations at the local and state level, and letters were mailed to therapists in the greater Pittsburgh metropolitan area. Solicitation procedures yielded four participants of whom three were female and one was male. Participants completed a research questionnaire, and provided written descriptions of the process and outcome of psychodynamic therapy. They expanded upon their descriptions in an individual interview.

A master psychological text that transcribed and combined each interview with each written description served as the focus of data analysis. The data was analyzed according to the empirical phenomenological method outlined by Giorgi (1975, 1985). The data analysis procedures for each text included the demarcation of meaning units, the formulation of central themes of each unit, and the integration of central themes. The results consisted of four situated structural descriptions of effective psychodynamic therapy for depression. These descriptions synthesized themes and relations among themes. A general structural description left out themes specific only to each situated description.

The study found that psychodynamic therapy helped participants to modify their involvement in a situation that was a source of suffering by teaching them to attend to their feelings differently and by facilitating their development of a complex sense of self. Regarding the effects of therapy, the therapy helped to relieve the intensity and duration of participants' depressive episodes, to improve the quality of participants' engagements with others and with their own projects, and to encourage participants' resiliency and continued psychological growth after termination. Regarding the helpful facets of therapy, in addition to client discussion of important topics such as relationships and loss, and in addition to therapist interventions such as clarification and confrontation, the deeply personal therapeutic relationship and the participants' integration of therapists' care was central to the process of therapy. The results of the study were discussed in regard to psychodynamic theories of depression and therapy, and to research on therapy for depression.