Seeking the Active Ingredients of Psychotherapeutic Change: Within and Outside the Context of Therapy

The isolation of active ingredients that initiate change may be able to shed light on process and outcome in counseling and psychotherapy. The purpose of this study was to investigate 20 significant or second-order change experiences that took place within and outside of therapy. The study used a Likert scale designed to disclose perceived necessary and sufficient conditions of change. Both the context of the experiences and theoretical constructs distilled from the literature were examined for their perceived potency for change. Constructs often rated as sufficient conditions were gaining insight, gaining a new perspective, confronting the problem, and becoming aware of the problem. Consistently rated as necessary conditions were a sense of necessity and the willingness to experience anxiety or difficulty. Implications for therapy are discussed, along with variables that may regulate the rate and magnitude of change.