‘How Can I Surpass That?’ Impact of Clients' Previous Therapy Experiences on How Therapists Experience and Navigate Therapy

ABSTRACT Objectives Around a third of clients return to NHS Talking Therapies (NTT) services. This study explores the impact of clients' previous therapy experiences on how NTT cognitive behavioural therapists experience and navigate therapy. Design This study employed a qualitative approach using therapist interviews. Methods Semi‐structured interviews were carried out with 12 therapists. Participants were invited to talk about examples of work with clients whose previous therapy experiences had appeared impactful. The resulting interview transcripts were analysed using reflexive thematic analysis. Results Four themes were created which represented participants' diverse experiences with therapy‐experienced clients: (1) Preventability of return—‘it's just a shame people have to come back’; (2) Conducting a post‐mortem of previous therapy; (3) Previous therapy as a wellspring—setting the therapist's course; (4) The big finale. Previous therapy experiences could be seen as a resource to draw on, create pressure to replicate positive experiences or break a pattern of less successful experiences. Conclusions The findings suggest therapists can have strong responses to clients' previous therapy experiences. When working with therapy‐experienced clients, supervision should be used to explore these responses to increase awareness of their impact. This would improve opportunities to draw on these experiences as a resource in the work to support both formulation and intervention.