Mark Knutzen, Psy.D. is a 2020 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle.

Dissertation Committee

Michael Toohey, PhD, Committee Chair

Ann Blake, PhD, Committee Member

Ned Farley, Ph.D., Committee Member


psychotherapy relationship, counseling relationship, common factors, phenomenological study

Document Type


Publication Date



Meta-analyses have indicated that there are likely common factors across varied treatment modalities that account for the effectiveness of psychotherapy. Research has attempted to identify therapist and treatment relationship components that correlate with effective mental health treatment. Yet, there is a paucity of research directly addressing the qualitative experience of the relationship between psychotherapists and their clients.

Eight adult psychotherapy clients were interviewed regarding their experience of the psychotherapy relationship with their mental health therapist. The interviews were analyzed through the use of Interpretative Phenomenological Analysis (IPA). Seven themes emerged. Three themes related to the formation, and overall foundation of a therapeutic relationship, were identified as: Knowing the Therapist, Trusting the Therapist (or Treatment Process), and Ruptures (and Resilience). Four themes related to therapeutic components of the psychotherapy relationship were identified as: Re-parenting/Hierarchy-Status, Seen/Witnessed By Therapist (Attunement), Therapeutic Qualities of the Therapy Relationship, and Specialness of the Relationship. Each participant report underscored the significance of the relationship to the therapeutic effect of the mental health treatment.


Mark Knutzen, PsyD, 2020

ORCID Scholar ID# 0000-0003-1928-8422