Therapist experiences and perspectives on moving beyond symptoms and into flourishing: a grounded theory analysis

Psychotherapy has historically focused on symptom reduction. However, there are calls for increasing our understanding of how psychotherapy impacts clients’ flourishing. In this study, licensed mental health professionals and trainees across different clinical settings with diverse therapeutic orientations were interviewed about their perspectives on the cultivation of flourishing in psychotherapy, as well as their own personal experiences with flourishing. We were interested in understanding how therapists define flourishing, how they integrate flourishing into their work with clients, and any barriers or catalysts for engaging in this process. To do so, we conducted eight focus groups, and interviews were analyzed using grounded theory to form a hierarchy of categories. The results were used to create a three-part grounded theory. Results suggested that flourishing is a distinct concept from well-being that involves active engagement, emotional connection and meaning making. Our three-part grounded theory of flourishing elucidates how flourishing can be pursued by guiding clients towards their experiences of suffering in order to engage in meaning making and to identify their values, as well how systemic barriers can be navigated. Themes emerged related to the training of psychotherapists to promote flourishing, and the associated clinical and training implications are discussed.