“I’ve built a good life for myself”: A qualitative study of patient-perceived change in transference-focused psychotherapy

OBJECTIVE: Despite growing evidence from outcome research on Transference-Focused Psychotherapy (TFP), studies focusing on patients' perspectives remain limited. This study aimed to examine how patients perceive change as a result of TFP. METHOD: Twelve patients (10 women, 2 men) in the advanced phase of TFP were recruited from private outpatient practices across Poland. Data were collected through semi-structured, in-depth qualitative interviews and analyzed using thematic analysis. RESULTS: Six overarching themes were identified: (1) From distance to trust: relational transformation in the therapeutic relationship, (2) Identity integration and change in self-image, (3) Increased capacity for ambivalence in experiencing others, (4) Internal change translated into real-life relationships, (5) Symptom reduction and improved everyday functioning, and (6) Change as an ongoing, non-linear process. CONCLUSION: Patients described therapeutic change in TFP primarily in terms of transformations in self-other representations, increased identity integration, and relational experience rather than symptom reduction alone. These findings demonstrate how qualitative data can complement quantitative research by capturing how therapeutic change is subjectively lived and made meaningful, responding to calls to broaden the evidentiary basis of psychotherapy research beyond quantitative studies.