Clients' perceptions of pivotal moments in couples therapy: a qualitative study of change in therapy.

Few qualitative research studies have been conducted on change processes in couples therapy, and even fewer have focused on the clients' perceptions of change processes. In this grounded theory qualitative study on marital therapy, clients' perceptions and experiences of pivotal moments are identified. Analysis of transcripts of therapy sessions, postsession questionnaires, and two posttherapy interviews with each couple revealed that clients did identify specific therapy events or discourses as pivotal. Reports of pivotal moments tended to be highly individualized accounts, with little overlap spouses and little overlap between therapist and client identification of pivotal moments. Pivotal moments tended to occur during discussions of topics that were presenting problems for the couple but, typically, after repeated discussions of the same topic. Other findings and implications are discussed.