The professional integrity of the psychologist can be aided by their collaborations with other professionals in various fields, such as medicine, education, and social work. This facilitation of integrity can be put into practice when a psychologist has developed coalitions through the legal network surrounding the client’s situation. In this process of collaboration, it is important to maintain a psychotherapeutic setting that enables the client to be capable of making decisions about themselves.

During the psychotherapeutic process, the biopsychosocial synthesis of the client’s life history and survival is achieved with the help of the collaborative work of the psychologist. At the end of the process, the professional integrity of the psychologist is realized on the grounds of shared human dignity. This concept, which constitutes the core of the United Nations’ Declaration of Human Rights, permeates current Japanese social welfare laws. The psychologist’s work should also focus on this concept in the legal system.

In this case report, I describe the case of a patient who was on medication for depression for four years and whose treatment regimen was changed through workplace industrial counseling, resulting in the recovery of the patient's complex PTSD. This case report was described by reviewing the patient's medical records. I attributed the patient's symptoms to childhood life circumstances and trauma as the cause of his psychiatric symptoms and the trigger for his depression. The patient was hospitalized for treatment, during which EMDR and hypnotherapy were administered. As a result, the patient went into early remission with the addition of his own self-treatment. The patient continues to experience periods of instability after discharge, but is able to cope with them through self-medication and new relationships that his developed during his hospitalization.

Summary Therapeutic factors in psychotherapy have been categorized into client factors, therapist factors, technique factors, relational factors, extra-therapeutic factors, and hope-expectation-placebo factors. Among these, client factors have often been considered the most important factors in determining the effectiveness of psychotherapy, but have not received the attention they deserve. This paper shares an recognition about how client factors are neglected in both theory and practice in the current situation, and then discusses the background circumstances of that. It then reviews previous research findings on various treatment factors and confirms that common factors have a greater impact on treatment effectiveness than technique factors. Based on the above, it examines how client factors have been treated in psychotherapy integration and discuss psychotherapy integration focusing on client factors.

This paper is a reworking of the presentations given at the symposium “The Power of Clients to Create Therapeutic Change” (held on March 9th, 2024) at the 4th academic conference of the Japanese Society for Psychotherapy Integration, by the six speakers at the symposium. First, the client factors in psychotherapy were briefly reviewed. Then, three therapists each reported on their experiences of cases in which they had a real sense of the power of the client in psychotherapy. After that, the power of the client in psychotherapy was discussed in relation to these cases.