Newly referred patients engaged in an ongoing and uncertain process to understand the causes of their psychological problems.

Methods Patients participated in unstructured, home interviews before their first appointment and approximately 2 weeks after the appointment. They were asked to explain how they had arrived at their current situation. Interviews were transcribed and analysed using constant comparison methods. Validity of findings was checked in second interviews (after the first appointment), and through 8 additional interviews with individuals who were currently in contact with the CMHT or who had ceased contact within the previous 6 months.