"Thus, there is a marked difference between the patients’ and the therapists’ experiences of the therapeutic process in cases of nonimprovement. We interpreted experiences of nonimproved patients as an unbalanced therapeutic alliance, with a good-enough emotional bond, but not enough agreement concerning therapy goals and tasks (Werbart et al., 2015 Werbart, A., von Below, C., Brun, J., & Gunnarsdottir, H. (2015). “Spinning one’s wheels”: nonimproved patients view their psychotherapy. Psychotherapy Research, 25(5), 546–564. doi: 10.1080/10503307.2014.989291
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]
). Conversely, the present study showed that the therapists experienced deficiencies in the emotional bond. However, both patients and therapists shared an experience of remaining core problems and that therapy was insufficient. The results from the two studies taken together indeed imply that therapists and patients did not find a common idea of what should be focused in therapy: the therapists tried to bring up countertransference as a means to address relational problems, but the patients did not mention this as helpful and wished for focus on concrete life matters. Thus, neither the goals and tasks in therapy seemed shared nor did they develop a trusting emotional bond."

Put simply, patient and therapist wanted to talk about different things.