Clients who had completed psychotherapy were interviewed about the significant experiences and moments they recalled within their sessions. These interviews were analyzed using grounded theory, creating a hierarchy of categories that represent what clients find important in therapy. From the hermeneutic analysis of the content of these categories, a list of principles was constructed to guide the moment-to-moment process of psychotherapy practice. The authors respond to the call for qualitative outcome studies and demonstrate how qualitative psychotherapy research can lead to empirically derived principles that then can become the foundation of future research and psychotherapy integration efforts.