Although psychotherapy for cancer patients is known to be effective, there is little in the research to indicate what elements of their therapy patients find most helpful. To explore this question, we interviewed cancer patients diagnosed with metastatic disease who had been offered two different forms of individual psychotherapy as part of a larger funded study. These interviews were then transcribed and analysed using grounded theory. Our aim was to explore patients' psychotherapy experience from their perspective and to determine what common elements in the two approaches they felt were of greatest benefit. Results indicated that patients offered cognitive behavioural therapy had similar experiences to those who received a type of relaxation therapy that included time for non-specific, patient-centred 'chat'. Central to participants' experiences was the opportunity both therapies gave them to enter a relationship in which they could safely share their thoughts and feelings with someone who seemed genuinely interested in understanding their cancer experience and 'truly cared'. These findings suggest that the unique perspectives of cancer patients can add considerably to our understanding of individual psychotherapy in cancer care settings and how this might be improved.