Sample Spread
I pulled a sample spread to test this layout. The decision was whether or not to stay with my eye-care provider of the last 37 years or find a new one. The situation is that the folksy family doctor has now become a corporate money-grubber and the care has become much less personal. I used reversal for this one.
I chose the Star as my Significator because of its definition as "clarity of vision." I probably could just as well have used the Ace of Swords.
Decision Chain #1: Stay
Challenges: 5 of Cups rx - I will be challenged to overcome my sense of disappointment if I stay. The Five is a contrary indicator, as are the Cups and the reversal.
Advantage: 5 of Pentacles rx - Even though my last visit was horrendously expensive, it may still be cheaper than finding a new provider. Once again, the Five is a contrary indicator, so it may not be hugely cheaper. The Pentacles and the reversal further undermine the sense of advantage in staying.
Success Potential: 5 of Wands - I will still feel put-upon by the arrangement. Although the Wands are supportive, the third and final Five makes me think I ought to walk away since no good can come of this.
Failure Potential: The Knight of Cups rx - I'm not likely to get much satisfaction out of hanging on. Although the Knight is supportive, the Cups and the reversal are not.
Quint: The Fool - Self-explanatory, I think. Time to move along.
Decision Chain #2: Leave
Challenge: Knight of Cups - I will be transferring my allegiance to an untested provider. There is more hope than assurance in this card, but the Knight is a supportive indicator even if the suit of Cups isn't.
Advantage: Queen of Cups rx - Despite the uncertainty shown by the reversal, I will most likely be comfortable with this arrangement. The Queen of Cups, however, is a doubly negative indicator so I shouldn't expect too much satisfaction out of it.
Success Potential: Knight of Wands rx - I'm looking for a newer practice with a less entrenched doctor who is interested in making a good impression. The reversal cautions against being too optimistic about what I find. But the Knight is another positive indicator for change, as is the suit of Wands.
Failure Potential: Page of Swords - this could very well be the untested Fool in another guise. I might be fobbed off on a junior associate. The Page is a neutral indicator, so there is no guarantee this would be an undesirable situation, but the risk is there.
Quint: The Hierophant - This seems to be saying that any new provider I sign on with will have the requisite credentials to meet my expectations (which he would have to possess in order to be licensed in this State.) It also could be saying I'll have to settle for another hidebound traditionalist.
I don't see anything here that suggests I could save money, but I should feel happier and more confidant about the situation.
I think I agree with Amanda that this should be set up in a "big X" for visual continuity. I've included pictures of it both ways. Now, instead of a guppy, it looks like crossed hockey sticks.