"It was like having half of the patient in therapy": Therapists of nonimproved patients looking back on their work. (8th October 2019)

• Record Type: Journal Article
• Authors: Werbart, Andrzej; von Below, Camilla; Engqvist, Karin; Lind, Sofia
• Is Part Of: Psychotherapy research. Volume 29:Number 7(2019)
• Page Start: 894
• Page End: 907
• Publication Date: 2019-10-08
• Subjects: psychoanalytic/psychodynamic therapy -- long term psychotherapy -- outcome research -- process research -- grounded theory -- therapist perspective -- negative processes; terapia psicanalítica / psicodinâmica -- psicoterapia de longo prazo -- pesquisa de resultados -- pesquisa de processo -- teoria fundamentada -- perspectiva do terapeuta -- processos negativos; terapia psicoanalitica / psicodinamica -- psicoterapia a lungo termine -- ricerca sui risultati -- ricerca di processo -- grounded theory -- prospettiva del terapeuta -- processi negativi; 精神分析/精神動力治療 -- 長期心理治療 -- 成效研究 -- 歷程研究 -- 紮根理論 -- 治療師觀點 -- 負向歷程; Psychotherapy -- Periodicals; Psychotherapy -- Research -- Periodicals; Psychotherapy -- Periodicals; Psychothérapie -- Périodiques; Psychothérapie -- Recherche -- Périodiques; 616.891405
• DOI: 10.1080/10503307.2018.1453621
• Languages: English
• ISSNs: 1050-3307

Abstract

Abstract: Objective: To explore therapists' experiences of therapeutic process in psychoanalytic psychotherapy with nonimproved young adults. Method: Eight nonimproved cases were identified according to the criterion of reliable and clinically significant change in self-rated symptoms. Transcripts of therapist interviews (8 at baseline and 8 at termination) were analyzed applying grounded-theory methodology. Results: A tentative conceptual process model was constructed around the core category Having Half of the Patient in Therapy . Initially, the therapists experienced collaboration as stimulating, at the same time as the therapeutic relationship was marked by distance. At termination negative processes predominated: the patient reacted with aversion to closeness and the therapist experienced struggle and loss of control in therapy. The therapists described therapy outcome as favorable in form of increased insight and mitigated problems, while core problems remained. Conclusions: This split picture was interpreted as a sign of a pseudo-process emerging when the therapist one-sidedly allied herself with the patient's capable and seemingly well-functioning parts. The therapists' experiences could be compared to the nonimproved patients' "spinning one's wheels" in therapy. The therapists seem not to have succeeded in adjusting their technique to their patients' core problems, despite attempts to meta-communicate.