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“It was like having half of the patient in therapy”: Therapists of nonimproved patients looking back on their work
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2018 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
2018.
Keyword [en]
psychoanalytic/psychodynamic therapy, long term psychotherapy, outcome research, process research, grounded theory, therapist perspective, negative processes
National Category
Psychology
Identifiers
URN: urn:nbn:se:su:diva-155737DOI: 10.1080/10503307.2018.1453621OAI: oai:DiVA.org:su-155737DiVA, id: diva2:1201820
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-05-23

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CiteExportLink to record
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