The personal self of psychotherapists : Dimensions, correlates, and relations with clients

ObjectiveThe personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self-ratings on specific self-attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. MethodData from the Development of Psychotherapists Common Core Questionnaire were available for>10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. ResultsMost psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self-experiences, and parallel dimensions of relationship with clients correlated strongly. ConclusionsAnalyses of>10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life.Peer reviewe

An exploration into the client at the heart of therapy : a qualitative perspective

Over 50 years ago Eysenck challenged the existing base of research into psychotherapy. Since that time, a large number of investigations have been conducted to verify the efficacy of therapy. Recently however, an increasing number of studies have cast new doubts on this research base. Instead of therapy being a function of the therapist, it is now becoming ever more apparent that the client plays a prime role in the therapeutic process. The qualitative studies presented in this paper provide some examples of research that demonstrates that clients are actively involved in their therapy, even making counselling work despite their counsellor. These studies suggest that clients may not experience therapy as beneficially as traditional outcome studies indicate. This raises a new challenge to researchers to more fully explore the client's experience of therapy, a challenge to which qualitative methods of inquiry would appear well suited

Interactional positioning and narrative self-construction in the first session of psychodynamic-interpersonal psychotherapy

The purpose of this study is to identify possible session one indicators of end of treatment psychotherapy outcome using the framework of three types of interactional positioning; client’s self-positioning, client’s positioning between narrated self and different partners, and the positioning between client and therapist. Three successful cases of 8-session psychodynamic-interpersonal (PI) therapy were selected on the basis of client Beck Depression Inventory scores. One unsuccessful case was also selected against which identified patterns could be tested. The successful clients were more descriptive about their problems and demonstrated active rapport-building, while the therapist used positionings expressed by the client in order to explore the positionings developed between them during therapy. The unsuccessful case was characterized by lack of positive self-comment, minimization of agentic self-capacity, and empathy-disrupting narrative confusions. We conclude that the theory of interactional positioning has been useful in identifying patterns worth exploring as early indicators of success in PI therapy

Clients’ experiences of one-to-one low-intensity interventions for common mental health problems : an interpretative phenomenological analysis

Objectives: Common mental health disorders such as depression and anxiety are highly prevalent and carry significant health care and economic burdens. The UK’s improving access to psychological therapies (IAPT) initiative was developed as a cost-effective way of reducing the pernicious effects of these disorders. IAPT interventions, such as guided self-help, have been subjected to considerable quantitative evaluation. However, there has been minimal investigation into clients’ experiences of the one-to-one low-intensity interventions (LIIs), which form a key component of IAPT service provision. Qualitative exploration could provide rich data regarding experiences of psychological change and factors affecting therapeutic experiences. This will enable informative, client led insights into how low-intensity therapy can be improved. Methods: Interpretative phenomenological analysis of eight semi-structured interviews was used to develop an idiosyncratic understanding of clients’ experiences of one-to-one LIIs following entry into a randomized control trial (RCT). Results: Four superordinate themes were identified from clients’ accounts: goals and expectations of therapy, beneficial aspects of therapy, non-beneficial aspects of therapy, and the experience of psychological change. A heuristic model of interrelationships between factors is proposed. Conclusions: Both therapeutic techniques and relationships contribute to beneficial therapeutic experiences. The results reported here can be used to inform practice by harnessing the most beneficial aspects of therapy, such as developing adaptive therapeutic approaches to clients’ clinical needs and facilitating idiosyncratic processes of psychological change. Due to limited qualitative research in this area, further research should be conducted in different service settings to assess differences and similarities in clients’ experiences

The path towards a professional identity: An IPA study of Greek family therapy trainees

Objective: Contemporary psychotherapy research has focused mainly on practitioners' training and education. The impact of training on professional development and the application of therapeutic skills have been the primary foci of the empirical literature. The aim of this paper is to present the experiences of seven family therapy trainees regarding their personal paths toward the development of professional identity as they underwent training in systemic psychotherapy. Method: In-depth interviews were conducted and analysed using Interpretative Phenomenological Analysis. Results & Conclusions: Seven themes were identified: The Quest, Developing by Relating, Learnings, Personification of Training, Use of Self, Self-Care and Empowerment, and Reflecting on the Role of the Therapist. The findings are discussed with regard to the development of the 'therapist as a person', gaining acknowledgement and autonomy, and the development of a community of therapeutic practice. © 2013 British Association for Counselling and Psychotherapy

Delivering effective counselling for people with dementia and their families: Opportunities and challenges

This article explores the prospect of delivering counselling to people affected by dementia from the perspective of persons responsible for delivering an integrated dementia support service, emphasising an underpinning relational approach. Findings originate from interviews with an experienced counsellor, the counselling service co-ordinator, and people affected by dementia. Framework Analysis was adopted to generate themes related to the study aims. Effective counselling delivery is reliant on the counsellor’s practice philosophy and appreciation of the lived experience of dementia from a person-centred understanding. Participants discussed the benefits to offering a holistically understanding service, supportive of the needs of people affected by dementia, and how this can affect access or uptake of counselling. Findings demonstrated that counselling is a worthwhile and effective intervention to offer to people living with dementia and family caregivers. A number of recommendations for adjusting the scope of relationship-based counselling to promote effective delivery have been made

The weirdness of having a bunch of other minds like yours in the room: The lived experiences of mentalization‐based therapy for borderline personality disorder

Objectives: Studies of lived experiences are important for improving treatment effectiveness, but most studies of mentalisation-based therapy (MBT) are quantitative. This qualitative study aimed to better understand service users’ lived experiences of MBT, including their experiences of change. Design: This is a qualitative study that used one-to-one semi-structured interviews. Method: Semi-structured interviews were conducted with eight MBT service users recruited via four NHS trusts. Interviews were analysed using interpretative phenomenological analysis (IPA). Results: Three superordinate themes were identified: being borderline, being in the group, and being on a journey. ‘Experiences of diagnosis’ and ‘the group’ are salient topics in the lived experiences of service users’ during the MBT journey, as is the nature/type of ‘change’ which can create symptom reduction albeit alongside a negative felt experience. Conclusion: Our research aligns with current thought regarding the complexity and challenges of treating BPD via psychotherapy and adds a further dimension, that of experiencing MBT and changes during therapy. The participants’ experiences of BPD, and of experiencing MBT are discussed

Looking both ways

On the occasion of the 25th anniversary of the journal, Psychotherapy Research, three former editors first look back at: (i) the controversial persistence of the Dodo verdict (i.e., the observation that all bona fide therapies seem equally effective); (ii) the connection between process and outcome; (iii) the move toward methodological pluralism; and (iv) the politicization of the field around evidence-based practice and treatment guidelines. We then look forward to the next 25 years, suggesting that it would be promising to focus on three areas: (i) systematic theory-building research; (ii) renewed attention to fine-grained study of therapist techniques; and (iii) politically expedient research on the outcomes of marginalized or emerging therapies

Evaluating the quality of social work supervision in UK children's services: comparing self-report and independent observations

Understanding how different forms of supervision support good social work practice and improve outcomes for people who use services is nearly impossible without reliable and valid evaluative measures. Yet the question of how best to evaluate the quality of supervision in different contexts is a complicated and as-yet-unsolved challenge. In this study, we observed 12 social work supervisors in a simulated supervision session offering support and guidance to an actor playing the part of an inexperienced social worker facing a casework-related crisis. A team of researchers analyzed these sessions using a customized skills-based coding framework. In addition, 19 social workers completed a questionnaire about their supervision experiences as provided by the same 12 supervisors. According to the coding framework, the supervisors demonstrated relatively modest skill levels, and we found low correlations among different skills. In contrast, according to the questionnaire data, supervisors had relatively high skill levels, and we found high correlations among different skills. The findings imply that although self-report remains the simplest way to evaluate supervision quality, other approaches are possible and may provide a different perspective. However, developing a reliable independent measure of supervision quality remains a noteworthy challenge