The experience of patients and therapists in psychological therapy (original) (raw)
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Therapist and client: Two views of the process and outcome of psychotherapy
Professional Psychology, 1978
Upon termination of their therapeutic relationships, 8 male and 7 female therapists, along with their 38 male and 37female clients, each independently and anonymously completed a questionnaire concerning the process and efficacy of therapy. Unlike previous findings, the clients rated therapeutic outcome more favorably than did their therapists. In addition, each group attributed the change to different aspects of the therapeutic relationship. Both the aspects cited and the ratings differed as a function of the sex of both therapist and client.
Depression and anxiety within the general population are a continuing and significant problem. Patients presenting with mild to moderate levels of these disorders are now commonly referred to Increasing Access to Psychological Therapy services. This project seeks to understand the experience of patients receiving psychological therapy in one IAPT service. Semi-structured interviews were conducted with 18 patients, with questions focussing around expectations of therapy, experience of homework, structure of sessions, perceived usefulness of therapy, and therapeutic endings. Data were analyzed using thematic analysis. Key features of cognitive behaviour therapy were present in participants’ descriptions of therapy. For example, empathy and normalisation was described by one participant “I felt like [the therapist] really got it every time I didn’t have to correct [the therapist] and say well actually, I didn’t really mean that” and also offering a client-centred approach “When I explained that I didn’t really see it as depression [the therapist] was happy to work with me on how I felt and what my feelings were”. Some participants felt that whilst CBT had been helpful they may need further support “I would probably find it more helpful to have a way of managing those core [emotional] responses which I think is beyond the scope of CBT”. CBT was reported to be a positive subjective experience overall, but with periods of conflicting emotions, such as feeling sad to be ending treatment but pleased to be considered well-enough to be discharged. Understanding the experiences of patients who receive therapy. Whilst outcome measures are routinely collected using standardised forms, anonymous, open-ended feedback is rarely able to be collected. This information can inform service provision within primary care psychology services.
Psychotherapy: Essence, Experience, and Examination
Was wir wirklich brauchen: Erfahrungen eines Psychoanalytikers, 2024
Foreword to Dieter Adler: What we Truly Need – Experiences of a Psychoanalyst. In any serious, scientific, and ethically justified healthcare profession, the focus should be always on the overall health, treatment, improvement, and amelioration of the patient. What clinical and professional background should therefore a mental health professional have? In his book, Adler does not want to simply offer a quick guide to self-help. In fact, he is clear about the fact that this is not the purpose of the book: “Maybe I’ll write one sometime: How you can reliably become independent of self-help books.” In fact, this book is a reflection on a 30-year-long professional career in which the author has learned to ask questions, to listen attentively, and to help shed light on some of the most complex and hidden aspects of what makes us human. To be sure, this does not mean that this book does not present a practical approach to well-being, quite the contrary. The author lists a series of areas the patient can focus on, in order to achieve a higher state of balance, healing, and happiness. Amongst these we find socialization, upbringing, and community, making friends, understanding and working on one’s emotions and the emotions of others, staying physically and mentally active, finding a sense of security and confidence, maintaining a sense of curiosity, finding a work-life balance and rediscovering peace and calmness, having goals, purposes, and meaning in life, and of course, understanding those negative, self-sabotaging mechanisms and processes which hinder such developments.
Aim. The study concerns the relationship between three groups of variables presenting the patient's perspective: (1) " patient's characteristics " before psychotherapy, including " expectations of the therapy " ; (2) " experience in the therapy " , including the " psychotherapeutic relationship " ; and (3) " assessment of the direct effectiveness of the psychotherapy ". Data from the literature are the basis for predicting relationships between all of these variables. Material and method. Measurement of the variables was conducted using a follow-up survey. The survey was sent to a total of 1,210 former patients of the Academic Center for Psychotherapy (AOP) in which the therapy is conducted mainly with the students and employees of the University of Warsaw. Responses were received from 276 people. 55% of the respondents were women and 45% were men, under 30 years of age. The analyses were performed using structural equations. Results. Two models emerged from an analysis of the relationship between the three above-mentioned groups of variables. One concerns the relationship between (1) the patient's characteristics (2) the course of psychotherapy, in which – from the perspective of the patient – there is a good relationship with the psychotherapist and (3) psychotherapy is effective. The second model refers to (2) the patient's experience of poor psychotherapeutic relationship and (3) ineffective psychotherapy. Conclusions. Patient's expectations of the psychotherapy (especially " the expectation of support ") proved to be important moderating variables in the models – among the characteristics of the patient. The mathematical model also revealed strong correlation of variables measuring " the relationship with the psychotherapist " and " therapeutic interventions " .
Patient experiences of psychological therapy for depression: a qualitative metasynthesis
BMC Psychiatry
Background: Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research. Method: PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis. Results: Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what's unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends. Conclusions: Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.
Client Experience in Psychotherapy: What Heals and What Harms?
Indo-Pacific Journal of Phenomenology, 2001
The experience of eight clients was explicated using a model based on Giorgi and Schweitzer. The counselling experienced as healing by clients has at its core a vibrantly warm and honest relationship where the client feels held in the safety of the good heart space of the counsellor. The counsellor is experienced as providing an intense beingness for the client that embraces the client's suffering and provides solid ground created out of the crucible of the counsellor's own encounter with his or her shadow. The counsellor is emptied out of his/her own agenda and provides space for the client's experience. The counsellor can evoke the higher resources of the client. The counselling is experienced as renewing and reconnecting the clients to his/her sense of self, of other and the lifeworld. The counselling relationship experienced as harming is described as being drained of human presence and transforming power. There is no alive human connection. The counsellor is experienced as insubstantial, and has no ability to hold traumatic experience. The counsellor's cold reception to the client's vulnerabilities has the power to shatter, fragment and splinter the client. The counsellor is full of self. This fullness may be ego that manifests as dry intellectualising or playing manipulative games as a substitute for human presence. This may lead the client to terror, sickness and anxiety. The counsellor may be full of their own fears and are experienced by the client as chaotic, avoidant and overwhelmed. Their unavailability leads clients to experience emotional depletion, exhaustion and frustration. The counsellor's self-righteousness, judgement and critical disengagement are experienced by clients as being belittled, condemned and diminished. The therapeutic encounter results in a weakening of the human potential for recovery. Both client and counsellor emerge as lesser human beings, with weakened relationships to self, others and the world.
Rivista di Psicologia Clinica, 3, 2008
The research we will present set out to study the expectations and assessments of psychotherapy expressed by a group of psychotherapists and a group of clients, proceeding with two parallel investigations, the data from which were then compared. This work seeks to contribute to psychotherapy research by exploring an area which is not often examined in such studies. We are referring to the experiences and the symbolic significance with which psychotherapists and clients represent the psychotherapy experience to themselves. As it ventures into largely unexplored country, the research takes the form of an initial survey of the themes in question. In terms of the model we will adopt to examine these experiences, we will talk about collusion, meaning the emotional dynamic by which people symbolise a context that they share 1 . The experiences of the psychotherapists and patients are therefore considered not in their individual dimension, but in their capacity to express a 'demand culture' in psychotherapy, seen from the point of view of the expectations with which the patients turned to it, and of the service the psychotherapists think they are delivering in response to these expectations. This study thus sets out to contribute to the debate on the relation between the commissioner of the intervention and the social mandate for psychotherapy intervention, an issue of particular interest for those that deal with development in our profession.