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Increased participation in the life context: a qualitative study of clients' experiences of problems and changes after psychotherapy
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro County Council, Örebro.
Department of Psychology, Umeå University, Umeå, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro County Council, Örebro.
2012 (English)In: European Journal of Psychotherapy, ISSN 1364-2537, E-ISSN 1469-5901, Vol. 14, no 4, p. 365-380Article in journal (Refereed) Published
Abstract [en]

People use psychotherapy in different ways depending on how they perceive their problems and themselves. Exploring a person’s experiences of problems and changes after psychotherapy is important for evaluating outcomes of therapies. Based on descriptions from people with recent experiences of psychotherapy, the aim of this study was to gain a deeper understanding of the participants’ problems before psychotherapy and of changes after psychotherapy. Fourteen participants  selected based on variations in age, gender, marital status, occupation, number of sessions and psychotherapy orientation (CBT and PDT), were interviewed after completing psychotherapy. A qualitative content analysis of the transcribed interviews was performed. Problems before psychotherapy showed a relationship between the categories overwhelming emotions, cognitive problems and problematic behaviours. The theme self-centredness captured the latent content of being so absorbed by problems that these prevent participation in the life context.  Descriptions of changes were summarized in the categories emotions became balanced, cognitive functioning became evident and possibility to influence one’s behaviour, overlapping the two therapy orientations. The themes awareness of self-agency and tools to handle problems expressed the understanding of the descriptions of changes which made an optimal participation in the person’s life context possible. No differences between therapy groups were found.

 

Place, publisher, year, edition, pages
Oxon, United Kingdom: Routledge, 2012. Vol. 14, no 4, p. 365-380
Keywords [en]
Affect theory, clients, interviews, psychotherapy, psychotherapy outcome, qualitative content analysis
National Category
Medical and Health Sciences Psychiatry
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27256DOI: 10.1080/13642537.2012.734498Scopus ID: 2-s2.0-84869890186OAI: oai:DiVA.org:oru-27256DiVA, id: diva2:602711
Available from: 2013-02-02 Created: 2013-02-02 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Psychotherapy patients in mental health care:: attachment styles, interpersonal problems and therapy experiences
Open this publication in new window or tab >>Psychotherapy patients in mental health care:: attachment styles, interpersonal problems and therapy experiences
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mona Wilhelmsson Göstas, School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden, mona.vilhelmsson gostas@orebroll.se Attachment styles are relevant to psychotherapy since they highlight the way a person handles interpersonal and emotional stress. This thesis aimed to examine how psychotherapy patients in the public mental health care system report attachment styles related to interpersonal problems and diagnosis before and after psychotherapy and to examine problems and changes and psychotherapy contract and process from patients’ experiences of cognitive behavioural oriented therapy (CBT) and psychodynamic oriented psychotherapy (PDT).

The studies are based on data from patients admitted to psychotherapy within the public psychiatric services in Örebro County Council. Studies I and IV were quantitative and used self-reports to examine attachment styles and interpersonal problems before and after psychotherapy. Studies II and III were qualitative interview studies examining patients experiences of problems, changes and psychotherapy process. The patients were diagnosed with mood disorders, anxiety disorders, adjustment disorders and personality disorders and reported insecure avoidant and anxious attachment styles that correlated positively with interpersonal problems when they started therapy. Psychotherapy with CBT or PDT enabled them to turn attachment styles into more secure ones and decrease interpersonal problems Patients aged between 26 and 39, patients who attended 11-25 sessions and patients diagnosed with a personality disorder reported greater changes in secure related attachment than others. Patients described their problems as emotions that could not be regulated, as cognitive disabilities and as problematic behaviours that implied a self-centredness. During the course of psychotherapy, the patients gained abilities to handle their problems. The perceived self-centeredness changed which increased their participation in their life-context.

Similarities across the therapy orientations showed that the creation of a new context was essential to pay full attention to the patient’s problems, and that the working method and cooperation with the psychotherapist made up a whole. To make the therapy effective, it is important to build up confidence in cooperation and secure base functions like offering predictability and shaping interventions according to the needs of the patient and their ability to use them.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. p. 91
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 103
Keywords
attachment styles, interpersonal problems, psychotherapy, psychiatric patients, qualitative analysis
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-33935 (URN)978-91-7529-014-0 (ISBN)
Public defence
2014-05-09, Hörsal C2, Campus USÖ, (Universitetssjukhuset), Södra Grev Rosengatan, 703 62 Örebro, 08:35 (Swedish)
Opponent
Supervisors
Available from: 2014-02-26 Created: 2014-02-26 Last updated: 2017-10-17Bibliographically approved

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Wilhelmsson Göstas, MonaKjellin, Lars

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