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’Hard work’ in a new context: clients’ experiences of psychotherapy
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Inst. för psykologi, Umeå University, Umeå, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2013 (English)In: Qualitative Social Work, ISSN 1473-3250, E-ISSN 1741-3117, Vol. 12, no 3, p. 340-357Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe and gain an understanding of clients’ experiences of psychotherapy contracts and processes in cognitive behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). Fourteen participants were interviewed after ending their psychotherapy. To get information richness they were selected with as great a variation as possible in relation to their life context. Qualitative content analysis was used to analyze the descriptions and the significance of the descriptions. Similarities between the two therapy orientations emerged throughout the informants’ experiences. These similarities were expressed in the two themes The creation of a new context and The working method and the cooperation with the psychotherapist made up a whole. The psychotherapy process was described as “hard work” in a new context, markedly different from the ordinary social context. From the informants’ perspective, the creation of a new context offered a possibility to give full attention, together with the psychotherapist, to oneself and to the problems one was grappling with. A salient feature was the informant’s responsibility for agreements in the psychotherapy contract, especially in relation to the number of sessions and the creation of cooperation with the therapist. Irrespective of therapy orientation the therapeutic techniques were described as inextricably linked to the cooperation with the psychotherapist. An implication for practice and research from these findings is to give more weight to the influence of cooperation in psychotherapy techniques, irrespective of therapy orientation. Another implication is an awareness that the client’s knowledge of her/his difficulties, needs and desire for change, capacity to make an effort and to assume responsibility always have to be highlighted and have an impact on the psychotherapy contract and process.

 

 

Place, publisher, year, edition, pages
Sage Publications, 2013. Vol. 12, no 3, p. 340-357
Keywords [en]
Cognitive behavioural therapy, patients’ experiences, psychodynamic psychotherapy, qualitative research
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27260DOI: 10.1177/1473325011431649ISI: 000319563700007Scopus ID: 2-s2.0-84877322293OAI: oai:DiVA.org:oru-27260DiVA, id: diva2:602713
Available from: 2013-02-02 Created: 2013-02-02 Last updated: 2018-05-17Bibliographically 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, MonaNeander, KerstinKjellin, Lars

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