The construct 'mentalization' refers to the ability to understand the meanings of behaviour in terms of mental states (e.g thoughts, desires, beliefs, intentions). Some researchers have hypothesised that mentalizing is the key underlying process in the effectiveness of all psychotherapeutic treatments, regardless of the theoretical approach of the therapist. A review of the empirical evidence for the effectiveness of mentalization-based interventions and other interventions that measured mentalization in relation to treatment outcome was carried out. The review found that although there is some evidence that such interventions are effective, there is little current evidence that mentalization-based interventions are effective because they increase the capacity to mentalize. One reason for this may be that the current measures used to evaluate mentalization are, at present, costly and time-consuming. To address this lack of evidence relating to mentalizing and therapy outcome, an empirical study was carried out. The study aimed to investigate whether the mentalizing capacity of the client at the start of treatment; and the change in mentalizing capacity during the course of treatment, is related to outcome in cognitive-behavioural therapy (CBT) and person-centred counselling (PCC}. The current study involved the development of a more efficient observer-rated measure of mentalization. The therapy audiotapes of 50 mothers with anxiety disorders who had received 8 sessions of either CBT or PCC were coded for mentalization at the beginning and at the end of their treatment. Regression analyses showed that the client's capacity for mentalization at the start of treatment significantly predicted treatment outcome but change in mentalization capacity did not. If mentalization predicts treatment outcome, then it may be important to tailor therapeutic interventions to an individual's mentalizing ability. Limitations of the study and further implications are discussed.

It is increasingly recognised in the literature that the mechanism of change in psychotherapy is not well understood. Several decades of research into this area has failed to demonstrate the relative superiority of one model of psychotherapy over another. This psychotherapy-equivalence research has led to speculation as to the importance of specific aspects of therapy (for example challenging thoughts in cognitive behavioural therapy), and the role of non-specific factors in producing therapeutic change, including emotional experiencing in therapy. The first paper provides an integrative review of the evidence for the importance of focusing on cognition in therapy and suggests that more emphasis must be placed on what the literature has identified as vital ingredients of therapy. These do not appear to relate to cognition, but emotion. The second paper is a qualitative exploration of the experience of receiving an affect- focused model of therapy (compassion focused therapy) and the process of becoming self- compassionate. Seven people with a diagnosis of posttraumatic stress disorder who had completed a course of such therapy were interviewed. Results of the interpretative phenomenological analysis suggested that self-compassion initially triggered a highly aversive emotional response and was frightening. This was an important obstacle in therapy and participants identified the therapeutic relationship and gaining a sense of feeling understood as important factors enabling them to overcome this. Participants described subsequent positive emotional responses to self-compassion, and a new sense of hopefulness for the future. A process model of the journey from self-criticism to self-compassion is proposed, which requires further investigation, but provides guideposts as to the stages that clients are likely to progress for therapists working with this model.

No description available.

For decades one of the most fundamental questions of psychotherapy research has been whether psychotherapy works. A substantial body of research (e.g. Lambert & Bergin, 1994; Lambert & Ogles, 2004) now allows us to answer this question positively. The next major question concerns the specific psychological mechanisms underlying therapeutic progress. This is also the central focus of the present thesis; both the literature review and the research paper attempt to address the question of how change occurs in therapy, although they do so in two different ways. The literature review looks specifically at one potential mechanism of change, namely the construct of transference and its therapeutic uses. Using a narrative approach, the evidence base behind transference and working in the transference in psychodynamic and non-psychodynamic approaches is examined. First, some evidence for the existence of transference processes is presented, followed by outlining an argument for the therapeutic benefits of working in the transference, in particular when working with people who have more pronounced personality difficulties. The research paper examines how therapeutic change occurs within the framework of Cognitive Analytic Therapy (CAT). In this study, grounded theory methodology was used to investigate the process of the emergence of "exits", a term used in the CAT model to refer to positive changes in therapy. Nine therapist-client dyads were jointly interviewed about their experience of how exits developed and a temporal model of this process was constructed. The results pointed towards the central process of "opening up new perspectives" underlying the development of exits and indicated that distinguishing between "one-off exits" and "planned exits" may be useful. The thesis concludes with personal reflections on and a discussion of advantages and disadvantages of interviewing therapist-client dyads.

No description available.

No description available.

No description available.

Text in Afrikaans / In hierdie studie is gepoog om die kongruensie tussen sosiaal konstruktivistiese teorie en sosiaal konstruktivistiese psigoterapie te ondersoek met spesifieke fokus op die ko-evolusieproses in psigoterapie. Die basiese onderliggende aannames van sosiale konstruktivistiese teorie word aangebied in die literatuurstudie. Die toepassing van die estetiese beginsels op die pragmatiese proses van psigoterapie, is bestudeer en beskryf. Die teoretiese beginsels word geillustreer in die praktyk aan die hand van 'n gevallestudie. In die aanbieding van die gevallestudie is daar spesifiek gefokus op die ko-evolusie van betekenissisteme deur onderskeidings te tref en deur die kompleksiteit van die ekologie van betekenissisteme te vermeerder. Die doel hiermee is om die probleem-gedetermineerde sisteem op te los. Die ekologie van betekenissisteme sluit ook die persoonlike en professionele betekenissisteem van die terapeut in. In die proses van navorsing is die rekursiewe interafhanklikheid van die drie konsepte, teorie, terapie en navorsing beklemtoon. / In this study an attempt has been made to research the congruence between social constructivistic theory and social constructivistic therapy, with particular focus on the process of co-evolution in psychotherapy. The basic underlying assumptions of the social constructivistic theory is presented in the literature review. The application of the aesthetic principles to the pragmatics of therapy, is researched and described. The theoretical principles are illustrated in practice by means of a case study. The presentation of the case study particularly emphasizes the co-evolution of meaning systems in the problem determined system, through the process of drawing distinctions and complexifying the ecology of meaning systems, with the aim to dissolve the problem determined system. The ecology of meaning systems includes the professional and individual meaning systems of the therapist. In the process of research, the recursive interdependence between theory, therapy and research was amplified. / Psychology / M.A. (Voorligtingsielkunde)

The term patient involvement is widely used within the physiotherapy vocabulary, yet it is poorly defined and understood. Little is known about NHS physiotherapists’ attitudes, knowledge or skills regarding patient involvement. The aims of this thesis were therefore to: i) identify the attributes which define the concept of patient involvement in physiotherapy using a method of concept analysis; ii) investigate physiotherapists’ attitudes towards the involvement of patients by means of a national survey; iii) explore patients’ attitudes towards their involvement in the physiotherapy consultation using a local survey; iv) explore physiotherapists’ ability to recognise effective practice in patient involvement by means of a regional study using video vignettes of simulated consultations; v) ascertain to what extent physiotherapists involve patients in their physiotherapy care by means of an in-depth local observational study.

Text in Afrikaans / In hierdie studie is gepoog om die kongruensie tussen sosiaal konstruktivistiese teorie en sosiaal konstruktivistiese psigoterapie te ondersoek met spesifieke fokus op die ko-evolusieproses in psigoterapie. Die basiese onderliggende aannames van sosiale konstruktivistiese teorie word aangebied in die literatuurstudie. Die toepassing van die estetiese beginsels op die pragmatiese proses van psigoterapie, is bestudeer en beskryf. Die teoretiese beginsels word geillustreer in die praktyk aan die hand van 'n gevallestudie. In die aanbieding van die gevallestudie is daar spesifiek gefokus op die ko-evolusie van betekenissisteme deur onderskeidings te tref en deur die kompleksiteit van die ekologie van betekenissisteme te vermeerder. Die doel hiermee is om die probleem-gedetermineerde sisteem op te los. Die ekologie van betekenissisteme sluit ook die persoonlike en professionele betekenissisteem van die terapeut in. In die proses van navorsing is die rekursiewe interafhanklikheid van die drie konsepte, teorie, terapie en navorsing beklemtoon. / In this study an attempt has been made to research the congruence between social constructivistic theory and social constructivistic therapy, with particular focus on the process of co-evolution in psychotherapy. The basic underlying assumptions of the social constructivistic theory is presented in the literature review. The application of the aesthetic principles to the pragmatics of therapy, is researched and described. The theoretical principles are illustrated in practice by means of a case study. The presentation of the case study particularly emphasizes the co-evolution of meaning systems in the problem determined system, through the process of drawing distinctions and complexifying the ecology of meaning systems, with the aim to dissolve the problem determined system. The ecology of meaning systems includes the professional and individual meaning systems of the therapist. In the process of research, the recursive interdependence between theory, therapy and research was amplified. / Psychology / M.A. (Voorligtingsielkunde)