This study investigated how a therapist and clients created couple change over the course of 15 sessions of Experiential Systemic Therapy (ExST) for the marital treatment of alcohol dependency. The aim of this research was to explore how change occurred during a single case of successful ExST and to refine and expand ExST theory. ExST has been shown to be an effective treatment for couple recovery from alcohol dependence yet little research has focused on how change occurs in ExST. The case selected for analysis was an exemplar of successful ExST couples therapy. The case met several criteria for success including therapist and client satisfaction with therapy, the cessation of alcoholic drinking, increased marital satisfaction at posttest and follow-up periods, and evidence of in-session couple change. Two therapy episodes containing relational novelty (couple change) were analyzed using the Comprehensive Discourse Analysis procedure. The results of this study highlighted the existence of a subtype of relational novelty called syncretic relational novelty. Syncretic change refers to the generation of intimacy by therapist and couple where initially there existed disparate beliefs and behaviour that isolated system members. The study found that the couple’s distance oriented beliefs and practices were reconciled and intimacy was enhanced through the employment of intense experiential activities and the provision of a collaborative therapeutic atmosphere. These two activities fostered increased couple intimacy by encouraging clients to engage one another through self disclosure, empathy, shared vulnerability, increased cooperation and greater personal awareness. Couple intimacy was fostered during experiential activity through a carefully paced intensification of clients’ thoughts, feelings and physical sensations. In addition, intimacy was facilitated by the therapist when she accepted clients’ experiences and adopted clients’ language styles. As well as working collaboratively, the therapist acted as a therapeutic guide interceding during harmful spousal interactions, altering the therapy agenda at client request, promoting joint decision-making and valuing marginalized client experience. Recommendations based on these findings were made for the refinement and expansion of ExST theory.

The case study method was used to trace the therapeutic process of a 23 year old woman, over a period of 12 sessions. The focus of the study was her issue with abandonment which emerged as the central theme in therapy. Hillman's archetypal approach was used as a framework in understanding the process and resolution of her feelings of abandonment. According to Hillman, the therapy process activates the archetypal abandoned child. For a successful therapeutic outcome the process of de-literalisation must occur in order for the patient to move from literal acting out to symbolic containment. Core moments in the therapeutic process were used, together with an interpretation from Hillman's approach, to illustrate the various themes around the issue of abandonment. The present case study illustrates how the theory in area was relevant in practice with this particular case.

From introduction: This study is an attempt to explore and describe phenomenologically a clients total retrospective experience of psychotherapy. The research consistently and radically approaches the phenomenon of the experience of psychotherapy from the clients own perspective and is conceived as a mutual project between researcher and subject. The phenomenological method is used to explicate the subjects qualitative experience of psychotherapy so as not to impose any presuppositions regarding the nature of this experience. At all times the research remains as faithful as possible to the subjects personal account of her therapy experience

Although there is an increasing amount of literature on the area of child sexual abuse, there is a dearth of information on the experiences of mothers following disclosure. Illuminating the issues of mothers following disclosure is necessary in formulating therapeutic procedures with these women and their families. This qualitative study explored the experiences of five mothers whose children were sexually abused by a father or step father. One and a half to two hour videotaped interviews were conducted utilizing a general interview guide. The findings were categorized into three areas: Reaction to Disclosure, Changing Social Relationships, and Healing Process. Emerging from these three categories were two themes that appeared to link the categories. These themes were the importance these women placed on their role as protector of their children, and the struggles with role or relationship disruptions. / Arts, Faculty of / Social Work, School of / Graduate

This study investigated how a therapist and clients created couple change over the course of 15 sessions of Experiential Systemic Therapy (ExST) for the marital treatment of alcohol dependency. The aim of this research was to explore how change occurred during a single case of successful ExST and to refine and expand ExST theory. ExST has been shown to be an effective treatment for couple recovery from alcohol dependence yet little research has focused on how change occurs in ExST. The case selected for analysis was an exemplar of successful ExST couples therapy. The case met several criteria for success including therapist and client satisfaction with therapy, the cessation of alcoholic drinking, increased marital satisfaction at posttest and follow-up periods, and evidence of in-session couple change. Two therapy episodes containing relational novelty (couple change) were analyzed using the Comprehensive Discourse Analysis procedure. The results of this study highlighted the existence of a subtype of relational novelty called syncretic relational novelty. Syncretic change refers to the generation of intimacy by therapist and couple where initially there existed disparate beliefs and behaviour that isolated system members. The study found that the couple’s distance oriented beliefs and practices were reconciled and intimacy was enhanced through the employment of intense experiential activities and the provision of a collaborative therapeutic atmosphere. These two activities fostered increased couple intimacy by encouraging clients to engage one another through self disclosure, empathy, shared vulnerability, increased cooperation and greater personal awareness. Couple intimacy was fostered during experiential activity through a carefully paced intensification of clients’ thoughts, feelings and physical sensations. In addition, intimacy was facilitated by the therapist when she accepted clients’ experiences and adopted clients’ language styles. As well as working collaboratively, the therapist acted as a therapeutic guide interceding during harmful spousal interactions, altering the therapy agenda at client request, promoting joint decision-making and valuing marginalized client experience. Recommendations based on these findings were made for the refinement and expansion of ExST theory. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

The overall objective of this study was to delve into the intricacies of the therapeutic process and the therapeutic relationship from an attachment perspective. A single retrospective child case study was conducted, which entailed the construction of a narrative synopsis of the process. The hermeneutic approach of a Reading Guide Method was applied, and through a repeated re-reading of the narrative, pertinent themes emerged that shed light on therapy as a process in motion. Specifically, the motion of the therapeutic process manifested through a scrutiny of the therapeutic relationship in view of the participant’s attachment style. The results of this study revealed the capacity of the participant to move away from an avoidant and somewhat ambivalent organisation of defences by virtue of establishing a secure base and exercising her faculty for emotional and self-expression. Accordingly, it can be established that in view of psychotherapy from an attachment perspective, the seemingly imperceptible vicissitudes of change are indeed appreciable.

From Introduction: This thesis involves a detailed explication of my experience as a client in psychotherapy. Being in therapy has brought about extremely important ·changes in my life and continues to do so. Being involved · in the field of· psychology as a student and therapist-to-be, the experience of therapy has also been a valuable source of a greater understanding of the process itself. The various facets of the importance of my experience of psychotherapy will become clear in my explication. It is a fact that experience, which is an essential aspect of our humanness, has been sadly neglected in psychological research. It is surely psychology's task to explore all aspects of humanity, and this neglect of experience has only fairly recently been questioned. Its reasons have been psychology's bias towards the natural sciences whose methods are not suitable for the study of experience. The tremendous achievements of the natural sciences caused psychology to adopt this slant, as Sigmund Koch (19.69) puts it, "The stipulation that psychology be adequate · to science outweighed the commitment that it be adequate to man". (p 65).

This study examines the workings of the ground rules which make up the framework of psychotherapy, in an institutional context, by analysing transcripts of twelve audio taped sessions of therapy conducted in a psychiatric hospital. The breaks in the ground rules of the sessions are noted and the patients' responses to these breaks are analysed using Langs's (1982, 1988) method for decoding patients' material, suitably modified for use as a hermeneutic research method. Although all of the ground rules are broken in the institutional context, only one of the ten ground rules appears to be essentially affected by this particular institutional context. Other ground rules are broken out of choice of technique or through error. The institutional context has a structural impact only on the ground rule requiring a one to one relationship with privacy and confidentiality and this ground rule is transgressed in a number of ways in all twelve sessions examined in this study. However the patients' responses to this breach only occur in ways predicted by communicative theory when the break in the ground rule involves actual entry into the therapy space by another person. Other contraventions to this ground rule that do not involve such an entry do not elicit the predicted patient responses. The many other ground rule breaks occurring in the institutional context evoke the predicted responses in the patients' material. In the study, no therapist interventions are found to comply with the communicative therapy requirements for sound interventions; concomitantly it was found that no therapist interventions receive the required derivative validation. The results indicate that it is possible to conduct therapy of a substantially secure frame variety in this institutional context with minimum effort on the part of therapists and given proper training and supervision of therapists in the techniques of communicative psychotherapy. Furthermore the results lend weight to the importance of the communicative methodology for listening to patients' material in psychotherapy in an institutional context. However, further rigorous study of competently performed therapy, executed within the context of a secure frame within an institutional context, is needed in order to demonstrate the benefits of the communicative psychotherapy interventions and interpretations in this context.

The purpose of this study was to explore the specific client issue of unfinished business by comparing the differential effectiveness of empathy plus the Gestalt empty-chair technique and empathic reflection. The population consisted of 28 subjects drawn from students enrolled in the first year of a Master's Degree program in Counselling Psychology at a major university. The subjects received two counselling sessions in either the empathy plus Gestalt condition or the Empathic reflection condition. Two relationship instruments, the Empathy Scale of the Barrett-Lennard Relationship Inventory and the Task Dimension of the Working Alliance Inventory, were administered to assess the subject's perception of their therapist's behaviour and to screen for subjects who were not engaged in the process. Two outcome measures, the Target Complaint Measure and the Affective Reactions Questionnaire, were used to assess the amount of resolution subjects felt in their presenting complaint and the amount of change in their feelings toward the significant other. Two session measures, the Session Evaluation Questionnaire and the Target Complaint Discomfort Box Scale, were used to assess the current amount of discomfort regarding the presenting complaint and to evaluate the subject's perception of the sessions. The study showed that empathy plus the Gestalt empty-chair dialogue produced significantly more tolerance in the subjects' feelings toward a significant other person as measured by the Affective Reactions Questionnaire on an issue of unfinished business than those produced by empathic reflection. The results further suggest that a greater improvement in initial target complaint as measured by the Target Complaint Measure was felt for the empathy plus Gestalt condition than for the empathic reflection condition. The review of the literature suggests that the issue of unfinished business is an important one and the tentative results from this study suggest the need for further investigation to determine if the preliminary results are upheld in a clinical setting. The tentative results suggest that the Gestalt empty-chair dialogue in the context of an empathic relationship may make a contribution to the treatment of the issue of unfinished business. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Includes bibliography. / The present study provides a description of selected core psychodynamic issues pertinent to a male transvestite patient. Case material from an ongoing 11 month psychodynamically-oriented psychotherapy is used for illustrative purposes. The theoretical roles of the 'core complex', castration anxiety; aggression and a particular ego style are thematically outlined and illustrated by a discussion of the therapeutic process. An attempt is made to demonstrate an increased capacity for depression, increased object-relatedness and disidentification from a symbiotically related female introject as the aim and partial gain of the therapy. The transference, case management difficulties and the therapeutic process of what has occurred as well as what is likely to, are considered. The unexpected outcome, in that the patient has ceased to fetishistically cross-dress, given the short space of therapeutic time is discussed. It is concluded that this be viewed tentatively. Finally, some thoughts are raised as to the utility of the psychoanalytic approach as against the general psychiatric-diagnostic approach.