This dissertation examines the question how do group therapy members perceive the therapeutic relationship in process group therapy? The study fits within the interpretivist paradigm and employs a phenomenological qualitative research approach (Moustakas, 1994). The theoretical framework used to orient the study drew on process group theory according to Rutan, Stone, and Shay’s (2007) psychodynamic group psychotherapy approach and Yalom and Leszcz’s (2005) interpersonal process model of group psychotherapy. Participants were 10 university counseling center clients who were members of process therapy groups at a large urban university. Data collection consisted of in-depth interviews and demographic questionnaires. Phenomenological data analysis procedures followed recommendations by Creswell (2007) and Moustakas (1994). To enhance the rigor and trustworthiness of the study, the researcher engaged in member checking, use of an external auditor, reflexive and methodological journaling, and negative case analysis. Results of the study are presented as descriptions of how participants perceived the therapeutic relationship and the relationship’s influence on the experience of group therapy. Eight categories emerged from the interviews: (a) presence of group leaders; (b) safety; (c) caring; (d) sharing; (e) running the group; (f) levels of leadership; (g) developing understanding; and (h) intimacy with boundaries. Categories consisted of one or more related themes. There is a consideration of how the researcher’s experiences and beliefs played a role in the study. The results are discussed in relation to relevant group therapy theory and research. Strengths, weaknesses, and considerations of the study findings are offered. Implications of the study findings for group therapy practice and research are noted.

A compreensão do cliente, considerando o cenário da psicoterapia, se dá não somente pelo que é enunciado em linguagem verbal, mas sim, por sua presença como um todo. Há uma atitude de cuidado que se dá especificamente na relação cliente-terapeuta que favorece essa compreensão. Defende-se que a compreensão sempre parte de uma compreensão prévia para interpretar o que se mostra articuladamente no discurso do cliente. Por isso, a teoria ou referencial clínico do terapeuta; a sua visão de homem e de mundo; e sua experiência são decisivos para tal compreensão. O objetivo é refletir e entender como se dá a compreensão do sentido do cliente por parte do terapeuta, admitindo que o terapeuta sempre parte de uma compreensão prévia. O desenvolvimento deste trabalho ocorreu com relatos de situações clínicas da pesquisadora, alinhavando o conhecimento aprendido pela experiência e, buscando em autores e principalmente em Heidegger, contribuições para ampliar a reflexão acerca do que se dá no acontecimento do encontro cliente-terapeuta. É trazido o conceito de téchne em oposição à técnica para apresentar o procedimento da psicoterapia. Noções básicas da fenomenologia existencial são apresentadas para situar o leitor de onde partem os pensamentos da autora e sua visão de homem e mundo. A apresentação dos existenciais de Heidegger disposição (Befindlichkeit), compreensão (Verstehen) e linguagem (Rede) fazem-se pertinente como abertura de mundo que oferecem a experiência na relação, fazendo assim, oposição à ideia de que o acesso ao conhecimento ao outro, e ao mundo, se dá via teórica. Dessa forma a linguagem verbal e não verbal como o corpo, o gesto, o tom de voz e tudo o que se apresenta são elementos fundamentais / The comprehension about the client, considering the psychotherapys scenario, is given not only by what is stated in verbal language but by his whole presence. There is a caring attitude that is given specifically in the client-therapist relationship that promotes such comprehension. It is argued that comprehension always came from a previous understanding to interpret what is present, articulately, on client\'s speech. For this reason, the theory or clinical therapist reference, their vision of men and world and their experience are crucial to this understanding. The purpose is to meditate and understand how occurs the comprehension of the client\'s meaning by the therapist, admitting that the therapist always comes from a previous comprehension. The development of this research took place with reports of clinical experiences lived by the researcher, adding knowledge learned by the experience and seeking to authors and particularly in Heidegger, contributions to increase the reflection about what happens in the event of the client-therapist encounter. I introduce the concept of téchne as opposed to the technique to present the psychotherapy procedure. Basic concepts of existential phenomenology are presented in order to situate the reader about from where my thoughts and ideas about men and world came from. The presentation of existential concepts as disposition (Befindlichkeit), comprehension (Verstehen) and language (Rede) are relevant as world\'s opening and offer the experience inside the relationship, thus, opposed to the idea that the access to the knowledge about the other and about the world is given theoretically. Therefore, the verbal and non-verbal language and body gesture, tone of voice and everything that is presented are crucial elements

Made available in DSpace on 2016-04-28T20:38:55Z (GMT). No. of bitstreams: 1 Nathalia Carballeira Pereira.pdf: 516636 bytes, checksum: 4c4f81b81be770eb6d06d8c94adede9a (MD5) Previous issue date: 2014-08-29 / This paper aims to reflect on the importance of empathy in the therapeutic relationship, seeking to verify their facilitative role in establishing the therapeutic relationship and consequent success in the analytic encounter. Text of the complete works of Carl Gustav Jung and articles over the past decade that addressed directly the issue within the field of analytical psychology were used. The discussion was conducted from possible congruencies and contradictions between the definition of empathy described by contemporary philosophy, by C G. Jung and post Jungian authors with a focus on clinical practice. The work has broadened the understanding of empathy as means of opening space for images into consciousness from both the patient and the therapist (when open to) when it comes to a relationship of alterity conducted by Eros / O presente trabalho tem como objetivo refletir sobre a importância da empatia na relação terapêutica, buscando verificar sua atuação facilitadora no estabelecimento do vínculo terapêutico e consequente êxito no encontro analítico. Foram utilizados textos das obras completas de Carl Gustav Jung e artigos nos últimos dez anos que tratassem diretamente do tema dentro do campo da psicologia analítica. A discussão foi conduzida a partir das possíveis congruências e contradições entre a definição de empatia descrita pela filosofia contemporânea, por C G. Jung e por autores pós junguianos com um enfoque na prática clínica. O trabalho ampliou a compreensão da empatia como mais um meio de abertura de espaço para que as imagens do inconsciente possam se apresentar à consciência (tanto do paciente quanto do terapeuta quando abertos a), em se tratando de uma relação de alteridade regida por Eros

Tendo, em vista, a importância da relação terapeuta-cliente na psicoterapia, o presente trabalho se propôs a identificar, empiricamente, a ocorrência de comportamentos de uma terapeuta e da sua cliente em sessões iniciais de psicoterapia, filmadas em vídeo e analisar os possíveis efeitos desses comportamentos no estabelecimento da relação terapêutica. Foram categorizados os comportamentos verbais vocais e verbais não vocais da terapeuta e da cliente em cinco sessões iniciais de terapia através do método observacional de gravações audiovisuais. Essas gravações foram realizadas no Laboratório de Terapia Comportamental do Instituto de Psicologia Clínica da Universidade de São Paulo. Os comportamentos da terapeuta e da cliente foram categorizados de acordo com o Sistema Multidimensional para a Categorização de Comportamentos na interação terapeuta-cliente (SMCCIT). Além desse instrumento, foi realizada uma revisão bibliográfica sobre a relação terapêutica e, também, sobre os relatos de pesquisas de categorização de sessões de terapia com a finalidade de auxiliar na identificação de comportamentos da terapeuta, favorecedores da relação terapêutica. Os resultados das categorizações indicam que as categorias mais frequentes do comportamento verbal vocal da terapeuta são: Facilitação (FAC: 31,2%), Empatia (EMP: 24,1%) e Solicitação de Relato (SRE: 18,4%). Já, no que se refere às categorias do comportamento verbal vocal da cliente, houve uma prevalência das categorias Relato (REL: 61,1 %), Concordância (COM: 21,9%) e Relações (CER: 8,1%). Em relação às categorias dos comportamentos verbais não vocais, houve uma prevalência de Concordância para ambos. Porém, para a terapeuta, essa categoria teve uma ocorrência maior. Essa categorização dos comportamentos da terapeuta e da cliente é uma contribuição para a evolução de pesquisas empíricas no contexto terapêutico e para uma melhor compreensão das consequências desses comportamentos para a eficácia da terapia. Portanto, de maneira geral, houve congruência entre os padrões encontrados da relação terapêutica nas cinco sessões e as descrições da literatura da área sobre o assunto. Porém, foi possível perceber, através da observação das sessões, que existem outros comportamentos da terapeuta e da cliente, apontados pela literatura como favoráveis para o estabelecimento da relação terapêutica além daqueles possíveis de identificação pelo SMCCIT. Esses comportamentos estão relacionados as características da terapeuta e da cliente. Por fim, sugere-se a criação de novas categorias que possibilitem investigações relacionadas a esses aspectos dos comportamentos da terapeuta e da cliente, envolvidos com o estabelecimento da relação terapêutica / Having in view the importance of client-therapist relationship in psychotherapy, this study proposes to identify, empirically, the occurrence of a behavior therapist and his client in early sessions of psychotherapy, videotaped and analyze the possible effects of these behaviors in the establishment of the therapeutic relationship. The patients verbal behaviors vocal and vocal non-verbal have been categorized in the initial five sessions of therapy via the observational method of audio-visual. These recordings have been performed at the Institute for Behavior Therapy Clinical Psychology laboratory, in the University of Sao Paulo. The behavior of the therapist and the client were categorized according to the System for Multidimensional Categorization Behaviors in the therapist-client interaction (SMCCIT). Beside this instrument, we performed a bibliographic review on the therapeutic relationship, and also on the research reports of categorization of therapy sessions in order to assist in identifying therapist behaviors, favoring the therapeutic relationship.The results indicate that the categorization of the most frequent categories of vocal verbal behavior of the therapist are: Facilitation (FAC: 31.2%), Empathy (EMP: 24.1%) and Request for Report (SER: 18.4%). Now, with regard to the categories of vocal verbal behavior of the client, there was a prevalence of reporting categories (REL: 61.1%), Agreement (COM: 21.9%) and Relations (CER: 8.1%). In relation to the categories of non-vocal verbal behavior, there was a prevalence of agreement for both. However, for the therapist, this category had a higher frequency. This categorization of the behaviors of the therapist and the client is a contribution to the evolution of empirical research in the therapeutic context and for a better understanding of the consequences of these behaviors for effective therapy. Therefore, in general, there was congruence between the patterns found in the therapeutic relationship in the five sessions and descriptions of the literature on the subject area. However, it was possible to note, by observing the sessions, that there are other behaviors of the therapist and client, appointed by the literature as favorable for the establishment of the therapeutic relationship beyond those possible identified by SMCCIT. These behaviors are related to the characteristics of the therapist and client. Finally, the creation of new categories that allow investigations related to these aspects of the behavior of the therapist and the client involved with the establishment of the therapeutic relationship is suggested

Tendo, em vista, a importância da relação terapeuta-cliente na psicoterapia, o presente trabalho se propôs a identificar, empiricamente, a ocorrência de comportamentos de uma terapeuta e da sua cliente em sessões iniciais de psicoterapia, filmadas em vídeo e analisar os possíveis efeitos desses comportamentos no estabelecimento da relação terapêutica. Foram categorizados os comportamentos verbais vocais e verbais não vocais da terapeuta e da cliente em cinco sessões iniciais de terapia através do método observacional de gravações audiovisuais. Essas gravações foram realizadas no Laboratório de Terapia Comportamental do Instituto de Psicologia Clínica da Universidade de São Paulo. Os comportamentos da terapeuta e da cliente foram categorizados de acordo com o Sistema Multidimensional para a Categorização de Comportamentos na interação terapeuta-cliente (SMCCIT). Além desse instrumento, foi realizada uma revisão bibliográfica sobre a relação terapêutica e, também, sobre os relatos de pesquisas de categorização de sessões de terapia com a finalidade de auxiliar na identificação de comportamentos da terapeuta, favorecedores da relação terapêutica. Os resultados das categorizações indicam que as categorias mais frequentes do comportamento verbal vocal da terapeuta são: Facilitação (FAC: 31,2%), Empatia (EMP: 24,1%) e Solicitação de Relato (SRE: 18,4%). Já, no que se refere às categorias do comportamento verbal vocal da cliente, houve uma prevalência das categorias Relato (REL: 61,1 %), Concordância (COM: 21,9%) e Relações (CER: 8,1%). Em relação às categorias dos comportamentos verbais não vocais, houve uma prevalência de Concordância para ambos. Porém, para a terapeuta, essa categoria teve uma ocorrência maior. Essa categorização dos comportamentos da terapeuta e da cliente é uma contribuição para a evolução de pesquisas empíricas no contexto terapêutico e para uma melhor compreensão das consequências desses comportamentos para a eficácia da terapia. Portanto, de maneira geral, houve congruência entre os padrões encontrados da relação terapêutica nas cinco sessões e as descrições da literatura da área sobre o assunto. Porém, foi possível perceber, através da observação das sessões, que existem outros comportamentos da terapeuta e da cliente, apontados pela literatura como favoráveis para o estabelecimento da relação terapêutica além daqueles possíveis de identificação pelo SMCCIT. Esses comportamentos estão relacionados as características da terapeuta e da cliente. Por fim, sugere-se a criação de novas categorias que possibilitem investigações relacionadas a esses aspectos dos comportamentos da terapeuta e da cliente, envolvidos com o estabelecimento da relação terapêutica / Having in view the importance of client-therapist relationship in psychotherapy, this study proposes to identify, empirically, the occurrence of a behavior therapist and his client in early sessions of psychotherapy, videotaped and analyze the possible effects of these behaviors in the establishment of the therapeutic relationship. The patients verbal behaviors vocal and vocal non-verbal have been categorized in the initial five sessions of therapy via the observational method of audio-visual. These recordings have been performed at the Institute for Behavior Therapy Clinical Psychology laboratory, in the University of Sao Paulo. The behavior of the therapist and the client were categorized according to the System for Multidimensional Categorization Behaviors in the therapist-client interaction (SMCCIT). Beside this instrument, we performed a bibliographic review on the therapeutic relationship, and also on the research reports of categorization of therapy sessions in order to assist in identifying therapist behaviors, favoring the therapeutic relationship.The results indicate that the categorization of the most frequent categories of vocal verbal behavior of the therapist are: Facilitation (FAC: 31.2%), Empathy (EMP: 24.1%) and Request for Report (SER: 18.4%). Now, with regard to the categories of vocal verbal behavior of the client, there was a prevalence of reporting categories (REL: 61.1%), Agreement (COM: 21.9%) and Relations (CER: 8.1%). In relation to the categories of non-vocal verbal behavior, there was a prevalence of agreement for both. However, for the therapist, this category had a higher frequency. This categorization of the behaviors of the therapist and the client is a contribution to the evolution of empirical research in the therapeutic context and for a better understanding of the consequences of these behaviors for effective therapy. Therefore, in general, there was congruence between the patterns found in the therapeutic relationship in the five sessions and descriptions of the literature on the subject area. However, it was possible to note, by observing the sessions, that there are other behaviors of the therapist and client, appointed by the literature as favorable for the establishment of the therapeutic relationship beyond those possible identified by SMCCIT. These behaviors are related to the characteristics of the therapist and client. Finally, the creation of new categories that allow investigations related to these aspects of the behavior of the therapist and the client involved with the establishment of the therapeutic relationship is suggested

Childhood abuse can impact the survivors' life in many ways. Children learn various skills from their caregivers, such as the tools needed to develop and maintain healthy relationships. When a child is abused by their caregiver, there can be a drastic impact on how the child perceives the world, and the therapeutic relationship is important in the healing process. This interpretative phenomenological analysis (IPA) study explored the lived experiences of therapists who work with adult women who are survivors of childhood sexual abuse to better understand the effects that childhood sexual abuse has on the therapeutic relationship. The theoretical base for the study was attachment theory that was conceptualized within a traumatic framework. Participants were recruited through online media forums and with the use of flyers posted at local counseling offices in the metro area of Albuquerque, New Mexico. Eight therapists who self-identified as meeting the criteria for this study were recruited and interviewed in-person; the data was analyzed by hand. Five themes emerged during the analysis: the enhancing effects of disclosure, seeking to empower clients, the client's emotional distress, negative feelings and loss of self, and ability to maintain boundaries. This study contributes to provide avenues for social change by developing awareness and education resources for therapists to increase their effectiveness of treatment and develop ways in which support can be employed to serve the affected population through education and rapport building. This in turn has the potential of increasing successful treatment outcomes, which allows clients to build better external positive, healthy relationships.

Transgender and gender nonconforming (TGNC) people who pursue gender affirming medical interventions, such as hormone therapy and surgery, are required to supply their physicians with referral letters from mental health professionals (Coleman et al., 2012). The process by which TGNC people are required to obtain referral letters before accessing gender affirming care is often referred to as gatekeeping in the TGNC literature (Budge, 2015; Cavanaugh, Hopwood, & Lambert, 2016). Despite implications that the current gatekeeping system may have for the relationship between TGNC clients and their therapists, few studies have examined TGNC individuals’ experiences related to obtaining referral letters in therapy (Bess & Stabb, 2009; Elder, 2016). This study used semi-structured interviews and a grounded theory approach to qualitatively examine the experiences of 15 TGNC individuals who have obtained a referral letter for gender affirming medical intervention from their therapists. Thematic analysis revealed two core themes: (1) “blessings” that TGNC individuals experienced because of the referral letter requirement and (2) “bullsh*t” (or “BS”) participants endured due to this requirement. Implications for psychotherapy practice and training, as well as healthcare policy, are discussed.

Since 1999, youth have experienced an increase in HIV incidence. Gay male youth, in particular, are a priority sub-population because they accounted for the highest exposure category in 2008 among youth. Due to the lack of studies on gay male youth who are susceptible to HIV, and the reality that most previous research on stigma may no longer reflect the contemporary context, nursing based research was undertaken. Utilizing critical theory, stigma within the therapeutic relationship was investigated through eight semi-structured interviews with gay male youth who were recruited through a gay men’s sexual health clinic in Ottawa, Canada. The results of this research showed that while stigma, whether perceived stigma or the fear of stigmatization, was still felt by these participants in some interactions, overall, these youth had positive experiences with the health care system, particularly within the context of the gay men’s sexual health clinic.

En terapeutisk relation är viktig i omvårdnaden av patienter med ätstörningar och det är viktigt att sjuksköterskan är medveten om dess betydelse i omvårdnaden. Syftet var att undersöka hur en terapeutisk relation skapas samt dess betydelse i omvårdnaden mellan sjuksköterskan och patienten med ätstörning. För sjuksköterskor kan det vara utmanande att etablera en terapeutisk relation till patienter med ätstörningar, då det är vanligt att dessa patienter inte har sjukdomsinsikt. Sjuksköterskan kan använda sig av olika strategier och verktyg för att skapa en terapeutisk relation och en vårdande miljö. Studien genomfördes som en litteraturstudie och 12 vetenskapliga artiklar analyserades. Studiens resultat visar att om en terapeutisk relation ska kunna etableras krävs det kunskap, tid, respekt samt kontinuerlig information från sjuksköterskan till patienten. Mer forskning efterfrågas om den terapeutiska relationens betydelse i omvårdnaden kring patienter med ätstörning, då det inte fanns mycket forskning i ämnet. Även mer utbildning i sjuksköterskeprogrammet om omvårdnad vid psykisk ohälsa efterfrågas. / A therapeutic relationship is important in nursing care of patients with eating disorders and it is significant that the nurse is aware of the importance in the nursing care. The purpose was to investigate how a relationship is created and its significance in the care between the nurse and the patient with an eating disorder. It can be challenging for nurses to establish a therapeutic relationship with patients with eating disorders, because it is common that these patients do not have illness insight. The nurse can make use of different strategies and tools to develop a therapeutic relationship and a caring environment. The study was conducted as a litterature study and 12 scientific articles were analyzed. The result of the study shows that if a therapeutic relationship is going to be established it demands knowledge, time, respect and continuous information from the nurse to the patient. More scientific research about the therapeutic significance in the nursing care around patients with eating disorders is requested, since there was not much research on the subject. Even more education in the nursing programme for nursing care in mental health is enquired.

Bakgrund: Självskadebeteende anses vara vanligt förekommande i dagens samhälle. Beteendet anses inte vara ett uttryck för en vilja att dö utan ett sätt att hantera inre svårhanterad psykisk smärta. Självskadebeteende kan vara svårt att definiera eftersom det finns många olika metoder och svårighetsgrader. Det finns olika uppfattningar om hur prevalensen av självskadebeteende är fördelat mellan könen, den vanligaste uppfattningen är dock att beteendet är mer vanligt förekommande bland kvinnor. Enligt DSM-5 är självskadebeteende ännu inte en egen psykiatrisk diagnos. Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av att vårda patienter med självskadebeteende. Metod: Detta är en allmän litteraturöversikt baserad på tio artiklar med kvalitativ ansats publicerade mellan 2002-2014. Resultat: Studien resulterade i fem teman. Dessa teman var: Positiva och negativa känslor, Uppfattning av självskadebeteende, Omvårdnadsrelationen, Upplevelsen av hjälpstrategier samt Arbetsgrupp och arbetsmiljö. Slutsats: Upplevelsen bland sjuksköterskor är att deras okunskap om ämnet är problematiskt i vården av patienter med självskadebeteende, vilket leder till upplevelser av frustration och maktlöshet som kan påverka den vårdande relationen negativt. Relationen bör präglas av visad förståelse, acceptans och engagemang för patienten. Ett realistiskt mål är att sjuksköterskans uppgift inte är att bota patienten, utan snarare att hjälpa patienten till självhjälp. Klinisk betydelse: Denna studie kan vara ett bidrag till kunskap för sjuksköterskor som möter den självskadande patienten, då resultatet ger en inblick i olika vårdkulturer och det kan vara givande att utvärdera arbetet på den egna avdelningen. Detta kan i sin tur bidra med kunskap till intern utbildning och kan användas som diskussionsunderlag.