People diagnosed with Borderline Personality Disorder (BPD) have been subjected to stigma and told that their difficulties are untreatable. Although recovery is now understood to be possible for this client group, much controversy exists around whether BPD is, in fact, an illness. The implications of this belief have not yet been explored from the perspective of the client. Furthermore, little research has attempted to deconstruct what constitutes the therapeutic alliance for people diagnosed with BPD and their clinicians from a Personal Construct Psychology (PCP) perspective. The present research study therefore aimed to explore what impacts on the recovery of people diagnosed with BPD. This included investigating the impact of the construct of illness and the therapeutic relationship. The research employed a correlational and non-randomised design, using a cross-sectional approach. The Repertory Grid technique was used among a sample of 20 clients diagnosed with BPD and their clinicians. Relevant questionnaires were also administered to ascertain BPD symptomatology and the perceived quality of the therapeutic relationship. Among findings, a statistically significant correlation is presented for the association between a poor therapeutic relationship and increased BPD symptoms. Evidence (in the form of a borderline significant correlation) is also revealed to suggest that clients diagnosed with BPD construe fewer benefits from psychological therapy when they consider the well-ill construct to be more important (i.e. superordinate). The results provide new information with regard to the treatment of people diagnosed with BPD.

Please read the abstract in the 00front part of this document Copyright 1996, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. Please cite as follows: Basson, LM 1996, A phenomenological study of therapist self-disclosure, DPhil thesis, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-01242007-134730/ > / Thesis (DPhil (Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

Client reports of perceived helpfulness in therapy may provide valuable information to clinicians and researchers about what makes therapy therapeutic for individuals. This may help us to understand more about common factors in effective psychotherapies, to explain the processes through which these factors might operate and to understand how the therapeutic relationship contributes to change for different clients. However, the meth-methodological complexity involved in the design of experimental studies has so far prevented research from being able to fully utilise what clients can tell us about their experience of change. This thesis aimed to address some of these challenges in client centered psychotherapy process research.

This is a descriptive study of the therapeutic relationship between Thando, who has been diagnosed with dyslexia and Ilze, an intern counseling psychologist. During our therapeutic relationship Thando’s view of herself and her diagnosed dyslexia improved remarkably. The improvement came without any specifically planned strategies or interventions. This study attempts to describe what happened in the therapeutic relationship to bring about the changes that occurred and attempts to give meaning to the changes. The study describes the impact that a diagnosis can have on the life of the diagnosed individual. It also suggests that the discovery of the person behind the label may be a therapeutic antidote to the negative affects that may result from such a diagnosis. A qualitative approach is taken and the data is presented through a case study and unstructured interviews. The interviews provide valuable information about Thando’s experience of the changes that occurred in her as well as her experience of someone who lives with a diagnostic label like dyslexia. / Dissertation (MA (Counselling Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

There has been relatively little robust research investigating the experience of family therapy from a client’s perspective. Much of the literature fails to make clear their methods for analysing the data, and takes an ‘either or’ approach to family and individual perspectives. Thus, either whole family perspectives, or the perspectives of a particular group are sought, making it difficult to understand the impact of the family context on individual perspectives or vice versa. The present research seeks to understand the family therapy experiences of individuals within their familial context. Two families of three were interviewed using a semi-structured interview guide and interviews were analysed using Interpretative Phenomenological Analysis. Results are presented as two family case studies. One over-arching theme of ‘the safety of the therapeutic relationship’ emerged from the accounts of both families. The therapeutic relationship provided the safety to talk and explore problems and relationships. This was described as cathartic and helped family members to see themselves and each other differently. Varying degrees of exploration of individuals was associated with differing levels of engagement with therapy. Being able to explore relationships for both families allowed them to develop new understandings of each other. Gender also emerged as an important theme and this is discussed in relation to issues of power and gender. Some key methodological limitations of the research including the small number of participants and the impact of an overly detailed interview schedule on the data are discussed. As this study involves two case studies of three family members each, it is not easily transferable, but points to some key themes and processes which have implications for practice and future research.

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.

Aim: The purpose of this study is to investigate and describe professional occupational therapists' experiences of what characterizes a good therapeutic relationship between the occupational therapist and the client. Method: The study was designed based on an qualitative approach where data is obtained via semi-structured interviews. The selection was made through strategic selection. Results: The following four main categories emerged: Flexible approach, Client-centered approach, Creating a safe relationship and Confident as an occupational therapist. The category Flexible approach reflects the occupational therapist's ability to adapt to person and situation. The category Client-centered approach means seeing the uniqueness of each client and working based on the client. The category Create a safe relationship reflects various aspects needed to create security in the relationship. The category Confident as an occupational therapist means being confident in the professional role of occupational therapist and also making preparations that provide security for the occupational therapist. Conclusion: These results increase the understanding that there are important aspects that form the basis for a good relationship between occupational therapist and client and how it promotes participation. Additional aspects based on the study are the time perspective required to promote a good relationship, but also the confidens of one's own professional role. The experience of occupational therapists shows that there is an awareness of what constitutes the basis for the good therapeutic relationship and its significance. The study also show that the occupational therapist works actively with the therapeutic relationship in their daily work. The relationship is affected by the occupational therapist's ability to be flexible, confident in himself/herself and his/her own professional role, the ability to work client-centered and the ability to make the client feel safe. Without these aspects, it becomes more difficult to create a good relationship and thus more difficult to promote participation. The relationship requires commitment from the occupational therapist, both to build and maintain it. Further research in the subject could be security in one's own professional role and how it affects the creation of relationships with the client. Other research that may be of value is the time perspective needed to establish a therapeutic relationship in relation to the cost-effectiveness of care

The authors integrate explorations by Blatt and colleagues of contributions of patient personality, therapeutic relationship, and change in mental representation to sustained therapeutic change. A pretreatment personality characteristic, self-critical perfectionism, a negative self-schema, significantly interfered with therapeutic progress in manual-directed, brief outpatient treatment for depression. The therapeutic relationship, however, facilitated changes in this negative self-representation, leading to sustained therapeutic change. The authors also explored change in the content and structural organization of representations of self and significant others in long-term, intensive inpatient treatment. A detailed clinical example elaborates the processes through which the therapeutic relationship facilitates changes in the thematic content and cognitive structural organization of patients' interpersonal schemas that appear to be the basis for sustained therapeutic gain.

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