Inledning: Vad är det egentligen som händer i den terapeutiska relationen mellan terapeut och patient? Som psykodynamisk terapeut kan det tyckas självklart att grubbla över den terapeutiska relationens kvalitet eftersom relationen mellan patient och terapeut är central för förändringsprocessen. Syftet med denna kvalitativa studie är att utforska patienters upplevelser av den terapeutiska relationen. Frågeställningarna fokuserar på patienters beskrivningar av den terapeutiska relationen, vad som upplevs som hinder respektive främjande för den terapeutiska relationen samt upplevelser av betydelsefulla ögonblick under terapin. Metod: I studien intervjuas fem patienter vars psykodynamiska terapi omfattat minst 50 sessioner. Resultaten visar att lugn och närvaro hos terapeuten är betydelsefullt för den terapeutiska relationen. Den återkommande ritualen och rummet, som patienterna går in i vid varje samtal, är viktigt för terapin och blir som en del av relationen. Ett bra möte beskrivs som ett tillfälle av bekräftelse bortom orden. Ömsesidighet i den terapeutiska relationen och en känsla av acceptans och värme från terapeuten har stor betydelse för den terapeutiska processen. Slutsatserna är att om patienten skall uppleva känslomässig ömsesidighet i den terapeutiska relationen krävs en terapeut med stark närvaro i stunden. Om ömsesidighet inte uppnås uppstår inte heller något genuint möte. När patienten i psykoterapi möter en terapeut som är varm, närvarande och engagerad, samt har förmåga att fånga ögonblicket och möta patienten där denna befinner sig, utvecklas relationen till något starkt och betydelsefullt som lever vidare och skapar trygghet långt efter att terapin är avslutad.

The aim of this study was to explore and describe the components required to build a therapeutic relationship with children diagnosed with Asperger Syndrome. Through this study therapists and other professionals working with these children could be guided to form functioning and healthy therapeutic relationships with children diagnosed with AS. An inductive, qualitative method was used to gain insight into the components required to build a therapeutic relationship with children diagnosed with AS by exploring the opinions and experiences of a selection of therapists from different therapeutic contexts that work with children diagnosed with AS. Six participants working with children diagnosed with AS at schools for children with learning difficulties, Autism and AS or therapists who form part of the referral teams of these schools in the Nelson Mandela Metropolitan took part in the study. Participants consisted of Occupational therapists, Speech therapists, Counselling Psychologists and Clinical Psychologists. The researcher used semi-structured interviews to explore and describe the opinions of the participants on the components required to build a therapeutic relationship with children diagnosed with AS. The results of this study indicated that building a therapeutic relationship with a child diagnosed with AS requires multiple components and a holistic outlook. Preparation in the form of research and being knowledgeable on the AS diagnosis, as well as obtaining thorough background information on the specific child was found to be fundamental. An awareness on the part of therapists and other professionals regarding child-related aspects such as co-morbid disorders; sensory considerations; therapeutic environment; coping with change; obsessions and dependence on the therapist was found to be of value. Other fundamental components that seem to be a requirement for building a therapeutic relationship with children diagnosed with AS were the therapist characteristics: body language and attitude. Therapeutic considerations, such as the importance of setting boundaries and remaining consistent, as well as the teaching aspect involved in building a therapeutic relationship became evident. Furthermore, the education of parents, siblings and other family members, as well as the importance of having fun while building a therapeutic relationship were recognized as important components. Teamwork was another crucial component identified which included parental and / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013.

The aim of this study was to explore and describe the components required to build a therapeutic relationship with children diagnosed with Asperger Syndrome. Through this study therapists and other professionals working with these children could be guided to form functioning and healthy therapeutic relationships with children diagnosed with AS. An inductive, qualitative method was used to gain insight into the components required to build a therapeutic relationship with children diagnosed with AS by exploring the opinions and experiences of a selection of therapists from different therapeutic contexts that work with children diagnosed with AS. Six participants working with children diagnosed with AS at schools for children with learning difficulties, Autism and AS or therapists who form part of the referral teams of these schools in the Nelson Mandela Metropolitan took part in the study. Participants consisted of Occupational therapists, Speech therapists, Counselling Psychologists and Clinical Psychologists. The researcher used semi-structured interviews to explore and describe the opinions of the participants on the components required to build a therapeutic relationship with children diagnosed with AS. The results of this study indicated that building a therapeutic relationship with a child diagnosed with AS requires multiple components and a holistic outlook. Preparation in the form of research and being knowledgeable on the AS diagnosis, as well as obtaining thorough background information on the specific child was found to be fundamental. An awareness on the part of therapists and other professionals regarding child-related aspects such as co-morbid disorders; sensory considerations; therapeutic environment; coping with change; obsessions and dependence on the therapist was found to be of value. Other fundamental components that seem to be a requirement for building a therapeutic relationship with children diagnosed with AS were the therapist characteristics: body language and attitude. Therapeutic considerations, such as the importance of setting boundaries and remaining consistent, as well as the teaching aspect involved in building a therapeutic relationship became evident. Furthermore, the education of parents, siblings and other family members, as well as the importance of having fun while building a therapeutic relationship were recognized as important components. Teamwork was another crucial component identified which included parental and / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013.

No description available.

Abstract: Aim: There is limited understanding of therapeutic relationships in community occupational therapy from a psychodynamic perspective. I explored community occupational therapists’ lived experiences of therapeutic relationships with special attention to countertransference. Methods: Interpretive and descriptive phenomenology was used. Eight occupational therapists with experience providing occupational therapy to people in their homes completed two qualitative interviews. Epoche and reduction analysis methods were applied during the thematic analysis and phenomenological writing phases of the study. Findings: Themes related to the therapeutic relationship illuminated tensions therapists experienced between 1) the need to obtain “buy-in” from clients and insecurity regarding their expertise and the potential effectiveness of occupational therapy; 2) self-disclosure and self-protection, and 3) “planting the seed” and feeling responsible for immediate therapeutic outcomes. Therapists voiced difficulty understanding the concept of countertransference but were able to provide powerful examples. They experienced objective, subjective, positive, and negative countertransference. Themes included: 1) fear: experiencing physical vulnerability; 2) sadness: experiencing emotional vulnerability; and 3) frustration: experiencing social vulnerability, all of which impacted therapists’ conscious and unconscious behaviours. Discussion: When reflected upon, countertransference appeared to be a powerful source of information during therapeutic clinical reasoning. It informed the therapists’ use of therapeutic skills including boundary setting, self-disclosure, compassion, empathy, and containment in a diverse array of therapeutic relationships. Significance: Occupational therapy may benefit from a more transparent discussion and acceptance of the emotional dimensions of practice. Integrating a greater awareness and understanding of the intersubjective dynamics of the therapeutic relationship in practice may be beneficial for community occupational therapists.

This non-experimental field study examined the relationship between participant reported experiences of relational depth (RD) with their individual counselors in substance use disorder (SUD) treatment and participant reported motivation to change substance use. Participants in the study were clients enrolled in inpatient and outpatient levels of substance use disorder treatment. A total of 78 clients (aged 18-77, with mean age 35.97, 80.1% Caucasian, 11.5% African-American, 3.8% Hispanic, 1.3% Asian, 1.3% multiracial, 1.3% other) with SUDs participated in the study. Results demonstrated that treatment process variables explained approximately 42% of the variance in participant recognition scores. Specifically, substance abuse community support involvement (β = .598, rs2 = .908, p < .001) and relational depth (β = .184, rs2 = .178, p = .045) were found to be significant predictors of participant recognition of a substance use problem. From these results, one may tentatively conclude that community support and the development of relational depth in SUD treatment are valuable additions to standard SUD treatment. Extended results are described and summarized using text, tables, and figures. The study has practical and clinical implications for counselors working with clients in substance use disorder treatment particularly concerning the length of individual counseling.

No description available.

The counseling relationship has long been considered an essential part of the foundation of positive client outcomes in counseling. While many factors play a role in the therapeutic relationship, the facilitative conditions of empathy, unconditional positive regard, and genuineness have been the most-researched components of the Person-Centered construct of the therapeutic relationship. The supervisory relationship parallels the therapeutic relationship in many ways, and as the therapeutic relationship is critical to counseling, the supervisory relationship is foundational to effective supervision. While the facilitative conditions are empirically proven to contribute to positive client outcomes within the therapeutic relationship, the role of the counselor’s supervisory relationship has been largely unexplored in its association to client outcomes. The purpose of this study was to determine if there is a relationship between the facilitative conditions perceived by the client during counseling, and the facilitative conditions perceived by the counselor-in-training during supervision. Additionally, these variables were tested for their ability to predict client outcomes. The sample of this study consisted of 88 clients and 55 counselors-in-training at a large university in the southeastern United States. Both clients and counselors-in-training completed two instruments to ascertain the quality of their counseling and supervision relationships. The Outcomes Questionnaire-45 was utilized to collect client outcomes data. Results validate a correlation between the client’s perception of the therapeutic relationship and client outcomes, however there appears to be no relationship between the supervisory relationship and client outcomes. Further results of the study and limitations were discussed

This study examined meditative practices among group participants and therapists, participating in the Domestic Violence Focused Couples Treatment (DVFCT) group using the phenomenology and systems frameworks. Specifically, this inquiry explored whether or not group participants and therapists experienced intrapersonal effects as well as relational effects from meditating, both within and outside of session. Little research examines the relational impact of meditating, or the use of meditation as a strategy for helping couples who experienced intimate partner violence. Systems theory and existing research regarding mindfulness meditation contributed to the development of interview questions. Five group participants and four therapists who facilitated the Domestic Violence Focused Couples Treatment group within the last two years were interviewed. The main theme that had emerged from the study were the differences between meditating during session versus out of session for all study participants. In the study, it was noticed that group participants also experienced more relational effects then were noticed by the therapists. While the experience for the therapists and group participants varied, some similarities were found consistently through their interviews. Also included are a discussion of the connections between these themes and the existing literature, the strengths and limitations of this study, and the implications for future research. / Master of Science

Background: attachment theory provides an account of human behaviour across the lifespan, has a strong theoretical foundation and is clinical applicable. It is particularly relevant to older adults, who are often exposed to a greater number of losses. Despite a growing awareness of increasing life expectancy worldwide, services for older adults in the NHS remains under-resourced. However, increased exposure to death and loss in the work might result in clinical psychologists being more reluctant to choose this specialism and may raise issues about their own early attachment experiences. Therefore, it is important to understand how clinical psychologists approach the complexities of their work in light of their own early attachment experiences. Qualitative research of the lived experiences of clinical psychologists is sparse and to date there are no studies addressing this specific issue. Aims: this is an exploratory study which addresses a gap in the literature. The aims are to capture the early attachment experiences of clinical psychologists specialising in working with older adults. It is hoped that the outcome of the study will shed some light on the characteristics of this under-researched group and how they manage the challenges of the work. Methodology: a semi-structured interview schedule was developed to explore how clinical psychologists make sense of their work with older adults in light of their early attachment experiences. Interviews were carried out with five clinical psychologists working in specialist older adult services. The transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: the analysis of the five interviews yielded five main themes – “Making sense of early attachment relationships”, “Developing identity in childhood and adolescence”, “Understanding of decision to work with older adults”, “Work with older adults as both challenging and rewarding” and “The person within the professional”. Each of the main themes and their subthemes were supported by excerpts from narratives of participants experiences. Implications: this study highlighted several research and clinical implications. First, the role of non-parental childhood attachments in the development of internal working models is currently an under-researched area which may provide important insights into resilience factors in the face of childhood adversity. Second, clinical implications suggest that access to older adult work early on in the career of clinical psychologists may increase desirability of working in specialist services. Third, the study supports attachment theory as a useful approach to understanding the work with older adults and as a valuable area for the professional development of clinical psychologists. Finally, systemic working with older adults remains an important part of the work which would benefit from further research in this area.