The thesis entitled 'Developing an early therapeutic alliance with the transferred client' explores how the early alliance develops within client-therapist dyads and the impact that a transfer of care can have on developing a new alliance. Section One presents a systematic review of 14 empirical studies, considering how client and therapist intra- and interpersonal variables impact upon the other person's perception of the early therapeutic alliance. The review provides a comprehensive and critical account of the current state of knowledge, indicating that client interpersonal difficulties consistently cause therapists to rate the alliance negatively. In addition, shared expectations within the dyad create a positive alliance, whilst therapeutic ruptures foster negative alliances for both parties. Section Two presents a research study exploring how clinical psychologists experience working with transferred clients. Nine participants were interviewed and the data analysed using interpretative phenomenological analysis (IPA). Four major themes emerged from the transcripts: Developing a boundaried and transparent alliance; Abandonment and raised expectations: the lasting influence of the previous therapist; Following on where somebody else left off: using or not using previous therapeutic work; and Working within the transfer culture. The themes describe the difficulty and frustration experienced within the transfer process, as clinical psychologists attempt to establish a new therapeutic alliance to promote positive change in clients. Section Three provides a critical review of the research study, specifically focusing on reflexivity. The author reflects on the experience of conducting interviews whilst having a dual-role, placing them on 'the inside' of participant accounts. In addition post-hoc reflexivity was used to provide practice guidelines for trainee clinical psychologists managing transfers of care. It is anticipated that the findings presented here will encourage clinical psychologists and associated professionals to consider the 'importance of establishing a solid therapeutic alliance, whilst also recognising the consequences of breaking this bond.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:552823 |
| Date | January 2010 |
| Creators | Rushton, Ian |
| Publisher | Lancaster University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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