The purpose of this research is to investigate former client's perception of change, reasons for consultation, therapeutic relationship, and termination. Semistructured interviews were conducted with 17 former clients who had been in a psychotherapeutic treatment. A qualitative approach, based on consensual qualitative research (CQR) was used to analyze the interviews. Results show how the balance of negative and positive aspects of the therapeutic relationship is associated with the perception of change. Likewise, categories related to reasons for consultation were associated with types of change and therapy termination. The relevance of the client's perspective is increasingly being recognized as valuable for the understanding of the psychotherapeutic processes and generates hypotheses for future research.
Although there is a growing body of research in both cross-cultural issues in psychotherapy and in the client's perspective, little is known about differences or similarities in the way clients from different cultures, particularly those from different nations, subjectively experience therapy. The present study addressed this gap through a qualitative analysis of interviews with former therapy clients in Argentina and the United States. The researchers used a consensual qualitative research (CQR; C. E. Hill, B. J. Thompson, & E. N. Williams, 1997, A guide to conducting consensual qualitative research, The Counseling Psychologist, Vol. 25, pp. 517-572; C. E. Hill, S. Knox, B. J. Thompson, E. N. Williams, S. A. Hess, & N. Ladany, 2005, Consensual qualitative research: An update, Journal of Counseling Psychology, Vol. 52, pp. 196-205) methodology and provide illustrative examples from the raw transcripts. Among other differences, Argentine and U.S. participants differed in their experience of the therapy setting, the interventions their therapists used, and in the types of change they reported to result from therapy. Also notable, Argentine participants spoke a great deal more about change than U.S. participants. Results are preliminary, but provide implications for the adaptation of treatments to different cultures and for the cross-cultural validity of researchers' and policymakers' current definitions of treatment efficacy.
La investigación a partir de la perspectiva del paciente ha brindado importante información acerca de cómo la terapia es percibida, ayudando a los terapeutas a entender algunas reacciones por parte de los pacientes. Aún hoy en día, la terapia enfocada a los niños no ha sido beneficiada por este movimiento, dada la escasez de investigaciones de este tipo en la población infantil. El trabajo que aquí se presenta, es de carácter empírico, con un enfoque de análisis cualitativo. En el mismo se indagó sobre las percepciones que los niños poseen sobre los distintos asuntos relacionados al proceso psicoterapéutico. Para ello, se realizaron entrevistas semi-estructuradas a 10 niños de entre 6 y 12 años que se encontraban realizando un tratamiento psicoterapéutico, o lo habían realizado en los últimos doce meses. Durante las entrevistas se indagó sobre elementos como “la relación terapéutica”, “las intervenciones del terapeuta”, “la valoración de la terapia”, “las nociones que poseía sobre la terapia”, “características de la terapia” y “el cambio percibido”. Las entrevistas fueron transcriptas y analizadas utilizando la metodología cualitativa consensual (CQR). Los resultados indican que los niños pudieron percibir los cambios en relación a su propia conducta, emociones y relaciones interpersonales y vincular dichos cambios con los terapeutas y el vínculo que con ellos habían establecido. También elementos del proceso terapéuticos, como por ejemplo la alianza con el terapeuta fueron relacionados al cambio
There is no consensus among different therapeutic approaches on the process of termination when therapy does not have a prefixed duration. Moreover, both clinicians and researchers are still exploring decision making in the termination of treatment. The present study assessed former client's perspective of therapy termination in a nonprobabilistic sample from Buenos Aires, Argentina. Seventy-three semistructured interviews, lasting ∼60 min each, were conducted with participants that had finished a therapeutic treatment or dropped out. They were asked about several aspects of therapy, including their experience of termination, specifically who decided to terminate, if there was agreement on termination or not, and their thoughts on the termination process. All interviews were transcribed and analyzed using an adaptation of Consensual Qualitative Research (CQR). Quantitative analyses were also conducted to examine associations between variables. Two main factors emerged from the analysis: client/therapist initiative on termination; and level of agreement between client and therapist regarding termination. Whereas nearly all (95%) of therapist-initiated termination cases agreed on termination, client-initiated termination cases could be sorted in agreed (49%) and disagreed (51%) terminations. Both therapist-initiated terminations and agreed upon terminations presented more categories of positive termination motives, better therapeutic bond, and higher overall satisfaction with treatment. Implications for research and clinical practice are discussed. (PsycINFO Database Record
Despite recent attempts to develop a consensus definition, questions still remain as to what constitutes corrective experiences (CEs) in psychotherapy and how clients perceive them. This qualitative study assessed clients' first person accounts of CEs associated with their own treatment-related changes. Participants were 8 clients in private psychotherapy in Buenos Aires. Treatment, by therapists from diverse theoretical backgrounds, varied from 4 to 24 months. The Patients' Perceptions of Corrective Experiences in Individual Therapy interview protocol was used to assess clients' perceptions of CEs at posttreatment. All interviews were audiorecorded and transcribed and submitted to a 2-stage thematic analysis to assess CEs and the contextual factors that contributed to them. Of the 8 participants, 5 narrated stories about CEs that changed the way they thought about themselves and their behavior. Additionally, clients highlighted disconfirmation of therapist role expectations and surprise regarding therapists' actions and behaviors as mechanisms of these corrective moments.
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