Aim: This study explored therapists' conceptualisations of their psychodynamic and cognitive behavioural therapies with clients with medically unexplained symptoms. Method: 12 semi-structured interviews were conducted with experienced psychotherapists, recruited from two National Health Service departments. Interview transcripts were analysed using grounded theory. Findings: Conceptualisations fell into two categories: (1) informal, bottom-up practice driven; (2) formal, top-down theory driven. In the former, therapists from both modalities shared experiential conceptualisations. In the latter, they shared some conceptualisations while retaining others from their theoretical training. Discussion: Therapists conceptualise using inherited theoretical concepts from their respective professional trainings, by developing experiential concepts of their own, and by borrowing and integrating theoretical concepts from other theoretical orientations.
Aim: To explore therapeutic activities and psychological interventions used by experienced cognitive behavioural and psychodynamic therapists to treat clients with medically unexplained symptoms (MUS). Method: Twelve in‐depth, semi‐structured, qualitative interviews with psychotherapists, recruited from two British National Health Service (NHS) Departments were conducted. Interview transcripts were analysed using grounded theory. Findings: Therapists from two modalities share the following therapeutic activities and psychological interventions in their work with MUS clients: working together with clients, sensitive, empathic responding and building trust, being flexible with techniques, keeping an open mind and multi‐disciplinary cooperation. They also use modality specific interventions discussed in this paper. Even though participants experienced difficulties in forming alliances with MUS clients early on in their work, they expressed the importance of nurturing hope, empowering and engaging clients in jointly constructing understandings, which helps symptom management.
This methodology paper presents how the application of grounded theory (GT) allowed the incorporation of additional data sources from what began as a systematic literature review (SLR) aimed at developing a counselling skills competencies framework for non‐career counsellors who provide counselling in a variety of care settings. This involved inclusion of purposive research material from experts with a wide range of relevant experience and critical input compensating for the limitations of the systematic review. GT provided the necessary analytic steps, and the paper discusses how the application of the constant comparative analysis procedure assured in‐depth analysis of the data from the systematic review, empirical data suggested by expert participants, researcher reflexivity, and critique and feedback from independent experts. Overall, this mixed‐methods approach enabled an expansion of relevant data and led to the construction of a framework for counselling skills organised into five key categories. A core group of practitioners and academics (CG) engaged in open and axial coding, holding in mind the goals of the project. Critical assessment and scrutiny through dialogue and reflection achieved saturation and agreement of the final framework. This meticulous process was inclusive of the views of experts in the field of counselling and led to an integrated framework of counselling skills for individuals in various care settings (nursing homes, NHS and social care services, charitable community projects, etc.). The paper shows that grounded theory allowed expansion of the data field and demonstrates how this approach added rigour and reliability to the developing framework.
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