The value of qualitative empirical research in the management and accounting disciplines lies in its “conceptual framing” of organizational actions, events, processes, and structures. Argues that the possibilities for conceptual framing extend beyond the highly abstract schema generally considered as “theories” by academics. In support of this argument, distinguishes five different forms of theorization. Explores the relationship between these theoretical “levels” and the different issues that empirical research explores, arguing that, as the “level” of theorizing “rises”, issues of agency give way to a focus on practice and, in turn, to a concern with structure. As this happens, research aims directed towards abstraction and explanation supersede those for contextualization and understanding. Concludes that views on “what counts as theory” are, currently, too narrow to conceptualize agency, emergence and change adequately in organizational life and, hence, the full range of significant empirical phenomena that characterize the management and accounting areas are not being researched.
Results are presented from a study in which 40 therapist-client pairs were asked to record, after each session of psychological therapy, their views concerning the helpful and unhelpful events which took place. On termination they were asked to describe their views of the helpful and unhelpful events in retrospect, and to report on outcome. A total of 1076 events was collected from 399 therapy sessions, and was content analysed using Elliott's Therapeutic Impact Content Analysis System. Results showed that during therapy the types of event most frequently reported by clients were reassurance/relief and problem solution events, whereas therapists reported the clients' gaining of cognitive and affective insight. After termination, both participants reported the importance to the client of personal contact. Many of the differences between the two perspectives were highly significant, although more differences were found when outcome was poor. It is suggested that different aspects of the therapeutic process have a different degree of salience for therapists and clients, in that clients are most interested in gaining a solution to their problems and feeling better, whereas therapists are more concerned with the aetiology of the problem and its transformation through insight. The implications of these differences are discussed.
This study compared the impact of helpful and hindering events, as perceived by 40 clients, in two forms of psychotherapy: an exploratory, relationship-oriented therapy, and a prescriptive, cognitive/behavioural therapy. All clients received eight sessions of each type of treatment in a crossover design. Events were obtained by self-report both during and at the end of each period, and content analysed for type of therapeutic impact by three trained raters. Results showed that during treatment the most commonly occurring helpful impacts across both types of treatments were 'problem solution', 'awareness' and 'reassurance', while the most commonly occurring hindering impact was 'unwanted thoughts'. Similar impacts were reported at the end of each period, with the addition of 'personal contact'. In addition, it was found that 'problem solution' and 'reassurance' impacts were more commonly reported in prescriptive treatment, whereas 'awareness' and 'personal contact' impacts were more prevalent in exploratory treatment. Only the prevalence of 'unwanted thoughts' was correlated (negatively) with outcome. Some possible reasons for the lack of correlation between reported impacts and outcome are suggested.
This study compared the assimilation of problematic experiences in four good-outcome cases versus four poor-outcome cases of very brief psychotherapy (two sessions plus a follow-up) for mild depression. Clients' central problems were consensually formulated, and transcribed passages concerning these problems were rated on the Assimilation of Problematic Experiences Scale by trained raters. Results supported the theoretical expectation that reductions in the intensity of depressive symptoms were associated with higher levels of assimilation. All of the good outcome cases reached Assimilation Level 4 (understanding/insight), whereas none of the poor outcome cases did so. Despite methodological limitations, it is suggested that this study represents an empirical endorsement of the assimilation model.
Comprehensive Process Analysis (CPA) is an interpretive, qualitative research method for analyzing significant therapy events. CPA was used to analyze 6 client-identified significant insight events in 2 treatments. Two events are presented in depth. The psychodynamic-interpersonal therapy event documented the existence of 2-part significant events and the value of key words. The cognitive-behavioral therapy event illustrated the role of context in transforming small therapy events into significant events. Events in both therapies involved therapist interpretations of recent difficult life events that were delivered in a firm but interactive style. Interpersonal therapy events were distinguished by links to themes from previous sessions and led to awareness of painful emotions. Cognitive therapy events were externalizing reattributions given to more clinically distressed clients. A revised 5-stage microprocess model of the insight is presented.
An initial ideal, rational model of alliance rupture and rupture resolution provided by cognitive-behavioral therapy (CBT) experts was assessed and compared with empirical observations of ruptures and their resolution in two cases of successful CBT. The initial rational model emphasized nondefensive acknowledgment and exploration of the rupture. Results indicated differences between what therapists think they should do to resolve ruptures and what they actually do and suggested that the rational model should be expanded to emphasize client validation and empowerment. Therapists' ability to attend to ruptures emerged as an important clinical skill.
The psychological problems and difficulties experienced by adults who report having been sexually abused in childhood are reviewed. These long-term effects include damage to the victims' emotional reactions and self-perceptions, relationship problems, problems with sexuality and difficulties in social functioning. Common presenting problems of victims of childhood sexual abuse (CSA) are described. Also discussed are the characteristics of incestuous abuse in terms of the victim, the abusive relationship and its termination; the contributions of the various aspects of CSA to the psychological impact of such abuse; and psychodynamic explanations of the development of long-term effects. The bulk of the published material regarding the long-term effects of CSA refers to female victims only, and this 'bias' is reflected in the review.
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