A preliminary study of an attraction-barrier model of patients' commitment and responses to dissatisfaction in psychotherapy.

Feeling Misunderstood: A Concept Analysis

“…Psychology and behavioral sciences introduce the concept of feeling misunderstood as related to 21 different topics including: therapy/counseling (Appelbaum, 1990; Barkham & Shapiro, 1986; Davies, 2004; Derlega, Mcintyre, Winstead, & Morrow, 2001; Doxsee & Kivlighan, 1994; Elliott, 1985; Fuller & Hill, 1985; Hamburg & Herzog, 1990; Jacobs, 1991; Lewis, 1995; Miller, Gilinski, Woodberry, Mitchell, & Indik, 2002; Minden, 2002; Muten, 1991; Nelson, 2002; Rapoport & Skellern, 1957; Strong, 2002; Weger, 2005), loneliness (Thompson & Heller 1990), counseling in middle schools (Gerler, 1991), marital difficulties (Rhodes, Hill, Thompson, & Elliott, 1994), interpersonal perceptions (Hatchett, Friend, Symister, & Wadhwa, 1997), self‐disclosure in siblings (Martin, Mottet, & Anderson, 1997), “controller personality” (Boldt & Mosak, 1998), perceived understanding (Martin, 1998), grieving children (McGlauflin, 1998), substance abuse (McMahon, Malow, & Penedo, 1998), validating anger (Paivio, 1999), addressing medical problems (Paton, 1999), using theater for interpersonal functioning (Wiener, 1999), schizophrenics (Barker, Lavender, & Morant, 2001; Brady, 2004), analyst fears (Bernstein, 2001), parents’ concerns of prodigy children (Staley, 2002), eating disorders (Cockell, Zaitsoff, & Geller, 2004), bisexuality (Morgenstern, 2004), professional liability in adolescent psychology (Tuckman & Ferro, 2004), heterosexual love (Gilmartin, 2005), and memory and achievement (Kazen & Kuhl, 2005). An example from the broad topic of “therapy/counseling” is a qualitative study of family members of schizophrenics by Brady (2004) that found “family members feeling misunderstood and invalidated when shared pandimensional experiences are negatively interpreted” (p. 63).…”

“…Consequences are “those events or incidents that happen as a result of the occurrence of the concept, or are the outcomes of the concept” (Walker & Avant, 2005, p. 73). The consequences of feeling misunderstood are summarized as a “transformation in behavior.” Some of the most frequently mentioned transformations in behavior that were identified in the references include termination of activity such as relationship, school, job, or therapy (Bernstein 2001; Day & Schoenrade, 1997, 2000; Derlega et al., 2001; Gilmartin, 2005; Martin et al., 1997; Muten, 1991; Young, 1999), withdrawing or avoidance of activity (Barker et al., 2001; Caap‐Ahlgren et al., 2002; Hansen & Hansen, 1991; Kazen & Kuhl, 2005; Koehler et al., 2002; Kraus, 1997; Nash, 1998; Oremland, 1986; Parr, 2000; Rhodes et al., 1994; Skabelund, 2005; Tax, 1993; Weger, 2005), aggressive or rebellious behavior (Barker et al., 2001; Nash, 1998; Parr, 2000; Skabelund, 2005; Strong, 2002), anger (Carlson, 1973; Miller et al., 2002; Paivio, 1999; Rapoport & Skellern, 1957), and emergence of new communication patterns or tools (Martin et al., 1997).…”

Effect of patient dissatisfaction with the therapist on group therapy outcome

“…Derlega and colleagues (Derlega, McIntyre, Winstead, & Morrow, 2001;Derlega, Winstead, & Lewis, 1993) have suggested that the quality of a person's object relations plays a major role in responses to difficulties in a relationship. Specifically, they have suggested that patients with a positive internal working model of others and a history of rewarding interactions would be more likely to have constructive rather than destructive responses to perceived difficulties in their relationship with the therapist.…”