Ideas of cure as a predictor of premature termination, early alliance and outcome in psychoanalytic psychotherapy

Philips, Björn; Wennberg, Peter; Werbart, Andrzej

doi:10.1348/147608306x128266

Cited by 29 publications

(30 citation statements)

References 37 publications

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“…Moreover, recent research also finds that a poor therapeutic alliance predicts dropout among adolescents (de Haan et al., ; O'Keeffe et al., ), and that adolescents initially hope for a strong and collaborative therapeutic relationship at the onset of therapy (Midgley et al., ). Another study finds that adolescents who take ownership in the therapy process have less likelihood of dropout (Philips, Werbart & Schubert, ), underscoring the importance of establishing a solid and reciprocal relationship with the adolescent client.…”

Section: Discussionmentioning

confidence: 99%

‘Nobody else can lead your life’: What adolescents need from psychotherapists in change processes

Lavik

Veseth

Frøysa

et al. 2018

Couns and Psychother Res

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Aim A startling number of adolescents have mental health problems, yet research on the effect of routine care shows sobering effect sizes and high dropout rates. This study's objective was to gain in‐depth, first‐person knowledge about what adolescents need from their therapists to engage therapeutically and benefit from treatment. Method A total of 22 adolescents aged 14–19 years participated in qualitative focus groups or individual interviews of their own choosing. The data material was analysed using a systematic, step‐wise and consensual qualitative research framework for team‐based analysis. Findings Six themes emerged from the analysis, named from the words of the adolescent participants: (1) facing a scary situation: Attend to the adolescent's starting point, (2) be warm, invested and emotionally engaged, (3) offer live company and presence as a real human being, (4) have integrity as an adult and a professional, (5) know the world of a teenager and get into their stories and (6) have mutuality as a virtue and treat the adolescent as an equal. Discussion and implications Overall, adolescents regard the quality of the therapeutic relationship with their therapist as essential for the success of psychotherapy. In terms of their needs in treatment, therapists need to overcome the adolescents’ initial misgivings and scepticism towards therapy through establishing trust and accommodating their developmental desire for autonomy and connectedness.

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Section: Discussionmentioning

confidence: 99%

‘Nobody else can lead your life’: What adolescents need from psychotherapists in change processes

Lavik

Veseth

Frøysa

et al. 2018

Couns and Psychother Res

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“…Both YAPP and YOUTH are naturalistic and longitudinal studies with a similar research design. YAPP focused on the young patients’ ideas of cure in relation to outcome (Johansson & Werbart, 2009; Lilliengren & Werbart, 2005; Lindgren, Werbart & Philips, 2010; Philips, 2005; Philips, Wennberg & Werbart, 2007; Philips, Wennberg, Werbart & Schubert, 2006; Philips, Werbart & Schubert, 2005), while YOUTH focused on understanding psychological developmental tasks among current young adults (Jacobsson, 2005).…”

Section: Methodsmentioning

confidence: 99%

Young adults talk about their problems

Jacobsson

Tysklind

Werbart

2011

Scandinavian J Psychology

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This study aims to explore how young adults in psychotherapy and young adults in general describe their problems and how their problem formulations change over time. Two matched samples from longitudinal prospective studies were compared using thematic analysis. Semi-structured, in-depth interviews were conducted at baseline, 1.5 years after termination of psychotherapy (N=12) in the clinical sample and 3 years after baseline in the non clinical sample (N=12). Inductive thematic analysis revealed six themes: problems associated with oneself, family, intimate relationships, sense of belonging, occupation, and social roles. The psychotherapy sample was characterized by problems with oneself closely related to other problematic areas, at both pre-treatment and at follow-up 1.5 years after termination, while problematic sense of belonging was a general theme only prior to psychotherapy. However, they were less troubled by their problems after psychotherapy. Problems with oneself decreased considerably in the non-clinical sample, while problems with intimate relationships were twice as frequent at follow-up. In the psychotherapy sample, the initial experience of being passively trapped within their problems was transformed into an experience of being an active agent in their own life. However, considerable differences between the psychotherapy sample and non-clinical sample still persisted at follow-up.

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“…Where studies have recruited from mental health services, the young people who participated were already receiving therapy, or had already completed treatment. Therapy is likely to impact on how young people understand their difficulties, as we would expect therapy to lead to some reconsideration of the causal beliefs that the young person brings to treatment [16]. …”

Section: Causal Beliefs For the Onset Of Depressionmentioning

confidence: 99%

“Did I bring it on myself?” An exploratory study of the beliefs that adolescents referred to mental health services have about the causes of their depression

Midgley

Parkinson

Holmes

et al. 2016

Eur Child Adolesc Psychiatry

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The causal beliefs which adults have regarding their mental health difficulties have been linked to help-seeking behaviour, treatment preferences, and the outcome of therapy; yet, the topic remains a relatively unexplored one in the adolescent literature. This exploratory study aims to explore the causal beliefs regarding depression among a sample of clinically referred adolescents. Seventy seven adolescents, aged between 11 and 17, all diagnosed with moderate to severe depression, were interviewed using a semi-structured interview schedule, at the beginning of their participation in a randomised controlled trial. Data were analysed qualitatively using framework analysis. The study identified three themes related to causal beliefs: (1) bewilderment about why they were depressed; (2) depression as a result of rejection, victimisation, and stress; and (3) something inside is to blame. Although some adolescents struggled to identify the causes of their depression, many identified stressful life experiences as the cause of their current depression. They also tended to emphasise their own negative ways of interpreting those events, and some believed that their depression was caused by something inside them. Adolescents’ causal beliefs are likely to have implications for the way they seek help and engage in treatment, making it important to understand how adolescents understand their difficulties.

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Ideas of cure as a predictor of premature termination, early alliance and outcome in psychoanalytic psychotherapy

Abstract: The positive finding regarding premature termination indicates the importance of negotiating ideas of cure as a part of the initial assessment process. Possible explanations for the negative findings are discussed.

Cited by 29 publications

References 37 publications

‘Nobody else can lead your life’: What adolescents need from psychotherapists in change processes

‘Nobody else can lead your life’: What adolescents need from psychotherapists in change processes

Young adults talk about their problems

“Did I bring it on myself?” An exploratory study of the beliefs that adolescents referred to mental health services have about the causes of their depression

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