Young adults' ideas of cure prior to psychoanalytic psychotherapy

Abstract

The study aims to explore systematically the ideas of cure among young adults prior to psychoanalytic psychotherapy. Forty-six individuals aged 18 to 25 years who applied for psychotherapy underwent the Private Theories Interview (PTI). Twenty distinct categories of ideas of cure were identified. Based on these categories, a theoretical model was constructed with the dimensions, Approaching-Distancing and Doing-Receiving. Individuals were classified into types using "ideal type analysis." Seven ideal types were formed: Processing and Understanding, Mastering Through Own Will and Action, Talking, Discordant Ideas, Incoherent Ideas, Getting It Out, and Avoiding or Placing the Solution onto Others. New hypotheses emerged concerning ideas of cure as an important factor for psychotherapy matching, thus potentially predicting premature termination, alliance, and outcome.

“Just like talking to someone about like shit in your life and stuff, and they help you”: Hopes and expectations for therapy among depressed adolescents

“…This finding is similar to Philips et al (2007), who found in their study of young adults' expectations of therapy that: …participants did not emphasize the interpersonal relationship as a possible curative agent in therapy… [instead their] expressed ideas of cure depicted fairly cool and professional relationship, e.g. with the therapist as an outsider who sees things differently than oneself, rather than an emotionally charged relationship (p.226).…”

“…For example, many of the young people in our study shared the expectation expressed by the young 22 adults in Philips et al (2007), that therapy would not necessarily involve the development of a strong personal bond with their therapist; and some shared the idea voiced by some of the adults in Westra et al (2010), that therapy would involve lying on a couch and being asked questions and 'grilled' (p.4). The difficulty that we identified for young people imagining therapy was perhaps the finding that was most specific to this study, and could be a reflection of the age of our participants, as well as the fairly severe level of depression which many of them were experiencing at the time these interviews were conducted.…”

“…Young people were interviewed prior to starting therapy, using open-ended, semi-structured interviews, aiming to promote freer exploration and to get at the young people's own ways of "making meaning" (Krauss, 5 2005). Unlike the Philips et al (2007) study, our aim was not to link expectations with treatment uptake. Instead, we wanted to investigate the ideas that young people have going into therapy, a sense of the otherwise unspoken feelings of young people, and thus help clinicians negotiate the delicate early phases of treatment, which can often be especially challenging with adolescents, as demonstrated by the very high levels (40-60%) of early drop-out from therapy in this age group (Oetzel & Scherer, 2003;Tuber & Caflisch, 2011).…”

Developing Pluralistic Practice in Counselling and Psychotherapy: Using What the Client Knows

“…An important set of qualitative studies has investigated client knowledge through exploring "ideas of cure" in clients receiving psychoanalytic psychotherapy (Lilliengren & Werbart, 2005;Philips, Werbart, Wennberg, & Schubert, 2007). In one study, young adults who were referred for psychoanalytic psychotherapy were invited to take part in pre-therapy interviews around their ideas of how therapy might help them .…”

“…One of the themes that has emerged from several qualitative studies is that over the course of therapy, some clients become aware that what they are being offered is not right for them, and reach the end of therapy with a feeling of disappointment or "something was missing". For example,Nilsson, Svensson, Sandell, and Clinton (2007) found that some clients were disappointed with the CBT therapy they had received because what they felt they had needed was to just talk about their difficulties and make sense of their relationships, whereas disappointed clients who had received psychodynamic therapy reported that they wanted more practical advice and ideas about how to cope.An important set of qualitative studies has investigated client knowledge through exploring "ideas of cure" in clients receiving psychoanalytic psychotherapy (Lilliengren & Werbart, 2005;Philips, Werbart, Wennberg, & Schubert, 2007). In one study, young adults who were referred for psychoanalytic psychotherapy were invited to take part in pre-therapy interviews around their ideas of how therapy might help them .…”