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Therapists' view of therapeutic action in psychoanalytic psychotherapy with young adults
Stockholms universitet.
Stockholms universitet.
2010 (English)In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 47, no 4, 570-585 p.Article in journal (Refereed) Published
Abstract [en]

Studying experienced therapists' implicit theorizing may contribute to our understanding of what is helpful and what hinders treatment with particular patient populations. In this study, 16 therapists' views of curative factors, hindering factors, and outcome were explored in 22 interviews conducted at termination of individual psychoanalytic psychotherapy with young adults. Grounded theory methodology was used to construct a tentative model of therapeutic action based on the therapists' implicit knowledge. The results indicated that developing a close, safe and trusting relationship was viewed as the core curative factor in interaction with the patient making positive experiences outside the therapy setting and the therapist challenging and developing the patient's thinking about the self. The therapeutic process was experienced as a joint activity resulting in the patient becoming a subject and acquiring an increasing capacity to think and process problems. The patient's fear about close relationships was seen as hindering treatment and leading to core problems remaining. The model is discussed in relation to major theories of therapeutic action in the psychoanalytic discourse and previous research focusing on young adults' view of curative and hindering factors in psychotherapy. Implications for practice and further research are suggested.

Place, publisher, year, edition, pages
2010. Vol. 47, no 4, 570-585 p.
Keyword [en]
Psychoanalytic psychotherapy, Therapeutic action, Young adults, Curative and hindering factors, Grounded theory
National Category
Applied Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:esh:diva-6415DOI: 10.1037/a0021179PubMedID: 21198244OAI: oai:DiVA.org:esh-6415DiVA: diva2:1148582
Available from: 2014-07-31 Created: 2017-10-11 Last updated: 2017-11-09Bibliographically approved
In thesis
1. Exploring therapeutic action in psychoanalytic psychotherapy: Attachment to therapist and change
Open this publication in new window or tab >>Exploring therapeutic action in psychoanalytic psychotherapy: Attachment to therapist and change
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed. 

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2014. 73 p.
Keyword
Therapeutic action, Mechanisms of change, Psychoanalytic, Psychodynamic, Psychotherapy, Young adults, Attachment to therapist, Therapeutic alliance, Process, Outcome, Grounded theory, Linear mixed models
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:esh:diva-6412 (URN)978-91-7447-988-1 (ISBN)
Public defence
2014-11-21, David Magnussonsalen (U31), Frescati hagväg 8, Stocksholm, 13:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Epub ahead of print.

Available from: 2017-11-09 Created: 2017-10-11 Last updated: 2017-11-09Bibliographically approved

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