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"It was hard work every session": Therapists' view of successful psychoanalytic treatments
Stockholms universitet.ORCID iD: 0000-0003-0859-1012
Stockholms universitet.
Stockholms universitet.
Stockholms universitet.ORCID iD: 0000-0003-1978-5322
2019 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 29, no 3, p. 354-371Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To explore therapists' experiences of the therapeutic process in successful cases of psychoanalytic psychotherapy.

METHOD: A two-stage, mixed-method design was used. Sixteen successful cases were drawn from a sample of 92 young adults in psychoanalytic psychotherapy according to Jacobson's criteria for reliable and clinically significant improvement. Therapist interviews at baseline and termination were analyzed applying Inductive Thematic Analysis.

RESULTS: Three core themes emerged: Being Particularly Motivated to be This Patient's Therapist, Maintaining a Safe and Attentive Therapeutic Position, and Assiduous Work Every Session. The therapists experienced positive feelings towards the patient from the outset of treatment and described active, relational work that included paying attention to incongruities in the patient's self-presentation and being mindful of patient's avoidant behavior. The therapist's motivation and attentive position made it possible to balance support and challenge in the therapeutic relationship.

CONCLUSIONS: Successful therapeutic work presupposes positive expectations, an active therapeutic stance and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginning of treatment. In addition to identifying the characteristics and actions of effective therapists, research should also focus on processes emerging within effective therapeutic dyads. Clinical or methodological significance of this article: Our study indicates several factors that seem to characterize therapist expertise and can inform psychotherapy training. Successful therapeutic work presupposes positive expectations, an active therapeutic stance, courage to challenge the patient, and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginning of treatment. In addition to identifying the characteristics and actions of effective therapists, research should also focus on processes emerging within effective therapeutic dyads.

Place, publisher, year, edition, pages
2019. Vol. 29, no 3, p. 354-371
Keywords [en]
Long term psychotherapy, Outcome research, Process research, Psychoanalytic therapy, Psychodynamic therapy, Qualitative research methods, Therapist expertise, Therapist perspective
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:esh:diva-6426DOI: 10.1080/10503307.2017.1349353PubMedID: 28714808OAI: oai:DiVA.org:esh-6426DiVA, id: diva2:1149568
Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2021-06-15Bibliographically approved

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Lilliengren, Peter

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