Therapists’ self-reported chronic strategies of disconnection in everyday life and in counselling and psychotherapy: an exploratory study

The aim of this study was to explore how therapists believe they may relationally disconnect from other people and their clients, with an overall objective of developing methods for enhancing relational depth in counselling and psychotherapy. Participants were 168 trainee and practicing therapists, who listed their chronic strategies of disconnections (CSoDs) in everyday relationships, and then rated the presence of these CSoDs in their therapeutic work. Thirty-nine categories of self-reported everyday CSoDs emerged, organised into seven domains. Most prevalent were behavioural, passive and intrapsychic strategies. Over half of the CSoDs were rated as being present in therapy to a minimal extent, most commonly passive CSoDs, disingenuous CSoDs and humour. Male therapists, and trainee therapists, were most likely to identify their CSoDs as present in therapy.     

Interpersonally traumatised patients’ view of significant and corrective experiences in the psychotherapeutic relationship

Background: Clinical experience points to the importance of significant experiences in the therapy relationship for patients who have been interpersonally traumatised but the empirical research is limited.

Aim: The aim was to gain increased knowledge about how significant and potentially corrective experiences within the therapeutic relationship were described by patients in trauma-focused therapy and how the participants thought such experiences might have affected the therapeutic work.

Method: Five patients who were, or recently had been, in trauma-focused therapy were interviewed about their experiences of the therapy relationship. Thematic analysis was used to analyse the interviews.

Results: Four themes were identified: ‘Human contact’, ‘Validation’, ‘To face the painful’ and ‘Development of trust’. Positive experiences in the therapeutic relationship were sometimes seen as crucial for the therapeutic work and for patients’ improvement.

Conclusions: Previous findings about the significance of corrective experiences in psychotherapy were confirmed, particularly experiences of the therapist’s accepting stance, personal and human contact and encouragement. The therapist’s ability to evoke trust in the patient and her capacity to help patients to face painful material may be particularly important for traumatised patients.     

The Relationship Between Client Emotional Expressions, Therapist Interventions, and the Working Alliance: An Exploration of Eight Emotional Expression Events

The relationship between client emotional expression and therapist interventions was studied in two working alliance conditions. An events-focused methodology was used to examine a total of 8 events taken from a variety of therapeutic orientations. Results indicated that, in the presence of a good client–therapist relationship, therapists showed higher levels of empathy and effectively focused on the immediately expressed feelings; in turn, their clients were engaged in exploration of feelings. In poor-relationship dyads, clients expressed negative feelings toward the therapists. Interventions rated as effective by clinical judges were characterized by accurate therapist understanding of clients' emotional expressions and working with strains in the therapeutic relationship. Ineffective interventions were associated with inaccurate assessments of clients' emotional states. Intensive analysis of these sessions led to three distinct models of in-session emotional expression events. Theoretical and practical implications of these models will be discussed.     

“The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist

The parent–therapist relationship is a central consideration in child counselling and psychotherapy, particularly in private practice where parents are typically financially, emotionally and practically invested in the process. The relationship, which can be ambiguous and anxiety-laden on both sides, has historically received scant attention in therapeutic discourse, leading to gaps in practitioner confidence and training. In this context, and seeking to centre parent voices, this study provides an interpretative phenomenological analysis of four mothers' experiences of their role in the relationship with their child's therapist. Key identified themes encompass parental expectation of involvement; the destabilising, disorienting nature of the relationship; the centrality of trust; and critical evaluations of value. Findings are discussed in relation to attachment theory and cultural expectations of parental responsibility. The study concludes that the relationship is a live and potent property with potential to impact the course of the intervention, and recommends that practitioners thoughtfully consider the potential benefits and drawbacks of meeting or frustrating parental involvement expectations.