Psychotherapist variables that may lead to treatment failure or termination-A qualitative analysis of patients' perspectives.

IF 2.6 2区心理学 Q2 PSYCHOLOGY, CLINICAL

Psychotherapy Pub Date : 2023-12-01 Epub Date: 2023-10-12 DOI:10.1037/pst0000503

Sven Alfonsson, Simon Fagernäs, Gabriella Sjöstrand, Mårten J Tyrberg

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引用次数: 0

Abstract

A substantial number of patients do not improve from psychotherapy, some even deteriorate, and some terminate treatment prematurely. Identifying therapist variables that may lead to treatment failures from patients' perspectives can inform how psychotherapists can increase effectiveness. Using a semistructured protocol, we interviewed 24 patients who had experienced unsatisfying individual face-to-face psychotherapy within the last 2 years. The study procedures were guided by the consolidated criteria for reporting qualitative research. The manifest content analysis provided 13 subcategories grouped into four categories: (a) psychotherapists' negative traits (inflexible, unengaged, unemphatic, insecure), (b) unprofessionalism (superficial, violating personal boundaries, breaking confidentiality, nontransparent), (c) incompetence (unstructured, poor assessment or understanding, poor knowledge, too passive), and (d) mismatch (therapist-patient mismatch). To reduce the risk of treatment failure, psychotherapists may need a multifaceted set of relational skills, theoretical and technical competence, ethical sensitivity, and engagement. Some of the identified subcategories were complex constructs (e.g., unengaged) that may need time and effort to develop for psychotherapists. Other identified subcategories were obvious inappropriate behaviors in professional psychotherapy (e.g., breaking confidentiality). However, the categories found in this study need further quantitative investigation to assess the validity, frequency, and relative impact on treatment outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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可能导致治疗失败或终止的心理治疗师变量——对患者观点的定性分析。

相当多的患者没有从心理治疗中得到改善，有些甚至病情恶化，有些过早终止治疗。从患者的角度识别可能导致治疗失败的治疗师变量，可以为心理治疗师如何提高疗效提供信息。采用半结构化方案，我们采访了24名在过去两年内经历过令人不满意的个人面对面心理治疗的患者。研究程序以报告定性研究的综合标准为指导。显性内容分析提供了13个子类别，分为四类：（a）心理治疗师的负面特征（不灵活、不投入、不强调、不安全），（b）不专业（肤浅、违反个人界限、打破保密、不透明），（c）无能（无组织、评估或理解能力差、知识贫乏、过于被动），以及（d）不匹配（治疗师-患者不匹配）。为了降低治疗失败的风险，心理治疗师可能需要一套多方面的关系技能、理论和技术能力、道德敏感性和参与度。一些已确定的子类别是复杂的结构（例如，未连接），可能需要时间和精力为心理治疗师开发。其他确定的子类别是专业心理治疗中明显的不当行为（例如，违反保密规定）。然而，本研究中发现的类别需要进一步的定量调查，以评估有效性、频率和对治疗结果的相对影响。（PsycInfo数据库记录（c）2023 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

4.60

自引率

12.00%

发文量

期刊介绍： Psychotherapy Theory, Research, Practice, Training publishes a wide variety of articles relevant to the field of psychotherapy. The journal strives to foster interactions among individuals involved with training, practice theory, and research since all areas are essential to psychotherapy. This journal is an invaluable resource for practicing clinical and counseling psychologists, social workers, and mental health professionals.