scholarly journals Safeguarding the Therapeutic Alliance: Managing Disaffiliation in the Course of Work With Psychotherapeutic Projects

2021 ◽  
Vol 11 ◽  
Author(s):  
Aurora Guxholli ◽  
Liisa Voutilainen ◽  
Anssi Peräkylä
Keyword(s):  
Therapeutic Alliance ◽  
Conversation Analysis ◽  
Therapeutic Process ◽  
Psychoanalytic Psychotherapy ◽  
Central Concept ◽  
Process And Outcome ◽  
The Moment ◽  
The Relationship

Therapeutic alliance is a central concept in psychotherapeutic work. The relationship between the therapist and the patient plays an important role in the therapeutic process and outcome. In this article, we investigate how therapists work with disaffiliation resulting from enduring disagreement while maintaining an orientation to the psychotherapeutic project at hand. Data come from a total of 18 sessions of two dyads undergoing psychoanalytic psychotherapy and is analyzed with conversation analysis. We found that collaborative moves deployed amidst enduring disagreement can assist the therapist in furthering the disagreement as part of the ongoing psychotherapeutic project. Relying on their collaborative format, therapists utilize collaborative moves to temporarily mend the disaffiliation without necessarily changing their position and re-affiliating with the patient. We show how the relation between the therapist and the patient gets transformed in the moment-by-moment work accomplished in the psychotherapeutic talk.

Therapist–Patient Alliance, Patient–Therapist Alliance, Mutual Therapeutic Alliance, Therapist–Patient Concordance, and Outcome of CBT in GAD

2008 ◽  
Vol 22 (1) ◽  
pp. 68-79 ◽  
Author(s):  
Christin Langhoff ◽  
Thomas Baer ◽  
Doris Zubraegel ◽  
Michael Linden
Keyword(s):  
Anxiety Disorder ◽  
Therapeutic Alliance ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Therapeutic Process ◽  
Generalized Anxiety ◽  
Cognitive Behavior ◽  
Process And Outcome ◽  
Observer Ratings ◽  
Hamilton Anxiety Scale

The therapeutic alliance is seen as an important dimension in any type of psychotherapy. But patient, therapist, or observers can have different views on the therapeutic alliance. The question is which perspective best represents the therapeutic alliance, and what are the differences between these alternative views. In the present study, the therapist–patient alliance (TPA, the view of the therapist), patient–therapist alliance (PTA, the view of the patient), and mutual therapeutic alliance (MTA, the view of an observer) were measured simultaneously in cognitive behavior therapy of patients suffering from generalized anxiety disorder. Additionally, the concordance between patient and therapist ratings (TPC) was calculated. Cognitive behavior therapists attained high positive scores in all perspectives for all dimensions of the therapeutic alliance, such as empathy, cooperation, transparency, focusing, and assurance of progress. Correlations were consistently higher for ratings between therapist and patient than between observer and patient. A relation with outcome (Hamilton Anxiety Scale) was only found for observer ratings. It was concluded that cognitive behavior therapists can achieve good alliances with their patients. Different perspectives on the therapeutic alliance should be distinguished and taken into account separately in studies on the therapeutic process and outcome.

Establishing a Group Educational Session for Hyperacusis Patients

2019 ◽  
Vol 28 (2) ◽  
pp. 245-250
Author(s):  
Ann E. Perreau ◽  
Richard S. Tyler ◽  
Patricia C. Mancini ◽  
Shelley Witt ◽  
Mohamed Salah Elgandy
Keyword(s):  
Therapeutic Process ◽  
Treatment Options ◽  
Clinical Group ◽  
Education Session ◽  
Group Approach ◽  
Treatment Protocols ◽  
Educational Session ◽  
Evidence Based Treatment ◽  
Relationship Of ◽  
The Relationship

Purpose Audiologists should be treating hyperacusis patients. However, it can be difficult to know where to begin because treatment protocols and evidence-based treatment studies are lacking. A good place to start in any tinnitus and hyperacusis clinic is to incorporate a group educational session. Method Here, we outline our approach to establishing a hyperacusis group educational session that includes specific aspects of getting to know each patient to best meet their needs, understanding the problems associated with hyperacusis, explaining the auditory system and the relationship of hyperacusis to hearing loss and tinnitus, describing the influence of hyperacusis on daily life, and introducing treatment options. Subjective responses from 11 adults with hyperacusis, who participated in a recent clinical group education session, were discussed to illustrate examples from actual patients. Conclusions Due to the devastating nature of hyperacusis, patients need to be reassured that they are not alone and that they can rely on audiologists to provide support and guidance. A group approach can facilitate the therapeutic process by connecting patients with others who are also affected by hyperacusis, and by educating patients and significant others on hyperacusis and its treatment options. Supplemental Material https://doi.org/10.23641/asha.8121197

Red Eyes

2017 ◽  
Vol 11 (3) ◽  
pp. 290-293
Author(s):  
Jasmine Thombs
Keyword(s):  
Therapeutic Alliance ◽  
Therapeutic Process ◽  
Maternal Deprivation ◽  
Severe Reaction ◽  
Grief And Loss ◽  
Internal Working Model ◽  
Internal Working ◽  
Threatening Condition ◽  
Sight Loss ◽  
Red Eyes

This vignette illustrates how an individual with a complex pathology can present with a sight-threatening condition that appears to resist medical treatment in some measure if the psychological component is ignored. The case exemplifies the way in which therapeutic intervention can help in the recovery from a sightthreatening condition and from the underlying trauma associated with it. It is recognised that people affected by sight-threatening conditions will understandably experience very strong and at times overwhelming feelings related to grief and loss. In this case, the possibility of sight loss created a severe reaction of panic and confusion, and disrupted cognitive functions. These problems were often compounded by symptoms including anger, disassociation, apathy, and depression. This vignette showed how Bowlby's concepts of attachment and loss, and maternal deprivation, helped in the therapeutic alliance. The understanding of the client's internal working model was fundamental to the ongoing therapeutic process that allowed her to heal.

Examining for the Protective Effects of Therapeutic Engagement on Child Aggression

2020 ◽  
pp. 106342662098070
Author(s):  
Qshequilla P. Mitchell ◽  
S. Taylor Younginer ◽  
John E. Lochman ◽  
Eric M. Vernberg ◽  
Nicole P. Powell ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Externalizing Behaviors ◽  
Preventive Intervention ◽  
Therapeutic Process ◽  
Task Orientation ◽  
Protective Effects ◽  
Coding System ◽  
Diverse Range ◽  
Research With Children ◽  
Coping Power

Therapeutic alliance is associated with treatment outcomes across a diverse range of intervention models and clinical populations. Likewise, the perceived quality of working alliance in adult psychotherapy has been a consistent predictor of engagement, while research with children is limited. This study draws from a sample of 180 children who were involved in a study of the Coping Power preventive intervention for elementary students with aggressive behavior. Approximately 1,080 individual intervention sessions were coded using the Therapeutic Process Observational Coding System (TPOCS-A). Results suggest that bonding, in the early sessions of Coping Power, predicted a reduction in teacher-reported externalizing behaviors. In addition, data analyses revealed that bonding interacted with children’s gender in the latter portions of Coping Power. Higher bonding for girls in later sessions predicted lower teacher-rated externalizing behaviors at 1-year follow-up. Finally, initial levels of aggression moderated the relationship between bond and parent-rated externalizing behaviors during the early and late sessions of Coping Power, with stronger effects for moderately aggressive children. Task orientation, a component of therapeutic alliance, in late sessions had counter-intuitive effect on parent-rated externalizing behaviors, possibly due to therapists’ efforts to impose more structure with children who were not progressing well.

The relationship between patient donation and satisfaction with online healthcare service quality

2019 ◽  
Vol 47 (12) ◽  
pp. 1-10
Author(s):  
Yuanrong Hu ◽  
Shengkang Lu ◽  
Zhongming Tang
Keyword(s):  
Patient Satisfaction ◽  
Healthcare Service ◽  
Outcome Quality ◽  
Healthcare Applications ◽  
Mobile Healthcare ◽  
Process And Outcome ◽  
Patient Consultation ◽  
The Impact ◽  
The Relationship

We explored how donation relates to patient satisfaction with the quality of process and outcome in an online healthcare service. Using a dataset of 496,723 patient consultation records collected from ChunyuDoctor, which is among the largest of the Chinese mobile healthcare applications, we conducted a multiple regression and found that patient satisfaction with both process and outcome jointly influenced their donation. We also found that higher quality satisfaction levels meant paying patients were more likely to donate than were free patients. Our results also showed satisfaction with the quality of the process and the outcome had an equal impact on patient donation for the free patients, but the impact of process quality was greater than that of outcome quality for the paying patients, suggesting the importance of enhancing the quality of the process in an online healthcare service. Implications of the findings are discussed.

Feelings of Guilt and Fantasies in Life Experiences of Brazilian Parents Due to Death of their Newborn: A Clinical-qualitative Study Conducted at a University Hospital

2017 ◽  
Vol 41 (S1) ◽  
pp. S616-S616
Author(s):  
L. Rodrigues ◽  
J.V. Freitas-de-Jesus ◽  
G. Lavorato-Neto ◽  
D.D. Lima ◽  
E.R. Turato ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Life Experiences ◽  
Technological Development ◽  
Emotional Experience ◽  
University Hospital ◽  
Parents And Children ◽  
Cultural Pattern ◽  
Competing Interest ◽  
The Moment ◽  
The Relationship

IntroductionThe relationship between parents and children is a complex link. In the process of pregnancy-birth-puerperium, frequent feelings such as responsibility, love, fear, uncertainty, generate strong expectations at birth. The death of a newborn may not be perceived as natural by the parents, considering the local culture and the context of great technological development of neonatology.ObjectiveTo explore possible guilt and fantasies in life experiences of parents during mourning process due to death of their newborn.MethodClinical-qualitative design, a particularization of qualitative methods here applied in clinical assistance settings with highlight to psychological aspects. Data collection with the technique of semi-directed interview with open-ended questions, in-depth. Sample intentionally constructed, with closure by theoretical saturation of information. The participants were 7 parents, mourning by the death of their child at the neonatal intensive care unit, in a university hospital of Campinas, São Paulo State.ResultsFeelings of guilt - conscious or not - lead to an internal and particular movement so that mourning can be lived. The participants showed certain embarrassment, accompanied by natural suffering facing to the cultural pattern that permeates the emotional experience. It predicts types of psychological meanings that the experience will give to the person.ConclusionHealth professionals working with bereaved parents should consider more deeply the moment these one experienced, with emphasis on the details of the death scenery, beside the problems of illness and death properly so called.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Embodying the Site: the Here and Now in Site-Specific Dance Performance

2005 ◽  
Vol 21 (4) ◽  
pp. 367-381 ◽  
Author(s):  
Victoria Hunter
Keyword(s):  
Creative Process ◽  
Dance Performance ◽  
Site Specific ◽  
The Creation ◽  
Spirit Of Place ◽  
The Moment ◽  
The University ◽  
The Relationship

In this article, Victoria Hunter explores the concept of the ‘here and now’ in the creation of site-specific dance performance, in response to Doreen Massey's questioning of the fixity of the concept of the ‘here and now’ during the recent RESCEN seminar on ‘Making Space’, in which she challenged the concept of a singular fixed ‘present’, suggesting instead that we exist in a constant production of ‘here and nows’ akin to ‘being in the moment’. Here the concept is applied to an analysis of the author's recent performance work created as part of a PhD investigation into the relationship between the site and the creative process in site-specific dance performance. In this context the notion of the ‘here and now’ is discussed in relation to the concept of dance embodiment informed by the site and the genius loci, or ‘spirit of place’. Victoria Hunter is a Lecturer in Dance at the University of Leeds, who is currently researching a PhD in site-specific dance performance.

Teaching oral requests

Pragmatics ◽  
2013 ◽  
Vol 23 (3) ◽  
pp. 499-517 ◽  
Author(s):  
Eleni Petraki ◽  
Sarah Bayes
Keyword(s):  
Conversation Analysis ◽  
English Language ◽  
Language Teaching ◽  
English Language Teaching ◽  
Cultural Appropriateness ◽  
Language Classroom ◽  
The Subject ◽  
Relationship Of ◽  
The Relationship ◽  
Everyday Communication

Research in English language teaching has highlighted the importance of teaching communication skills in the language classroom. Against the backdrop of extensive research in everyday communication, the goal of this research was to explore whether current discourse analytic research is reflected in the lessons and communication examples of five English language teaching textbooks, by using spoken requests as the subject of investigation. The textbooks were evaluated on five criteria deriving from research on politeness, speech act theory and conversation analysis. These included whether and the extent to which the textbooks discussed the cultural appropriateness of requests, discussed the relationship of requests and other contextual factors, explained pre-sequences and re-requests and provided adequate practice activities. This study found that none of the coursebooks covered all of the criteria and that some coursebooks actually had very inadequate lessons. The results of the textbook analysis demonstrate that teachers using these five coursebooks and designers of future coursebooks must improve their lessons on requests by using pragmatics research and authentic examples as a guide.

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