"For Me It Was a Key Moment of Therapy": Corrective Experience From the Client's Perspective.

Despite recent attempts to develop a consensus definition, questions still remain as to what constitutes corrective experiences (CEs) in psychotherapy and how clients perceive them. This qualitative study assessed clients' first person accounts of CEs associated with their own treatment-related changes. Participants were 8 clients in private psychotherapy in Buenos Aires. Treatment, by therapists from diverse theoretical backgrounds, varied from 4 to 24 months. The Patients' Perceptions of Corrective Experiences in Individual Therapy interview protocol was used to assess clients' perceptions of CEs at posttreatment. All interviews were audiorecorded and transcribed and submitted to a 2-stage thematic analysis to assess CEs and the contextual factors that contributed to them. Of the 8 participants, 5 narrated stories about CEs that changed the way they thought about themselves and their behavior. Additionally, clients highlighted disconfirmation of therapist role expectations and surprise regarding therapists' actions and behaviors as mechanisms of these corrective moments.

Client-therapist agreement in the termination process and its association with therapeutic relationship.

There is no consensus among different therapeutic approaches on the process of termination when therapy does not have a prefixed duration. Moreover, both clinicians and researchers are still exploring decision making in the termination of treatment. The present study assessed former client's perspective of therapy termination in a nonprobabilistic sample from Buenos Aires, Argentina. Seventy-three semistructured interviews, lasting ∼60 min each, were conducted with participants that had finished a therapeutic treatment or dropped out. They were asked about several aspects of therapy, including their experience of termination, specifically who decided to terminate, if there was agreement on termination or not, and their thoughts on the termination process. All interviews were transcribed and analyzed using an adaptation of Consensual Qualitative Research (CQR). Quantitative analyses were also conducted to examine associations between variables. Two main factors emerged from the analysis: client/therapist initiative on termination; and level of agreement between client and therapist regarding termination. Whereas nearly all (95%) of therapist-initiated termination cases agreed on termination, client-initiated termination cases could be sorted in agreed (49%) and disagreed (51%) terminations. Both therapist-initiated terminations and agreed upon terminations presented more categories of positive termination motives, better therapeutic bond, and higher overall satisfaction with treatment. Implications for research and clinical practice are discussed. (PsycINFO Database Record

Cambio y Psicoterapia: La perspectiva del niño / Change and Psychotherapy: The Child's Perspective

Resumen La investigación a partir de la perspectiva del paciente ha brindado información importante acerca de cómo la terapia es percibida, ayudando a los terapeutas a entender algunas reacciones desde los pacientes. Debido a las pocas investigaciones de este tipo en la población infantil, la terapia con niños no ha sido beneficiada por este movimiento. El presente trabajo es de carácter empírico con un enfoque de análisis cualitativo. En este estudio se exploraron las percepciones de los niños sobre distintos elementos del proceso psicoterapéutico. Para esto, se realizaron entrevistas semiestructuradas a 10 niños entre 6 y 12 años que se encontraban realizando tratamiento psicoterapéutico, o lo habían realizado en el último año. Durante las entrevistas se indagó sobre la "relación terapéutica", las "intervenciones del terapeuta", la "valoración de la terapia", las "nociones sobre la terapia", las "características de la terapia" y el "cambio percibido". Se analizaron las entrevistas bajo una metodología cualitativa consensual (CQR). Los resultados indican que los niños percibieron cambios vinculados a su propia conducta, emociones y relaciones interpersonales y pudieron relacionarlos con sus terapeutas y la alianza establecida con ellos.

Abstract Research from the patients' perspective has provided valuable information about how the psychotherapy process is perceived, helping therapists to understand some of the patient's reactions. Due to the limited research of this type in the children population, therapy with children has not benefited from this movement. The present study is an empirical work framed in a qualitative analysis approach, in which we inquired about children's perceptions about different elements related to the psychotherapeutic process. For this purpose, we conducted semi-structured interviews with 10 children between 6 and 12 years old, who were undergoing a psychotherapeutic treatment or had done it in the last year. During the interviews, we inquired about elements such as "therapeutic relationship," "therapist interventions," "therapy assessments," "notions about therapy," "therapy characteristics," and "perceived change." The interviews were analyzed using a consensual qualitative methodology (CQR). The results indicate that children were able to perceive changes concerning their behavior, emotions, and interpersonal relationships and could link these changes with their therapists and the therapeutic alliance established with them.

A qualitative investigation of former clients' perception of change, reasons for consultation, therapeutic relationship, and termination.

The purpose of this research is to investigate former client's perception of change, reasons for consultation, therapeutic relationship, and termination. Semistructured interviews were conducted with 17 former clients who had been in a psychotherapeutic treatment. A qualitative approach, based on consensual qualitative research (CQR) was used to analyze the interviews. Results show how the balance of negative and positive aspects of the therapeutic relationship is associated with the perception of change. Likewise, categories related to reasons for consultation were associated with types of change and therapy termination. The relevance of the client's perspective is increasingly being recognized as valuable for the understanding of the psychotherapeutic processes and generates hypotheses for future research.

Differential client perspectives on therapy in Argentina and the United States: a cross-cultural study.

Although there is a growing body of research in both cross-cultural issues in psychotherapy and in the client's perspective, little is known about differences or similarities in the way clients from different cultures, particularly those from different nations, subjectively experience therapy. The present study addressed this gap through a qualitative analysis of interviews with former therapy clients in Argentina and the United States. The researchers used a consensual qualitative research (CQR; C. E. Hill, B. J. Thompson, & E. N. Williams, 1997, A guide to conducting consensual qualitative research, The Counseling Psychologist, Vol. 25, pp. 517-572; C. E. Hill, S. Knox, B. J. Thompson, E. N. Williams, S. A. Hess, & N. Ladany, 2005, Consensual qualitative research: An update, Journal of Counseling Psychology, Vol. 52, pp. 196-205) methodology and provide illustrative examples from the raw transcripts. Among other differences, Argentine and U.S. participants differed in their experience of the therapy setting, the interventions their therapists used, and in the types of change they reported to result from therapy. Also notable, Argentine participants spoke a great deal more about change than U.S. participants. Results are preliminary, but provide implications for the adaptation of treatments to different cultures and for the cross-cultural validity of researchers' and policymakers' current definitions of treatment efficacy.

Las intervenciones terapéuticas desde la perspectiva del paciente: una aproximación cualitativa / Therapeutic interventions from patient´s perspective: a qualitative approach

Introducción: diferentes autores han presentado la necesidad de complementar investigaciones cuantitativas con otras de carácter cualitativo, que permitan profundizar sobre la experiencia subjetiva de los pacientes en sus tratamientos, y su relación con el cambio en psicoterapia. Objetivos y métodos: con un diseño observacional, exploratorio-descriptivo, y un enfoque cualitativo de análisis, se realizaron 73 entrevistas semi-estructuradas a pacientes de psicoterapia. Se indagó la perspectiva de los pacientes respecto de las intervenciones llevadas a cabo por sus terapeutas. Resultados y discusión: se generaron tres áreas temáticas: 1) la percepción del formato de tratamiento ofrecido por el terapeuta al comienzo de la psicoterapia, 2) las intervenciones del terapeuta percibidas como directivas vs aquellas percibidas como receptivas y 3) la valoración del contenido y la forma en que se realizaron las intervenciones. Se discuten las implicancias de estos resultados para la práctica clínica, la investigación y el entrenamiento de terapeutas.

Introduction: Numerous psychotherapy researchers addressed the need to complement quantitative research with qualitative approaches, in order to reach a deeper understanding of patients´ subjective experience of their treatment and its relationship with change in psychotherapy. Objectives and methods: 73 semi-structured interviews to subjects who had participated in a psychotherapeutic treatment terminated within 36 months prior to the date of interview were conducted. The aim of this observational and exploratory study was to inquire patients´ perspective of the interventions carried out by their therapists. A qualitative approach, based on Hill et al. CQR (1997) was conducted to analyze the interviews. Results and discussion: Three thematic areas emerged as a result of the analysis: 1) the perception of the overview of the treatment done by the therapist at the beginning of psychotherapy, 2) indicative vs. receptive perceived interventions, and 3) participants´ assessment of the content vs. the way in which interventions were made. Implications of these findings for clinical practice, research and training of therapists are discussed.