Answering the call : qualitative analysis of an exceptional therapist

Botelho, Lourenço Saud Moniz

http://hdl.handle.net/10400.12/8529

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Botelho, Lourenço Saud Moniz

Abstract(s)

Objective: Psychotherapy, when delivered in the form of virtually any bona fide psychotherapeutic treatment, is effective (Lambert, 2013). However, there are still significant challenges to psychotherapeutic effectiveness and no measurable improvement in the effectiveness of psychotherapy has occurred in the last 30 years (Wampold & Imel, 2015). Superior outcome studies adopt the premiss that, in order to understand the processes that lead to better psychotherapeutic results, it is necessary to study therapists with superior outcomes (Hansen, Lambert & Vlass, 2015a). However, there is little investigation regarding the process that leads to the existence of therapists with superior outcomes and what characterizes their therapeutic approach (Tracey et al., 2014; Chow et al., 2015). Therefore, the aim of this investigation is to detail the clinical way of being and in-session approach of a therapist with superior outcomes. Method: An exceptional therapist with superior outcomes as presented in the Outcome Questionnaire 45 (Lambert, Burlingame, et al., 1996; Umphress, Lambert, Smart, Barlow, & Clouse, 1997) was selected, and three of her patient’s full treatments, consisting of two sessions of two patients and one session of another patient, were transcribed and subsequently qualitatively analysed using the grounded theory approach (Glaser & Strauss, 1965). Results: Two core categories composed of three sub-categories for the former and 4 sub-categories for the later were found. The categories were developed in light of the therapeutic actions that best supported each other and the therapist’s overall approach. The therapist was found to carry out therapeutic actions that allow for a consistent approach that is both unique to herself and adaptable to each patient. Conclusions: This exceptional therapist’s approach is composed by a combination of her intuitive, empathetic, and genuine nature, theoretical orientation, and balanced use of techniques.