Experienced psychotherapists’ reports of their assessments, predictions, and decision making in the early phase of psychotherapy.

Abstract

Thirteen highly experienced psychotherapists' retrospective accounts of their initial assessments, predictions, and decision making in recently completed psychotherapies were analyzed by the qualitative method of Grounded Theory. Three main categories were identified, reflecting conceptual, attitudinal, and procedural aspects of initial clinical judgments. These were category 1-"contextualized, individualized conceptualizations"; category 2-"attitude of openness to the unique other," and category 3-"feeling one's way." These results are discussed with respect to the theory and research on decision-making processes involving scripts and implicit reasoning, psychotherapist expertise and experience, and the working alliance.