Experiential Psychotherapy Research Articles

“As a Grandmother, I Trust Her 100%!” A Qualitative Study of Therapists’ Experiences with Unexpected Changes in the Mother–Grandmother Relationship Among Perinatal Women with Adverse Childhood Experiences

ABSTRACT Despite its importance for therapeutic work, therapists’ experiences in perinatal psychotherapy remain largely underinvestigated. This qualitative study examined therapists’ experiences in addressing intergenerational adversities in perinatal women with adverse childhood experiences. It specifically emphasized the negotiation of the “motherhood constellation” and the relational changes in the mother – grandmother relationship nearing and after birth. Data from individual interviews and a follow-up focus group with seven therapists were analyzed via reflexive thematic analysis. Two main themes with associated subthemes were derived from the data: (1) therapists’ experiences with unexpected changes toward closeness in the mother – grandmother relationship during pregnancy and postpartum and (2) therapists’ attempts to understand why some women change from perceiving their mother as an adverse caregiver to their closest support in their transition to motherhood. The therapist’s empathic and reflective capacity was challenged by abrupt changes in mother – grandmother relationships. Their attempts to make sense of the changes ranged from expected developmental processes to more pathological processes. The findings from the present study highlight therapeutic challenges in working with mother – grandmother relationships in the perinatal period and the importance of therapists having multiple perspectives in their understanding of intergenerational relational changes.

Supplemental Material for Prevalence and Navigation of Discrimination and Microaggression Experiences in Psychotherapy and Supervision Processes Among Therapists in Training

Supplemental Material for Prevalence and Navigation of Discrimination and Microaggression Experiences in Psychotherapy and Supervision Processes Among Therapists in Training

Reflections from LGBTQIA+ individuals of their past experiences of psychotherapy and counselling and the use of creative therapy—A qualitative study

AbstractBackgroundPrevious literature tends to suggest that the LGBTQIA+ community face higher rates of mental disorders and illnesses. This appears to be due to minority stress as a result of the discrimination and hostility towards the community from society. In relation to psychotherapy and/or counselling, affirmative therapy has been found to be helpful; however, it is clear from the literature that the LGBTQIA+ population do not feel accepted or understood when accessing mental health support.MethodParticipants were invited to take part in an interview consisting of open‐ended questions relating to the topic of interest. Following this, a thematic analysis was completed.FindingsThe thematic analysis revealed four main themes: these were ‘sexuality and gender within the therapeutic relationship’, ‘desirable characteristics and attributes in a therapist’, ‘undesirable characteristics and attributes in a therapist’ and ‘creative therapy’.Implications for PracticeThe results could be used to inform mental health practitioners of the importance of cultural competency in relation to the LGBTQIA+ community, as well as helping aid how to approach sexuality and/or gender in a therapeutic space. The conclusions also highlight the need for practitioners to explore context with LGBTQIA+ clients rather than solely emotion focus.ConclusionThis study indicated that the LGBTQIA+ community prefer working with LGBTQIA+ therapists due to a shared lived experience and perceived baseline understanding of each other. It was also found that context was important for them in therapy, rather than emotion focus, and creative therapy was also shown to be useful for the community.

Treatment "non-responders": the experience of short-term psychoanalytic psychotherapy among depressed adolescents, their parents and therapists.

Short-term psychoanalytic psychotherapy (STPP) is an evidence-based treatment for adolescents with depression, but like all treatment approaches, not all patients benefit from it. Previous investigations of the process of STPP have mostly focused on successful cases, and only a few studies have included the perspectives of young people, their parents, and therapists in the understanding of treatment non-response. Semi-structured interviews were carried out with young people who were considered "non-responders" to STPP, as well as with their parents and therapists. These cases were analyzed using a descriptive-interpretative approach. The data analysis revealed three themes: (1) Therapy as a safe space; (2) Can short-term psychotherapy ever be enough?; and (3) Therapists making links and connections that did not make sense to the young people. This study's findings indicate that "poor outcome" psychotherapy does not necessarily equate to a "poor experience" of psychotherapy, with different stakeholders appreciating the treatment setting as a "safe space." However, they also suggest that some felt that a relatively short-term treatment could not lead to substantial change and that young people in STPP might have a more negative view of their outcomes compared to their parents and therapists. Finally, the findings indicate that some interventions made by clinicians in STPP feel wrong or do not make sense to young people, potentially affecting the therapy process.

Swedish elite athletes’ experiences of psychotherapy for mental health concerns provided by licensed psychologists and psychotherapists: a qualitative study

This study explores elite athletes’ experiences of psychotherapy administered by Swedish licensed psychologists or psychotherapists with and without specialisation in elite sports, addressing the research question: What do elite athletes...

No pain, no gain revisited: the impact of positive and negative psychotherapy experiences on treatment outcome.

Psychotherapy may have many benefits for patients with mental health problems, but patients may also have negative experiences related to the therapy. Not much is known about these negative psychotherapy experiences and their impact on treatment outcome. The aim of this study was to examine the association between positive and negative psychotherapy experiences and treatment outcome. A total of 130 patients participated in the study. They received treatment as usual and were assessed for positive and negative psychotherapy experiences at mid-treatment and post-treatment using the Positive and Negative Experiences of Psychotherapy Questionnaire (PNEP). Treatment outcome was measured by the Outcome Questionnaire - 45 (OQ-45). Multiple linear regression was used to analyze the data. All patients reported positive psychotherapy experiences at mid-treatment. At least one negative experience was reported by 69% of participants. After correction for baseline severity (i.e., OQ-45 at baseline) and relevant demographic variables, positive psychotherapy experiences at mid-treatment emerged as a predictor for treatment outcome. In contrast, negative psychotherapy experiences did not predict treatment outcome. However, reporting more negative experiences was associated with reporting fewer positive experiences at mid- and end of treatment. Both positive and negative psychotherapy experiences commonly occur. Although in this study negative psychotherapy experiences did not predict treatment outcome in terms of symptom reduction, the findings do suggest that negative experiences may influence the way in which patients evaluate their treatment. Although positive experiences outweigh negative experiences, patients should be informed that negative experiences may also occur.

Living the Language of Psychotherapy: How Therapists Use Their Experiences from Being Patients

Personal therapy is a requirement in several psychotherapy-training programs, and more than 80% of therapists have been psychotherapy patients. No quantitative evidence of the effects on their patients’ outcomes has been presented. However, qualitative studies and expert experiences highlight the value of therapists having been patients themselves. To investigate this further, we used in-depth qualitative methods to explore the experiences of eight early career psychologists. For our data collection, the participants wrote reflexive notes on two occasions, and met for a full day of focus groups. The notes and transcriptions of the focus groups were analyzed from the perspective of reflexive hermeneutic phenomenology. In all, the therapists had been patients in 19 courses of various psychotherapies. The core experiential themes were: (1) their own suffering had been for real; (2) ambivalence of sharing vulnerability; (3) the significance of experiencing theoretical concepts – the language of psychotherapy – in real life; (4) dealing with shame; (5) the need to know that therapists may become so important that the patient can easily be hurt; and (6) the therapist became an inner model that the patient could use. The therapists seemed to use their psychotherapy experiences in their personal development and professional lives. Therapists may have a unique opportunity to benefit from psychotherapy due to the language they have acquired for sharing experiences with their therapists.

“It Felt Like I Was Being Tailored to the Treatment Rather Than the Treatment Being Tailored to Me”: Patient Experiences of Helpful and Unhelpful Psychotherapy

ABSTRACT Objective This qualitative study explores patients’ experiences of psychotherapy, focusing on elements perceived as helpful or unhelpful and suggestions for improvement in the context of public mental health care. Methods A total of 148 adults (Mean age = 32.24, SD = 9.92) who had been or are currently receiving psychological treatment from the National Health Service (NHS) responded to an online survey. The survey included open-ended questions regarding their experiences of psychotherapy, asking them to identify helpful or unhelpful aspects, and suggestions for improvement. Using thematic analysis, key themes were identified. Results The analysis highlighted the patient’s preference for personalized treatment, the importance of therapeutic alliance, the demand for depth in therapy, and life skills and agency as therapeutic outcomes. Participants suggested improvements such as more tailored approaches and stronger therapist-patient relationships, supporting an adaptable, patient-centered model. Conclusion The study highlights challenges in public mental health services where patients might feel their specific needs are not being recognized and met and underscores the importance of personalized treatment plans that satisfy and evolve with patient needs, suggesting that therapists must be attentive and responsive to individual desires to enhance the patient experience.

Children and young people’s experience of psychoanalytic psychotherapy: a qualitative meta-synthesis

ABSTRACT The development of evidence-based practice guidelines for psychotherapy is based primarily on the findings from randomised controlled trials, but there is also a need to understand and learn from the experience of those who attend therapy. Some studies have begun to examine the experience of children and adolescents who have been in psychoanalytic psychotherapy. However, no investigations to date have synthesised this body of work and drawn clinical implications from this research. Therefore, this study aimed to provide the first qualitative meta-synthesis of empirical studies examining children and young people’s experiences of psychoanalytic psychotherapy. Articles meeting the inclusion criteria (n = 11) addressed treatments taking place in the UK, Scandinavia and Western Europe, and most of them focused on those who were in therapy as adolescents. The overall methodological quality of the studies was high. Based on the qualitative meta-synthesis, four over-arching themes were identified: (1) Children and adolescents learn to navigate their role during therapy; (2) The importance of the therapeutic relationship; (3) Psychoanalytic psychotherapy as a ‘painful’ process; and (4) Perceived impact of psychotherapy varies and is difficult to gauge. Some of the findings were consistent with the literature on adults’ experiences of psychoanalytic therapy, as well as young people’s experiences of other types of therapy. However, the findings also point to certain unique features of psychoanalytic psychotherapy for children and adolescents. The clinical implications of the findings are discussed.

A Scale for Measuring Positive and Negative Experiences of Psychotherapy (PNEP): First Psychometric Findings of a New Instrument for Monitoring Clients' Experiences.

Clients' adverse experiences during psychotherapy are rarely monitored in clinical practice or research trials. One obstacle here is the lack of a measure to gauge both positive and negative experiences during psychotherapy. We developed and evaluated a new instrument for measuring such experiences. The Positive and Negative Experiences of Psychotherapy (PNEP) questionnaire was developed based on pilot data, a literature review, and two existing scales for measuring primarily adverse experiences during psychotherapy. Mental healthcare clients (N = 200) anonymously completed and evaluated the PNEP. Subsequently, a sample of professionals (N = 34) who underwent psychotherapy in the context of their training filled in the PNEP twice, with a 2-week interval in between. The positive and negative experiences subscales of the PNEP were found to possess excellent internal consistencies (αs ≥ 0.90). The PNEP test-retest reliability was 0.93 for the positive experiences subscale and 0.78 for the negative experiences subscale. For the positive subscale, four factors were extracted: symptom reduction and positive well-being, high quality of therapy and therapeutic relation, personal growth and acceptance and interpersonal functioning. For the negative subscale, exploratory factor analysis suggested a three-factor solution: escalation of symptoms and emotional distress, low quality of therapy and therapeutic relation and (self-)stigmatization and dependency. Participants related a median of 13 positive and six negative therapy experiences to their most recent treatment. The most frequently endorsed negative experiences were having more negative thoughts and memories, feeling emotionally overwhelmed and an increase in stress due to the therapy. A minority of participants (10.5%) reported no negative treatment experiences. In the field of psychotherapy, the evaluation of risks and benefits is crucial for assessing safety and effectiveness. The PNEP could be a promising instrument for achieving this objective, although further research is needed to replicate and expand upon the current findings.

The Bodily Roots of Experience in Psychotherapy

The Bodily Roots of Experience in Psychotherapy

Online therapy with families - what can families tell us about how to do this well? A qualitative study assessing families' experience of remote Dyadic Developmental Psychotherapy compared to face-to-face therapy.

Dyadic Developmental Psychotherapy (DDP) is a family-based therapy for adopted children aiming to achieve secure attachment between the child and parent. Due to restrictions under the COVID-19 pandemic, delivery of DDP transitioned from face-to-face to online methods. This study aimed to explore families experience of online DDP compared to face-to-face DDP, looking at the advantages and disadvantages of remote delivery methods and the implications this has on future service delivery for clinicians. Semi-structured interviews with 6 families were conducted online. Analysis of transcripts using Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes: environment and child engagement, non-verbal communication, travel and familiarity with remote interactions. Parents recognised the influence the physical and online environment had on their child's engagement levels, however, varied in their experience and hence preference of delivery method. All families emphasised the importance of non-verbal communication within DDP sessions and majority highlighted this may be lost online. For families who travelled to face-to-face DDP, car journeys provided a unique opportunity to decompress and reflect after sessions. For families where travel is unfeasible, online DDP was a lifeline, demonstrating the ability of remote therapy to widen access to specialist healthcare. Familiarity with online work emerged as a strong indicator of positive attitudes towards remote DDP, especially if the previous experience is positive and the child is confident using technology. Overall, families differed greatly in their experience of remote and face-to-face DDP indicating a new approach must be undertaken with each family beginning therapy, ensuring it is unique and individual to their needs.

Exploring the Counselors and Psychotherapists Perceptions of Therapeutic Errors in the Treatment Room

A therapeutic error as a multifactorial phenomenon in psychotherapy and counseling is an action and behavior that is committed by the therapist and leads to treatment failure or client dissatisfaction with the treatment process. Thus, the treatment method deviates from the intended practical and scientific techniques. To this end, the present study aimed to identify the counselor’s perceptions of therapeutic errors in the treatment room. This qualitative study was conducted using conventional content analysis. The data were collected through in-depth and semi-structured interviews with counselors and psychotropics with at least 3 years of experience in psychotherapy and counseling in various fields. They were selected through purposive sampling in 2021 in Tehran. The data were saturated by interviewing 24 counselors and psychotherapists and analyzed by the content analysis approach. The findings showed that therapeutic errors occur for different reasons and in various forms and involve different aspects of the therapist-client interaction. The most important therapeutic errors were intrapersonal and organizational errors including; treatment errors, lack of practicality of the treatment, the therapist’s errors, mistakes committed due to the treatment space, non-compliance with ethical principles and standards, and not informing the clients. The occurrence of these errors and mistakes in the treatment session leads to the abandonment of the session by clients, negative experiences invoked by treatment sessions, and most importantly damage to clients and a range of negative consequences. The findings of this study can have some implications for understanding various forms of treatment errors, preventing errors in treatment sessions, and avoiding harm to clients in treatment sessions.

Perceptions and Experiences of Psychotherapy Among Forced Migrants With Limited English Proficiency

This qualitative study focused on the perspectives of forced migrants’ and their pursuit of mental health services, specifically as they relate to language use in therapy. Semistructured interviews were held during two face-to-face focus groups consisting of 16 adult participants identifying as forced migrants. Analysis of translated and transcribed interviews was conducted by a research team utilizing a constructivist approach to grounded theory. A substantive theoretical model on engagement in therapy emerged, with the core category of culture, which influences forced migrants’ level of trust and mistrust in psychotherapy. Multiple factors, including perceptions of therapy and English language facility, impacted forced migrants’ willingness to engage in psychotherapy. Findings supported language as a barrier to psychotherapy, even when an interpreter was utilized. Consistencies and inconsistencies of findings between the present study and existing literature were offered. Clinical, training, advocacy, and research implications of this study were explored.

Transforming Experiences in Literature and Psychotherapy

The article presents an analysis of Leo Tolstoy’s novella The Death of Ivan Ilyich, with a view to transforming experiences in literature and psychotherapy. It focuses on three central points: the question of personal authenticity, the autobiographic narration of self as source of our identity, and the importance of physical contact as a bridge between individuals. A short clinical note highlights some critical issues that could be important for the reader, personally as well as professionally.

Addressing harm from adverse religious/spiritual experiences in psychotherapy: A scoping review.

Addressing harm from adverse religious/spiritual experiences in psychotherapy: A scoping review.

New skills for distance regulation: Therapists’ experiences of remote psychotherapy following the COVID-19 pandemic.

New skills for distance regulation: Therapists’ experiences of remote psychotherapy following the COVID-19 pandemic.

Mental health treatment experiences among sexual and gender minority individuals: Trauma exposure, barriers, microaggressions, and treatment satisfaction

Introduction While trauma experiences and treatment-seeking are common among sexual and gender minority (SGM) individuals, little is known about their specific experiences in psychotherapy, including treatment types, characteristics (e.g., length, episodes), barriers, satisfaction, and microaggressions. Method SGM individuals (N = 2,685) from a national cohort study completed a survey. Results The majority (87%) of participants endorsed past therapy, including for trauma (56%). Ratings of therapy barriers and microaggressions were low and satisfaction with therapy was high. However, therapy experiences differed based on sexual orientation, gender, and if the therapy was focused on trauma. Conclusion Effective treatments for trauma should be informed by the needs of the diverse groups that comprise the SGM community.

Nursing in psychedelic-assisted psychotherapy: new opportunities and future prospects

This article looks at the emerging field of psychedelic-assisted psychotherapy and the nurse's role within that – something which is currently unexplored and wholly undefined. It draws from lived experience in psychedelic-assisted psychotherapy and is co-authored by a significant contributor in this field. The aim of the article is to give nurses a brief introduction to the field of psychedelic-assisted psychotherapy (history and present) and provide insights on professional development opportunities in the wake of such treatments being widely recognised, accepted and in need of nursing input in the future.

Developing expertise in psychotherapy: The case for process coding as clinical training.

Routine outcome monitoring (ROM) is a major development in the field since it offers likely outcome trajectories and is particularly helpful for failing cases. However, ROM has not led to improved skill development more generally, and it is debatable as to whether expertise is even possible to acquire in psychotherapy. What is missing but crucial to expertise is feedback on the outcome of one's actions in real time, which would enable responsive adjustments and improve outcomes. It is argued in this article that by identifying empirically validated moment-to-moment markers capable of differentiating later clinical outcomes, process researchers have uncovered the possibility of extracting prognostic information in real time, but one must develop the requisite observational skills. Multiple lines of research are reviewed to support the contention that real-time outcome information is available to guide responsivity and improve outcomes. And the typically hidden nature of these important signals further underscores the need for systematic training in process acuity. Given the pressing need to improve training methods, process coding training should not be restricted to research laboratories but should be exported to the clinical setting and tailored to the needs of clinicians for use in real time during therapy sessions. These are testable hypotheses that, if successful, hold the possibility of improving training and reversing the worrying trend of experience in psychotherapy being unrelated to outcome. (PsycInfo Database Record (c) 2024 APA, all rights reserved).