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Title Seasoned Psychotherapists' Experience of Difficult Clinical Moments
Publication Date
Degree Psy. D.
Discipline/Department Antioch Seattle: Clinical Psychology
Degree Level doctoral
University/Publisher Antioch University
Abstract Purpose: This phenomenological study was concerned with the clarification of the experience of the difficult clinical moment which is defined as a discrete moment in which the psychotherapist experiences distress as a result of his or her work with a client.Method: Retrospective descriptions of experience of difficult clinical moments were obtained from a diverse sample of ten seasoned psychotherapists in the Seattle area. The interviews were transcribed, analyzed, and summarized, and these summaries were confirmed by each participant as being an accurate representation of their experience.Results: Thematic analysis revealed six themes of experience during a difficult clinical moment: 1) Feeling Fear, 2) Feeling Inadequate, 3) Feeling Anger, 4) Feeling Confused, 5) Feeling an Urge to Hide Feelings, and 6) Feeling an Urge to Terminate. An essential general structure of the experience of difficult moments was derived from these themes.Discussion: Conclusions are discussed including: 1) the novel findings of feeling fear and feeling an urge to hide one’s feelings during difficulty; and 2) the urge to hide one’s feelings during difficulty appears to be motivated by both therapist shame and an urge to maintain the therapeutic relationship. Implications are discussed including: 1) the dilemma regarding whether or not a therapist should entertain the urge to hide his or her feelings; and 2) the culture of shame within the field of psychotherapy that stigmatizes therapist difficulties which interferes with consultation. Recommendations for training and research are provided including a recommendation to disseminate these findings to normalize the experience and to encourage therapists and supervisors to discuss difficult clinical moments within consultation, supervision, and training which might reduce the distress of the moment, improve coping skills, provide treatment strategies, and ultimately improve client outcomes. The electronic version of this dissertation is at Ohiolink ETD Center www.ohiolink.edu
Subjects/Keywords Psychology; Psychotherapy; Therapy; Counseling Education; Counseling Psychology; Psychotherapy; psychotherapist; counseling; counselor; therapist; self-care; therapist difficulty; countertransference; treatment failure; counselor training; phenomenological; therapist experience; counselor experience; supervision; shame; qualitative
Contributors Russell, Mark (Committee Chair)
Language en
Rights unrestricted ; This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
Country of Publication us
Format application/pdf
Record ID oai:etd.ohiolink.edu:antioch1407265327
Repository ohiolink
Date Retrieved
Date Indexed 2018-02-20
Grantor Antioch University

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…These are but a few examples of difficult clinical moments psychotherapists will experience throughout their career, and without proper guidance, these difficult moments can be destructive to the therapist, the client, and the therapy. Psychotherapy can…

…the inner experience of a therapist (Bermak, 1977; Davis et al., 1987; Deutsch, 1984; Iliffe & Steed, 2000; Orlinsky & Rnnestad, 2005; Schrder & Davis, 2004; Smith et al., 2007; Thriault & Gazzola, 2010). In their large-scale study of…

…Psychological Association. As seen in Table 1, psychotherapists, on average, do not experience difficulties very often, but they experience them nonetheless. Recognizing hazards of psychotherapeutic practice–such as difficult moments–is crucial to therapist

…career. Even though difficult moments are often associated with therapist distress and negative outcomes, studies on therapists’ subjective experience of difficulties are extremely rare (Gelso & Hayes, 2007; Thériault & Gazzola, 2005). Orlinsky…

…Phenomenological studies involving in-depth interviews on the experience of psychotherapists can help efforts to increase therapist self-awareness by discovering the common elements of the felt experience of difficult moments and by disseminating those discoveries…

…studies (Rachlin & Lev, 2011; Waska, 2011), however writers and researchers usually focus on how patient pathology causes the difficulty rather than focusing on the experience of the therapist. The following review comprises the only published…

…in The United Kingdom, Davis, Elliott, Davis, Binns, Francis, Kelman, and Schrder, developed a taxonomy of nine situations that psychotherapists experience as difficult with the aim of making therapist difficulties accessible to investigation. As the…

…first researchers to examine the construct of therapist difficulties, they claimed this inquiry was overdue because: 1) empirical study of therapists’ experience of psychotherapy had been scant, 2) there had been little investigation of…