This article features a study by Binder et. al 2009, Why did I change when I went to therapy? A qualitative analysis of former patients’ conceptions of successful psychotherapy.
The findings of this study provides us with some answers to what patients or clients of psychotherapy regard as change in psychotherapy, and how they perceive their experience in therapy which is considered successful for them.
The client’s point of view is very important. Mental states cannot be fully measured, as opposed to physical states. There is no machine, or test kit to measure the mental state of health. A person’s mental wellness is witnessed through his/her ability to function in daily life, and also his/her own perception of how things are.
What is successful psychotherapy or counseling? If a client claims to feel better, we’d ask what they meant. It could mean they feel more relaxed, less stress, less anxiety. They could say that they are able to sleep better, have less physical pain. Or they could feel more energetic– whichever is important to the client at the time.
Methodology of this Study
The qualitative research was conducted using semi-structured, qualitative, in-depth interviews with 10 former psychotherapy patients, recruited through an advertisement in a local newspaper. A descriptive and hermeneutically modified phenomenological approach– i.e. using expert interviewing and not just questionnaires in order to grasp full meaning of what is transpired in conversation –was used to analyze interview transcripts.
What was most important explicitly for the clients in the therapy?
1 Having a relationship to a wise, warm and competent professional.
- the client’s feeling of safety within the therapeutic relationship was mention.
- the therapist having the right doses of contact with the client, and
- the therapist having flexibility in approach to working with the client.
2 Having a relationship with continuity, safety and hope when feeling inner discontinuity.
- the continuity, consistency of the therapy.
- therapist being with them through difficult emotional experiences.
3 Having beliefs about oneself and one’s relational world corrected.
- the patient is able through therapy to reconnect with his/her meaning making, having a look at misconceptions or introjects of which the client was not aware of.
- therapists guides the client through his change of the worldview.
4 Creating new meaning and see new connections in life patterns.
- the idea of having been helped by having one’s beliefs and belief systems corrected,
- help in making new choices, or change in habitual patterns
- helps the client see how the his/her present experiences and behavior in reaction to the experiences are rooted in the past experiences, i.e getting clarity and insight.
Psychotherapy is quite unlike medicine. The clients’ or patients’ needs for treatment are very diverse and individual. Even though there is such a thing as diagnostics in psychiatry, we have to understand that these diagnostics are constructs for professionals to communicate the symptom of the client with each other. With psychological issues, the same symptom displayed
may does not mean same source or cause of problem. It also does not mean that the clients with same symptoms will benefit from similar treatment.
Put simply, it is because the mental state of the individual is the product of the individual’s relationships, culture, physical health, age, economic situation… etc. The psychotherapist sees the client as a whole person, whose experiences and meaning making are important in therapy.
The result of the findings reflect this.
Binder, P. E., Holgersen, H., & Nielsen, G. H. (2009). Why did I change when I went to therapy? A qualitative analysis of former patients’ conceptions of successful psychotherapy. Counselling and Psychotherapy Research, 9(4), 250-256.