Analyzing a Gestalt Psychotherapy Session Using the Helbig Method of Dialogue Analysis (HELDA)

Abstract

How can we visualize the evolving psychotherapeutic alliance in dialogue? The psychotherapeutic dialogue is an important source of data for psychotherapy outcome and process research. Micro-analyses of dialogical turns within the therapeutic session support the understanding of the therapeutic method. This paper introduces the Helbig Method of Dialogue Analysis. This method is founded upon 4 pillars: 1) that dialogue is implicit action between persons that is supported by explicit verbally uttered content, 2) that the individual’s mode of inter-action within the dialogical dyad reflects the person’s relationship theme or pattern which plays out in the here-and-now, 3) that dialogue is an intersubjective process that leads to the development of new intersubjective configurations, and 4) that the observer-researcher’s phenomenological involvement plays a part in the analytical process. In this study, a 28-minute video-recorded gestalt therapy session is selected. The transcription of the session is coded using the instrument, the Core Conflictual Relationship Theme Leipzig/Ulm. Results obtained from this study are quantified graphical representations of the developing relationship between therapist and client. Simple to operate, scalable and practical, this method is designed for use by therapists and researchers who are interested in tracking, comparing and/or contrasting the developing psychotherapeutic alliance in a single or in multiple psychotherapy sessions.

Keywords: psychotherapy research, dialogue analysis, psychotherapeutic alliance, Core Conflictual Relationship Theme, gestalt therapy.

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The Psychotherapeutic Alliance and Change: A discussion on the healing aspects in a psychotherapeutic relationship

Abstract

This thesis addresses the complicated nature of the psychotherapeutic alliance, by attempting to deconstruct what is already in practice. In piecing out the different aspects of the relationship between psychotherapist and client, and referring back to relevant literature, one can understand better the dynamics that exist within the therapeutic encounter. In the process, one can also see how the different principles of different psychotherapy schools fit into what we understand today as the profession of psychotherapy. Considered a profession, psychotherapy is bound to ethics, within which is the question of competence and accountability. The importance of understanding what really happens in a client-therapist meeting that is unique to psychotherapy, and that which leads to therapeutic change, is emphasized in this paper, with case studies from classical texts and referred back to modern day change-process research.

Keywords: psychotherapeutic alliance, psychotherapeutic relationship, psychotherapeutic change, psychotherapeutic process, psychotherapeutic dialogue, I-Thou.

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Research: Orlinsky Generic Model of Psychotherapy

What is psychotherapy as a profession deconstructed? This paper by Orlinsky (2009)  provides some definable guides, providing graphical structure of psychotherapy. The profession of psychotherapy is more complex than meets the eye, because most of what is important in the work is difficult to measure by empirical methods. This is a meta-theory for the use of psychotherapy research.

The “Generic Model of Psychotherapy” was initially presented 25 years ago and was conceived as a trans-theoretical frame for integrating the varied empirical findings of hundreds of studies relating therapeutic process to outcome that had appeared during the previous 3 decades into a coherent body of knowledge

 

This conceptual model offers a comprehensive framework in which various clinical theories of psychotherapy can be systematically combined and compared. 

It was considered almost impossible to compare these different branches of therapies because of their different focus and “operating language”. This is of course not a very good description of what psychotherapy is about.

Aspects of the Psychotherapeutic Process

If we were to detangle the layers of the psychotherapy profession, we can imagine these parts that make up the whole

1. The Therapeutic Contract: 

This is the getting together of the client and therapist; it is an agreement on the set, setting and conditions of the therapy.

2. Therapeutic Operations : Technical Aspects

After the formalities are set, the client comes into the therapy session and begins his/her dialogue with the therapist. The patient presents his/her situation, the therapist provides interventions. From the figure below one can see the co-createdness of this step.

3. The Therapeutic Bond

When people meet, the interpersonal relationship that builds in-between is unique. How this bond is formed is multi-factorial.  These factors have been used a variables in psychotherapy research, e.g. age, gender, socio-cultural-economic status, and personality. The therapeutic bond is dynamic and changes over time.

4. Self Relatedness
This is the intra-personal aspects of both therapists and client: how open each are to the conditions and situations that arises within and outside of the therapy sessions.

5. In-Session Impacts
These are happenings that occur during the therapy session that impacts the client-therapist relationship.

6. Temporal Patterns
As the name suggests, this is about taking into account how change evolves with time. Small changes and ah-ha moments, together with outside influences through time creates changes to the therapeutic relationship.

Considering the Context of Therapy

The client and therapists are also affected by what goes on in life outside the therapy hours. This brings into consideration the larger context related to the therapist and client as individuals.

The big picture is a schema of how fluid and ever-changing the influences of the psychotherapeutic alliance is. This makes psychotherapy research very challenging and also interesting.

Read also my essay on the psychotherapeutic alliance and change.

Bibliography

Orlinsky, D. E. (2009). The “Generic Model of Psychotherapy” after 25 years: Evolution of a research-based metatheory. Journal of Psychotherapy Integration19(4), 319.