Aim
This study explores a strategically chosen case where both client and therapist regarded the alliance as poor for the approximately first 15 sessions. After this they managed to develop a solid and stable alliance. The client completed therapy with good outcome. The aim is to give a close inspection of the reparation process.
Data
The client is a depressed woman in her forties who sought help from a senior male psychotherapist. The therapy lasted for 43 sessions. The data is drawn from an intensive process-outcome study at the University of Oslo, Norway in which 18 highly experienced therapists and their patients participated.
Methods and analysis
Quantitative measures (WAI) were used to guide strategic selections of qualitative data and to describe the therapeutic process and outcome. Qualitative material (session- and interview recordings and transcriptions) was analysed by hermeneutic phenomenological analysis.
Findings and discussion
The analysis shows how important relational problems were handled on an interpersonal level. Some important steps and hallmarks of the healing process were identified. To study both patient and therapist makes room for different perspectives on the same process. Close inspection of the course of events in psychotherapies is seen as a promising method for bringing a better understanding of how change processes unfold.
Keywords
- Case study
- Qualitative research method
- Rupture and repair
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Working alliance