Prosjektet er fremdeles i en fase hvor data innsamles
Aim
A good alliance established during the early sessions of psychotherapy will most likely lead to a good outcome. As a result, there is much to learn from a case in which both the patient and therapist regarded the alliance as being poor for an extended period (the first 15 sessions), yet still managed to develop a solid and stable alliance and reached a successful completion of therapy. The aim is to give a close inspection of this reparation process.
Methods and analysis
Ratings on the Working Alliance Inventory (WAI) were used to guide the strategic selection of a case in which a depressed woman in her thirties sought help from a highly experienced senior male psychotherapist. A detailed analysis of the therapeutic dialogue brought forth what the parties expected from each other and how they responded to explicit and implicit expressions about how to proceed. Post-termination interviews revealed their subjective configurations of events in therapy and their corresponding reflections.
Findings and discussion
Important steps and hallmarks of the alliance formation and reparation were identified:
(i) Early in the process, incompatible expectations about what the relationship could achieve led to repetitious struggles.
(ii) Their conflicting notions came forward in a more open dialogue about two specific issues (her medication and sick leave).
(iii) They developed playful ways to explore her decision making in everyday life.
(iv)Temporary breaks seemed to consolidate her autonomy.
(v) Late in the course of therapy, the therapist introduced a literary metaphor that seemed to further consolidate the alliance.