Llewelyn S P
Department of Psychology, Branksome Clinic, Poole, Dorset, UK.
Br J Clin Psychol. 1988 Sep;27(3):223-37. doi: 10.1111/j.2044-8260.1988.tb00779.x.
Results are presented from a study in which 40 therapist-client pairs were asked to record, after each session of psychological therapy, their views concerning the helpful and unhelpful events which took place. On termination they were asked to describe their views of the helpful and unhelpful events in retrospect, and to report on outcome. A total of 1076 events was collected from 399 therapy sessions, and was content analysed using Elliott's Therapeutic Impact Content Analysis System. Results showed that during therapy the types of event most frequently reported by clients were reassurance/relief and problem solution events, whereas therapists reported the clients' gaining of cognitive and affective insight. After termination, both participants reported the importance to the client of personal contact. Many of the differences between the two perspectives were highly significant, although more differences were found when outcome was poor. It is suggested that different aspects of the therapeutic process have a different degree of salience for therapists and clients, in that clients are most interested in gaining a solution to their problems and feeling better, whereas therapists are more concerned with the aetiology of the problem and its transformation through insight. The implications of these differences are discussed.
该研究要求40对治疗师与来访者在每次心理治疗结束后，记录他们对治疗过程中发生的有益和无益事件的看法。治疗结束时，要求他们回顾对有益和无益事件的看法，并汇报治疗结果。从399次治疗疗程中总共收集到1076个事件，并使用埃利奥特的治疗影响内容分析系统进行了内容分析。结果显示，在治疗过程中，来访者最常报告的事件类型是安心/宽慰和问题解决事件，而治疗师报告的是来访者获得认知和情感领悟。治疗结束后，双方都报告了人际接触对来访者的重要性。两种观点之间的许多差异非常显著，不过在治疗效果不佳时发现的差异更多。研究表明，治疗过程的不同方面对治疗师和来访者具有不同程度的显著性，即来访者最感兴趣的是找到问题的解决方案并感觉好转，而治疗师更关注问题的病因及其通过领悟实现的转变。文中讨论了这些差异的影响。
