Department of Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, Brandenburg Medical School, Rüdersdorf, Germany.
Independent Researcher, Germany.
Int J Qual Stud Health Well-being. 2024 Dec;19(1):2333064. doi: 10.1080/17482631.2024.2333064. Epub 2024 Mar 29.
Over the last decades, psychotherapy of psychosis has increasingly gained attention. The quality of the therapeutic alliance has been shown to have an impact on therapy outcome. Yet, little is know about the influence of the therapeutic stance on the alliance. In this study, we explore psychotherapists' stance towards persons with psychosis with the aim of better understanding its characteristic-hindering and helpful-aspects.
6 semi-structured interviews with psychotherapists from three different schools (CBT, PD, ST) were analysed with Grounded Theory. Credibility was checked through external and peer-researcher-supported debriefing.
4 core categories were generated and interrelated in a theoretical model. Therapists' stance was initially characterized by insecurity. Diffent ways of dealing with insecurity yielded different stances: a monological and an open one. A helpful stance was conceived as stemming from openness and was characterized by a dialogical structure. A co-presence (or "dosing") of you and I was conceived as its core aspect.
These findings specify the interpersonal dynamics arising from different stances and their impact on the therapeutic alliance and process. Research is still needed to further understand the characteristics of helpful and hindering therapeutic stances, which should also inform the training of psychotherapists.
在过去的几十年中，精神病学的心理治疗越来越受到关注。治疗联盟的质量已被证明对治疗结果有影响。然而，对于治疗立场对联盟的影响知之甚少。在这项研究中，我们探讨了心理治疗师对精神病患者的立场，旨在更好地了解其特征阻碍和有益方面。
对来自三个不同学派（CBT、PD、ST）的 6 名心理治疗师进行了半结构化访谈，并采用扎根理论进行了分析。通过外部和同行研究人员支持的汇报来检查可信度。
生成了 4 个核心类别，并在一个理论模型中相互关联。治疗师的立场最初以不安全感为特征。处理不安全感的不同方式产生了不同的立场：独白式和开放式。一个有帮助的立场被认为源自开放性，并以对话结构为特征。“你和我”的共存（或“剂量”）被认为是其核心方面。
这些发现具体说明了不同立场产生的人际动态及其对治疗联盟和过程的影响。仍需要进一步研究有助于治疗的立场的特征，这也应该为心理治疗师的培训提供信息。
