Personal therapeutic approach in Gestalt therapists working with clients suffering from medically unexplained psychosomatic symptoms

Abstract

Treatment specificity and adherence to treatment manuals represent essential components of the medical model in psychotherapy. The model assumes that psychotherapists who work with the same type of clients and who identify with the same theoretical approach work very similarly. This study illustrates the shortcomings of that assumption and explores how therapists’ individuality forms and shapes their unique approaches that resonate with their own personalities, inclinations, and worldviews. Semi-structured interviews with eight Gestalt therapists working with clients who experienced medically unexplained physical symptoms were analysed using the grounded theory method. Considerable differences were found among the therapists within four domains of the personal therapeutic approach, namely Case Conceptualization, Therapeutic Task, Therapist’s Position, and Alternative Strategy. However, regardless of the differences, all the therapists endeavoured, either implicitly or explicitly, to convey to the clients what they considered to be healthy functioning. There is considerable diversity in the way therapists work even when they subscribe to the same psychotherapeutic approach and work with the same type of clients. The exploration of psychotherapists’ usual strategies, as well as the alternative strategies they use when their usual strategies do not work, appears helpful for capturing their personal therapeutic approaches.

What works in the treatment of medically unexplained physical symptoms? The psychotherapist perspective

“…We argue that even if some theoretically sound approaches do not offer high-quality research yet, they may help clients with MUPS when they utilize effective trans-theoretical mechanisms of change that can be identified across a wide range of approaches (Řiháček & Čevelíček, 2019). In fact, there are significant differences in the therapeutic style of therapists espousing the same approach (Roubal, Hytych, Cevelicek, & Rihacek, 2021). Therefore, studying effective mechanisms of change across different approaches may provide better evidence of effectiveness.…”