Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency

Lippe, Anna Louise von der; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

doi:10.1080/10503307.2017.1373205

Cited by 13 publications

(10 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on the co-creative interaction pattern, we learned that strategies, such as contextualizing violent events, exploring the client's subjectivity of the violent events, investigating the client's perspective of those affected by the abuse, and connecting the client's resources and general tasks in therapy, were strategies that engaged the clients in a dialog that constructed violence as a personal problem, and the client completed therapy with a good outcome. The connection between the therapist strategies that fostered proactive client agency and a good treatment outcome and the connection between the strategies that discouraged proactive agency and a poor outcome are supported by other studies (Räsänen et al, 2012b;2014;von der Lippe, Oddli, & Halvorsen, 2017).…”

Section: Expectations Of Therapy the Conceptual Model Of Gateways Ansupporting

confidence: 55%

From Resistance to Invitations: How Men Voluntarily in Therapy for Intimate Partner Violence May Contribute to the Development of a Working Alliance

Lømo

Haavind

Tjersland

2016

J Interpers Violence

View full text Add to dashboard Cite

The high drop-out rate and modest outcome for men in treatment for intimate partner violence (IPV) have highlighted the question of how therapists can establish an effective working alliance with these clients. The aim of this study was to conceptualize the variety of ways in which male clients using violence against a female partner might present themselves to form a working alliance that might appeal to them. We studied how 20 men voluntarily in individual IPV treatment contributed at the beginning of therapy to forming an alliance with therapists skilled in such treatment. The first therapy session in 10 drop-out and 10 completed cases was transcribed verbatim and analyzed qualitatively, following guidelines drawn from the constructionist grounded theory. The analysis resulted in a conceptual model of gateways and invitations to an alliance. Gateways are themes that have the potential to open a path toward collaboration on personal change. Each of the three gateways identified, comprised solide and weak invitations to an alliance: (a) presenting reasons for seeking treatment-as their own choice, as avoidance, or as a mistake; (b) presenting notions of change-as their own need to change their violent behavior, as ambivalence toward the project, or as a need to change the partner; and (c) disclosing and describing violence-as a personal narrative, as a scene, as a fragment of their life, or as something else. Implications for therapists' understanding of clients' motivational goals, negotiation of alliance, and disclosure of violence early in therapy are discussed.

show abstract

Section: Expectations Of Therapy the Conceptual Model Of Gateways Ansupporting

confidence: 55%

From Resistance to Invitations: How Men Voluntarily in Therapy for Intimate Partner Violence May Contribute to the Development of a Working Alliance

Lømo

Haavind

Tjersland

2016

J Interpers Violence

View full text Add to dashboard Cite

show abstract

“…Increase in agency was indeed found to be related to improvement in mental health; moreover, increases in agency occurred prior to improvement in mental health (Adler, 2012). Consequently, recommendations have been made for therapists to facilitate developing or increasing a sense of agency in patients over the course of therapy (e.g., Williams and Levitt, 2007;Todd, 2014;von der Lippe et al, 2019).…”

Section: Continuity With Prior Empirical Researchmentioning

confidence: 99%

Agency via Awareness: A Unifying Meta-Process in Psychotherapy

Gorlin

Békés

2021

Front. Psychol.

View full text Add to dashboard Cite

To address the need for conceptual and clinical consensus within the field, psychotherapy research has increasingly focused on identifying common principles of change. While the field contends that this approach is atheoretical, we argue that principles of change cannot be fully understood or applied without the context of some theoretical framework. This article develops such a framework by identifying and explicating two theoretical assumptions that are implicitly shared by multiple therapeutic approaches: (1) that increasing agency is a fundamental aim of psychotherapy, and (2) that therapists enhance clients' agency by increasing their awareness. Building on the largely disparate empirical literatures demonstrating the importance of client agency and awareness to successful therapeutic outcomes, we provide a theoretical account of the highly iterative and synergistic meta-process by which these two factors jointly produce change. Explicit identification and empirical investigation of this Agency via Awareness psychotherapy meta-process, we argue, could facilitate scientific and clinical progress within the field. The hypothesized meta-process is discussed in relation to existing integrative models of therapeutic change, and its manifestations in the theory and practice of major therapeutic orientations are reviewed and illustrated. We discuss how this framework can facilitate psychotherapy research by providing a common language and conceptual foundation for wide-ranging therapeutic approaches, constructs, and findings. Finally, by raising clinicians' awareness of the implicit assumptions underlying their therapeutic work, we suggest that the Agency via Awareness framework can increase their agency over when and how they apply these assumptions in therapy to maximize client improvement.

show abstract

“…These findings are supported by previous qualitative studies showing that patients’ accounts of agency are central when they are asked to describe therapy experiences (Hoener, Stiles, Luka, & Gordon, 2012), which was also mentioned in one of the aforementioned studies on complex PTSD (Stige et al, 2013). In line with this, it has also been shown that therapists promoting patient agency during early phases of therapy is connected to favorable outcomes (Von der Lippe, Oddli, & Halvorsen, 2019). Also, as these differences may relate to patients’ pretreatment motivation to change, it may be important to assess such characteristics before the start of treatment (e.g., Norcross, Krebs, & Prochaska, 2011).…”

Section: Discussionmentioning

confidence: 77%

Change processes related to long-term outcomes in eating disorders with childhood trauma: An explorative qualitative study.

Olofsson¹,

Oddli²,

Hoffart³

et al. 2020

Journal of Counseling Psychology

View full text Add to dashboard Cite

To date, eating disorder (ED) treatments are lacking for ED patients with psychiatric sequelae of childhood trauma, and successful outcomes are scarce. Therefore, the aim of this study was to explore therapeutic change processes from a patient perspective in relation to good versus poor long-term ED outcome at 1-year follow-up. Outcome categories were based on clinician assessment of ED behavior and diagnoses, body mass index, and Eating Disorder Examination Questionnaire scores. Eleven White, cisgendered female ED patients with childhood trauma were interviewed after a 3-month inpatient treatment: data was analyzed with elements from grounded theory and interpretative phenomenological analysis. The qualitative analysis rendered change-related descriptions (9 subcategories) and obstacles to change (6 subcategories), and 3 process-related domains differentiated good from poor long-term outcome: trauma exposure (4 subcategories), patient agency (6 subcategories), and patient-therapist dynamics (3 subcategories). First, sensory and emotional trauma exposure in good outcome informants was contrasted with avoiding or not addressing trauma and body in poor outcome informants. Second, promotion of patient agency while receiving support in the good outcome group was contrasted to an orientation toward others' needs, distrust in own abilities, and difficulties showing vulnerability in the poor outcome group. Third, poor outcome informants described either a distanced or immersed/idealizing relationship to their therapist, as opposed to more balanced between self-assertion and vulnerability in good outcome informants. Our findings raise new hypotheses that trauma work, fostering patient agency, and focusing on relational dynamics in patient-therapist dyad may be important in producing enduring ED outcomes for these patients. Public Significance StatementThis study uses a patient perspective on therapeutic change processes in good and poor outcome cases at 1-year follow-up. Findings are reported from a patient sample for which proper treatments and successful outcomes are scarce: eating disorder patients with childhood trauma. Findings indicate that trauma exposure, fostering patient agency, and an experience of a supportive yet agencypromoting therapist-patient relationship may be potent ED treatment elements across treatment models.

show abstract

Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency

Cited by 13 publications

References 82 publications

From Resistance to Invitations: How Men Voluntarily in Therapy for Intimate Partner Violence May Contribute to the Development of a Working Alliance

From Resistance to Invitations: How Men Voluntarily in Therapy for Intimate Partner Violence May Contribute to the Development of a Working Alliance

Agency via Awareness: A Unifying Meta-Process in Psychotherapy

Change processes related to long-term outcomes in eating disorders with childhood trauma: An explorative qualitative study.

Contact Info

Product

Resources

About