What's on the therapist's mind? A grounded theory analysis of family therapist reflections during individual therapy sessions

Abstract

The authors used a videotape-assisted recall procedure to study the content of family therapists' inner conversations during individual sessions with a standardized client. Grounded theory was used to analyze therapists' reflections, resulting in a taxonomy of 282 different codes in a hierarchical tree structure of six levels, organized into four general domains: attending to client process; processing the client's story; focusing on therapists' own experience; and managing the therapeutic process. In addition to providing a descriptive model of therapists' inner conversation, this research led to an appreciation of the wealth of therapists' inner conversation. In particular, the authors found that therapists work hard to create an intersubjective space within which to talk by trying to be in tune with their clients and by using clients as a guide.

Re-visioning a Model of Clinical Judgment for Systemic Practitioners

“…Research on the processes of couple and family therapy is needed (Heatherington, Friedlander, & Greenberg, 2005), and detailed descriptions of the processes of systems therapy have begun to emerge (e.g., Harvie, Strong, Taylor, Todd, & Young, 2008;Rober, Elliott, Buysse, Loots, & De Corte, 2008a, 2008bStrong, Zeman, & Foskett, 2006). However, it seems to us that, as Wampler (2010) noted, couple and family therapy research simply has not kept pace with research in the other clinical disciplines.…”

The Therapist's Inner Conversation in Family Therapy Practice: Struggling with the complexities of therapeutic encounters with families / Das innere Gespräch des Therapeuten in der familientherapeutischen Praxis: Schwierigkeiten mit der Komplexität therapeutischer Begegnungen mit Familien / Los diálogos internos del terapeuta en la práctica de terapia de familia: Luchando con las complejidades de los encuentros terapéuticos de familia / La Conversation Intérieure du Thérapeute dans la Pratique de la Thérap

“…We analyzed the data using a grounded theory method and we proposed a descriptive model of the therapist's inner conversation with four positions: attending to the client's process; processing the client's story; focusing on the therapist's own experience; and managing the therapeutic process. The model highlights the importance of the dialogue with the client for the therapeutic process, as the therapist's first concern is with tuning into the client and with the dialogical creation of a space to talk in which the client can tell their story (Rober et al, 2008a). In addition, in the model the therapist's self is portrayed as a dynamic multiplicity of inner positions embodied as voices, having dialogical relationships in terms of questions and answers, or agreement and disagreement (Rober et al, 2008b).…”

“…Here the therapist's responsibility is of central importance, because this is where the therapeutic and ethical choices are made. Recently, we studied the therapist's inner conversation as a dialogue between the experiencing self and the professional self in a more systematic way, using a tape-assisted recall procedure to obtain therapist reflections during role-played sessions (Rober, Elliott, Buysse, Loots, & De Corte, 2008a, 2008b. We analyzed the data using a grounded theory method and we proposed a descriptive model of the therapist's inner conversation with four positions: attending to the client's process; processing the client's story; focusing on the therapist's own experience; and managing the therapeutic process.…”

Therapist's Subjective Experience During Significant Segments of Psychotherapy

“…Los resultados de este estudio reflejan información acerca de los estados emocionales de la terapeuta y su experiencia con las emociones de la paciente, su vínculo terapéutico, sus intervenciones y fundamentos y su formulación de caso y caracterización de la paciente. Estas categorías coinciden, en buena medida, con el estudio de Rober et al (2008), que indica que la información provista por los terapeutas se centra en cuatro aspectos: el proceso del paciente, el procesamiento de la historia del paciente, la propia historia del terapeuta y el manejo del proceso terapéutico.…”