Investigating Therapeutic Relationship through Avoidance Patterns of Client and Psychotherapist: A Conversational Analysis

Abstract

Psychotherapy process research can be conducted to analyze therapeutic relationship, emotions, change process in therapy and therapist-client interaction by using qualitative research methods (McLeod, 2001). Conversational analysis is preferred with its main focus on interaction within dialogue, to investigate therapeutic relationship (Perakyla, 2004). This study as a psychotherapy process research aimed at analyzing the avoidance within therapist-client interaction and its effect on therapeutic relationship. Conversational analysis of three schema therapy oriented sessions which represented the avoidance pattern of therapist and client were explored. The focus was on weak agreement and disagreement in the dialogue, interruption and overlap within turn taking organization. Over the course of schema therapy sessions, it was observed that therapist avoided deeply analyzing client’s negative emotions related to therapy and changed the topic. Besides, client was withdrawn, and therapist could not repair the disagreement in the therapeutic dialogue. Investigating avoidance patterns of psychotherapist and client was important to uncover therapeutic rupture. Interaction of avoidance behaviors of client and therapist was discussed in terms of therapeutic alliance rupture and schema therapy model.

Keywords

• Pyschotherapy research,conversational analysis,therapeutic relationship,schema therapy,qualitative study

Terapi İlişkisinin Terapist ve Danışanın Kaçınma Örüntüleri Açısından İncelenmesi: Bir Konuşma Analizi Çalışması

Abstract

Nitel araştırma yöntemlerinin kullanıldığı psikoterapi araştırmaları ile terapi ilişkisi, duygular terapide değişim süreci ve terapist danışan etkileşimi gibi konularda psikoterapide süreç araştırmaları yapılabilmektedir (McLeod, 2001). Konuşma analizi, dilin etkileşimsel dinamiğine odaklandığı için terapi ilişkisinin araştırılmasında tercih edilmektedir (Perakyla, 2004). Bu çalışmanın amacı, bir psikoterapi süreç araştırması olarak, kaçınmanın terapist ve danışan etkileşim sürecinde nasıl ortaya çıktığının ve terapi ilişkisinin bundan nasıl etkilendiğinin anlaşılmasıdır. Şema terapi yaklaşımı ile gerçekleştirilmiş ve terapist-danışan arasındaki kaçınma örüntüsünün ortaya çıktığı üç seans, konuşma analizi ile incelenmiştir. Araştırmanın odağı, terapi diyaloğundaki zayıf anlaşma ve anlaşmazlık bildiren ifadeler, söz kesme, çakışmaları içeren sıra alış organizasyonu olmuştur. Analiz sonuçlarına göre şema terapi seanslarında, terapistin, danışanın terapi seansı ile ilgili negatif duygularını derinlemesine analiz etmekten kaçındığı, konuyu değiştirdiği; danışanın ise geri çekildiği ve terapistin terapi diyaloğundaki anlaşmazlığı onaramadığı gözlenmiştir. Terapist ve danışan arasındaki kaçınma örüntüsünün analiz edilmesi terapötik ittifakta kırılma ile ilgili bilgi vermesi açısından önemlidir. Terapist ve danışanın kaçınma davranışlarının etkileşimi, terapötik ittifakta kırılma ve şema terapi mod modeli bağlamında tartışılmıştır.

Keywords

• konuşma analizi,terapi ilişkisi,şema terapi,Psikoterapi araştırması,nitel araştırma

References

1. Arntz, A., Berstein, D. P., & Jacob, G. (2013). Schema therapy in practice. UK: Wiley Blackwell.
2. Avdi, E., & Georgaca, E. (2009). Narrative and discursive approaches to the analysis of subjectivity in psychotherapy. Social & Personality Psychology Compass, 3(5), 654-670.
3. Berger, R. (2015). Now I see it, now I don't: researcher's position and reflexivity in qualitative research. Qualitative Research, 15(2), 219-234.
4. Elliott, R., Fischer, C. T., & Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. The British Journal of Clinical Psychology, 38, 215-229.
5. Finlay, L. (2002). "Outing" the researcher: the provenance, process, and practice of reflexivity. Qualitative Health Research, 12(4), 531-545.
6. Fischer, C. (2009). Bracketing in qualitative research: Conceptual and practical matters. Psychotherapy Research, 19(4-5), 583-590.
7. Heritage, J. (1984). Garfinkel and ethnomethodology. Cambridge, UK: Polity Press.
8. Hill, C., & Knox, S. (2009). Processing the therapeutic relationship. Psychotherapy Research, 19(1), 13-29.

9. Jefferson, G. (1985). An exercise in the transcription and analysis of laughter. T.A. Van Dijk (ed.), Handbook of discourse analysis, Volume 3 içinde, (25-34), London: Academic Press. Kondratyuk, N., & Perakyla, A. (2011). Therapeutic work with the present moment: A conversationanalytical study of guidance into immediacy. Psychotherapy Research, 21(3), 316-330.
10. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, California: Sage Publications.
11. McLeod, J. (2001). Qualitative research in counselling and psychotherapy. London: Sage.
12. Eubanks, C. F., Lubitz, J., Muran, J.C., Safran, D. (2019). Rupture resolution rating system (3RS): Development and validation, Psychotherapy Research, 29(3), (306-319).
13. Perakyla, A. (2004). Making links in psychoanalytic interpretations: A conversation analytical perspective. Psychotherapy Research, 14, 289-307. Perakyla, A., Antaki, C., Vehvilainen, S., & Leudar, I. (2008). Conversational analysis and psychotherapy. Cambridge: Cambridge University Press: Sage.
14. Sacks, H., Schegloff, E. A., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50(4), 696-735.
15. Sacks, H. (1995). Lectures on conversation. UK: Wiley.
16. Safran, J. D., & Muran, J. C. (1996). The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology, 64(3), 447-458.
17. Safran, J.D. & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York, NY: Guilford Press.
18. Sarı, S., & Gençöz, F. (yayında). Women's experiences of group intervention with schema therapy techniques: A qualitative process analysis. Counselling and Psychotherapy Research.
19. Soygüt, G., & Gulum, I. V. (2016). A thematic analysis of therapists’ perspectives on therapeutic alliance rupture moments. Research in Psychotherapy: Psychopathology, Process and Outcome, 19(2), 103-113.
20. Stancombe, J., & White, S. (1997). Notes on the tenacity of therapeutic presuppositions in process research: examining the artfulness of blaming in family therapy. Journal of Family Therapy,19, 21-41.
21. Sutherland, O., & Strong, T. (2011). Therapeutic collaboration: a conversation analysis of constructionist therapy. Journal of Family Therapy, 33(3), 256-278. Wynn, R. & Bergvik, S. (2011). Qualitative methods for the analysis of verbal interactions in psychotherapy. M. Rimondini (ed.), Communication in Cognitive Behavioral Therapy içinde, (249-263).
22. Viklund, E., Holmqvist, R., & Nelson, K. Z. (2010). Client-identified important events in psychotherapy:Interactional structures and practices. Psychotherapy Research, 20 (2), 151-164. Voutilinen, L., Perakyla, A., & Ruusuvuori, J. (2011). Therapeutic change in interaction: Conversational analysis of a transforming sequence. Psychotherapy Research, 21(3), 348-365.
23. Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy practitioner’s guide, New York: