Terapistin Bilinçli Farkındalığının Terapötik İttifak ve Terapötik İlişki Çerçevesinde İncelenmesi: Sistematik Bir Gözden Geçirme

Öz

Bu çalışmanın amacı, terapistin bilinçli farkındalığı ile terapötik ittifak ve terapötik ilişki arasındaki ilişkileri inceleyen alanyazın çalışmalarını sistematik olarak gözden geçirmektir. Bu amaçla, 2006- 2024 yılları arasında konu ile ilgili yayınlanmış makaleler belirlenen anahtar kelimeler kullanılarak, PubMed, Web of Science, Medline, Taylor & Francis Online, Science Direct, Türk Psikiyatri Dizini, ULAKBİM ve TR Dizin veri tabanlarında taranmıştır. Dahil etme ve hariç tutma kriterlerine dayalı incelikli bir değerlendirme sürecinin ardından, nicel, nitel ve karma yöntemlerle yürütülmüş 25 araştırma bu çalışma kapsamında ele alınmıştır. Bilinçli farkındalık uygulamaları çoğunlukla beden tarama tekniği, hatha yoga, oturma meditasyonu, günlük farkındalık uygulamaları ve bilinçli gevşeme egzersizleri gibi farklı pratikleri içeren Farkındalık Temelli Stres Azaltma programı rehberliğinde gerçekleştirilmiştir. Elde edilen sonuçlar son derece tutarlı bir şekilde bilinçli farkındalığın terapötik ittifakı desteklediğini ortaya koymuştur. Bilinçli farkındalık uygulamaları ile terapistlerin kendilerine ve danışanlarına yönelik kabulünün arttığı, bilinçli farkındalık düzeyi yüksek olan klinisyenlerin ise terapötik ittifakı daha etkili biçimde sürdürebildikleri bulunmuştur. Haftalık olarak farkındalık egzersizi yapan klinisyenlerin hiç pratik yapmayanlara göre; haftalık egzersiz sıklığı yüksek olan klinisyenlerin ise uygulama sıklığı düşük olanlara kıyasla daha güçlü terapötik ittifak kurabildikleri saptanmıştır. Ayrıca, bilinçli farkındalık uygulamalarının karşı aktarımı azaltma, empatiyi ve olumsuz duygulara karşı tahammülü arttırma gibi farklı mekanizmalar aracılığıyla terapötik ittifakı desteklediği bulunmuştur. Sonuç olarak, bu derlemenin bulguları, terapistlerin bilinçli farkındalık düzeylerini artırmalarının, güçlü bir terapötik ittifak geliştirme açısından oldukça kaydadeğer bir çaba olacağını ortaya koymaktadır.

Anahtar Kelimeler

• Terapistin bilinçli farkındalığı
• mindfulness
• terapötik ittifak
• terapötik ilişki

Examining the Therapist Mindfulness in the Context of Therapeutic Alliance and Therapeutic Relationship: A Systematic Review

Abstract

The objective of this study is to conduct a comprehensive review literature researches examining the relationships between therapist mindfulness and the therapeutic alliance and therapeutic relationship. To this end, articles published on the subject between 2006 and 2024 were identified through a search databases PubMed, Web of Science, Medline, Taylor & Francis Online, Science Direct, Turkish Psychiatry Index, ULAKBIM and TR Index databases using the identified keywords. After rigorous evaluation process based on the inclusion and exclusion criteria, 25 quantitative, qualitative and mixed methods studies were included in this study. Mindfulness practices were mostly conducted under the guidance of the Mindfulness-Based Stress Reduction programme, which includes a variety of practices such as body scanning, hatha yoga, sitting meditation, daily mindfulness practices and conscious relaxation exercises. The results showed that mindfulness supports the therapeutic alliance in a very consistent way. It was found that therapists' acceptance of themselves and their clients increased with the practice of mindfulness, and that clinicians with high levels of mindfulness were able to maintain the therapeutic alliance more effectively. It was found that clinicians who practised mindfulness on a weekly basis were able to engage in a stronger therapeutic alliance than those who did not practise at all, and clinicians with a high frequency of weekly practice were able to engage in a stronger therapeutic alliance than those with a low frequency of practice. In addition, mindfulness practice was found to support the therapeutic alliance through several mechanisms, such as reducing countertransference, increasing empathy, and increasing tolerance of negative emotions. In conclusion, the findings of this review suggest that increasing therapists' levels of mindfulness would be a highly worthwhile endeavour in terms of developing a strong therapeutic alliance.

Keywords

• Therapist mindfulness
• mindfulness
• therapeutic alliance
• therapeutic relationship

Kaynakça

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