Facets of the psychotherapy relationship: a metaphorical approach

Abstract

Although many separate aspects of the psychotherapy relationship have been studied, including empathy, working alliance, and self-disclosure, a metaphorical approach has the potential to generate a more holistic perspective of this phenomenon. Hence, the goal of this study was to explore the nature of the psychotherapy relationship from the psychotherapists’ perspective using a metaphorical approach. In an online survey, a sample of N=373 Czech psychotherapists and counselors rated a set of relational metaphors in terms of how accurately they depicted their roles in their relationships with their clients. The single most endorsed metaphor for the practitioner’s role was a guide. Furthermore, the principal component analysis identified three relational components, namely, Mentor, Resource Supplier, and Remedy Distributor. The associations among these components and multiple practitioners’ variables, including demographic and practice-related variables and theoretical orientation, were explored. These three components represent general dimensions of the psychotherapy relationship that cut across various theoretical orientations and, thus, define psychotherapy relationships in a general sense.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Angus, L. E., & Rennie, D. L. (1988). Therapist participation in metaphor generation: Collaborative and noncollaborative styles. Psychotherapy: Theory, Research, Practice, Training, 25(4), 552-560. doi: https://doi.org/10.1037/h0085381

Angus, L. E., & Rennie, D. L. (1989). Envisioning the representational world: The client’s experience of metaphoric expression in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 26(3), 372-379. doi: https://doi.org/10.1037/h0085448

Austin, W., Bergum, V., Nuttgens, S., & Peternelj-Taylor, C. (2006). A re-visioning of boundaries in professional helping relationships: Exploring other metaphors. Ethics & Behavior, 16(2), 77-94. doi: https://doi.org/10.1207/s15327019eb1602_1

Beisecker, A. E., & Beisecker, T. D. (1993). Using metaphors to characterize doctor-patient relationships: Paternalism versus consumerism. Health Communication, 5(1), 41-58. doi: https://doi.org/10.1207/s15327027hc0501_3

Beutler, L. E., & Harwood, T. M. (2000). Prescriptive psychotherapy: A practical guide to systematic treatment selection. Oxford: Oxford University Press.

Burlingame, G. M., McClendon, D. T., & Alonso, J. (2011). Cohesion in group therapy. Psychotherapy, 48(1), 34-42. doi: https://doi.org/10.1037/a0022063

Cain, D. J. (2002). Defining characteristics, history, and evolution of humanistic psychotherapies. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (1st ed., pp. 3-54). Washington, DC: American Psychological Association.

Carter, A. H. (1989). Metaphors in the physician-patient relationship. Soundings: An Interdisciplinary Journal, 72(1), 153-164.

Castonguay, L. G., Janis, R. A., Youn, S. J., Xiao, H., McAleavey, A., Boswell, J. F., O’Leary Wiley, M. (2017).

Clinicians’ prediction and recall of therapeutic interventions: Practice research network study. Counselling Psychology Quarterly, 30(3), 308-322. https://doi.org/10.1080/09515070.2017.1334628

Cooper, M. (2008). Essential research findings in counselling and psychotherapy: The facts are friendly. Los Angeles, CA: Sage.

Cooper, M., Norcross, J. C., Raymond-Barker, B., & Hogan, T. P. (2019). Psychotherapy preferences of laypersons and mental health professionals: Whose therapy is it? Psychotherapy, 56(2), 205-216. doi: https://doi.org/10.1037/pst0000226

Corsini, R. J. (2008). Introduction. In R. J. Corsini & D. Wedding (Eds.), Current psychotherapies (pp. 1-14). Belmont: Thompson.

Crits-Christoph, P., Gibbons, M. B. C., & Mukherjee, D. (2013). Psychotherapy process-outcome research. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th ed., pp. 298-340). Hoboken, NJ: John Wiley & Sons.

Curtin, J. (2017). lmSupport: Support for Linear Models. R package version 2.9.8. https://CRAN.R-project.org/package=lmSupport

Elkins, D. N. (2009). The medical model in psychotherapy: Its limitations and failures. Journal of Humanistic Psychology, 49(1), 66-84. doi: https://doi.org/10.1177/0022167807307901

Fernández-Álvarez, H., García, F., Lo Bianco, J., & Corbella Santomá, S. (2003). Assessment questionnaire on the personal style of the therapist PST-Q. Clinical Psychology and Psychotherapy, 10(2), 116-125. doi: https://doi.org/10.1002/cpp.358

Fox, J., & Weisberg, S. (2011). An {R} companion to applied regression (2nd ed.). Thousand Oaks, CA: Sage.

Gelso, C. J., & Carter, J. A. (1985). The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents. The Counseling Psychologist, 13(2),155-243.

Gelso, J. C., & Hayes, J. A. (2007). Counter-transference and the therapist’s inner experience: Perils and possibilities. London: Routledge.

Grencavage, L. M., & Norcross, J. C. (1990). Where are the commonalities among the therapeutic common factors? Professional Psychology: Research and Practice, 21(5), 372-378. doi: https://doi.org/10.1037//0735-7028.21.5.372

Henson, R. K., & Roberts, J. K. (2006). Use of exploratory factor analysis in published research: Common errors and some comment on improved practice. Educational and Psychological Measurement, 66(3), 393-416. doi: https://doi.org/10.1177/0013164405282485

Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrica, 30(2), 179-185. doi: https://doi.org/10.1007/BF02289447

Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9-16. doi: https://doi.org/10.1037/a0022186

Huang, F. (2015). hornpa: Horn’s (1965) test to determine the number of components/factors. R package version 1.0. https://CRAN.R-project.org/package=hornpa

Keefer, L. A., & Landau, M. J. (2015). Frighteningly similar: Relationship metaphors elicit defensive information processing. Social Psychological and Personality Science, 6(8), 931-939. https://doi.org/10.1177/1948550615597975

Kopp, R. R. (1995). Metaphor therapy: Using client generated metaphors in psychotherapy. Bristol, PA: Brunner/Mazel.

Kuhn, T. S. (1996). The structure of scientific revolutions (3rd ed.). Chicago, IL: University of Chicago Press. doi: https://doi.org/10.7208/chicago/9780226458106.001.0001

Lakoff, G., & Johnson, M. (2003). Metaphors we live (2nd ed.). Chicago, IL: The University of Chicago Press.

Leary, D. E. (Ed.). (1990). Metaphors in the history of psychology. Cambridge, UK: Cambridge University Press.

LimeSurvey Project Team. (2015). LimeSurvey: An open source survey tool. LimeSurvey Project Hamburg, Germany. Available from: http://www.limesurvey.org

Norcross, J. C. (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York, NY: Oxford University Press.

O’Connor, B. (2000). SPSS and SAS programs for determining the number of components using parallel analysis an Velicer’s MAP test. Behavior Research Methods, Instruments, & Computers, 32(3), 396-402. doi: https://doi.org/10.3758/BF03200807

Orlinsky, D. E., & Rønnestad, M. H. (2005). How psychotherapists develop: A study of therapeutic work and professional growth. Washington, DC: American Psychological Association.

R Core Team. (2017). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Available from: https://www.R-project.org/.

Revelle, W. (2016). psych: Procedures for Personality and Psychological Research. Evanston, IL: Northwestern University. Available from: http://CRAN.R-project.org/package=psych Version=1.6.4.

Řiháček, T., & Roubal, J. (2017a). Personal therapeutic approach: concept and implications. Journal of Psychotherapy Integration, 27(4), 548-560.

Řiháček, T., & Roubal, J. (2017b). The proportion of integrationists among Czech psychotherapists and counselors: A comparison of multiple criteria. Journal of Psychotherapy Integration, 27(1), 13-22. https://doi.org/10.1037/int0000069

Řiháček, T., & Roubal, J. (2019). Využívání psychoterapeutických technik v praxi [The use of psychotherapy techniques in practice]. E-psychologie, 13(1), 1-17. https://doi.org/10.29364/epsy.335

Řiháček, T., & Roubal, J. (2020). Common principles of psychotherapeutic change: Patterns of use. British Journal of Guidance and Counselling, 48(4), 489-499. https://doi.org/10.1080/03069885.2018.1503230

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consultin Psychology, 21(6), 95-103. doi: https://doi.org/10.1037/h0045357

Rowat, R., Stefano, J. De, & Drapeau, M. (2008). The role of patient-generated metaphors on in-session therapeutic

processes. Archives of Psychiatry & Psychotherapy, 10(1), 21-27. doi: https://doi.org/10.1007/BF00120585

Safran, J. D., Muran, J. C., & Eubanks-Carter, C. (2011). Repairing alliance ruptures. Psychotherapy: Theory, Research, Practice, Training, 48(1), 80-87. doi: https://doi.org/10.1037/a0022140.

Santa Ana, E. J., Martino, S., Ball, S. A., Nich, C., Frankforter, T. L., & Carroll, K. M. (2008). What is usual about “treatment-as-usual”? Data from two multisite effectiveness trials. Journal of Substance Abuse Treatment, 35(4), 369-379. http://doi.org/10.1016/j.jsat.2008.01.003

Scaturo, D. J. (2002). Technical skill and the therapeutic relationship: A fundamental dilemma in cognitive-behavioral and insight-oriented therapy. Family Therapy, 29(1), 1-21.

Schlippe, A. von, & Schweitzer, J. (1998). Lehrbuch der systemischen Therapie und Beratung. Göttingen: Vandenhoeck & Ruprecht.

Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates.

Young, J. S., & Borders, L. D. (1999). The intentional use of metaphor in counseling supervision. The Clinical Supervisor, 18(1), 137-149. doi: https://doi.org/10.1300/J001v18n01_09

Ziv-Beiman, S. (2013). Therapist self-disclosure as an integrative intervention. Journal of Psychotherapy Integration, 23 (1), 59-74. doi: https://doi.org/10.1037/a0031783.

Published
2021-01-14
Info
Issue
Section
Articles
Keywords:
Metaphor, professional role, psychotherapy relationship, survey, theoretical orientation.
Statistics
  • Abstract views: 273

  • PDF: 72
How to Cite
Řiháček, T., Roubal, J., & Motalová, K. (2021). Facets of the psychotherapy relationship: a metaphorical approach. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(3). https://doi.org/10.4081/ripppo.2020.468