Relational development in psychotherapy from beginning to end : Connecting structural and interpersonal aspects

Abstract

With the concept of the working alliance as a starting point, the aim is to explore relational development in psychotherapy in an experience-near and clinically relevant way. The approach is qualitative and hermeneutic phenomenological. Reflexive data from participants in psychotherapy is combined with observational data from the therapeutic interaction. Case studies are used to explore relational processes of development from different perspectives. The findings are presented in three separate articles. The first article is a single case study which explores the relational struggles early in a therapy process and the development of a therapeutic alliance in a case which started with relational strains but developed a good alliance and ended with good outcomes. The second article is a single case study which explores an ambiguous process of ending in an exceptional case. The third article explores the process of ending across twelve cases. A main finding is that patients and therapists seemed to share an ideal of reaching a concerted decision to end. The agreement seemed to be based on sensed affect, rather than for instance metacommunication.