Vändpunkter
i barnpsykoterapi
Psykoterapeuters erfarenheter av förändringsprocesser
Turning Points in Child Psychotherapy
Psychotherapists' experiences of change processes
Gunnar Carlberg
leg. psykolog, leg. psykoterapeut, fil. dr.
Abstract
Psychotherapists' experiences of change processes were investigated in four
consecutive studies. The focus of the analysis was a session or a part of a
process the therapist identified as a "turning-point". Data were
collected from 14 psychotherapies through interviews, process records and
questionnaires. In addition examples of changes in 102 psychotherapies were
collected through a questionnaire. The aim of the studies was to investigate the
nature and content of change, and factors underlying change processes.
It was concluded that different kinds of turning points can be described. A
few were turning points in the sense of a sudden, unexpected change that
persists. Some were better categorised as "the process goes on". It
was often possible to reconstruct a process leading up to the change. How one
categorises an identified change is dependent on factors such as "the
severity of the child's disorder" and on "the way the psychotherapist
organises his experience of psychotherapy processes". The therapists'
experiences of turning points can be seen as a part of their way of creating
meaning.
In the beginning of therapy turning points were connected with "the
therapeutic alliance" and later with "conflict" and "working
through". From the analysis of factors seen as underlying change processes,
a description of conditions beneficial for change is given. For example: The
psychotherapist is psychologically present and offers firm frames and continuity.
The psychotherapist "as a new object" is an important change agent. He/she
becomes a model for how to relate and the child internalises the
psychotherapist's reflecting attitude and quest for meaning.
Change was often identified when the therapeutic frame was broken. Something
unpredictable, and/or unusual happened in the usually predictable process. The
meeting between two subjects, mutually influencing each other is the nucleus of
change. The emotional meeting can be described in terms of "the creation of
a new intersubjectivity".
In Swedish with a summary in English.
Key words: Psychotherapy research; child psychotherapy; psychoanalytic;
turning points; process of change; therapeutic alliance; psychotherapeutic frame;
intersubjectivity.
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