A study of the working interface between two different therapy and counselling modalities in a low-cost service
Thesis or dissertation
University of Exeter
Reason for embargo
This is the account of a qualitative study of practitioners in a low-cost counselling and psychotherapy scheme in a rural town. The practitioners within the organisation have been trained in two major modalities, psychodynamic and humanistic. The aim of the research is to look at how the three key psychoanalytic concepts: therapeutic alliance; transference and containment are understood and employed by these practitioners with the aim of demonstrating the differences, similarities and meeting points between the modalities. A total of twenty-eight participants met in six focus groups. These participants were already members of existing groups within the structure of the organisation i.e. the trustees, the management group and four mentor groups. The researcher was the Clinical Director of the service at the time of the study. She was the moderator in each group and an independent observer was present in each group. The discussions were recorded and transcribed and a thematic analysis was then undertaken. The psychoanalytic concepts were adopted as top down themes each with six associated sub-themes. Three further major themes were identified namely: the power dynamics in the therapy relationship; reference to theory: barrier or bridge to communication, and the therapy relationship. The thematic analysis revealed where the statements from the participants in the two modalities agreed, differed and/or demonstrated meeting points. The study includes a reflexivity section focussing on the dynamics of the researcher as the director of the organisation throughout the process, the contributions of the observer in the focus groups and the reflections of the participants about their experience in the focus groups. In addition, how the participants differed and what impact the research has had on the service was thought about in the context of the possible unconscious processes present in this work setting. It was found that there were key differences in the way practitioners from each modality approached the psychoanalytic concepts, but there were also differences between practitioners of the same modality. The differences about theoretical language and experts were substantial. Overall, the participants were able to discuss the subjects and exchange differing viewpoints with enthusiasm and curiosity. These findings are not generalizable to all psychotherapy services, but are likely to be relevant and transferable to those services, both voluntary and otherwise, that employ practitioners from different modalities. A conclusion was that it is not advisable to try and impose one way of working from one theoretical background onto another. This conclusion has implications for the service when providing training events, when matching practitioners with supervisors and when training mentors to lead and facilitate groups of practitioners from differing modalities. The study also offers contributions to the therapy world at large towards the contemporary thinking about the three psychoanalytic concepts, the timing of integrating therapy approaches, the value of mixed modality discussion groups, the obstacles to understanding that theoretical language can cause and the importance of the observation of the unconscious processes in such settings.