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First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals

This article examines how therapists and patients start building and managing relationships and pursue institutional goals at the same time. Based on a corpus of 6 audio-recorded therapies (client-centered therapy and psychodynamic therapy), I investigate first encounters between therapists and pati...

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Autor principal: Scarvaglieri, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769839/
https://www.ncbi.nlm.nih.gov/pubmed/33384639
http://dx.doi.org/10.3389/fpsyg.2020.585038
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author Scarvaglieri, Claudio
author_facet Scarvaglieri, Claudio
author_sort Scarvaglieri, Claudio
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description This article examines how therapists and patients start building and managing relationships and pursue institutional goals at the same time. Based on a corpus of 6 audio-recorded therapies (client-centered therapy and psychodynamic therapy), I investigate first encounters between therapists and patients as the starting points of any therapeutical process and the place where a relationship between the interactants is established for the first time. Following a microlinguistic qualitative approach and applying methods from conversation analysis and discourse analysis, I show how therapists, on the one hand, try to align with patients to build a positive working alliance and, on the other hand, work to fulfill specific interactive tasks of therapeutic discourse which demand disaligning with the patients’ communicative activity and their interactive expectations. Specific interactive “jobs” that need to be fulfilled in psychotherapy are identified, namely the performance of institutional roles by the interactants, the establishment of an interaction structure and the pursuit of helpful change in the patient. I show at which places in the interaction therapists (dis-)align with the patients’ projected communicative activity and how aligning and disaligning are related to the interactive process and the establishment and performance of these interactive jobs. The analysis shows that, at the beginning of therapy, alignment and disalignment are both important processes for the following reasons: Aligning with the patient contributes to a positive relationship, which has been shown to be vital for successful psychotherapy, while disaligning introduces the patient to the specific discursive mechanisms that characterize therapeutic discourse and constitute the basis for its effectiveness. Overall, the paper argues that reducing therapy to a dichotomy between relationship and “technique” seems overly simplistic, as both aspects need to be handled and managed at the same time.
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spelling pubmed-77698392020-12-30 First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals Scarvaglieri, Claudio Front Psychol Psychology This article examines how therapists and patients start building and managing relationships and pursue institutional goals at the same time. Based on a corpus of 6 audio-recorded therapies (client-centered therapy and psychodynamic therapy), I investigate first encounters between therapists and patients as the starting points of any therapeutical process and the place where a relationship between the interactants is established for the first time. Following a microlinguistic qualitative approach and applying methods from conversation analysis and discourse analysis, I show how therapists, on the one hand, try to align with patients to build a positive working alliance and, on the other hand, work to fulfill specific interactive tasks of therapeutic discourse which demand disaligning with the patients’ communicative activity and their interactive expectations. Specific interactive “jobs” that need to be fulfilled in psychotherapy are identified, namely the performance of institutional roles by the interactants, the establishment of an interaction structure and the pursuit of helpful change in the patient. I show at which places in the interaction therapists (dis-)align with the patients’ projected communicative activity and how aligning and disaligning are related to the interactive process and the establishment and performance of these interactive jobs. The analysis shows that, at the beginning of therapy, alignment and disalignment are both important processes for the following reasons: Aligning with the patient contributes to a positive relationship, which has been shown to be vital for successful psychotherapy, while disaligning introduces the patient to the specific discursive mechanisms that characterize therapeutic discourse and constitute the basis for its effectiveness. Overall, the paper argues that reducing therapy to a dichotomy between relationship and “technique” seems overly simplistic, as both aspects need to be handled and managed at the same time. Frontiers Media S.A. 2020-12-15 /pmc/articles/PMC7769839/ /pubmed/33384639 http://dx.doi.org/10.3389/fpsyg.2020.585038 Text en Copyright © 2020 Scarvaglieri. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Scarvaglieri, Claudio
First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title_full First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title_fullStr First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title_full_unstemmed First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title_short First Encounters in Psychotherapy: Relationship-Building and the Pursuit of Institutional Goals
title_sort first encounters in psychotherapy: relationship-building and the pursuit of institutional goals
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769839/
https://www.ncbi.nlm.nih.gov/pubmed/33384639
http://dx.doi.org/10.3389/fpsyg.2020.585038
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