基于来访者视角的心理治疗和咨询过程中不良反应影响因素的质性研究

Qualitative research on the influencing factors of side effects in psychotherapy and counseling from the perspective of clients

目的探索来访者在心理治疗和咨询过程中体验到的不良反应的影响因素。方法对正在或曾经接受过心理治疗和咨询的6名受试者进行有关不良反应的半结构式访谈,对访谈内容进行主题分析,步骤包括:(1)浸润阅读,(2)初始编码,(3)寻找主题,(4)形成主题框架,(5)清晰地定义和命名主题。最终,提取"不良反应影响因素"的主题。结果 6名受试者的访谈内容中提取了"不良反应影响因素"一级主题4个和二级主题17个。心理治疗和咨询过程中不良反应影响因素主题如下:1.治疗师因素:(1)诊断和评估能力不足;(2)解决问题能力不足;(3)不够中立;(4)治疗技术运用不当;(5)治疗师的个人特质;2.治疗设置因素:(1)治疗费用;(2)治疗场所;(3)保密设置;(4)关系剥夺;(5)多重关系;3.治疗技术因素:(1)揭示问题;(2)支持性技术;(3)创伤修复技术;4.来访者因素:(1)人格特质;(2)心理状态;(3)家庭压力;(4)社会压力。结论治疗师和来访者的个体因素以及治疗互动过程中的设置和技术因素,共同影响着不良反应的发生发展。

Obiective To explore the influencing factors of side effects experienced by clients in the process of psychotherapy and counseling. Method The 6 subjects who are or have received psychotherapy or counseling were interviewed in a semi-structured way about the side effects in psychotherapy,and the content was analyzed in a deductive way to extract the related topics of the influencing factors of side effects in psychotherapy. Results Four kinds of first order themes of the influencing factors of side effects and 17 kinds of second order themes were extracted from the interview contents of six clients. The themes of the influencing factors of side effects in psychotherapy and counseling are as follows :1. Therapists factors of :(1)the ability of diagnosis and evaluation;(2)the ability to solve problems;(3)the lack of neutrality;(4)the improper use of treatment techniques;(5)the personal characteristics of therapists;2. treatment setting factors :(1)treatment cost;(2)treatment place;(3)confidentiality setting;(4)relationship deprivation;(5)multiple relationships;3. treatment technology factors :(1)reveal problems;(2)supportive technology;(3)trauma repair technology;4. client factors :(1)personality;(2)psychological state;(3)family pressure;(4)social pressure. Conclusion The individual factors of the therapist and the clients,as well as the treatment settings and technology factors in the process of psychotherapy interaction,jointly affect the occurrence and development of side effects in psychotherapy and counseling.