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Directiveness in psychotherapy: A phenomenological-narrative study of therapist attitudes
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0002-7275-1925
2017 (English)In: Psychology and Psychotherapy: Theory, Research and Practice, ISSN 1476-0835, E-ISSN 2044-8341, Vol. 90, no 4, p. 600-616Article in journal (Refereed) Published
Abstract [en]

Objectives

This study of directiveness draws on the literature on patient–therapist matching, neutrality, and resistance. Our aim was to investigate how psychotherapists conceptualize directiveness as an attitude, with a focus on pantheoretical aspects of directiveness.

Design and methods

Our data are narratives from 18 interviews with psychotherapists of different theoretical orientations (cognitive-behavioural, family-systems, humanistic-experiential, and psychodynamic), and from focus-group discussions with six other psychotherapists.

Results

The analysis yielded four general themes: expression of directiveness (behaviour, agency, structure), its presence (depending on phase of and goals for therapy), its positive and negative outcomes (for patients and therapists, respectively), and therapist awareness (initial and shifting, depending on theoretical orientation).

Conclusions

Directiveness may be construed as an attitude. It supposedly increases via certain responses, but only a few of these are considered positive by therapists at large. Directiveness may be more present in early and late phases of therapy, and more warranted with patients that function poorly. There are both positive and negative outcomes of directiveness, but therapists are more prone to disclose the former.

Practitioner points

  • Therapist directiveness supposedly increases via advice, questions, clarifications, steering to topics, goal setting, self-disclosure, and session management. Directiveness is seen as more present in early and late phases of therapy.
  • Directing is more warranted with patients who function poorly. Possible positive outcomes of directiveness are clarity, feeling of security, and saving time; negative outcomes are decrease of agency, increase of resistance, and less patient self-attribution of improvement.
  • It is unlikely that therapists disclose adverse directive behaviours. Those who do, attribute them to psychotherapy structure if their attitudes are negative, and to personal choice if they are positive. This may hamper therapists managing their own level of directiveness.
Place, publisher, year, edition, pages
2017. Vol. 90, no 4, p. 600-616
Keywords [en]
directive attitude; matching; neutrality; psychotherapy; reactance; resistance
National Category
Applied Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-333802DOI: 10.1111/papt.12128ISI: 000415053500006PubMedID: 28477393OAI: oai:DiVA.org:uu-333802DiVA, id: diva2:1157906
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-20Bibliographically approved

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Rautalinko, Erik

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