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A comparison of two cases in experiential systemic therapy : a case study approach Prette, Liz

Abstract

The problem of this study was to examine the variables that contributed to a successful case of Experiential Systemic Couples Therapy as compared to a non-successful case using a qualitative, exploratory case study. The main purposes were: (a) to generate concepts that may have led to or hindered therapeutic change, (b) to investigate the process of change in Experiential Systemic Couples Therapy, and (c) to contribute to the clinical understanding of how change occurs in ExST. The case data sources included documentation (objective measures, situation diaries and reviews of therapy) and video tapes (15 taped sessions from each of the cases). The two cases were chosen using Pinsof's (1988) techniques of Success-Failure Strategy from a larger pool in The Alcohol Recovery Project. A qualitative case study methodology was implemented to discover the major differences between the two cases. Along with these descriptive methods, three sessions from each case were also analyzed using the Vanderbilt Psychotherapeutic Process Scale. The researcher also used Pinsoff's small chunk strategy and analyzed the "best and worst" session of each of the cases. Again a qualitative analysis was done of the sessions, as well as using the Hill (1993) Category Systems. Key findings from each of the cases were identified and compared. The findings revealed nine major differences which occured between the two cases. The analysis of the cases revealed nine major findings associated with outcome. First, three pre-existing variables were discovered to be associated with the successful and unsuccesful case: client variables, stage of change and length of therapy. Second, three findings were delineated as to why change may have occurred: therapeutic alliance, addressing intimacy issues and practicing opportunities in therapy. Finally, three findings were discovered as to how greater change may have occurred: depth of experiencing, therapist techniques and the completion of a 'story' during a therapy session. These findings are integrated with current research. As well, implications for future research and clinical practice are discussed. The limitations of this study and it's methodology are also presented.

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