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Momentos de não saber em sessões desafiantes : um estudo qualitativo com psicoterapeutas
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Orientador(es)
Resumo(s)
O trabalho psicoterapêutico está repleto de momentos desafiantes tanto para o terapeuta
como para o paciente, que podem influenciar a eficácia da terapia em função do modo
como são geridos. Desta forma, o presente estudo pretende explorar a experiência dos
terapeutas face a desafios clínicos designados de Momentos de Não-Saber (Moments of
Not Knowing - MONK). MONK é definido como experiências significativas e repetidas
de incerteza e dúvida por parte dos terapeutas durante as sessões, sendo caracterizado
por momentos em que os terapeutas são desafiados na forma mais comum de
trabalharem, levando-os a experienciar sentimentos de improdutividade ou a sentirem-se
de alguma forma perdidos no processo terapêutico, sem saber o que fazer, comunicar ou
como estar.
Foi construído um guião para recolher os dados especificamente ancorados num
momento concreto e além dele. Com este guião, tenta-se a) compreender como MONK
são experienciados e percebidos pelos terapeutas; b) explorar o que estes fazem
concretamente para lidar com MONK; c) averiguar sobre a existência prévia de treino
formal ou informal que os ajude a lidar com MONK; e ainda d) compreender as lições e
aprendizagens adquiridas com momentos MONK ao longo da sua carreira em geral. Os
dados foram recolhidos numa amostra de 44 psicoterapeutas internacionais.
Os resultados demonstram a influência que as rupturas na aliança terapêutica mostram
ter para a ocorrência de Momentos de Não-Saber e os sentimentos dolorosos que os
terapeutas experienciam face a MONK. A meta-comunicação e a postura de presença
terapêutica e mindfulness, destacam-se enquanto estratégias adoptadas pelos terapeutas
para lidarem com MONK. Os resultados revelam também possíveis tipos de treino que
mais auxiliam os terapeutas nestes momentos, entre eles a supervisão e o treino em
mindfulness.
Discutem-se limitações do estudo e implicações dos resultados para o treino e prática
psicoterapêutica. São apresentadas considerações metodológicas e sugerem-se linhas de
investigação futuras.
The psychotherapeutic work is filled with challenging moments, both for the therapist and the patient. The way those two parties cope with those challenges will influence the efficacy of the therapy. Thus, this research aims to explore therapists’ experiences regarding clinical challenges called “Moments of Not Knowing” – MONK. MONK are defined as significant and repeated experiences of uncertainty and doubt during sessions. During a MONK, therapists are repeatedly challenged in their usual ways of working and dealing with clients, which may induce awkward behaviours and ultimately lead them to experience feelings of unproductivity and disorientation. In this context, an interview schedule was built to collect data concerning not only a specific recent MONK moment but also MONK in general. Thus, the purpose of this study is to try to a) understand how a MONK is experienced and perceived by therapists; b) explore and understand what therapists specifically do to deal with a MONK; c) investigate the possible existence of prior formal or informal training that can help them deal with a MONK, and finally; d) to comprehend the kind of knowledge a MONK can actually provide to therapists throughout their careers. The data was gathered from a sample of 44 international psychotherapists. The results prove the relationship between therapeutic alliance ruptures and the socalled “Moments of Not Knowing” and also the painful feelings that therapists face when challenged with a MONK. Meta-communication, therapeutic presence and mindfulness stand out as the most common strategies adopted by therapists to deal with MONKs. The results also revealed possible types of training that better assist therapists in those moments, such as supervision and mindfulness training. Both the limitations of this study and implications of the results for training and psychotherapeutic practice are hereby discussed, as well as several methodological considerations and potential new approaches for future research.
The psychotherapeutic work is filled with challenging moments, both for the therapist and the patient. The way those two parties cope with those challenges will influence the efficacy of the therapy. Thus, this research aims to explore therapists’ experiences regarding clinical challenges called “Moments of Not Knowing” – MONK. MONK are defined as significant and repeated experiences of uncertainty and doubt during sessions. During a MONK, therapists are repeatedly challenged in their usual ways of working and dealing with clients, which may induce awkward behaviours and ultimately lead them to experience feelings of unproductivity and disorientation. In this context, an interview schedule was built to collect data concerning not only a specific recent MONK moment but also MONK in general. Thus, the purpose of this study is to try to a) understand how a MONK is experienced and perceived by therapists; b) explore and understand what therapists specifically do to deal with a MONK; c) investigate the possible existence of prior formal or informal training that can help them deal with a MONK, and finally; d) to comprehend the kind of knowledge a MONK can actually provide to therapists throughout their careers. The data was gathered from a sample of 44 international psychotherapists. The results prove the relationship between therapeutic alliance ruptures and the socalled “Moments of Not Knowing” and also the painful feelings that therapists face when challenged with a MONK. Meta-communication, therapeutic presence and mindfulness stand out as the most common strategies adopted by therapists to deal with MONKs. The results also revealed possible types of training that better assist therapists in those moments, such as supervision and mindfulness training. Both the limitations of this study and implications of the results for training and psychotherapeutic practice are hereby discussed, as well as several methodological considerations and potential new approaches for future research.
Descrição
Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicoterapia Cognitiva-Comportamental e Integrativa), Universidade de Lisboa, Faculdade de Psicologia, 2015
Palavras-chave
Aliança terapêutica Tomada de decisão Psicoterapeutas Teses de mestrado - 2015