Successful psychotherapies with young adults: an explorative study of the participants' view

Abstract

In order to understand mechanisms of change, patients' experiences are an invaluable source of information. Psychotherapy with young adults confronts therapists with specific challenges. This qualitative study explores experiences of therapeutic process and outcome in 11 cases of psychoanalytic psychotherapy that fulfilled the rigorous quantitative criteria for long-term therapeutic success. Interviews at termination and at a 1.5-year follow-up were analysed applying basic grounded theory methodology and the software ATLAS.ti. At the core of the tentative conceptual model is the experience of a growth-promoting and secure therapeutic relationship. Within the therapeutic frames, the patients and the therapists could overcome obstacles to their collaboration. The patients obtained support in close relationships and continued to apply therapeutic experiences after termination. The therapists experienced the therapeutic work in a strikingly similar way, worked actively towards joint goals, explored what was painful and actively promoted the use of new skills after termination. Positive factors in therapy and in life reinforced each other in a positive feedback loop. The patients' and their therapists' view of successful change processes confirms the centrality of the therapeutic relationship as a secure base for exploration and change.

Keywords:

• successful cases
• process and outcome
• young adults
• psychoanalytic psychotherapy

Acknowledgements

This study is a part of the prospective, longitudinal Young Adult Psychotherapy Project conducted at the former Institute of Psychotherapy, Stockholm County Council and the Psychotherapy Section, Department of Clinical Neuroscience, Karolinska Institutet. The project was supported by grants from the Bank of Sweden, Tercentenary Foundation and from the R&D Secretariat, Stockholm County Council. The project was approved by the Regional Research Ethics Committee at the Karolinska Institutet and all participants have given their informed consent.