Emergence of psychotic content in psychotherapy

An exploratory qualitative analysis of content, process, and therapist variables in a single case study

Bethany L. Leonhardt, Marina Kukla, Elizabeth Belanger, Kelly A. Chaudoin-Patzoldt, Kelly D. Buck, Kyle S. Minor, Jenifer Vohs, Jay A. Hamm, Paul H. Lysaker

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Method: Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Results: Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient’s experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Conclusions: Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient’s movements toward recovery in integrative metacognitive therapies.

Original languageEnglish (US)
Pages (from-to)1-17
Number of pages17
JournalPsychotherapy Research
DOIs
StateAccepted/In press - Aug 13 2016

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Psychotherapy
Therapeutics
Schizophrenia

Keywords

  • insight
  • psychotherapy
  • qualitative methods
  • recovery
  • schizophrenia

ASJC Scopus subject areas

  • Clinical Psychology

Cite this

Leonhardt, B. L., Kukla, M., Belanger, E., Chaudoin-Patzoldt, K. A., Buck, K. D., Minor, K. S., ... Lysaker, P. H. (Accepted/In press). Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study. Psychotherapy Research, 1-17. https://doi.org/10.1080/10503307.2016.1219421

Emergence of psychotic content in psychotherapy : An exploratory qualitative analysis of content, process, and therapist variables in a single case study. / Leonhardt, Bethany L.; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A.; Buck, Kelly D.; Minor, Kyle S.; Vohs, Jenifer; Hamm, Jay A.; Lysaker, Paul H.

In: Psychotherapy Research, 13.08.2016, p. 1-17.

Research output: Contribution to journalArticle

Leonhardt, Bethany L. ; Kukla, Marina ; Belanger, Elizabeth ; Chaudoin-Patzoldt, Kelly A. ; Buck, Kelly D. ; Minor, Kyle S. ; Vohs, Jenifer ; Hamm, Jay A. ; Lysaker, Paul H. / Emergence of psychotic content in psychotherapy : An exploratory qualitative analysis of content, process, and therapist variables in a single case study. In: Psychotherapy Research. 2016 ; pp. 1-17.
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