Understanding your difficulties
As therapists gain more experience they become more skilled at tracking and using their own countertransference responses (emotional, cognitive and bodily reactions). To help develop this growing awareness Davis and colleagues described the key difficulties and coping mechanisms a therapist might experience, such as feeling threatened or blocked by an ethical dilemma.
Read more about exloring therapist difficulties
Taxonomy of therapist difficulties and coping strategies
Br. J. Med. Psychol. 60 (2): 109-120.
(Based on Davis, JD. Elliott, R. Davis, ML. et al (1987) The development of a taxonomy of therapist difficulties: Initial report.
As a training aid try recalling a difficult moment in a session when you listen to a recorded session- describe it as clearly as possible, and then guess how the client might be feeling. You are trying to get a better understanding of what was difficult and your “go to” coping strategies.
Then look through the taxonomy and try to describe your difficulty and also your coping strategies.
This can be done alone but it is best done in a group of trusted colleagues (ideally with a clinical supervisor present).
Therapist difficulties (based on therapist’s reported experience)
- Therapist feels incompetent
- Therapist feels damaging
- Therapist feels threatened
- Therapist feels out of rapport
- Therapist feels stuck
- Therapist feels thwarted
- Therapist’s personal issues evoked
- Therapist faces painful reality of the client’s situation
- Therapist faces ethical dilemma
Therapist coping strategies (based on the source of support sought)
Taxonomy of therapist difficulties and coping strategies
Br. J. Med. Psychol. 60 (2): 109-120.
(Based on Davis, JD. Elliott, R. Davis, ML. et al (1987) The development of a taxonomy of therapist difficulties: Initial report.
As therapists gain more experience they become more skilled at tracking and using their own countertransference responses (emotional, cognitive and bodily reactions). To help develop this growing awareness Davis and colleagues described the key difficulties and coping n=mechanisms a therapist might experience, such as feeling threatened or blocked by an ethical dilemma.
As a training aid try recalling a difficult moment in a session when you listen to a recorded session- describe it as clearly as possible, and then guess how the client might be feeling. You are trying to get a better understanding of what was difficult and your “go to” coping strategies.
Then look through the taxonomy and try to describe your difficulty and also your coping strategies.
This can be done alone but it is best done in a group of trusted colleagues (ideally with a clinical supervisor present).
Therapist difficulties (based on therapist’s reported experience)
- Therapist feels incompetent
- Therapist feels damaging
- Therapist feels threatened
- Therapist feels out of rapport
- Therapist feels stuck
- Therapist feels thwarted
- Therapist’s personal issues evoked
- Therapist faces painful reality of the client’s situation
- Therapist faces ethical dilemma
Therapist coping strategies (based on the source of support sought)
Therapist turns to self by
- re-appraisal of the situation
- using self-management
Therapist turns to client- to share and discuss aspects of the difficulty
Therapist turns to others
- for consultation
- for education
- to diffuse or share responsibility
- for gratification / comfort
Therapist turns to practice
- using a technical intervention
- using a non-technical intervention
- -changing tack
Therapist turns away from the difficulty (avoids)
Therapist turns against the client
Therapist turns away from the client and terminates therapy
Going back to basics
See the original films developed to learn PIT
When PIT was first being developed three videotapes were used with some sessions of discussion and supervision to offer basic psychotherapy training. They are available to try out.