Therapist operations that facilitate very good moments in Gestalt therapy sessions.

Abstract

Using a procedure that borrowed from both a quantitative and a qualitative research approach to psychotherapy, this study investigated audiotaped recordings of six sessions of Gestalt therapy conducted by five distinguished therapists. This in-depth, discovery-oriented research explored the interrelations between in-session client conditions, therapist operations and very good moments. In the first phase of the study, composite descriptions of six categories of very good moments were generated, based on the identification and the subsequent descriptions of 17 instances of very good moments made by a team of twelve judges. The six categories of very good moments were: From Neutral to Strong Feeling; Strong Expression Directly Toward Therapist; Extratherapy Behavior Change Intention; Acceptance of Problem-Self; State of General Well-Being; and New, Deeply Felt Personality Process-State. In the second phase of the investigation, judges identified explicit therapist operations and methods which, when carried out under identified client conditions or states, were judged as being instrumental in the subsequent occurrence of the given category of very good moments. The main finding was as follows: (a) The skilled and competent use of specific therapist operations, (b) with a client who is ready and willing to use the operations, and to move toward that very good moment, (c) appeared to result in the occurrence of that very good moment. For practitioners who value these categories of very good moments, the findings may be used as provisional suggestions for ways of facilitating the occurrence of these very good moments. For researchers, the findings are illustrative of continuing explorations into how psychotherapy works, into the relations between in-session client conditions or states, therapist operations, and consequent in-session very good moments. By means of careful, in-depth examination, researchers can learn what practitioners do to help bring about important and useful in-session client events.