Zusammenfassung
Psychotherapeuten zeigen eine große Variation in ihrer Fähigkeit, gute Therapieergebnisse zu erzielen. Sie unterscheiden sich v. a. in ihrer Fähigkeit, Brüche der therapeutischen Allianz zu bemerken und zu reparieren. Allianzrupturen sind ein häufiges Phänomen, bleiben aber oft unentdeckt. Andererseits stellt die Reparatur von Allianzrupturen eine große Chance für den Therapieprozess und das Therapieergebnis dar. Empirische Studien legen nahe, Rückmeldungen der Patienten systematisch in den Therapieprozess zu integrieren, um Allianzrupturen frühzeitig zu entdecken. Aus psychodynamischer Sicht ist ein Psychotherapeut dann ein „ausreichend guter“ Therapeut, wenn er seine eigenen, auf unbewussten Aspekten seiner Gegenübertragung beruhenden Begrenzungen bei der Beurteilung der therapeutischen Beziehung zu seinen Patienten anerkennt und ihre Rückmeldungen nutzt, um unvermeidliche Allianzbrüche zu entdecken und zu reparieren. Konsequenzen für Forschung, Praxis und Psychotherapieausbildung werden erörtert.
Abstract
Psychotherapists show a great variation in their ability to achieve positive outcomes in therapy. Specifically, they vary in terms of their ability to identify and repair ruptures in the therapeutic alliance. Alliance ruptures are a frequent phenomenon but often go undetected; however, repairing alliance ruptures represents a great opportunity to improve the psychotherapy process and therapy outcome. Empirical research suggests that patient feedback should be included in the psychotherapy process to be able to detect alliance ruptures better. From a psychodynamic point of view, a “sufficiently good” therapist is a therapist who can acknowledge the countertransference-based limitations in evaluating the therapeutic alliance with patients and the need to use feedback in order to detect and repair inevitable alliance ruptures. The consequences for research, practice and psychotherapy training are considered.
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M. Cierpka, Heidelberg
V. Kast, St. Gallen
P. Henningsen, München
Überarbeitete Fassung eines Vortrags bei den 65. Lindauer Psychotherapiewochen 2015.
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Wöller, W. Der ausreichend gute Therapeut. Psychotherapeut 61, 105–109 (2016). https://doi.org/10.1007/s00278-016-0086-3
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DOI: https://doi.org/10.1007/s00278-016-0086-3