A grounded theory of the conceptualisation of the therapeutic relationship by practitioners of cognitive-behavioural therapy (CBT)

• Main Author: Reinhardt, Stefanie
• Published: University of East London 2011
• Subjects: 150
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.550446

The concept of the therapeutic relationship has been emphasised by different therapeutic traditions. In Cognitive-Behavioural Therapy (CBT) the therapeutic relationship has received more attention in recent years after being considered less important than the application of cognitivebehavioural techniques to outcome. Qualitatively the therapeutic relationship in cognitive-behavioural therapy has generally been described as the working alliance. This study has sought to explore how practitioners of CBT conceptualise the therapeutic relationship in their work. Data were collected in the form of audio recorded semi-structured interviews with eight psychologists, some of whom were also CBT therapists. A constructivist version of grounded theory was chosen to analyse the data, which reflected epistemological and methodological considerations. The core dynamic suggests that the therapeutic relationship in CBT is an individual, ever-changing concept shaped by each therapist's training, experience, ongoing practice and reflection. The participants' practice of CBT was influenced by, and influential to the personal meaning they attributed to the therapeutic relationship. The therapists' prior training and experience provided the conceptual basis for the understanding of the therapeutic relationship. This conceptualisation was adapted to fit the participants' work contexts. A process of reflection enabled the clinicians to incorporate ideas they held about CBT and the therapeutic relationship into their work, and allowed for the continual adaptation and refinement of the concept of the therapeutic relationship. Suggestions for further research are made considering that practitioners of CBT come from diverse professional backgrounds and there are implications for the training and practice of this range of practitioners.