Critical incidents in psychotherapy

The critical-incident technique was used to obtain a list of patient behaviors that create special difficulties for the psychotherapist. The list was prepared by a group of seven clinicians during a series of meetings. Included in the list were such items as: insulting the therapist; coming late to...

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Bibliographic Details
Published in:American journal of psychotherapy 1994, Vol.48 (1), p.75-84
Main Authors: PLUTCHIK, R, CONTE, H. R, BYRAM KARASU, T
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Countertransference (Psychology)
Female
Humans
Individual psychotherapy
Male
Medical sciences
Middle Aged
Personality Development
Physician-Patient Relations
Problem Solving
Psychiatrists
Psychiatry
Psychoanalytic Interpretation
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotherapies. Psychological and clinical counseling
Psychotherapy - methods
Transference (Psychology)
Treatments
Citations: Items that cite this one
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Description
Summary:The critical-incident technique was used to obtain a list of patient behaviors that create special difficulties for the psychotherapist. The list was prepared by a group of seven clinicians during a series of meetings. Included in the list were such items as: insulting the therapist; coming late to the session; threatening suicide; and offering gifts. The list was given to 21 experienced psychiatrists who were asked to rate both the importance and the frequency of occurrence of each incident in their experience. The critical incidents could be divided into five major categories: threat of harm from the patient; criticism of the therapist or the therapy; occurrence of a major life crisis; attempts by the patient to seek friendship or seduction, and miscellaneous incidents, such as being consistently late. When ratings by the experienced psychiatrists were compared with those of 10 third-year psychiatric residents, it was found that the inexperienced psychiatrists in almost every case rated the incident as less important and more frequent than did the experienced clinicians. In terms of implications, knowledge of critical incidents in psychotherapy may provide a source of material for training purposes, may enable the development of modeling procedures for training in communication skills, and may encourage supervisors to focus attention on important therapeutic issues.
ISSN:0002-9564
2575-6559
DOI:10.1176/appi.psychotherapy.1994.48.1.75