The resolution of client confrontation challenges in exploratory psychotherapy : developing the new paradigm in psychotherapy research
'How are Client Confrontation Challenges to the therapeutic relationship in Exploratory therapy best addressed? 'was the question explored here. Given the significance of the therapeutic relationship in Exploratory therapy (a Psychodynamic Interpersonal therapy), Confrontation Challenges are significant, 'make or breaw, moments. Depending on the effectiveness with which they are addressed, Confrontation Challenges may significantly threaten or significantly promote therapeutic change. The question was explored within the new Change Process Paradigm in psychotherapy research. Therapeutic change is conceptualised as a fluid, continuous, heterogeneous process; outcomes are achieved cumulatively, during and between sessions and after therapy. With this reconceptualisation of relations between process and outcome, the new paradigm aims to inform micro-level, momentto moment, psych othe rape utic decision-making and theory-development. The new paradigm's Significant Change Events strategy and its Task Analysis method were used to explore the question. Thus Client Confrontation Challenges were recast as affective tasks'calling for' resolution; Challenge Resolution Events are Significant Change Events in Exploratory therapy. The researcher's 'best guess' at how resolution may proceed (expressed in a Rational Model) was revised by iterative and cumulative comparison with detailed, descriptions of more and less effective resolution performances observed (in the Empirical Analysis) in therapy practice. The Rational Empirical Comparison resulted in a Revised Model of effective Confrontation Challenge Resolution; this represented the task analytic answer. Effective Challenge Resolution was interpreted as process of 'Going with but containing the Challenge' and thereafter managing two interdependent subprocesses, Negotiation and Exploration. This substantive contribution was discussed in relation to clinical thinking and to previous empirical work. The task analytic approach and the Change Process Paradigm were developed by enhancing the triangulation of psychotherapeutic theory and practice with the research approach.