Title:
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Hopelessness: Causes of, and a Dialogical Sequence Analysis of Recovery in Therapy
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Objectives: To review the literature around causes of hopelessness, explore the
interaction between hope and the therapeutic relationship, and critically appraise the
process.
Literature review: Recent articles in PsychINFO with 'hopelessness' in the title were
summarised. Feeling out ofcontrol, thinking negatively and being perfectionist are risk
factors for hopelessness. Conversely, being motivated, tackling problems and engaging
in purposeful action are protective factors. Repeated negative experiences inhibit people
from tackling problems, making hopelessness more likely. Conversely, positive
experiences and life opportunities promote hope. Thus, high levels ofhopelessness are
seen in impoverished and disenfranchised communities.
Dialogical sequence analvsis: Therapy transcripts were analysed using dialogical
sequence analysis to compare therapists' therapeutic relationships with clients who
regained hope over the first four sessions oftherapy, (responders) and who did not (nonresponders).
Participants were drawn from a previous studys in which depressed clients
referred for therapy agreed for their sessions to be recorded. The two therapists whose
clients had the most extreme range ofresponders and non-responders were identified,
and those 4 clients' transcripts were analysed. With the responders both therapists were
.more confident, more optimistic, made more use ofthe therapeutic relationship, and
took more risks. A transactional model oftherapeutic hope was proposed: a therapist's
optimism about outcome results from balancing hislher own sense of competence
against an evaluation ofthe client's entrenchment. Optimism appeared to enable more
effective ways ofworking.
Critical appraisal: A personal reflection upon the research process.
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