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Title: Reformulation in Cognitive Analytic Therapy: Effects on the Working Alliance and the Client's Perspective on Change.
Author: Shine, Liam
ISNI:       0000 0001 3406 6591
Awarding Body: University of East Anglia
Current Institution: University of East Anglia
Date of Award: 2007
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Little is known about the impact of refonnulation upon the therapeutic relationship and the client's experience of the process. Such research has an important role to play in infonning evidence-based practice within mental health services. The perspectives of researchers, clinicians and clients all need to be taken into account to ensure that such research makes a constructive contribution to mental health care (Roth & Parry, 1997). Aims This study aims to investigate whether the refonnulation process in Cognitive Analytic Therapy (CAT) has an impact upon a measure of working alliance, and to explore the client's perspective of the refonnulation process. Method A single-case, multiple baseline design across subjects was used. A measure of alliance was given on a weekly basis and the session in which the written refonnulation was presented provided a marker. To address the second research question a qualitative approach was used whereby interviews were conducted with participants postr~ fonnulation. Template analysis (Crabtree & Miller, 1992) was used to analyse the transcripts. Results Quantitative data showed no significant impact of the refonnulation process on a measure of working alliance, either as a step-change or slope-change. Template analysis, however, identified seven themes within the qualitative data: Feeling heard, Understanding patterns, Space to talk, Feeling accepted, Having something tangible, Working together, and Feeling exposed. Discussion It is proposed that elements of the refonnulation process may have impacted upon the participants outside of the refonnulation session, and as such had a more cumulative, longitudinal impact upon the working alliance. The use of template analysis in this study has presented an analysis of the data that enables readers to learn something that might be applied to the people that clinicians work with. Theoretical implications and suggestions for future research are also discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available