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theses

This exploratory study investigated the impact of a mental health professional’s illness, injury, or disability on the therapeutic relationship. Primary issues, as identified in the literature, included: (a) disclosure; (b) alteration in the therapist/patient dyad, e.g., transference, countertransference, and a change of focus from patient health to include patient concerns for the therapist; (c) influences on therapist subjectivity; and (d) ethical and training implications. Thirteen clinicians who had faced an illness, injury, or disability while treating patients were interviewed in-person or by phone. A qualitative analysis of the interviews was conducted using a grounded theory approach (Corbin & Strauss, 2014). Study results identified themes consistent with the literature in multiple domains. Themes relating to disclosure of the therapist’s illness included: (a) the trend towards a more relational understanding and acceptance of a therapist’s self-disclosure of illness; (b) disclosing the illness out of necessity; (c) disclosure enhancing treatment progress; and (d) selective disclosure, e.g., disclosing to some patients, but not to others. Themes related to patients’ reactions to disclosure included transference responses elicited by the therapist’s illness, and the positive effect on treatment resulting from patient concern for the therapist. Themes identified in exploring therapists’ reactions included positive and negative emotional and countertransference responses to the illness, and positive and negative changes to the therapist’s subjectivity. The finding of ethical challenges arising from a therapist’s illness was consistent with the literature. Additional themes expanded upon current knowledge, such as: (a) how illness alters a therapist’s conceptualization of patient treatment; (b) how patient concern for the therapist might be utilized to promote treatment progress; (c) adherence to ethical guidelines; and (d) how enhanced training might prepare therapists for future personal crises. Implications for research indicated the need for more systematic qualitative and quantitative investigations. Implications for clinicians and the mental health field were identified as pertaining to: (a) issues of disclosure; (b) patient and therapist reactions; and (c) the need for training programs and professional organizations to better prepare clinicians for potential crises, such as illness, and to revise ethical guidelines to incorporate current research findings.

ETD_9175

Psy.D.

Includes bibliographical references

by Joshua Romero

doi:10.7282/T379488S

ETD doctoral

The author owns the copyright to this work.