Individual psychotherapy and the patient's significant other.

Abstract

The majority of outpatient psychotherapy consumers engage in individual treatments. Meetings are conducted one-on-one with the treating clinician, and the content and process of these sessions is seen as confidential and deeply personalized to the identified patient. Inherent in this work is the assumption that what goes on within the treatment relationship will intimately tie in to what goes on for the patient outside of it, but we know little about how this actually works. The present study was designed: (1) to assess individual psychotherapy's effects on the patient-partner (P-P), his/her significant other (SO), and the relationship between the two; (2) to explore potential influences on these effects; and (3) to identify common outcomes for the couple, treatment, and SO attitudes toward and willingness to use psychotherapy. Research participants (n = 15) were drawn from a self-selected, community sample of individuals who currently were or previously had been involved in a serious relationship with a partner undergoing individual psychotherapy. No restrictions were made according to participant history of direct experience with psychotherapy, whether the relevant therapy had yet been completed, or on the basis of which relationship preceded the other. Following a mixed-methods design, each participant completed a 75--90 minute semi-structured interview, a survey questionnaire, and a one-week follow-up phone call. Using grounded theory and the constant comparative method, qualitative data were systematically coded into units, which were then categorized according to thematic content. Descriptive statistical analyses of quantitative data were used to validate and frame the qualitative findings. Study results confirmed and expanded on past findings of positive therapeutic spread, and partially confirmed theories regarding triangulation and negotiation of the therapist as an important other. However, the present study's findings did not lend support to the deterioration hypothesis or to the idea of individual therapy as an isolated, self-focused endeavor. Important emergent themes included SO role strain, therapeutic misattribution, therapy-related silencing, therapy as 'feminizing', and therapy as a purchased friendship. The implications of these findings for future clinical research and practice are discussed.