Improvement and positions in psychodynamic psychotherapy: A qualitative exploration of adolescents’ and adult patients’ experiences

The mental health services have a strong obligation to offer helpful treatment to patients. However, what is helpful? The main aim of this thesis was to explore this in psychodynamic psychotherapy, as seen from the patients’ perspective. The research questions were how adolescent and adult patients with depression experienced improvement in time limited psychodynamic psychotherapy, what improvement meant to them, as well as to explore positions and mutuality in adolescent psychotherapy. Nine adolescent and 12 adult patients were qualitatively interviewed post-treatment about their experiences with time-limited psychodynamic psychotherapy. The interviews covered what the patients experienced as helpful and not helpful in therapy, how therapy affected their relations and life circumstances and whether they could use something from therapy outside of the therapy room. The interviews were analyzed using content analysis in combination with hermeneutic interpretation, and by applying positioning theory. The results revealed the patients’ need for talking about how to deal with specific challenges they encountered in their everyday lives. Examples could be what to say or do to better deal with relational difficulties at home or school, as well as how to better master troublesome thoughts, feelings or practical tasks. To achieve this, both the adolescents and adults emphasized a supporting and acknowledging therapist; opening oneself up to the therapist and accepting oneself; getting insight and new perspectives; and changing their ways of thinking, feeling or acting. Improvement showed to be non-linear processes of great diversity, which also could include paradoxical experiences of both beneficial and non-beneficial positions. The thesis points to the potential of psychodynamic psychotherapy, a relational-oriented psychotherapy mode, integrating a focus on how to master the specific challenges the patients face in their everyday circumstances