Psychology and Psychotherapy: Theory, Research and Practice

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Volume 73 Issue 4 (December 2000), Pages 433-567

A conflict of responsibilities: A grounded theory study of clinical psychologists' experiences of client non‐attendance within the British National Health Service (pages 465-481)

Within psychotherapy process research, the effects of client non‐attendance upon therapists has been neglected. The present study interviewed six clinical psychologists concerning their experiences of client non‐attendance in health service practice in the UK. Their accounts were analysed using a grounded theory method. A core category was identified and termed ‘responsibility’. This highlighted conflicting relationships between participants' responsibilities in several areas. A process model pertaining to non‐attendance was also developed. Client non‐attendance was seen to produce a level of disruption, experienced as an affective reaction and often experienced in terms of negative affect. In response, re‐organizational strategies were used to restore equilibrium. Reasons are suggested as to why negative affective reactions were experienced. These include factors concerning therapeutic competency, but also reflect upon the profession's espousal of an ‘all‐knowing’ expert identity. This is seen to be incongruent to the complexities of clinical practice.

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