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Kirk J. Honda is a 2014 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle.

Kirk Honda has been faculty at Antioch University since 1998 and psychotherapist since 1996. He also hosts The Psychology In Seattle Podcast.

Dissertation Committee

Mark Russell, PhD - Dissertation Chair

Ned Farley, PhD - Committee Member

Tim Popanz, PhD - Committee Member

Keywords

psychotherapy, psychotherapist, counseling, counselor; therapist; self-care; therapist difficulty; countertransference; treatment failure; counselor training, phenomenological, therapist experience; counselor experience, supervision, shame, qualitative, phenomenology

Document Type

Dissertation

Publication Date

2014

Abstract

Purpose: This phenomenological study was concerned with the clarification of the experience of the difficult clinical moment which is defined as a discrete moment in which the psychotherapist experiences distress as a result of his or her work with a client. Method: Retrospective descriptions of experience of difficult clinical moments were obtained from a diverse sample of ten seasoned psychotherapists in the Seattle area. The interviews were transcribed, analyzed, and summarized, and these summaries were confirmed by each participant as being an accurate representation of their experience. Results: Thematic analysis revealed six themes of experience during a difficult clinical moment: 1) Feeling Fear, 2) Feeling Inadequate, 3) Feeling Anger, 4) Feeling Confused, 5) Feeling an Urge to Hide Feelings, and 6) Feeling an Urge to Terminate. An essential general structure of the experience of difficult moments was derived from these themes. Discussion: Conclusions are discussed including: 1) the novel findings of feeling fear and feeling an urge to hide one’s feelings during difficulty; and 2) the urge to hide one’s feelings during difficulty appears to be motivated by both therapist shame and an urge to maintain the therapeutic relationship. Implications are discussed including: 1) the dilemma regarding whether or not a therapist should entertain the urge to hide his or her feelings; and 2) the culture of shame within the field of psychotherapy that stigmatizes therapist difficulties which interferes with consultation. Recommendations for training and research are provided including a recommendation to disseminate these findings to normalize the experience and to encourage therapists and supervisors to discuss difficult clinical moments within consultation, supervision, and training which might reduce the distress of the moment, improve coping skills, provide treatment strategies, and ultimately improve client outcomes. The electronic version of this dissertation is at Ohiolink ETD Center www.ohiolink.edu

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