How reconceptualization of the self is negotiated in psychotherapy: an exploratory study of the therapeutic collaboration

Abstract

This case study explores the collaboration that occurs between therapist and client when reconceptualization innovative moments emerge. Reconceptualization innovative moments are exceptions to the problematic self-narrative that brought the client to therapy and are associated with successful psychotherapy. Reconceptualization innovative moments have two main components: a contrast between a past problematic facet and a current, more adjusted one (e.g., before I did/thought/felt X . . . , now, I do/think/feel Y) and an attribution for what allowed this transformation to occur (e.g., this was possible because I realized Z). The collaboration between therapist and client was analyzed using the Therapeutic Collaboration Coding System, which conceptualizes the relationship as collaborative or as noncollaborative. The majority of interactions in this case were clearly collaborative, with the therapist and client working inside the therapeutic zone of proximal development, which is typical of successful psychotherapy cases. Reconceptualization innovative moments begin with collaborative exchanges in which the therapist supported the problem and the client elaborated on the change afterward. Implications of these findings for change in psychotherapy are discussed.