Exploring experiences of power in therapeutic relationships between NHS service users and Clinical Psychologists

Farrar, Oliver (2023) Exploring experiences of power in therapeutic relationships between NHS service users and Clinical Psychologists. Doctoral thesis, University of East Anglia.

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Abstract

Background: A positive therapeutic relationship is often cited as the most stable predictor of outcomes in psychotherapy (Horvath, Del Re, Flückinger & Symonds, 2011). However, this is poorly understood from the perspective of the service user. Power is theorised to be an important factor in therapeutic relationships for service users but there is no current empirical research investigating this from a service user perspective.

Aims: This portfolio aims to identify and synthesise the current literature on factors that impact NHS services users’ experiences of the therapeutic relationship and undertake novel empirical research into how NHS service users experience of power in therapeutic relationships with Clinical Psychologists.

Methodology: A systematic review was conducted, and from this thematic synthesis investigated factors that impact NHS service users experience of therapeutic relationships. Further, an Interpretative Phenomenological Analysis was undertaken to explore NHS service users’ experiences of power in therapeutic relationships with Clinical Psychologists.

Results: Four themes relating to NHS service users’ experiences in therapeutic relationships were developed in the systemic review. In the empirical paper, one superordinate theme emerged ‘the dynamic tapestry of power’, constructed by three subsidiary themes. These spoke to the different experiences of disempowerment prior to therapy, balancing of power in the relationship and pivotal therapeutic moments or ruptures.

Conclusion: The results demonstrated that that power operates on a number of complex levels within the therapeutic relationship in ways that may not be attended to by clinicians. It also showed how power can be used positively and the benefits of power being made more visible so that it can be attended to by clinicians, service users, and policymakers. Implications and future research options are discussed.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Nov 2023 08:54
Last Modified:	09 Nov 2023 08:54
URI:	https://ueaeprints.uea.ac.uk/id/eprint/93608
DOI:

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