The resolution of client confrontation challenges in exploratory psychotherapy : developing the new paradigm in psychotherapy research.

'How are Client Confrontation Challenges to the therapeutic relationship in Exploratory
therapy best addressed? 'was the question explored here. Given the significance of
the therapeutic relationship in Exploratory therapy (a Psychodynamic Interpersonal
therapy), Confrontation Challenges are significant, 'make or breaw, moments.
Depending on the effectiveness with which they are addressed, Confrontation
Challenges may significantly threaten or significantly promote therapeutic change.
The question was explored within the new Change Process Paradigm in
psychotherapy research. Therapeutic change is conceptualised as a fluid,
continuous, heterogeneous process; outcomes are achieved cumulatively, during and
between sessions and after therapy. With this reconceptualisation of relations
between process and outcome, the new paradigm aims to inform micro-level, momentto
moment, psych othe rape utic decision-making and theory-development.
The new paradigm's Significant Change Events strategy and its Task Analysis method
were used to explore the question. Thus Client Confrontation Challenges were recast
as affective tasks'calling for' resolution; Challenge Resolution Events are Significant
Change Events in Exploratory therapy. The researcher's 'best guess' at how
resolution may proceed (expressed in a Rational Model) was revised by iterative and
cumulative comparison with detailed, descriptions of more and less effective resolution
performances observed (in the Empirical Analysis) in therapy practice. The Rational
Empirical Comparison resulted in a Revised Model of effective Confrontation
Challenge Resolution; this represented the task analytic answer.
Effective Challenge Resolution was interpreted as process of 'Going with but
containing the Challenge' and thereafter managing two interdependent subprocesses,
Negotiation and Exploration. This substantive contribution was discussed in relation
to clinical thinking and to previous empirical work. The task analytic approach and the
Change Process Paradigm were developed by enhancing the triangulation of
psychotherapeutic theory and practice with the research approach.