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Juicy Conceptualizations: Increasing Alliance Through Attending to Client Metaphoric Language

Published online by Cambridge University Press:  17 May 2017

Fiona Mathieson Open the ORCID record for Fiona Mathieson [Opens in a new window] ,
Jennifer Jordan ,
Paul Merrick  and
Maria Stubbe
Fiona Mathieson*
Affiliation:
University of Otago, Wellington, New Zealand
Jennifer Jordan
Affiliation:
University of Otago, Christchurch, New Zealand
Paul Merrick
Affiliation:
Massey University, Albany, Auckland, New Zealand
Maria Stubbe
Affiliation:
University of Otago, Wellington, New Zealand
*
Correspondence and reprint requests to Fiona Mathieson, Department of Psychological Medicine, University of Otago, Wellington, PO Box 7343, Wellington 6242, New Zealand. E-mail: [email protected]
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Abstract

Background: There is increasing interest in the use of metaphor in cognitive behaviour therapy. Experts advocate bringing client metaphors into case conceptualizations, but there is little empirical research to support this. Aims: This study evaluated the effect of training 12 therapists to attend to client metaphors and bring them into case conceptualizations. Method: Pre- and post-training role-played therapy sessions were conducted and video-recorded. Alliance was rated by role play ‘clients’ and an external expert rated the quality of the sessions and of the shared conceptualizations. Results: There were significant increases in some ratings of alliance, based on role play ‘client’ ratings and external ratings of role plays of therapy sessions before and after training. The greater the difference between therapist and ‘client’ on a measure of preference for producing metaphor, the lower the rating of the session by the ‘client’ on the Bond factor score of an alliance measure, the Working Alliance Inventory. This result suggests that working metaphorically may be most effective when the therapist and client have a similar degree of preference for speaking metaphorically. Conclusion: This study provides preliminary support for the idea that attending to client metaphors during conceptualization can be beneficial for alliance.

Keywords

Metaphorcognitive behaviour therapyconceptualizationalliance
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 6 , November 2017 , pp. 577 - 589
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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