Subjective Experiences of Clients who have Attended Psychotherapy at Tikur Anebessa Specialized Hospital and Zewditu Memorial Hospital, Ethiopia 2021: A Qualitative Study

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Date

2021-11

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Addis Ababa University

Abstract

Background Psychotherapy, traditionally known as talk therapy is one of the main management modalities used in mental health. It is used to help clients with claimed psychosocial problems to overcome their symptoms and to improve their well being and mental health by applying psychosocial methods. Clients are the reasons why all the psychotherapies are made for and understanding their subjective experiences of the psychotherapies helps us the understanding them, to make psychotherapy meaningful and to design contextual modalities of intervention compatible to a given psychosocial context. This study focuses on assessing the subjective experiences of clients who have attended psychotherapy at TASH and ZMH. Objective To explore and understand the subjective experiences of clients who have attended psychotherapy at TASH and ZMH, so that we would learn from how psychotherapy appears for the clients from their perspective. Method Qualitative study was conducted on clients who have attended psychotherapy at TASH and ZMH by using in-depth semi-structured interview questions that was prepared after referring different articles on the topic. Participants were recruited using non-probabilistic heterogeneous purposive sampling technique from the hospitals referred above. Participants were those who have attended psychotherapy at least for four sessions, consented to take part, speak Amharic language fluently and on stable mental condition. Sampling proceeded until theoretical saturation was achieved. Eight in-depth interviews were conducted and all were included in the results. The in-depth interviews were audio recorded, transcribed and translated into English. Thematic analysis was used to identify key themes. Findings The subjective experiences of clients who have attended psychotherapy were summarized in to four major themes with subordinate subthemes. Firstly, how clients perceived psychotherapy and all of them have defined it as a means of discharging out impacted emotions. They have also differentiated talk therapy from other routine advices based on their experiences and they have had different types of goals set by collaborating with the clinicians. The second theme was their positive experiences and except one all of the participants had helpful experiences which were categorized under how it has impacted their self concept, their social life and their understanding of factors that had contributed to their illnesses. Clients have also described mechanisms at which how psychotherapy has healed them. In the healing process is attributed to clinicians’ factors such as empathic listening and clients’ factors such as willingness to be healed and their belief on the therapy. The third theme was the negative experiences of clients. They have experienced it due to different factors like the therapist, the society and the therapy itself. How they had experienced relationships were the fourth theme identified. Conclusion Clients have experienced psychotherapy as beneficial in most cases and harmful in some cases. What mattered most for the clients were; an empathic listening, unconditional acceptance and their connection with the therapist who is emotional sensitive and focusing on them as a person not on their problems as priority. Therapists’ being not persistent and sensitive had a counterproductive effect on the therapeutic alliance and contributed to the worsening of symptoms. Clients were not comfortable with frequent turnover of clients, being evaluated in front multiple people and long waiting time they spent. Most of the concepts mentioned as healing mechanisms and negative impacts were mainly described in the contexts of identity of clients, interpersonal relationships and social life.

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Psychotherapy Subjective experience Healing mechanism Clinicians/therapists Clients/patients Qualitative study

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