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Clients’ Experiences of Disengaged Moments in Psychotherapy: A Grounded Theory Analysis

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Abstract

The study offers an empirically derived model of clients’ experiences of disengaged moments, defined as moments when clients withdraw, distance, or lessen their intensity of involvement with therapy-relevant material or relationships. Interpersonal Process Recall (IPR) interviews were conducted with nine psychotherapy clients of therapists with varied orientations and experience. The interviews were transcribed verbatim and subjected to qualitative analysis using grounded theory analysis (Glaser and Strauss, The discovery of grounded theory: Strategies for qualitative research, 1967) methodology. The results suggested that clients use disengagement for protection from pain, strategic retreat, relationship management, self-through-other discovery, and self-betterment. The core category across all of the experiences of disengagement relates to communicating difficulties and experimenting within the therapy relationship toward self-change. Recommendations are offered for research and practice.

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Acknowledgement

We would like to acknowledge and express our gratitude to Dr. Robert A. Neimeyer, Dr. Sharon G. Horne, Dr. Sam B. Morgan, Dr. Karina Koerner, and Joseph Currier for their help with this study.

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Authors and Affiliations

  1. The University of Memphis, Memphis, TN, 38152, USA

    Ze’ev Frankel

  2. Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN, 38152, USA

    Heidi M. Levitt

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  1. Ze’ev Frankel
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Correspondence to Ze’ev Frankel.

Appendix A: Disengagement Interview Questions

Appendix A: Disengagement Interview Questions

Statements Made Preceding Each Interview

  1. 1.

    I am meeting with you today to learn about your experience in the therapy session.

  2. 2.

    If at any part during the interview you are uncomfortable with a certain question or topic please let me know and we can move to another topic, or if you need we can terminate the interview altogether.

  3. 3.

    I am particularly interested in moments where you might lessen your involvement in the session, remove yourself from the topic that was being discussed, or hold back things that you are thinking or feeling. For instance, when you feel yourself detach from the therapy conversation or pull back from what’s being discussed or feel less involved in the therapy process. I call these occurrences disengaged moments. I am particularly interested in what is happening for you in the session rather than your reactions now, but if you share a new reaction, please let me know that it is not what you were feeling then.

  4. 4.

    Before we start are there any moments like this that stand out for you within your last session? Because we’re going to go through the whole tape—and I’ll want to hear more about it later—could you give me a brief description now?

  5. 5.

    I’ll give you the remote control and you can watch the tape, stopping at such disengaged moments.

Questions about Each Disengaged Moment

  1. 1.

    What were you experiencing in this disengaged moment?

  2. 2.

    How did these feelings come up for you at this point? What was going on before?

  3. 3.

    What was it that prompted you to disengage?

  4. 4.

    Was there anything else going on for you during this moment?

  5. 5.

    What do you think was going on for the therapist at this point?

  6. 6.

    How would you have liked the therapist to respond to you here? How would that have made you feel through the rest of the session?

Questions and Statements to be Made at the End of the Interview

  1. 1.

    We’re almost finished with the interview. I would like to ask you some questions about our interview today because I will be interviewing some more people and I would like to make sure that I am asking the best questions and using the best interviewing style that I can.

  2. 2.

    What did these moments mean for you? Do you see a trend in your disengagement? Do you have a theory about disengagement after viewing your session tape?

  3. 3.

    Which disengaged moment felt the most important to you?

  4. 4.

    Is there anything I haven’t asked that feels like it would help me understand your experience of disengagement?

  5. 5.

    Is there anything you have learned from this interview process?

  6. 6.

    Is there anything you would want to share with your therapist?

  7. 7.

    Do you have any questions or comments, about anything?

  8. 8.

    How do you feel about our meeting today?

  9. 9.

    Let me remind you that I’ll be asking for your feedback once the findings of this study are compiled. I’ll be interested in hearing what you think about the study’s findings. This is actually really important for the study, as part of the assessment of my findings is whether they are coherent and fitting with your experience. So even if you have nothing to add to the findings it is important to me that you return the feedback form.

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Frankel, Z., Levitt, H.M. Clients’ Experiences of Disengaged Moments in Psychotherapy: A Grounded Theory Analysis. J Contemp Psychother 39, 171–186 (2009). https://doi.org/10.1007/s10879-008-9087-z

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