Disagreement and the therapeutic relationship

Project aims

The aim of this project is to increase our scientific understanding of disagreements due to value differences, its relevance for the therapeutic relationship and its implications for our understanding of patient autonomy. This project is situated at the interface of empirical ethics and psychotherapy research. I will pursue two major objectives: 1) define and explore ruptures due to value differences in the psychotherapeutic context and the resolution thereof, and 2) evaluate these findings in relation to their implications for patient autonomy.

The challenge

This project will provide a greater understanding of disagreements due to value differences in the psychotherapeutic setting and strategies used to resolve them. Having such strategies are important to enhance individual rights of the patients as they will be better informed and are in a better situation to embrace their patient autonomy. The results will be useful not only to the psychotherapeutic community but also to other healthcare professions.

Key Project Partners: Prof. Sigal Zilcha-Mano, University of Haifa

Methods

Aim 1: Mixed-methods approach

Scoping review

Review literature on value differences in psychotherapy

Examine definitions, impact on the therapeutic alliance, resolution strategies, and implications for patient autonomy

Empirical analyses

Analyze pre-coded, transcribed psychotherapy sessions from a research clinic

Conduct qualitative analyses of value-based ruptures and therapists' repair strategies

Qualitative–quantitative integration

Explore how rupture and repair processes are reflected in acoustic, movement, physiological, and facial expression data

Examine links between quantitative measures and subjective experience

Aim 2: Ethical analysis

Use findings from the scoping review and qualitative analyses to inform a theoretical ethical analysis of value-based ruptures, their resolution, and implications for patient autonomy