摘要
为了探索我国来访者在心理咨询中的负面体验,本研究对42名被试进行半结构化一对一访谈,并进行了现象学主题分析。结果表明心理咨询中来访者的负面体验包括4个主题:一是与心理咨询行业特质相关的负面体验,包括与心理咨询本身的特点以及与行业发展阶段相关的负面体验;二是咨访契合度不高,包括风格不匹配、来访者难以敞开心扉、来访者反感咨询师;三是与咨询师胜任力相关的负面体验,包括来访者对咨询师能力与经验、态度、组织管理咨询的方式,以及伦理方面的不满;四是对咨询效果的不满意,包括未能满足来访者的期待,咨询引发的不良影响,以及来访者对咨询失望或停止咨询。综上,文化适应性、咨询中的权力关系不平等等问题对于来访者的体验有突出影响。来访者对咨询师胜任力的不满主要集中在胜任力的基本维度。咨询师应当对来访者的负面体验保持警觉。研究发现为改进本土心理咨询实践和提升咨询质量提供了有益的参考。
In China,a significant proportion of individuals with psychological disorders rarely seek psychological counseling,indicating the limited reach of mental health interventions.Despite common beliefs in the positive impact of psychological counseling,negative experiences,often unrecognized by counselors,can occur.The negative experiences in counseling may be attributed to a lack of counselor competence,poor therapeutic alliance,and high client expectations.However,considering the cultural discrepancies between Chinese traditions and Western-imported counseling practices,coupled with the unique development trajectory of the mental health industry in China,these findings may not fully encapsulate the negative experiences encountered by Chinese clients.Additionally,the lack of evidence-based practice in China could further contribute to adverse treatment outcomes.Therefore,this research aims to delve into the subjective negative experiences of Chinese clients in counseling.Adopting the sample size calculation method for qualitative research proposed by Fugard and Potts(2015),this study included 42 participants.Participant selection was designed to mirror the market demographics of clients,utilizing a combination of purposeful and quota sampling methods.Data were collected via semi-structured one-on-one telephone interviews,with an average length of 25 minutes.The interview question list was refined based on insights from the preliminary interviews.Following Braun and Clarke's(2006)six-step phenomenological thematic analysis,the study analyzed the transcripts to ensure a systematic and credible derivation of themes,with multiple validation processes throughout the coding and theme development phases.The analysis revealed four main themes concerning clients'negative experiences in counseling:(1)constraints inherent to the industry,(2)poor matching between the counselor and the client,(3)negative experiences associated with poor competence,and(4)dissatisfaction with treatment outcomes.The four main themes are further delineated into twelve subthemes for a detailed examination of the challenges faced.The first theme highlights two subthemes:the intrinsic characteristics of counseling,such as theoretical orientations,fixed counseling settings,and unequal power dynamics,as well as the development stage of the counseling industry in China,marked by the difficulty in finding qualified counselors and issues of cultural fit.The theme of mismatch between counselors and clients encompasses three subthemes:a mismatch in personal styles,hardship in trusting the therapist,and disliking the therapist.The theme of counselor incompetence,which contains the most significant number of nodes,is characterized by counselors'lack of professionalism and experience,proper attitudes,the ability to arrange sessions,and ethical violations.The final theme encapsulates clients'dissatisfaction with treatment outcomes,encompassing three subthemes:unmet expectations,negative effects of counseling,and becoming disappointed or stopping counseling.This study underscores the profound impact of industrial factors on clients'subjective experiences,particularly highlighting how issues such as cultural adaptability and the imbalance of power relations significantly influence these experiences.It also reveals deficiencies in the fundamental competencies of Chinese counselors.Furthermore,it acknowledges the potential for negative effects in psychological counseling and the significance of client expectations.These findings not only deepen and enrich our understanding of clients'negative experiences in the psychological counseling process but also highlight the complexity of the counseling process itself.The study emphasizes the interplay between clients,counselors,and the industrial environment.By identifying and understanding these negative experiences,the research offers insights for improving counselor training and contributes to the localization of counseling in China.
作者
李牧阳
雷霆
谢燮
国泽宇
刘可欣
陈雯青
孙沁怡
董韫韬
臧寅垠
LI Muyang;LEI Ting;XIE Xie;GUO Zeyu;LIU Kexin;CHEN Wenqing;SUN Qinyi;DONG Yuntao;ZANG Yinyin(School of Psychological and Cognitive Sciences,Beijing Key Laboratory of Behavior and Mental Health,and Key Laboratory of Machine Perception(Ministry of Education),Peking University,Beijing 100871,China;Guanghua School of Management,Peking University,Beijing 100871,China)
出处
《心理学报》
北大核心
2025年第7期1216-1230,共15页
Acta Psychologica Sinica
基金
青年科学基金[32000776]
国家自然科学基金[32371139,U2336214]
认知神经科学与学习国家重点实验室开放基金[CNLZD2103]。
关键词
心理咨询
咨访关系
咨询师胜任力
文化适应性
主题分析
psychological counseling
therapeutic alliance
counselor competence
cultural adaptability
thematic analysis
