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A phenomenological understanding of dilemma from the tTherapist's perspective

10 December 2004


Literature on therapeutic dilemmas is scarce. Related literature on therapeutic impasse fails to capture therapist experiences of being in a situation in which any available interventions appear to be counter-therapeutic. This study was a phenomenological investigation of therapists' experiences of being in dilemmas. Results suggest that dilemmas can be characterized by therapists' perceived inability to act juxtaposed with the experienced need to take action. Additionally, three main themes were obtained from this study. The first theme, therapists' experiences of being in a dilemma, includes both being stuck and generating alternative options. The second theme, therapists' attitudes, was divided into attitudes that reflect compassion and commitment and attitudes that reflect frustration towards the client and/or the situation. The third theme, therapists' personal responses, was divided into the recognition of personal and professional limits and comparisons with past situations. Available writings on therapeutic impasse suggest that dilemmas may fit definitions of impasse, but not all definitions of impasse fit dilemmas. The main difference is that therapists. experiencing an impasse reported a sense of self-alienation and disconnection, whereas therapists in dilemmas did not consistently report this experience.


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