关键词: 心理治疗, 领悟, 质化研究

Abstract:

Insight is a crucial phenomenon in counseling with its importance been confirmed by counseling theory and empirical studies. However, there is a lack of specific studies on this topic, and most researchers focused on psychodynamic area whereas little attention has been laid on pantheoretical counseling. There is no unified definition of insight available at the moment. Psychodynamic therapy regards insight as the formation of connections, e.g. between past and present, inner conflict and external performance, attachment relationships and transference. Experiential therapy equates insight to awareness and meta-awareness. Cognitive–behavioral therapy views insight as a cognitive restructuring or change of schema; insight occurs when previous irrational beliefs or schemas are recognized and replaced by new, rational beliefs or schemas. Meanwhile, different researchers also gave different operational definitions in cross-theory empirical research. As a result, the lack of a unified definition of insight, in either theoretical or empirical research, has made it impossible to integrate different results and prevented the development of a specialized and reliable measurement of insight. In addition, nearly all definitions were proposed by researchers or clinicians. Whether or not clients have a different perspective is unknown. Moreover, all the definitions currently in use were developed by western researchers focusing on western psychotherapy. Would Chinese psychotherapy present a different perspective? This study sought to delineate insight from Chinese clients’ perspective via a qualitative approach. Fourteen clients counseled in a university counseling center and a client counseled in a social counseling institution participated in the study. They were interviewed with a semi-structured protocol, either face-to-face, by phone, or through internet, about their opinions and experiences of insight during counseling. Their responses were analyzed by a research team using Consensual Qualitative Research (CQR) method. Analysis revealed seven key issues: contents of insight, effects of insight, factors influencing the appearance of insight, basis for evaluating insight quality, feelings when insight appears, source of insight, and factors that hinder insight from having an effect. Based on interviewees’ responses, a definition of “insight” from the client perspective is proposed: “insight is a new understanding of oneself and others (mainly oneself), the contents of which include problematic patterns, their reasons, their effects, solutions for psychological distress or problematic patterns, and awareness of one’s internal mental state.” Results suggested that most contents of insight from client and counselor’s perspectives are in concordance. However, the description level is different and some contents which haven’t been thought as insight before was confirmed by clients. It reminds counselors that they could change their angle of view in order to understand insight from client’s point. The current study also provides the foundation of future study’s development of scale for insight.

Key words: psychotherapy, insight, qualitative research