Adaptation of Luborsky’s Core Conflictual Relationship Theme (CCRT) method : a phenomenological case study

Abstract

In this research a novel adaptation of Luborsky’s Core Conflictual Relationship Theme (CCRT) method was implemented within a phenomenological methodology. The Duquesne phenomenological research method (DPRM) provided the framework for the new methodology. This new method was applied to a case study consisting of transcripts of therapy sessions conducted by the researcher with a Burning Mouth Syndrome (BMS) client. The CCRT method provides a useful structure for analysing relational experiences in transcripts. Application of the CCRT to a transcript however proved insufficient to provide the depth and richness of information that was of interest to the researcher. For this reason application of the CCRT as a technique within a broader phenomenological method was considered. This integration combines benefits of both methods, in terms of providing a more structured way of identifying meaning units in transcripts, as well as through retaining the depth and richness of recorded relational experiences. In the original CCRT method client accounts of relational interactions are analyzed in terms of the wishe/s, need/s and intention/s (WIN/s) of the client directed towards some person/s, the response of the other person/s and the client’s response to him/herself. In the proposed modification of the CCRT method the emphasis was changed to analysis of all accounts of interactions, even if occurring outside of therapy, as pertaining to interpersonal occurrences within the client-therapist relationship. Analysing transcripts in this way, i.e. emphasising the importance of current context, required a structured means of identifying relational experiences, not only in terms of the client’s WIN/s, but also in terms of the therapist’s WIN/s. The results of this study suggest that the above method resulted in increased insight and understanding of the interpersonal experiences examined, and that it transformed the therapist’s insight regarding his own role in interpersonal interactions with this specific client. The increased understanding resulting from this study should benefit future clients in therapy with the therapist. The modified method’s main contributions are that it provides a more structured approach to the identification of meaning units as well as a more formal way of including context through evaluation of the flow of experiences between relational experiences (REs). The main drawbacks of the method were the difficulties associated with demarcating REs and ordering of information in the developed Unit Interaction Record Sheet (UIRS). These difficulties initially caused application of the method to be very time consuming. This improved as the researcher’s expertise at using the new technique increased. Although the method has the potential to be a general tool for analysing transcripts, which are not limited to a specific theoretical orientation, further research is necessary to determine the usefulness of the modified methodology as a general research instrument.