Phd in DYNAMIC AND CLINICAL PSYCHOLOGY

Thesis title: Gestione del confine nel processo terapeutico: analisi qualitativa dell’esperienza di psicologi-psicoterapeuti italiani

International literature has explored the critical role of maintaining boundaries between psychologists and their clients, highlighting the complex interplay between the beneficial and detrimental aspects of boundary management. A systematic review and thematic analysis were conducted to explore therapeutic boundary management, examining variables related to psychotherapists, clients, and settings across different therapeutic orientations. This review aimed to identify common challenges in boundary management and analyze studies and observations on boundary dilemmas, consequences of poor boundary management, and key themes in boundary handling beyond theoretical approaches. Using academic search databases, original research articles from peer-reviewed journals were identified. Articles employing qualitative (n=18), quantitative (n=18), and mixed methods (n=1) were included. Based on the coding of findings and discussions from the articles included in the systematic review, four themes were identified: (1) Boundary Management and Power Dynamics; (2) The Emotional and Personal Role in Therapy; (3) Professional Competence and Continuing Education; and (4) Values, Culture, and the Context of Therapy. Two independent evaluators appraised the articles, using criteria for quality assessment that highlighted methodological strengths and weaknesses. Despite the significance of this topic, insights from experienced therapists regarding boundary maintenance with clients are notably scarce in the Italian context. This qualitative study aimed to enrich our understanding of the perspectives of experienced clinical therapists on maintaining boundaries in their clinical practice. Through Consensual Qualitative Analysis of 15 semi-structured interviews with seasoned clinical therapists—who have obtained their licenses and have been providing mental health treatment for at least ten years—this research has unveiled insights and expanded our knowledge on this crucial topic. The analysis yielded three distinct themes, revealing participants' nuanced understanding of boundary management. The conclusion drawn from this study underscores the importance that licensed and experienced clinical therapists place on managing boundaries with clients, recognizing their varied stances on the rigidity versus flexibility of these boundaries, and the factors influencing boundary management practices. Furthermore, this study highlights the imperative for novice therapists to undergo comprehensive training and gain practical experience in effective boundary management.