‘it’s important for me not to let go of hope’: psychologists’ in-session experiences of hope
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‘It’s important for me not to let goof hope’: Psychologists’ in-sessionexperiences of hopeDenise J. Larsen a , Rachel Stege a & Keri Flesaker aa Department of Educational Psychology , University of Alberta ,Edmonton , AB , CanadaPublished online: 17 Jun 2013.
To cite this article: Denise J. Larsen , Rachel Stege & Keri Flesaker (2013) ‘It’simportant for me not to let go of hope’: Psychologists’ in-session experiences of hope,Reflective Practice: International and Multidisciplinary Perspectives, 14:4, 472-486, DOI:10.1080/14623943.2013.806301
To link to this article: http://dx.doi.org/10.1080/14623943.2013.806301
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‘It’s important for me not to let go of hope’: Psychologists’in-session experiences of hope
Denise J. Larsen*, Rachel Stege and Keri Flesaker
Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
(Received 13 March 2013; final version received 15 May 2013)
Helping professionals are often expected to have a ready and limitless supply ofhope. However, novice and experienced psychologists alike recognize the chal-lenge of maintaining hope when working with difficult presenting problems anddemoralized clients. As professionals, to hold hope in session while witnessingour clients’ hopelessness and experiencing our own can be very difficult. Theimportance of client hope is well recognized in psychotherapy research, yetresearch exploring psychologists’ own experiences of hope has been neglected.This study, part of a larger program of research on hope in psychological prac-tice, invited psychologists to reflect on their experiences of hope in practice.Interpersonal Process Recall allowed psychologist-participants to view playbackof their video-recorded session and reflect on their in-session experiences ofhope. Using basic interpretive inquiry, this case study identified categories of:(a) psychologist self-influence on hope, (b) client-specific factors relating topsychologist hope, and (c) psychologist hope experienced in the therapeuticrelationship. Implications for practice include encouraging psychologist self-awareness about hope, recognizing that psychologist hope can fluctuate naturallyin session, encouraging psychologist hopeful self-care, and seeing psychologisthope as providing therapeutic information.
Keywords: reflective practice; hope; counselling; psychology; psychotherapy;psychologist self-awareness; psychotherapist process
Introduction
Psychological practice and research literature consistently asserts the importance ofpractitioner hope to the therapeutic endeavour. Indeed, it is difficult to conceive ofpositive therapeutic outcomes where the psychologist does not believe that beneficialchange is possible. Herein lays a tension for psychologists. By definition, psycholo-gists often work with intense human suffering and, understandably, their hope can bechallenged. Off-handedly we may speak as if hope is in ready supply for psycholo-gists, available to be easily dispensed. However, research on psychologist burnoutand compassion fatigue calls this assumption into question (e.g. Austin et al., 2013).Little research has been done on psychologist hope and none describes psychologisthope in session. To begin to address this gap, the current study involved asking fivepsychologists working with 11 individual clients to reflect on their in-vivoexperiences of hope. We begin with an overview of hope research and a review ofliterature available on psychologist hope. This is followed by a description of thestudy, findings, and discussion focused on practice implications.
*Corresponding author. Email: [email protected]
Reflective Practice, 2013Vol. 14, No. 4, 472–486, http://dx.doi.org/10.1080/14623943.2013.806301
� 2013 Taylor & Francis
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What is hope?
Integral to human experience, hope is described as ‘the fundamental knowledge andfeeling that there is a way out of difficulty, that things can work out, that we ashuman persons can somehow handle and manage internal and external reality’(Lynch, 1965, p. 32). For researchers studying the concept of hope, many overlap-ping, research-derived definitions of hope exist. Hope models are often conceptual-ized as uni-dimensional or multi-dimensional, depending on the level of complexityused to describe the phenomenon. Uni-dimensional models tend to emphasize hopewithin a singular focus, typically concentrating on goals, whereas multi-dimensionalmodels illuminate the experience of hope across various modalities (e.g. cognitively,spiritually, relationally). Both perspectives inform current understandings of hope.
One of the most well-known uni-dimensional hope models is Snyder andcolleagues’ Hope Theory (Snyder et al., 1991). Snyder defined hope as a goaldirected process which includes: agency (motivation to move toward goals) andpathways (perceived ways to achieve those goals). Referring to the colloquialexpression, ‘Where there’s a will, there’s a way’, Snyder likened agency to the‘will’ and pathways to the ‘way’ (Snyder, 1995).
Research-informed multi-dimensional models of hope find that hope implicates awide range of human experience. Across a number of models, commonly identifiedcharacteristics of hope include temporal (e.g. Benzein & Savemen, 1998; Cutcliffe,1997; Farran, Herth, & Popovich, 1995), cognitive (e.g. Dufault & Martocchio,1985; Farran et al., 1995), affective (e.g. Dufault & Martocchio, 1985; Farran et al.,1995), behavioural (e.g. Benzein, Saveman, & Norberg, 2000; Dufault & Martoc-chio, 1985), spiritual (e.g. Farran et al., 1995; Gaskins & Forté, 1995), interpersonal(e.g. Dufault & Martocchio, 1985; Farran et al., 1995), and goal-oriented (e.g. Benz-ein et al., 2000; Gaskins & Forté, 1995) aspects. Stephenson (1991) offered a com-prehensive definition encompassing these multi-dimensional aspects, describing hopeas ‘a process of anticipation that involves the interaction of thinking, acting, feelingand relating, and is directed toward a future fulfillment that is personally meaningful’(p. 1459). Succinctly summarizing the breadth of human experience touched byhope, Jevne (2005) wrote that hope criss-crosses ‘goal and soul, doing and being,process and outcome, state and trait’ (p. 266).
The importance of hope for psychologists’ well-being
Psychological practice is challenging work, with serious ‘occupational hazards’(Saakvitne, 2002, p. 325). Hope, meanwhile, is believed to support psychologists’well-being across psychotherapeutic contexts. Hope is believed to facilitate coping,permitting psychologists to envision future positive outcomes while working withexceptionally challenging circumstances. Jevne and Nekolaichuk (2003) assertedthat ‘professionals must find a way of sustaining a hopeful orientation in the pres-ence of those who don’t comply with treatment, don’t get well, won’t take advice,and don’t convey a sense of appreciation’ (p. 197). Hope is associated with helpingprofessionals’ ability to cope with work-related stressors (Dufrane & Leclair, 1984;Edey & Jevne, 2003; Frost, 2004; Janzen, 2001; Schwartz, Tiamiyu, & Dwyer,2007; Shechter, 1999; Snyder, 1995), particularly in working with challengingpsychotherapeutic contexts (Collins & Kuehn, 2004; Flesaker & Larsen, 2012).Responding to the realities of professional practice, including situational stressors,
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individual factors and vicarious traumatization, Saakvitne (2002) asserted that ‘hopeis our most essential commodity as therapists’ (p. 338).
The importance of psychologists’ hope in practice
The hope of the psychologist is increasingly understood as an important factor intherapeutic effectiveness. Meta-analyses reveal hope to be a crucial factor in theclient change process (e.g. Hubble, Duncan, & Miller, 1999), with many leadingpsychological theories identifying hope as a key change agent (Larsen & Stege,2010). Hope can have an emotional contagion effect (Larsen & Stege, 2010), lead-ing researchers to emphasize that effective practice involves ‘relationships that traf-fic in hopeful thinking’ (Snyder, 1994, p. 289). Hope is offered in session when apsychologist can convey a genuine belief in, and hope for, the client. In support ofthis claim, Coppock, Owen, Zagarskas, and Schmidt (2010) recently found a signifi-cant relationship between psychologists’ hope in their clients and client outcomes.Jevne (2005), an early hope scholar, asserted that developing one’s hope is an ethi-cal, professional competency requiring both effort and learning. She contended thatreflecting on one’s own hope is the crucial starting point for this professional com-petency.
Most hope research on therapeutic relationships begins with the assumption thatprofessionals already possess ‘a reservoir of hope’ (Koenig & Spano, 2007, p. 46)to draw from for clients (Cutcliffe, 2004). Unfortunately, this is often not the case.Faced with especially difficult cases, professionals may lack hope and pessimisti-cally view client capacities for change (Goldney, 2005; Schroeder, 2005; Schwartz,2000). In their work on psychological change processes, both Snyder (1995) andHanna (2002) contended that a lack of hope on behalf of the psychologist can nega-tively affect the psychotherapeutic process. As such, psychologists’ struggle forhope becomes of crucial importance for both psychologist and client well-being.
Fluidity, nuance and hope: hope as process
Reviewing the research literature on hope and psychology, it may be tempting tooversimplify the topic. With compelling research-evidenced findings like therelationship between higher hope and better life outcomes (Cheavens, Michael, &Snyder, 2005) and higher psychotherapist hope associated with enhanced clientoutcome (Coppock et al., 2010), we may have a tendency to think of hope dichoto-mously, as either present or absent. This perception may place undue pressure onpsychologists by pathologizing the experience of low hope.
Interestingly, hope scholars consistently speak of hope and hopelessness asco-existing (e.g. Jevne, 2005) and neurological research indicates that hope andhopelessness may be experienced in different parts of the brain (Gottschalk,Fronczek, & Buchsbaum, 1993). Speaking from her experience as a family therapistand supervisor, Flaskas (2007, p. 189) acknowledged ‘the possibility of strong hopeand strong hopelessness existing side by side’ in the therapeutic relationship. As apsychologist, being attuned to one’s own fluctuating sense of hope may be moreimportant than never losing hope. Research on hope for caregivers and health careprofessionals correspond with this trend (Duggleby, Williams, Wright, & Bollinger,2009; Flesaker & Larsen, 2012; Lipschitz-Elhawi, 2009), suggesting that profession-als commonly experience both hope and hopelessness and that it is possible to both
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witness one’s own experiences of hopelessness, as well as intentionally foster one’sown hoping process during challenging moments in practice.
With the importance of hope in the psychological context receiving increasingrecognition, how psychologists sustain hope and face inevitable threats to hope inthe course of practice is a vital consideration. However, as with much research onpsychologist self-awareness (Williams, 2008), psychologist hope has received littleresearch attention. This research seeks to address the following research question:When reflecting on their own practice, what do therapists identify as factors thatinfluence their hope in session?
Research design
The research design1 was guided by case study methodology, in line with principlesof basic qualitative inquiry (Merriam, 1998). Intensity sampling (Patton, 2002)defined the boundaries of the study, as we intentionally sought rich examples of thephenomenon of interest (i.e. psychologists familiar with hope principles and able toaccess and describe their own hope).
Participants
The five psychologist-participants were female and ranged in age from late 20s tomid-50s, utilizing a variety of theoretical approaches. Three of the participants wereRegistered Psychologists and two were Registered Provisional Psychologistscompleting doctoral internships as part of a Canadian Psychological Associationaccredited doctoral Counselling Psychology program. According to the selectioncriteria for the study, all psychologist-participants had participated in formal hopeeducation through (a) a university graduate course on hope in psychology, (b)workshops on hope in practice, and/or (c) supervision specific to hope in practice.Table 1 provides a summary of the psychologist-participants.
The study included 11 individual client-participants, five male and six female,ranging in age from early 30s to 60s. Presenting problems included: depression,grief, relationship problems, illness, disability, substance use and employmentconcerns. Client-participants were recruited through a community agency affiliatedwith a large research-intensive university, with pamphlets distributed to local socialservice agencies and medical offices. In order to minimize wait time for treatment,client-participants were paired with the first available psychologist-participant.
Data collection
Interpersonal Process Recall (IPR) protocol was employed for the qualitativeresearch interviews (Larsen, Flesaker, & Stege, 2008). IPR is an interview methoddeveloped initially as a counsellor training program. It requires individuals to focuson their thoughts and feelings as they remember these to have occurred during aprofessional interaction (Kagan, 1980, 1984). As such, IPR is uniquely positionedas a methodology designed to encourage reflection on practice. For the currentstudy, video-recording was used to capture a single session early in the psychothera-peutic process (session 1, 2 or 3) for each client-psychologist pairing. Within 48hours of each recorded session, the psychologist- and client-participants were inter-viewed individually while viewing playback of his/her video-recorded session. The
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use of IPR assisted participants to reflect on and describe hope-related experiencesas they remembered them to have occurred during the session. Each session andIPR interview was audio-recorded and transcribed verbatim.
Analysis and interpretation
As the current study is focused on psychologists’ accounts of their hope in practice,our data analysis included the transcripts of the 11 sessions and the accompanying11 psychologist-participant IPR interviews. With ATLAS.ti software used forqualitative data management purposes, interpretation of the data involved recursiveanalysis of the research texts (Braun & Clarke, 2006). The researchers reviewedtranscripts independently and contributed to the construction of themes and catego-ries. Differences in analysis were addressed and negotiated between the researchersto work toward points of mutual understanding. The findings were further reviewedby two of the psychologist-participants, who confirmed that the themes andcategories resonated well with their experiences.
Acknowledging the importance of our own reflexivity as researchers, we aimedto understand how our experiences and understandings affected the research process(Morrow, 2005) through the ongoing use of individual research journals. Informed
Table 1. Psychologist-participants’ characteristics.
Name AgeYears inpractice Therapeutic approaches Hope training Education
Anna 40s 15+ - Cognitive Behavioural- Feminist
Hope-focusedcounsellingpsychologyworkshops andreadings.
PhD
Andrea 20s 0–5 - Humanistic- Experiential- Narrative- Cognitive Behavioural
Graduate coursein hope andcounsellingpsychology.
Masters,PhDCandidate
Joy 30s 5–10 - Feminist- Social Constructivist- Narrative- Cognitive Behavioural- Psychodynamic
Hope-focusedcounsellingpsychologypractice,supervision andreadings.
PhD
Louise 50s 10–15 - Hope-focused- Narrative- Solution-focused- Ericksonian
Hope-focusedcounsellingpsychologypractice,supervision andreadings.
Masters
Marie 20s 0–5 - Humanistic- Narrative- Emotion-focused- Therapeutic Hypnosis
Graduate coursein hope andcounsellingpsychology.
Masters,PhDCandidate
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by peer debriefing practices in qualitative research (Padgett, Mathew, & Conte,2004), we also employed ongoing team discussions and a secure online team blogto further enhance reflexivity. Taking an interpretivist stance (Crotty, 1998) asresearchers in this study, we acknowledge the role we played in the interpretationof all elements of the research, including the categories and themes developed inthe process of analysis.
Findings
We identified three broad categories, providing a framework for understandingpsychologists’ reflections on their own sense of hope during the recorded session. Thecategories include: (a) psychologist self-influence on hope, (b) client factors impact-ing psychologist hope, and (c) psychologist hope within the therapeutic relationship.Specific themes contributing to each of these categories are further described below.
Psychologist self-influence on hope
During the IPR interviews, psychologists recognized moments in session where theyimpacted their own sense of hope both positively and negatively. Thoughts, specificself-talk and behaviours all held potential to influence psychologists’ own hope.Three aspects of self-influence and hope were especially noted by psychologists: (a)intentionally attending to their own hope, (b) feelings about their competence atvarious points in the session, and (c) psychologists’ projections about the future.
Intentionally attending to psychologist hope
Aware that the process and context of psychological practice is often challenging,psychologists identified ways in which they intentionally sponsored their own hopein session. Identifying positive personal beliefs about the psychotherapeutic processand even the clients themselves helped anchor psychologist hope while facing theinevitability of client problems. Andrea described holding onto one such belief,even at difficult points in the session:
Trusting the process … [I have] hope for counselling and trust that things are goingthe way they need to be going … I just trust that we’re going to those dark places fora reason … good will come out of that. So, … I do hold the hope in the session.
Viewing their own experience of hope in session as important, psychologistssometimes intentionally influenced the conversation in hopeful directions in order tosupport their own sense of hope. Anna viewed taking an intentional, implicit hopefocus in session as a way of allowing her sense of hope to stay ‘strong’ and ‘vali-dated’. Louise was more explicit about sustaining a focus on hope. Her clientsought to explore sadness, although he reported that doing this in the past hadopened a ‘floodgate of depressive and angry thoughts’. Responding to her client’sdesire along with her own need to sustain hope, Louise sought his consent tocounterbalance the therapeutic conversation about sadness with ideas about hope.
I was promising him that one thing that would be different this time when weexplored sadness is that we would explore hope at the same time. I was as much
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doing that to support my hope as anything else … I was still worrying that he hasquite a long mental health history … so I was promising both myself and him that wewould keep on looking at hope … to keep me on track … [to] hear myself say it.
Self-perception of competence
Feeling competent as a practitioner was an important aspect of psychologist hope.Psychologists described feeling hopeful when they saw themselves as capable andefficacious in relation to specific interactions in session. On a larger scale, seeingevidence that they were benefiting the client fostered hope in the psychologist. Onviewing her intervention with a client, Anna noted, ‘Yeah, that [intervention] wasthe right way to go’, while Joy commented, ‘[that’s] evidence that some of mysuggestions could have impact’. Further, feeling a sense of self-competence was notlimited to delivering specific interventions but appeared to include a broader senseof self as a capable clinician. Joy continued, ‘when I feel I can make an impactwith people, I feel lucky in what I do and that I’m doing what I’m good at. And so… it affects my hope’.
Self-doubts about one’s competence, however, were painful and threatenedpsychologist hope. As Marie, who was early in her career, disclosed: ‘my own criti-cal evaluation of me as a therapist … [is] very, very high … that really makes mefeel disconnected with my hope’. Being aware of her self-doubt during the sessiononly invited more self-criticism and further struggle for hope: ‘maybe I’m not inthe moment right now … Oh my god, I’m a horrible therapist … a lot of internaldialogue … can negate where my hope goes’.
Experience appeared to play an important role in psychologist hope. Working inunfamiliar ways or with interventions that were new to the psychologist sometimesled to feelings of vulnerability. As Marie reflected, ‘trying something that I don’ttend to try very often … [hope] is very sensitive, very, very vulnerable ‘cause Iwas like … “I don’t know if this is going to work”’. Conversely, experiencedpsychologists appeared to anchor their hope more in the overall process rather thanspecific interactions in session. While they identified their own imperfections inpractice, they appeared less critical with themselves and more appreciative of theircontributions to the process. Louise commented:
When I watch my particular work, I see holes in it, things that could be done so muchbetter. If I look at the little picture, I see how things can be sharper. I don’t mind thatreally, as long as I see that the big picture is working out well. And here, the bigpicture is working out well.
Internal projections about the future
Another aspect of psychologist self-influence on hope was internal dialogue relatingto a vision of future work with the client. These projections produced a ‘psycholo-gist story’ about the likelihood of psychotherapeutic success, either positive ornegative. Marie identified that her hope ‘diminished’ when she saw the client‘taking some steps back’ and she believed that this was a sign of things to come.‘Right away I noticed … in myself that that was a point where I felt, “Uh oh” …This scenario will continue going and going and the cycle will continue’. Louise
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similarly described that her hope was threatened when she believed that the client’s‘fighter instinct’ would continue.
I feel fear about the future, that he’s going to enter into causing more of the kind ofproblems he’s had … largely because of what happened right at the beginning of the[session] … I see a fight in the future already.
On the other hand, perceiving a direction for intervention inspired psychologists’hope about their own work and eventual outcomes. Psychologists described feelinghopeful when they were able to see paths and ideas available for future work withthe client. Andrea’s client provided an image of ‘a trickling brook’ to describe herfeeling that things were going to work out alright. During her IPR interview,Andrea said this image offered her hope as a psychologist, ‘I was like, “Okay, wecan use this. I’m gonna bank this in my memory for later [use]”’.
Client factors impacting psychologist hope
Clients’ presentation in early sessions
In analyzing psychologists’ reflections of their own hope, it became clear thatparticipants assessed clients’ presentations in early sessions for signs of hope.Psychologists’ hope fluctuated based on client-specific characteristics or behavioursthat became apparent during these early sessions. For example, Marie described howthe client’s ‘rigid ways of seeing himself’ and seemingly entrenched beliefs dimin-ished her own hope for their work. Similarly, Louise, an experienced psychologist,found herself ‘perplexed’ by a client’s apparent contradictions and inconsistencies.She described a tempered hope, feeling ‘cautious about how I will be of help to himbecause he clearly is going to throw me curveballs and surprises all over the place’.
Conversely, client qualities that psychologists perceived as being suggestive ofchange, such as being open, assertive and ready to work, fostered psychologist hopefrom the outset. For example, Andrea described feeling hopeful based on a client’sopen body language and smiles. Joy, viewing the video of her first session with aclient, reflected, ‘I felt actually hopeful that … she was someone that I could get toknow and work well with in counselling … she shared a lot and she’s a very drivenperson and I found that very, very inspiring’.
Client progress
Further into the therapeutic process, psychologists consistently noted signs of clientprogress as fostering their own sense of hope. Client progress indicators includednew client behaviours or ways of being, accessing outside resources or personalstrengths, exhibiting a positive future orientation, demonstrating learning fromsessions, or a readiness to deepen their investment in the process. For example,Anna felt hopeful when she saw her client shift away from a pattern of being‘over-controlled’ in life. In session the client commented, ‘I’m letting this take mewhere it takes me. A lot of people say, “Well, what are you going to do?” And forthe first time in my life I don’t know. I have no plan’. During her IPR interview,Anna remarked about the client, ‘that’s such a hopeful statement. “For the first timein my life I’m letting go”. That’s so cool’. For Louise, hope lay in the recognitionthat client progress sometimes entailed working through difficult content for the
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client: ‘I see that we’re uncovering new ground all the way through here. [Client]appears to be getting more hopeless. But that is not bothering me, because we arereally, truly unearthing new ground here’.
However, when faced with signs that a client was not progressing (e.g. goingback to an old story or behaviour), psychologists described the impact on their hoperanging from, ‘affected’, ‘waned’ and ‘diminished’, to ‘plunged’. Indeed, Marieidentified that ‘the not changing’ led her to feeling, ‘quite hopeless, when I get thesense that [client]’s in this cycle’.
Psychologist hope within the therapeutic relationship
Therapeutic connection
Hope was strongly supported for psychologists when they felt a clear sense ofconnection with the client. Psychologists remarked, ‘my hope as a therapist is verycontingent on my feelings of connection with the client’ and that hope ‘is verymuch defined by connection’. This sense of connection or with-ness was both ahoped-for aspect of the psychotherapeutic process and ultimately a sign of hope fora good outcome. The sense of connection was based on the psychologist’s feelingthat both psychologist and client held common understandings about specificaspects in session. Joy provided an example when she shared in session a letter shehad written for her client.
When I was going through [the letter in session] and talking about the things that …have happened for her [the client] over the last year … I feel connected … it seems tobe resonating [with the client] in some ways and that’s meaningful for me. Yes, that’sconnected to hope …
Louise elaborated on the importance of an ongoing connection with the client assupporting her own hope as a psychologist. ‘I hope to stay the course with her, notmove too far ahead … and not miss important cues’. Similarly, Andrea found hopeknowing that she was tracking well with the client, ‘I know we’re on the right track… our focus is where she wants it to be and needs it to be, ‘cause she gave me thatconfirmation’. Psychologists also described connection with clients as an energeticsensation that was reflective of their experience of hope. For Anna,
Often what I’m paying attention to is the energy between us … like a barometer … Ican feel the intensity of that connection getting stronger or dissipating … when I getthe sense that it’s dissipating, and a metaphor can bring her back into connection,that’s where hope often comes out …
Further to a sense of connection, evidence of client trust in the therapeuticrelationship served to deepen psychologist hope in session. This appeared to beattached to the belief that good client outcomes require a safe atmosphere whereclients feel comfortable to take personal risks. Indeed, for Anna, a client revealingvulnerabilities or ‘underlying damage’ was hope inducing:
It brings [hope] up because all the sudden we got the stuff … she’s with me here …This is a woman who defends well, and she was being vulnerable … she is telling meher worst fears. And that is to be needy ... so that to me is a very hopeful piece, thatshe has somehow figured out there’s enough trust here …
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Andrea responded similarly to her client’s vulnerability in session, saying thatevidence of client trust in the therapeutic relationship fostered her hope as apsychologist.
That seemed like an area where [client’s] hope is threatened. So I was feeling actuallyquite hopeful that [client] surprised herself by saying, “I didn’t think I’d go into thisthis early”.… that offered me hope as a therapist … that means we’ve established arelationship where there’s enough trust for her to talk about this. I actually felt a lot ofhope there.
Empathic hoping
Psychologists also described how their own experience of hope in session was, inpart, reflective of their understanding of the client’s experience of hope in session.As such, their internal experience of hope appeared to serve a therapeutic purpose,with potential to inform them about the client’s experiences of hope in therapy.Marie used metaphor in her IPR to describe this connection, ‘my hope is very muchaffected by my client’s hope … that dance is a dance that’s very intimate and so itgoes back and forth’. Andrea described that her own experiences of hope are some-times ‘a mirror’ of client hope. ‘My level of hope is like a mirror for where she is… she was saying, “This is the area of my life that’s least hopeful” … I just sankdown with her for a second as a therapist’.
Participants recognized the importance of connecting with both client hopeless-ness and hope. Further, psychologists identified that it was essential to stayconnected to their own sources of hope when experiencing clients’ struggles. AsMarie reflected, ‘it’s important for me to go there with him … it’s equally importantfor me not to let go of that hope. Because then we’ll become lost together with noability to say, “Okay, where are some potential ways out?”’.
Shared responsibility
Psychologists described how their own hope was supported when they felt that boththey and the client were actively and fully committed to the process. When the cli-ent’s well-being seemed like a shared responsibility and clients were beginning totake enhanced responsibility for their growth, psychologists reported feeling hope-ful. When they felt increased pressure and responsibility for client process or safety,psychologist hope was less secure. Marie offered an example with a depressedclient, when she felt a strong initial burden to carry hope in the session:
Depression can take over so many aspects of [client’s] life and doesn’t leave room forhope sometimes – that’s not to say there is no hope. But from his perspective at thatpoint, it’s way too distant for him to even recognize it … at those points, that’s whenI feel like I need to hold onto it.
Marie found the added pressure of holding hope for this client relieved when theclient began to see some hope for himself. ‘It’s very hopeful for me because I seeperhaps he can hold onto his hope for just a little bit. Even just for right now. Evenif I have to hold onto it again’. Anna offered another example, highlighting howher hope as a psychologist was bolstered when the client brought her own ideas tosession. ‘She’s identified that she’s in charge of her change process, that she’s doing
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it on her own … she’s asking for what she wants and she’s putting it into perspec-tive. Like, how much is that the goal of counselling?’
Discussion
We [as psychologists] are not exempt from hopelessness, or from defenses that protectus from it. Failure to examine our personal working assumptions about hope andhopelessness places us at risk for imposing our template of hope on those who seekour help. (Jevne, 2005, p. 271, italics in original)
In this study, psychologists’ reflections highlighted that their in-session experiencesof hope and hopelessness were strongly tied to their ability to envision a goodfuture for the client and for their work together. In this sense, psychologist hopewas often goal- or outcome-oriented, i.e. seeking an effective resolution to thepresenting problem. Nevertheless, psychologists’ hope for a good outcome was alsobalanced with process elements such as: psychologist hope in the therapeuticrelationship itself; viewing process as often recursive with steps forward andbackward; and recognizing that psychologists’ own self-awareness of hope insession is important.
Drawn from psychologists themselves, this research reveals potentially usefulinsights and implications for practice, along with support for future research on psy-chologist hope. Importantly, it is clear that psychologists are able to meaningfullyreflect on their experiences of hope in session and take action to support their ownhope. According to this research, numerous sources and threats to psychologisthope may be present during a single session. While psychologists saw significantvalue in supporting their own hope, they also recognized that their own experiencesof hope and hopelessness in session may represent information both aboutthemselves and their clients. Further, they took specific actions to support their ownhope, both by redirecting their own thoughts in hopeful directions and invitinghopeful therapeutic dialogue with clients.
It would seem that clients may also be sensitive to psychologist hope in session.In his landmark research on client experiences in psychotherapy, Rennie (1994)found that clients in his grounded-theory study tended toward being deferential withtheir psychotherapist when matters they disagreed with in session were relativelyunimportant. Clients’ stated reasons for deference to their psychotherapist includedthe fact that they did not want to shake the psychotherapists’ confidence in thetherapeutic endeavour. In short, it seems that clients also believe psychologists’hope in a good outcome is of importance.
Aligned with these notions, the present study highlights that while a sense ofself-competence fed psychologist hope, inexperience or uncertainty about thedirection of therapy held the power to threaten hope. Ogrodniczuk, Joyce, and Piper(2005) remind us that where therapists believe they have failed, this ‘belief may, inturn, impair therapists’ confidence and effectiveness’ (p. 58). This study suggeststhat reflecting on and attending to one’s own hope as a psychologist, and learningto do so early in one’s career, is a crucial step in supporting the work of thetherapist.
Where experienced psychologists in this study appeared to situate their hopemore in the overall process of their work, newer psychologists tended to focus onspecific interventions and their effectiveness. This may suggest several important
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considerations. First, psychologist training that includes conversations aboutpsychologist hope and hopelessness may permit learners to acknowledge and dis-cuss experiences of high and low hope, while also exploring what can be learnedfrom them. This learning may include normalizing experiences of low hope, therebyinviting psychologist self-compassion (Patsiopoulos & Buchanan, 2011). Second,the experience of psychologist hopelessness may not exclusively be one’s own. It ispossible that psychologists’ experiences of low hope mirror the experience of theclient, offering important psychotherapeutic information. Third, more professionalexperience may provide hopeful ‘big picture’ perspectives on psychological practicethat are important reminders in moments of feeling stuck or hopeless about aparticular therapeutic situation. Being reminded to shift perspective from focusingon specific interventions to one’s larger storehouse of wisdom regarding psychother-apeutic process may serve as a useful source of psychologist hope. Since experiencemay help to mitigate fluctuations in psychologist hope (especially lower hope),early career psychologists may find hope in the many stories and examples providedby their supervisors. In short, novices may be able to ‘borrow’ supervisors’ hopefulpractice stories until they have accumulated their own.
Finally, while psychologists clearly acknowledged the importance of traversingdark places alongside clients, they also sought to draw out positive content with cli-ents, in part because it provided the psychologists with a more hopeful perspectiveon the client and the future. Psychologists in the present study provided clear exam-ples of directing the session such that their own hope for the client was supported.Louise, for example, invited dialogue with a client about his strengths because shefelt it would help her see the client in a more expansive and hopeful way. This mayserve as an important aspect of self-care that both protects the psychologist andserves the client. Attending to their own hope may be particularly important forpsychologists, given recent research indicating that psychologist hope may impactpsychotherapeutic outcome even more than client hope (Coppock et al., 2010).
Future research
As an exploratory study into psychologist experiences of hope, this research offersboth insight and support for future research on the role of psychologist hope inpractice. Seeking an information-rich sample, all participants in this bounded casestudy were hope educated. Future research should include psychologists withoutformal hope training. Further, potential differences in the experience of hopebetween experienced psychologists and novices should be further investigated, asthis current study suggests the possible heightened importance of addressing psy-chologist hope in training.
Summary
While psychologist hope continues to be considered an integral aspect of therapy,assumptions that psychologists are in constant and ready supply of hope are beingchallenged. This research is amongst the first to ask psychologists directly abouttheir experiences of hope in session. Findings indicate that psychologists’ hope isintimately linked with their perception that psychotherapy is making a worthwhiledifference to the client. Psychologists’ hope is impacted by their own self-influenceduring the therapeutic endeavour, their perceptions of the client, and their
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experiences within the therapeutic relationship. Participants were self-aware regard-ing their experiences of hope and described hope as fluctuating naturally in session.Further, participants demonstrated specific internal and external actions to supporttheir own hope, providing preliminary evidence that psychologist early trainingshould specifically address strategies for reflecting upon and supporting one’s ownhope as a psychologist.
Note1. This research was approved by the University of Alberta, Education and Extension
Research Ethics Board.
Notes on ContributorsDenise Larsen is a registered psychologist and professor of Counselling Psychology at theUniversity of Alberta. With a primary interest in the study of hope, she is also the team leadof Hope Studies Central.
Rachel Stege is a registered psychologist focusing on hope-based practices in both researchand applied practice settings.
Keri Flesaker is a registered psychologist and PhD candidate at the University of Alberta.
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