Shame in therapy : the perceptions of trainees, counsellors, and early career psychologists concerning the identification and amelioration of shame : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology, Massey University, Albany, New Zealand
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Date
2024
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Massey University
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Abstract
Shame has many facets that make it difficult to be defined (Bradshaw, 1988). The complexity of defining shame extends to the difficulty in identifying it in therapy. Research has indicated that shame can have overlapping symptoms in client presentations with that of depression as well as social anxiety, and this could hinder the treatment of shame (Swee, Hudson, & Heimberg, 2021; Kim, Thibodeau, &Jorgensen, 2011). This study aimed to explore how students in their final year of psychology, counsellors, and early-career psychologists perceive shame as a distinct construct in client case scenarios. The study also sought to determine whether introducing a prime would influence case conceptualisation. Recognizing that these emotional states, depression, feeling ashamed and socially anxious can influence each other during therapy sessions, and might hinder the identification of shame, this study intended to shed light on the potential implications this may have on effective treatment. A total of 18 participants who met the criteria were recruited. Six distinct online questionnaires were developed, each presenting the same two client case scenarios and questions but employing different primes related to the three emotional states under investigation. Each participant completed one online questionnaire. Data were analysed using descriptive statistics indicating the frequency of the affective terms before and after the prime effect as well as Thematic Analysis to identify the prominent themes otherwise mentioned in the case conceptualisation. The findings of the study highlighted the complex relationship between shame, depression, and social anxiety and how shame can be masked in client presentations. Social Anxiety was the most prominent affective term that was identified by the participants. Although shame was only identified twice, self- compassion was recommended 42% of the time as the most suitable treatment option across all affective states identified. This study highlighted the need for improved understanding of shame and how it can present as different affective states in therapy and the effective identification and treatment of it.
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depression, self-compassion, shame, social anxiety disorder, therapists, therapy