CRITICAL INCIDENTS IN PSYCHOTHERAPY

The critical-incident technique was used to obtain a list of 52 critic al incidents defined by the behavior of patients who create special di fficulties for psychotherapists. The critical incidents could be divid ed into four major categories: threat of harm, criticism of the therap ist or of the therapy, occurrence of a major life crisis, and attempts by the patient to seek friendship or seduction. Twenty-one experience d psychiatrists rated the importance and the frequency of occurrence o f each of the 52 critical incidents. Ten third-year psychiatric reside nts also rated the incidents. For almost every incident the inexperien ced psychiatrists rated the incident as less important and more freque nt than did the experienced psychiatrists. Implications for the traini ng and supervision of psychotherapists are discussed.