Estructura territorial

The research proposal was submitted to the University of South Africa for ethical clearance and the study had been approved. The participa nts were informed of the study, its procedure, aims, methods, use of findings and any foreseeable consequences to the participant (Strydom, 2011). According to Grinnell and Unrau (2008), the participants should be given the

opportunity to choose what can and cannot happen to them within the study. I had therefore sought informed consent in writing before the study could continue.

Additionally, the aims, methods, purpose, use of findings, possible harm to the participant were discussed with each participant. The duration of the interview, which had lasted approximately 60 minutes on average, as well as the option to withdraw at any time without any consequences were made explicit. Additionally, any further queries or concerns were addressed. Once the participant was comfortable with the information, the informed consent form was handed to them to sign. The participants as qualified clinical psychologists were all able to fully comprehend the nature of the study as well as the risks involved and had made a voluntary decision regarding their participation.

3.8.3 Confidentiality

Every individual has the right to privacy (Strydom, 2011). Therefore the participants of the study were informed that their privacy will be protected. Information by the participant about their clients could be potentially harmful for both the participant and their clients; therefore confidentiality was of great importance to protect these individuals. In reporting the findings, pseudonyms were used in place of participants‟ names, for example, “Participant A”. Any identifying details or names reported by the participant during the interview were also changed to pseudonyms. Access to identifiable information of the participants was limited to my supervisor and myself only. This restricted access applied to all raw data of the study. If any names or identifying information had been mentioned by the interviewee, the details were removed in order to protect the individual. Furthermore, all raw data, including audio-

56 recordings, will be destroyed after five years. In the interim period, the physical and

electronic data is being kept securely in a locked filing cabinet.

The study was conducted according to the research design outlined above. In doing so, the data was gathered, transcribed and analysed. The findings of this are provided in the

following chapter. A discussion is further included so as to integrate the findings of the study more comprehensively.

57 CHAPTER FOUR: FINDINGS AND DISCUSSION

In this study, clinical psychologists‟ therapeutic experience with clie nts wit h BPD was explored. Current evidence provided the basis for the exploration, indicating in one study, for example, that 84% of participants reported clients wit h BPD as more difficult than other clients (Clearly et al., 2002). The difficulty, it seems, stems from the pervasive pattern of instability of interpersonal relationships, self- image and affects, and marked impulsivity that is indicated by the presence of very specific symptoms (American Psychiatric Association, 2013). In lieu of these symptoms, a client experiencing BPD becomes a challenge as their behaviour may be as unpredictable as their intense range of emotional experiences. The resulting interaction between the client wit h BPD and the practitioner, may face various challenges and the client may be labelled as „difficult‟. The problem with a client being regarded as „difficult‟ is as Wilson (2005) states, that „difficult‟ clients may be treated in specific ways, given the negative feelings to these clients that may develop. Initially, this may be expressed through annoyance or dislike but can escalate towards frustration and anger. It is needless to say that the therapeutic relationship may be affected.

This study explores clinical psychologists experience working with BPD, specifically how they identify, manage and cope. Studies have also reported that burn-out, stress, anxiety and other forms of negative physical and emotional ramifications may be experienced on the part of the psychotherapist (An et al., 2013). This study is therefore deemed relevant and

important as it will enable the development of an understanding that can improve the clinical relationship between client and clinician. Additionally, a comparison between what Skovho lt and Rønnestad (2003) term the „novice professional‟ and the „experienced professional‟ will allowed us to determine whether experience of six years or more of clinical practice

influences the therapeutic relationship with clients wit h BPD in any way.

Seven clinical psychologists participated in the study and the interviews were recorded and transcribed. Thematic analysis was the chosen analytical tool and three themes were highlighted. These are 1) conceptualisation of difficult clients; 2) management o f clie nts wit h BPD; 3) coping strategies of clinical psychologists. The interview transcripts were also compared according to number of years that the participants had, practicing as clinical psychologists. It was considered important to understand if there was any difference in working with difficult clients wit h BPD, as the more years of clinical experience gained,

58 may influence the therapeutic interaction. In this regard, participants were categorised in two categories, namely, those with one to five years‟ experience and those with six or more years of experience. This is aligned with Skovholt and Rønnestad‟s (2003) work, which indicates that number of years working with clients may influence the therapist‟s interaction.

59 Figure One: Summary of the mes and sub-the mes

60 The findings and discussion of the current study have been integrated as this will allow for a more comprehensive and detailed understanding of the experiences of the participants in working with difficult clients wit h BPD. The themes identified will be discussed in relation to the literature reviewed. This will be followed by a discussion on the participants‟

experience working with clients.