Qualitative exploration of the experience of psychoanalytic psychotherapy complemented the quantitative evaluation of mental health and life functioning improvements in the Melbourne Study of Psychoanalytic Psychotherapy. Twice-weekly treatment was offered to adults for 2 years by the private sector Glen Nevis Clinic for Psychoanalytic Psychotherapy, established by the Victorian Association of Psychoanalytic Psychotherapists as a subsidized, low-cost community service over 8 years. This paper is the second of two presenting the qualitative arm of the study, involving in-depth narrative interviews with patients and psychotherapists. Analysis of 143 transcripts further contributes to evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of psychoanalytic psychotherapy in a community setting. The first qualitative paper reports themes concerning patient expectations of psychotherapy and perspectives of both patients and psychotherapists on the experience and benefits of the treatment. This paper reports what was perceived by participants as facilitative or challenging for therapeutic progress, illuminating how experiences of the nature of psychoanalytic psychotherapy may have affected the Implementation, Effectiveness and Maintenance of the program. The most notable facilitative factors emerging were the exploratory, insight-oriented nature of the work, elements of the patient-psychotherapist relationship, and the frame of the treatment. Challenges were also often seen as inherent to Effectiveness; however, proposing the frame of 2-year treatment, as both an expectation and a limit, probably inhibited program Reach, Adoption and overall Implementation. The limitations and strengths of the qualitative arm of the research, together with implications for further investigation, are discussed.

中文翻译：

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墨尔本精神分析心理治疗研究 III：患者和心理治疗师对进展和挑战的看法

对精神分析心理治疗经验的定性探索补充了墨尔本精神分析心理治疗研究中对心理健康和生活功能改善的定量评估。私营部门格伦尼维斯精神分析心理治疗诊所为成年人提供每周两次的治疗，为期两年，该诊所由维多利亚州精神分析心理治疗师协会建立，作为一项为期 8 年的补贴、低成本社区服务。本文是介绍该研究定性部分的两篇论文中的第二篇，涉及对患者和心理治疗师的深入叙述性访谈。对 143 份记录的分析进一步为精神分析心理治疗在社区环境中的影响范围、有效性、采用、实施和维持提供了证据。第一篇定性论文报告了有关患者对心理治疗的期望以及患者和心理治疗师对治疗的体验和益处的看法的主题。本文报告了参与者认为对治疗进展有促进作用或具有挑战性的因素，阐明了精神分析心理治疗性质的经历如何影响该计划的实施、有效性和维持。最显着的促进因素是工作的探索性和洞察力性质、患者与心理治疗师关系的要素以及治疗的框架。挑战也常常被视为有效性所固有的；然而，提出两年治疗框架，既作为期望，又作为限制，可能会抑制计划的达成、采用和总体实施。讨论了该研究定性部分的局限性和优势，以及对进一步研究的影响。