Ambivalence in narrative therapy: a comparison between recovered and unchanged cases

Research on the identification of poor outcome predictors is crucial for the prevention of therapeutic
failure. Previous research suggests that clients’ persistent ambivalence is one possible path to unsuccessful
psychotherapy. The present study analyses ambivalence—here operationalized as return-tothe-problem
markers (RPMs)—in five recovered and five unchanged cases of narrative psychotherapy
for major depression. The results suggest that both recovered and unchanged cases presented a similar
proportion of RPMs at baseline and a decreasing pattern of these ambivalence markers throughout
therapy. However, the decreasing was more accentuated in recovered than in unchanged cases, and at
the end of the treatment, the proportion of RPMs of the unchanged cases was significantly higher.
The results are discussed in light of previous research on ambivalence in psychotherapy, focusing on
the meaning of ambivalence and its clinical implications.