The purpose of this study was to reconstruct the main ideas—universal but grounded in particular diagnostic experiences—used by psychotherapists during the case conceptualisation process. Authors focus on the process of diagnostic thinking expressed in graphic conceptual maps of a specific case. Two main questions were posed: (1) how do psychotherapists build patient understanding (a model of a patient)? (2) With what conceptual tools (categories, assumptions, ideas) do they think? The sample of fourteen conceptual maps from psychotherapists was used for the study presented here. The psychotherapists who were the authors of fourteen selected maps (years of experience: M = 21.38 years, SD = 13.53; 3 male, 11 female; age: M = 44.71; SD = 13.27) represented various approaches. A thematic analysis framework (Braun & Clarke, 2006 ) was used. Four major themes were identified across conceptual maps: (1) parental figures are depicted as pivotal; (2) basic assumptions about the “world order” are employed; (3) immersion in the patient’s inner world (or internal phenomena); and (4) maintaining the tolerance of indefiniteness. Joining those themes together shows that assessment for psychotherapeutic purposes proves to be a generally dynamic, hypothetical and adjustable process, but also seems personally engaging and prone to using fixed categories, such as patient’s parents and mental representations of them. Moreover, a psychotherapist’s uncertainty seems not to inhibit the patient’s understanding. This knowledge, based on generalized experience, can be particularly crucial for psychotherapists in monitoring their practice to direct their attention and reflection.

中文翻译：

---

心理治疗师如何进行案例概念化？概念图的专题分析

本研究的目的是重建心理治疗师在案例概念化过程中使用的主要思想——普遍但基于特定的诊断经验。作者专注于在特定案例的图形概念图中表达的诊断思维过程。提出了两个主要问题：（1）心理治疗师如何建立对患者的理解（患者模型）？(2) 他们用什么概念工具（类别、假设、想法）思考？来自心理治疗师的 14 个概念图样本用于此处介绍的研究。创作了 14 张精选地图的心理治疗师（经验年数：M = 21.38 年，SD = 13.53；3 名男性，11 名女性；年龄：M = 44.71；SD = 13.27）代表了各种方法。使用了主题分析框架（Braun & Clarke，2006 年）。在概念图中确定了四个主要主题：(1) 父母形象被描绘为关键；（二）采用“世界秩序”的基本假设；(3) 沉浸在患者的内心世界（或内部现象）中；(4) 保持对不确定性的容忍度。将这些主题结合在一起表明，以心理治疗为目的的评估被证明是一个总体上动态的、假设的和可调整的过程，但似乎个人参与并倾向于使用固定的类别，例如患者的父母和他们的心理表征。此外，心理治疗师的不确定性似乎不会抑制患者的理解。这种基于一般经验的知识对于心理治疗师监测他们的实践以引导他们的注意力和反思尤其重要。