Cheetahs on the Couch:

Issues Affecting the Therapeutic Working Alliance
With Clients Who Are Cognitively Gifted

Doctoral Dissertation, Aimee Yermish, 2010

Abstract

Within the gifted community, the common wisdom is that one must find a therapist who understands the intrapersonal, social, and cultural experiences of being highly intelligent. Without this understanding, informal reports suggest that miscarriages of the therapeutic working alliance may be frequent, and that clients may avoid or leave therapy as a result. However, few therapists or researchers acknowledge intelligence as a dimension of human difference which could be relevant to therapy, or how their own relational selves might be affected by the prospect of doing this work. The specialist literature in the field of giftedness rarely includes consideration of mainstream psychological theories. Thus, little is widely known about how to effectively engage these clients, and there are few opportunities for therapists to recognize when they are making mistakes or to develop competence with this group. This study used a consensual qualitative research model (Hill, Thompson, & Nutt-Williams, 1997), in an attempt to connect these two areas of the literature. Individuals who self-identify as gifted and who have previously been clients in individual or family therapy were asked to describe their felt experiences of the alliance, helpful or unhelpful therapist behaviors, and how the course of therapy may have been affected. The responses were analyzed thematically and interpreted through the lenses of the specific literature on giftedness and mainstream psychological theories. Respondents in this study described their intelligence as having pervasive effects on their lives, the material they wished to explore in therapy, and the therapeutic relationship itself. Substantial connections to the theoretical literature on trauma and object relations were considered in relational context. Additionally, the data permitted some exploration of the general question of whether some differences between therapist and client may be too great to bridge. Finally, a set of provisional clinical guidelines for working with gifted clients was developed.

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You can read the entire text of the dissertation here.

You can read the provisional clinical guidelines I developed for therapists who wish to work with gifted clients at the end of the dissertation, or in a standalone file here.

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