The purpose of this study is to provide a social constructionist perspective on the therapeutic relationship. This is to aid a broader conceptualisation and understanding of this important therapeutic concept. To attain this, multiple truths or theories regarding the therapeutic relationship are explored. Additionally, a possible different conceptualisation of a therapeutic relationship between three participants and myself as the researcher is set out using social constructionist epistemology. This includes an investigation of the researcher as an important constructer of the study, and the co-creative nature of the therapeutic relationship. The subjective nature of the research is continually emphasised throughout the dissertation. Given the social constructionist approach to this dissertation, context plays a vital role. Therefore an exploration of the social constructionist epistemology in general, psychology and psychotherapy is set out, as these form the backdrop of the study. This is followed by a look at the importance of the therapeutic relationship in psychotherapy, as well as the different contributions six broad theoretical orientations have made to the understanding of the therapeutic relationship. The importance of context is also reflected in the research design. A qualitative approach is taken, using case study methodology. Observation, field notes and unstructured interviews were used to gather the information from the participants and researcher, and the information was analysed using thematic analysis. The results are set out in the form of themes generated using the thematic analysis. The importance and development of a connection between therapist and client is explored. This includes a discussion on the role of knowledge, influence, trust in the client, and a not-knowing attitude in the process of development of a connection. The therapeutic relationship’s empowerment perspective and aim is shown. This perspective highlights the flow of power in the therapeutic relationship between therapist and client. The context of helping and the professional nature of the relationship are also discussed. These themes are grouped together under one encompassing theme, namely that of difference. It is indicated that, in general, the therapeutic relationship is one of difference. In conclusion, the contributions of this study are highlighted. These include the re-emphasis on the importance of the therapeutic relationship as a central construct in psychotherapeutic intervention. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2005. / Psychology / unrestricted

The aim of the essay has been to investigate how therapists explain the causes for the occurrence of men's violence against women in intimate relations, and the opportunities and difficulties they experience during the treatment of these men. The study is based on qualitative interviews with four therapists who work with violent men. We analyzed the interviews with the help of thematic analysis which resulted in the sub-themes masculinity norms, violent experiences and powerlessness, which further created the main theme: causes of the violence. The sub-themes alliance building, motivated client, responsibility insight and gender norms in treatment created the main theme: opportunity for change. The sub-themes addiction, lack of mentalizing ability and shaming created the main theme: difficulties in treatment. The results indicate that the therapist agrees that there is no simple explanation for the occurrence of violence by men against women in intimate relations and neither a way of working against it. The results also indicate that the explanation for the occurrence of violence differs between therapists and they have some different opinions about how one should work to fight men's violence against women. / Uppsatsens syfte har varit att undersöka hur behandlare beskriver orsaker till uppkomsten av mäns våld mot kvinnor i nära relationer samt vilka förutsättningar och svårigheter de upplever i behandlingen. Studien baseras på kvalitativa intervjuer med fyra behandlare som arbetar med våldsutövande män. Vi har analyserat intervjumaterialet med hjälp av tematisk analys som resulterade i subtemana maskulinitetsnormer, våldserfarenheter och vanmakt som utgjorde huvudtemat orsaker till våldet. Alliansbyggande, motiverad klient, ansvarsinsikt, könsnormer i behandling utgjorde huvudtemat förutsättningar för förändring. Missbruk, bristande mentaliseringsförmåga och skambeläggande utgjorde huvudtemat svårigheter i behandlingen. Resultaten tyder på att behandlarna är överens om att det inte finns någon enkel förklaring till våldets uppkomst eller ett sätt att arbeta mot det. Resultaten tyder också på att förklaringen till våldets uppkomst skiljer sig åt mellan behandlarna och de har en del skilda meningar kring hur man bör arbeta för att bekämpa mäns våld mot kvinnor.

This paper aims at therapeutic relationship of adolescents, specifically at therapeutic alliance, which is factor often connected to successful outcome of therapy. The main research goal of this study was to explore therapeutic alliance with adolescents within the Day care centre for adolescents with mental health difficulties and understand how they perceive therapists and their work. The first part of this paper is describing concept of alliance from historical perspective, types of alliance are presented as well as factors on both side of therapeutic process involved in forming of the alliances. Further it presents specifics of alliance in group therapy and in adolescent patients. For research purposes, we chose to use semi structured interview. We were inspired by official tools for measuring this concept. The FIRO-B inventory was added to see, how adolescents form their relations with others, and what do they expect from others in terms of relationships. The purpose for using this tool was to see how their interpersonal orientation could be connected to forming of alliances with therapists. 7 adolescents participated in this study and their data were processed by qualitative approach, specifically by repeating themes analysis. The result of this analysis showed two main categories: "Goals" and...

Te aim of the research dissertation thesis is to introduce transactional analysis as a practi- cal tool applicable for efective communication with clients in low-threshold addictology services. Te main objective is the discovery of ego-states that clients use in communication with employees, determining the representation of individual ego-states at both client and employee side. A partial goal is to observe the methods of communication with the client, which lead to the provision of services in the framework of Adult to Adult transactions. Te output usable in real life is a manual of communication between employees and clients using principles of transaction analysis. Te research group consists of 88 observed, recorded and evaluated interviews between employees and clients of the low-threshold addictology service Drop In Prevention and Treatment of Drug Addiction Center, specifcally in the Drop In Low-threshold Center. Tey were active users of illegal addictive substances who have requested some service from the spectrum of harm reduction services at the time of the research. Te thesis uses qualitative research in the form of text and word analysis used in the com- munication of clients and employees in the Drop In Low-threshold Center with the aim of capturing the usual communication...

This study intends to examine the psychotherapist`s experience of videotherapy and therapeutic relation and alliance in videotherapy. Earlier studies show that videotherapy is a positive contribution to healthcare systems and increases accessibility for patients, but there are technical issues and limitations in non-verbal communication. The therapeutic alliance between patient and therapist is not negatively affected. The experience of the patient tends to be more positive than the experience of the therapist. This study´s approach is qualitative and inductive. Data are obtained from interviews with five licensed psychotherapists. The study shows that videotherapy is a good flexible alternative, but therapist attitude towards it, varies. A good therapeutic relation and alliance is possible and depends on both patient and therapist factors, though the quality is deepened in face-to-face sessions. The psychotherapists describe that some therapeutic interventions need to be modified and amplified, due to the unique settings.

No description available.

Bakgrund: Psykiatrisjuksköterskan behöver ta hänsyn till olika aspekter i sitt värv, alltifrån Sveriges lagar till rådande normer på avdelningen. Informellt tvång som enligt tidigare forskning är ett kulturellt fenomen i psykiatri då personal med påtryckningar försöker få patienten att följa vårdarnas upplägg - inte sällan mot sin vilja. Bärande begrepp: Första begreppet är makt, vilket ger vidare förståelse för mekanismerna bakom vårdens etik. Det andra bärande begreppet är vårdrelation. Syfte: Belysa före detta patienters upplevelse av informellt tvång i psykiatrisk heldygnsvård och dess påverkan på vårdrelationen. Metod: Fallstudie med semistrukturerad intervjuguide utfördes med tre informanter. Intervjuerna transkriberades och pseudonymiserades. Narrativ analys utfördes på intervjuerna. Resultat: Informanternas upplevelser sätts i ett narrativ som börjar vid ankomst till vårdavdelningen och intrycket av att hamna i en onaturlig värld. Vidare skildras händelserna kring vårdens innehåll där känsla av vanmakt dominerar. I slutet reflekterar informanterna kring känslan, förväntningar inför framtida vård och vårdrelationen. Slutsats: Genom att analysera informellt tvång ur ett maktperspektiv kan etiken bakom fenomenet synliggöras. Med psykiatrisjuksköterskans interpersonella kompetens kan hen i det kliniska arbetet med den terapeutiska relationen verka för att minska informellt tvång och därmed maktobalansen och således möjliggöra den goda vården. / Background: The psychiatric nurse has to consider many different aspects while working, from Swedish laws to existing norms in the ward. Informal coercion is according to research a cultural phenomenon in psychiatric inpatient care where nursing staff use pressure techniques to get the patient to comply, often against the patient’s will. Key concepts: Key concepts are used within this paper. The first key concept is power, where we can gain more understanding of the mechanisms of caring ethics. The caring relationship is the other key concept in this paper. Aim: To enlighten former inpatients’ experience of informal coercion and its impact on the caring relationship. Method: A case study using a semi-structured interview guide was performed with three interviewees. The interviews were transcribed and pseudonymized. Narrative analysis was performed on the interviews. Results: The informants' experiences are put in a narrative and start with arrival at the ward and the feeling of entering an unnatural setting. Later the depictions revolve around the content of the given care which evoked feelings of powerlessness. At the end of the narrative the informants describe feelings, expectations of future care and the caring relationship. Conclusion: By viewing informal coercion as a form of excursion of power one can unravel the ethics behind the phenomena. Using the psychiatric nurse's interpersonal competence, she can in the clinical work with the therapeutic relationship strive to reduce informal coercion and thus the imbalance of power and thereby enable the good care.

No description available.

Bakgrund: Självskadebeteende kopplas ofta ihop med psykiatriska tillstånd så som depression och ångestsyndrom och en vanlig uppfattning är att syftet med beteendet är suicidalt. Självskada används ofta som en strategi för att reglera negativa känslor. Patienter med självskadebeteende kan behöva insatser från olika nivåer och områden inom hälso- och sjukvården Det finns stigmatisering av patienter med självskadebeteende inom vården och samhället. Ett dåligt bemötande inom vården kan minska patientens självkänsla, tillit till vården samt leda till att patienten blir mindre benägen att söka vård i framtiden. Sjuksköterskan har en central roll i omvårdnaden av patienter med självskadebeteende, genom att lyssna, skapa sig förståelse samt identifiera behov. Syfte: ​​Syftet var att belysa sjuksköterskans erfarenheter vid omvårdnad av patienter med självskadebeteende.​ Metod: Metoden var en litteraturöversikt i enlighet med Fribergs metodbeskrivning. Sökningar genomfördes i databaserna Cinahl Complete och PubMed. Tio kvalitativa vetenskapliga originalartiklar valdes ut. Artiklarna analyserades ​för att identifiera likheter och skillnader. Resultat: ​Kunskap om självskadebeteende samt kommunikationsstrategier efterlystes av sjuksköterskor. Flera sjuksköterskor upplevde bristande förmåga att ge omvårdnad till patienter med självskadebeteenden. Vårdrelationen lyftes som central i omvårdnaden av denna patientgrupp och sjuksköterskans bemötande. Förmågan att lyssna och få patienten att känna sig hörd ingick i sjuksköterskornas omvårdnadsarbete. Ytterligare aspekter av omvårdnaden var sjuksköterskans attityder och dessa ansågs kunna ändras med hjälp av ökad kunskap. Resultatet visade även att en del i omvårdnaden av patienter med självskadebeteende var att hindra patienten från att självskada, sköta om fysiska skador samt att göra olika typer av riskbedömningar. Omvårdnaden inom akutmiljöer beskrevs som utmanande då ett stort fokus låg på snabb somatisk vård samt att det var svårt att förse patienterna med en lugn miljö. Slutsats: ​​Det finns en osäkerhet hos sjuksköterskor kring vårdandet av patienter med självskadebeteende och mer kunskap efterfrågas. Den akuta vårdmiljöns brist på tid och resurser försvårar omvårdnaden av patienter med självskadebeteende. Vårdrelationen och kommunikationen mellan sjuksköterska och patient är centralt för en personcentrerad omvårdnad. Sjuksköterskor anser även att en viktig aspekt av omvårdnaden är bemötande och attityder där ett empatiskt, icke dömande och in lyssnande förhållningssätt är fördelaktigt. / Background: Self-injurious behavior is often linked with psychiatric conditions such as depression and a common perception is that the aim is suicide. Self-injury is often used as a strategy to regulate negative emotions. People with self-harming behavior may need interventions from different levels and areas within the health care system. There is stigmatization of patients with self-harming behavior, both within healthcare and society. Poor treatment in care can reduce the patient's self-esteem, trust in care and lead to the patient being less inclined to seek care in the future. The nurse has a central role in the care of patients with self-harming behavior, by listening, understanding and identifying needs. Aim: Nurses experiences of caring for patients with self-injurious behaviour Method: ​​The method used was a literature review following Friberg‘s methodological framework. Searches were conducted in the databases Cinahl Complete and PubMed. Ten qualitative original scientific articles were selected. The articles were analyzed  to identify similarities and differences.​ Results: Knowledge of self-injurious behavior and communication strategies were requested by nurses. Several nurses experienced a lack of ability to provide nursing care to patients with self-harming behaviors. The nursing relationship was highlighted as central in the care of this patient group, and the nurse's approach, ability to listen, and making the patient feel heard were integral aspects of nursing care. Other aspects of nursing care included nurse's attitudes, which were believed to be changeable through increased knowledge. The results also showed that an important part of the nursing care of patients with self-harming behavior was to prevent the patient from self-harming, caring for physical injuries and making different types of risk assessments. Nursing care in emergency settings was described as challenging as there was a large focus on rapid somatic care and it was difficult to provide patients with a calm environment.​ Conclusions: ​​Nurses express uncertanty regarding the care of patients with self- harming behavior and there is a demand for increased knowledge. The lack of time and resources in emergency departments complicates the care for patients with self-injurious behavior. The relationship and communication between the nurse and patient is central to person-centered care. Nurses also believe that a crucial aspect of care involves attitudes approaches, emphasizing the importance an empathic, non- judgemental and attentive demeanor.

The current study is the first to explore the role of cultural humility, cultural comfort, and the therapeutic relationship in play therapy. Participants consisted of 69 parent-therapist dyads recruited from university clinics, private practices, and a non-profit counseling center in the southwestern United States. Parents completed a demographic questionnaire, Cultural Humility Scale, Therapist Cultural Comfort Scale, and Barrett-Lennard Relationship Inventory – Other to Self 40 (BLRI OS – 40). Play therapists completed a demographic questionnaire and BLRI MO – 40. A multiple regression analysis indicated that after controlling for the race/ethnicity of both play therapist and parent, parents' perceptions of play therapists' cultural humility and cultural comfort predicted parents' perception of their therapeutic relationship with their child's play therapist. Additionally, exploratory analyses suggested that when therapists report the occurrence of cultural conversation in parent consultations there may be an increase in parent-reported therapeutic relationship scores. However, when also controlling for the child's race/ethnicity, cultural humility and cultural comfort did not have a statistically significant impact on the play therapist's perception of the therapeutic relationship with their child client. These findings underscore the significance of play therapists' cultural humility and cultural comfort on the development of a strong therapeutic relationship with parents of children in play therapy. Limitations and implications for practice and future research are discussed.