Avsikten med studien är att ge en fördjupad förståelse av hur terapeuter upplever att relationen till patienten påverkas av att genomföra psykoterapeutisk behandling online. Designen var en kvalitativ studie med strategiskt urval genom semi-strukturerade intervjuer. I studien har 11 terapeuter med erfarenhet av individuell psykoterapeutisk videobehandling medverkat. Alla deltagare har arbetat med psykologi inom olika sjukvårdsregioner och innehar som minst grundläggande utbildning i psykoterapi. Analysmodellen som användes var tematisk textanalys Malterud (2014). Huvudteman som framkom var. 1. Teraputens inställning till mediet och dess förutsättningar kan påverka relationen, 2. Pt-online är inte som sedvanlig terapi- digitala förutsättningar påverkar mötet och 3. Relationellt samspel blir annorlunda (även om vissa aspekter kan vara lika). Resultaten visar deltagarnas olika upplevelser av hur det relationella samspelet förändras under psykoterapeutisk behandling online. Det kan vara värdefullt för terapeuter att veta vad de kan göra för att överbrygga och kompensera för bortfall av sinnesintryck under psykoterapeutiska videosamtal.

The relationship between counsellor and client has been extensively researched ever since the founding of psychotherapeutic treatment. Subsequently, it has been established as an integral and essential part of successful therapy. Yet, in regards to substance use treatment aforementioned research is still lacking. Few studies shed light on such relationships – even fewer on relationships formed within the unique settings of live-in treatment centres. Furthermore, the emotional handling of inter-relational work from the perspective of the professional is still remarkably absent from the scholarly world. Notably, professional perspectives are mainly presented in situations of boundary breaking behaviour and ethical misconduct. The aim of the present study was, consequently, to research how professionals conduct, care, and convey the phenomena of counsellor-client connections that are constituted within the above stated context. In order to fully capture the lived experiences of addiction counsellors, a hermeneutic-phenomenological approach was applied throughout – acting as both theoretical and methodological ground. Accordingly, a total of five semi-structured qualitative interviews were carried out and analysed through a hermeneutic-phenomenological lens. The result presents several significant findings in regards to how the professionals view boundaries, closeness and control in substance use treatment settings, which primarily include a certain all-encompassing duality: role changing is perceived as beneficial, albeit debilitating; closeness is seen as imperative, yet distance as integral; working with the self equates to working on the self. Overall, professional progression appears to echo that of the client’s – a supporting network, along with being earnest and daring, presents itself as keys for facilitating conducive change. Implications of above-mentioned co-occurrences are discussed, including suggestions for future research.

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Personality disorders are considered a possible factor affecting the relationship between therapeutic alliance and therapy outcome. The present study investigated the alliance-outcome effect in patient groups with borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCPD). Data derived from a sample of n = 66 patients, treated in a day care hospital setting with a dialectical-behavioral and schema therapeutic treatment concept. Patients rated their symptom severity at admission, early alliance after 4–6 therapy sessions and symptom severity as well as alliance at discharge. Results showed no significant differences between BPD and OCPD patients regarding symptom severity and alliance. Multiple regression analyses indicated that the alliance was a significant predictor of symptom reduction, however only in the OCPD group. Our results showed an exceptionally strong alliance-outcome relationship in OCPD patients, suggesting that focusing on building a strong alliance and measuring it early in therapy may be especially beneficial for this patient group. For patients with BPD, a more regular screening of the therapeutic alliance might be helpful.

Syftet med uppsatsen är att genom kvalitativa intervjuer belysa musikens plats i musikterapeutisk traumabehandling. Tolkning av intervjumaterial har skett genom ett hermeneutiskt teoretiskt perspektiv. I bakgrunden presenteras litteratur och studier inom ämnesområdet musikterapi och trauma. I resultatet presenteras det tre teman som växt fram under intervjuerna: hur musiken kan vara hjälpsam vid musikterapeutisk traumabehandling, vilka musikterapeutiska arbetssätt och metoder musikterapeuter använder samt vilka terapeutiska kunskaper musikterapeuter besitter och utövar som möjliggör behandling. I diskussionen framkommer att resultat stärks av tidigare forskning och litteratur i ämnesområdet. / This thesis sheds light on the place of music in the treatment of trauma through music therapy. Qualitative interviews were conducted and interpreted through a hermeneutic theoretical perspective. Articles and prior research in music therapy and trauma are presented in the background chapter. In the results chapter three themes that emerged from the interviews are presented: ways in which music can be helpful in the treatment of trauma through music therapy, which music therapy methods are used by music therapists treating trauma as well as what type of therapeutic knowledge music therapists master to enable treatment. In the discussion chapter, the results from this study are supported by previous research and literature in the field.

Communication can be divied into two broad areas namely, the verbal and nonverbal levels. While attention has been paid to nonverbal communication in the literature, few studies address the nonverbal communication that takes place in the natural setting of a therapeutic session. The present study provides such a naturalistic study, where the verbal content of actual therapy sessions are integrated with the nonverbal content to yield a holistic view of the session. An ecosystemic epistemology is adopted in this study, and represents a move away from more traditional approaches to nonverbal behaviour which are largely confined to a positivistic framework of thought and design. Symlog Interaction Scoring is employed as a practical method of assisting observers in distinguishing nonverbal behaviours, which are usually perceived unconsciously, and lifting them into consciousness, allowing this infonnation to be integrated with the meanings and hypotheses generated during therapy. By deliberately including descriptions of nonverbal behaviour, the descriptions of therapy were broadened, thereby providing a more holistic approach to therapy. / Psychology / M.A. (Clinical Psychology)

Cette étude vise à comprendre la place du sentiment d’impuissance de l’intervenant dans l’établissement d’une alliance thérapeutique. La perception des intervenants à l’égard du sentiment d’impuissance et les conséquences possibles qu’ils lui reconnaissent sont analysées. Par les moyens développés par les intervenants pour contrer ce sentiment d’impuissance, des pistes de solutions sont proposées. Par une méthodologie qualitative, vingt-cinq entrevues semi-dirigées ont été réalisées dans le cadre de la recherche «L’identification des interventions qui permettent de bâtir une alliance thérapeutique avec les jeunes contrevenants : un enjeu de première importance» du professeur Louis-Georges Cournoyer de l’École de criminologie de l’Université de Montréal. Elles constituent les données principales de la présente étude. Un groupe de discussion, réalisé en milieu communautaire, a permis de les compléter. Les ruptures d’alliance thérapeutique constituent un contexte favorable au développement du sentiment d’impuissance de l’intervenant, conditionnellement au soutien de l’équipe et à la perception qu’à l’intervenant de son rôle et de son contrôle. Le sentiment d’impuissance peut mener à une remise en question positive. Toutefois, il peut aussi être à l’origine du développement de l’impuissance apprise, qui se traduit par les déficits cognitif, motivationnel et affectif. Parmi les autres conséquences du sentiment d’impuissance, une lutte s’exprime par l’évitement, l’expression de la colère et le contrôle, qui ne sont pas souhaitables en contexte d’intervention. En misant sur le soutien de l’équipe ainsi que sur la perception des intervenants à l’égard de leur rôle et de leur contrôle, il est possible de prévenir et de contrer le sentiment d’impuissance. / This study aims at understanding feelings of powerlessness of the helper and its place in the development of the therapeutic alliance with youths. The workers perceptions about the feeling of powerlessness and the possible consequences it has on their practice are analyzed. A number of solutions are proposed, based on strategies developed by workers. With a qualitative methodology, the twenty-five interviews from the research «Alliance building interventions with youth offenders», conducted by Louis-Georges Cournoyer, professor at the University of Montreal’s School of Criminology, are used. In order to complete this data, a focus group was held with community workers. The therapeutic alliance ruptures, who is mediated by team’s support and worker’s self-perceived role and control, can engender the feeling of powerlesness. This feeling might lead to a positive self-questioning. However, it might also lead to the development of learned helplessness, which manifest itself by cognitive, motivational and affective deficits. Among the other consequences of the feeling of powerlesness, is a struggle that is expressed by withdrawal, anger and control, whom are not suitable in an intervention context. By focusing on the team’s support and on the self-perceived role and control of the worker, it is possible to prevent and counter the feeling of powerlessness.