När de nationella riktlinjerna för vård och ångesttillstånd utkom 2010, ansågs psykodynamisk terapi sakna evidens och förbisågs nästan helt som metod i offentlig vård. Vad detta inneburit för de offentliganställda dynamiska terapeuterna och deras patienter är okänt. Syftet med studien var att få veta hur psykodynamiska terapeuter upplever sin arbetssituation och om de nationella riktlinjerna som utkom 2010 förändrat arbetet som dynamisk terapeut i offentlig sektor. Som metod användes en kvalitativ intervju med en öppen frågeställning där fem seniora legitimerade terapeuter med minst femton år i yrket deltog. Intervjuerna bearbetades i en med en tematisk analys, vilket resulterade i fyra övergripande teman. Resultatet redovisas mot en tidsaxel bestående av förr, nuvarande situation och framtiden. Dagens situation har gjort det svårt att upprätthålla den psykodynamiska ramen och terapeuterna tecknar en relativt mörk bild av den psykodynamiska terapins och sin egen framtid inom den offentliga psykiatriska vården. Diskussionen berör legitimerade psykodynamiska terapeuters rätt att utöva sitt yrke inom de rättigheter och skyldigheter som legitimation ger. Situationen som patienterna befinner sig i när de efterfrågar dynamisk terapi diskuteras också och kopplingen till aktuell lagstiftning. / When the national guidelines for care regarding depression and anxiety disorders were published in 2010, psychodynamic therapy was considered to lack evidence and was subsequently ignored almost entirely as a method in public care. What this meant for public servants, dynamic therapists and their patients is unknown. The aim was to find out how the psychodynamic therapists experience their current work situation and if the national guidelines, published in 2010, have affected their work as dynamic therapists in the public sector. A qualitative interview with an open issue where five senior qualified therapists with at least fifteen years in the profession attended was used as method. The interviews were processed in a thematic analysis, which resulted in four overarching themes. The results are reported against a timeline consisting of past, present situation and future. The current situation has made it difficult to maintain the psychodynamic framework and therapists paint a fairly bleak picture of the future of psychodynamic therapy and their own future within the public mental health services. The discussion concerns registered psychodynamic psychotherapists’ right to practice within their given responsibilities. The discussion also concerns the patient’s situation when requesting psychodynamic therapy, as well as the link to current legislation.

Today, it seems that informal relationships in the workplace are more important for employees than ever. Furthermore, we have seen a rising interest for staff work, even in small companies. Research has shown that staff work in small companies can be described as ad hoc. However, what influence the informal relationships have on the staff work is a rather unexplored topic. In this study, we wanted create a deeper understanding of how the informal relationships are expressed in a small company and their potential influence on the staff work. To achieve this we conducted a qualitative study with 14 in-depth interviews in a small company with about 30 employees in the south of Sweden. In the beginning of this study we believed that we would find many informal relationships with a high impact on the staff work. The result of this study has shown that informal relationships in a small company can be shallow in their character but still be perceived as good. Moreover, the study has shown that shallow informal relationships can have a similar impact in organizations as earlier research has shown that deeper informal relationships can. The impact that these informal relationships has shown in this study, is interpreted to be engagement, trust and wellbeing. But also negative aspects such as frustration founded in a lack of communication. The informal relationships has also shown an impact on how the staff work is constructed. The informal relationships that are not interpreted as well-functioning has in this study been interpreted to have a negative impact on the ad hoc staff work that the company is conducting. With this study we want to create an awareness around informal relationships and its impact on small companies and their staff work. All this to give small companies good conditions in conducting a beneficial staff work.

Inledning: Ramen är grundförutsättningen för terapiprocessen. Det saknas i dagsläget kunskap om hur psykoterapeuter resonerar kring de svårigheter som kan uppstå för psykoterapeuter när den psykodynamiska ramen påverkas och förändras under de särskilda omständigheter som Covid-19 pandemin inneburit. Syfte: Att undersöka hur psykodynamiskt skolade psykoterapeuter resonerar kring sitt arbete med den psykodynamiska ramen och den yttre påverkan under Covid-19 pandemin.  Metod: Kvalitativ metod användes där fem psykoterapeuter intervjuades med semistruktureradr intervjuer. Materialet analyserades med tematisk metod. Resultat: Alla deltagare beskrev den psykodynamiska ramen som oerhört viktig och som ett fundament för terapin. Samtliga deltagare i studien återgav ett förhållningssätt i sitt kliniska arbete, som utgick från tydliga överenskommelser i tid, plats, betalning, sekretess och anledning till att träffas för att prata kring det som patienten ville arbeta med. Alla deltagare ger en enhetlig och klar bild av att politiska direktiv i samband med Covid-19 påverkat dem. Diskussion: Diskussionen visar tre betydelsefulla delar, hur ramen är ett krav för en terapiprocess, att ramen behöver anpassas efter verkligheten och att ramen både är konstant och föränderlig. Studies resultat bekräftades i relation till tidigare forskning. Mer kvalitativ forskning behövs i ämnet. / Abstract: The "frame" is the basic prerequisite for the therapy process. There is currently a lack of knowledge about how psychotherapists reason about the difficulties that may arise for psychotherapists when the psychodynamic "framework" is affected and to change under the special circumstances that the Covid-19 pandemic has entailed. Purpose: To examine how psychodynamically trained psychotherapists reason about their work with the psychodynamic "framework" and the external influence during the Covid-19 pandemic. Method: Qualitative method was used where five psychotherapists were interviewed with a semi-structured interviews. The material was analyzed using the thematic method. Results: All participants described the psychodynamic framework as extremely important and as a foundation for the therapy. All participants in the study reported an approach in their clinical work, which was based on clear agreements in time, place, payment, confidentiality and reason for meeting to talk about what the patient wanted to work on. All participants give a uniform and clear picture that political directives in connection with Covid-19 affected them. Discussion: The discussion shows three important parts, how the frame is a requirement for a therapy process, that the frame needs to be adapted to reality and that the frame is both constant and changeable. The results of this study were confirmed in relation to previous research. More qualitative research is needed on the subject.