The necessary distinction between methodology and philosophical assumptions in healthcare research

Methodological discussions within healthcare research have traditionally described a methodological dichotomy between qualitative and quantitative methods. The aim of this article is to demonstrate that such a dichotomy presents unnecessary obstacles for good research design and is methodologically and philosophically unsustainable. The issue of incommensurability is not a question of method but rather a question of the philosophical premises underpinning a given method. Thus, transparency on the philosophical level is important for validity and consistency as well as for attempts to integrate or establish an interface to other research. I argue that it is necessary to make a distinction be…

Therapy the Natural Way: A Realist Exploration of the Wilderness Therapy Treatment Process in Adolescent Mental Health Care in Norway

Wilderness therapy has the potential to meet the specific needs of the current adolescent population by providing a rather unique outdoor group treatment. Wilderness therapy is not a new approach to mental health treatment, but its theoretical basis is not yet clearly delineated, in part because of the diversity found across programs and contexts. This article presents a critical realist exploration of a wilderness therapy program that was recently implemented as part of adolescent mental health services in Southern Norway. In this study, we combine fieldwork and interviews for an in-depth investigation of the treatment process, where the objective was to acquire a deeper understanding of t…

Practitioners' positive attitudes promote shared decision-making in mental health care

Rationale and aims: There is a growing expectation of implementing shared decision making (SDM) in today's health care service, including mental health care. Traditional understanding of SDM may be too narrow to capture the complexity of treatments of mental health problems. Although the patients' contribution to SDM is well described, the contribution from the health care practitioners is less explored. Therefore, our aim was to explore the attitudes of practitioners in mental health care and the associations between practitioners' attitudes and SDM. Method: We performed a cross‐sectional study where practitioners reported their sharing and caring attitudes on the Patient‐Practitioner Orie…

Unpacking the Black Box of Wilderness Therapy

Despite considerable progress within wilderness and adventure therapy research over the last decade, researchers are still unable to precisely answer why, how, and for whom this treatment modality works. There is also a need for more knowledge regarding the circumstances under which the treatment does not appear to be effective. In this realist synthesis, we attempt to unpack this “black box” of wilderness therapy more specifically, defined as a specialized approach to mental health treatment for adolescents. Through a focused review of the primary qualitative wilderness therapy studies, empirical findings are used to test and refine a key program theory. The synthesis results in a propose…

Therapy in the open air: Introducing wilderness therapy to adolescent mental health services in Scandinavia

Despite the rich traditions of outdoor life in the Scandinavian countries, structured nature-based therapeutic interventions remain underexplored in adolescent mental health services. We suggest that wilderness therapy is an age-appropriate and effective group treatment that may hold particular appeal for at-risk youth who are less responsive to conventional forms of treatment. Although more widespread in other parts of the world, wilderness therapy may also be a viable treatment modality for the Scandinavian region. Our overall aim of this state-of-knowledge article is to provide an overview of wilderness therapy with regard to conceptualization, practice and research, and to discuss curre…

Shame’s Unwelcome Interruption and Responsive Movements. Body, Religion, Morality – an Interdisciplinary Study

Emerging stories of self: long-term outcomes of wilderness therapy in Norway

This paper is a twelve-month follow-up study that explores perceived outcomes from participation in a Norwegian wilderness therapy program. Through a critical realist approach, the authors performe...

Spiritual Well-being in Patients With Metastatic Colorectal Cancer Receiving Noncurative Chemotherapy

Spiritual well-being (SWB) is an important quality-of-life dimension for cancer patients in the palliative phase. Therefore, it is important for healthcare professionals to recognize the concept of SWB from the patient's point of view. A deeper understanding of how patients experience and reflect upon these issues might influence patient care. The aim of this study was to explore SWB in colorectal cancer patients receiving chemotherapy in the palliative phase. We used a qualitative method of in-depth interviews and a hermeneutic editing approach for the analyses and interpretations. Twenty colorectal cancer patients in the palliative phase, aged 34 to 75 years, were included: 12 patients we…