Lähisuhdeväkivallan tunnistaminen ja ehkäisy edistävät hyvinvointia
Sosiaali- ja terveydenhuollon ammattilaisetkaan eivät aina huomaa lähisuhdeväkivaltaa, ja siksi sen havaitsemiseen pitää panostaa
Lähisuhteissa eli muun muassa pari- ja perhesuhteissa tapahtuva väkivalta on Suomessa hyvin yleistä. Noin joka kymmenes suomalainen eli noin 340 000 henkilöä elää parhaillaan väkivaltaisessa parisuhteessa ja lapsuudessaan lähisuhdeväkivaltaa on kokenut jopa 70 % aikuisväestöstä eli yli kaksi miljoonaa henkilöä. Lähisuhdeväkivalta voi olla henkistä, fyysistä tai seksuaalista. nonPeerReviewed
Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence: An evaluation of three methodological approaches.
Better therapeutic alliances are known to predict better treatment outcomes, but little knowledge still exists on the patient characteristics that lead to better alliances. In a sample of 128 outpatients assigned to long-term psychodynamic psychotherapy and suffering from mood and/or anxiety disorder, this study evaluated how the alliance, measured using the Working Alliance Inventory (WAI), is predicted by three different measures for assessing psychological resources and vulnerabilities: the Wechsler Adult Intelligence Scale—Revised (WAIS–R), the Defense Style Questionnaire (DSQ), and the Rorschach-based Ego Impairment Index (EII-2). All the three measures showed some ability to predict t…
Positions constructed for a female therapist in male batterers' treatment group
How the gender of the therapist affects the treatment of intimately violent men has been little researched. In this study we examined the positions that batterers construct for a female therapist in batterers' group treatment. The data consisted of five videotaped therapy groups for male batterers. Three positions of a woman were constructed: woman in general; woman as spouse and woman personally as herself. These positions were often based on a constructed difference between men and women. The female therapist repositioned herself to diminish the difference constructed between the genders and to make fear of the spouse visible. peerReviewed
Lähisuhdeväkivallan tunnistaminen erikoissairaanhoidossa
Tutkimuksen tarkoituksena oli selvittää potilaiden lähisuhdeväkivaltakokemusten yleisyyttä, koetun väkivallan muotoja ja toistuvuutta sekä hoidontarvetta. Tutkimus toteutettiin Keski-Suomen keskussairaalan synnytysyksikössä, päivystysalueella sekä psykiatrisessa sairaalassa. Tutkimukseen osallistui yhteensä 530 potilasta. Projektin pilottiyksiköiden hoitohenkilökunta käytti potilaiden lähisuhdeväkivaltakokemusten ja niiden aiheuttaman hoidontarpeen selvittämiseksi suodatin- ja kartoituskysymyslomaketta. Kyselyn aikainen tai aiempi lähisuhdeväkivalta vaikutti potilaan oman arvion mukaan kielteisesti hänen hyvinvointiinsa ja elämänhallintaansa 10,5 %:lla synnytysyksikön, 31,7 %:lla psykiatris…
”Mä kertakaikkiaan löydän jonkun konstin, että nousen täältä” - Kroonista väsymysoireyhtymää (ME/CFS) sairastavien toimijuuden modaliteetit
Krooninen väsymysoireyhtymä (ME/CFS [myalgic encephalomyelitis/ chronic fatigue syndrome]; G93.3) on pitkäkestoinen, harvinainen ja vaikeasti diagnosoitava sairaus, jolle on tyypillistä voimakas pitkäaikainen väsymys, joka ei selity millään muulla fyysisellä tai psykiatrisella sairaudella. Valtakunnalliset Hyvä käytäntö konsensussuositukset sairauden hoitoon julkaistiin helmikuussa 2021. Tässä tutkimuksessa tarkastellaan viiden kroonista väsymysoireyhtymää sairastavan toimijuuden kokemuksia. Erityisenä tarkastelun kohteena ovat terveydenhuollon palvelu- ja hoitojärjestelmän vaikutukset sairastuneiden toimijuuteen. Aineisto on kerätty ennen konsensussuositusten julkaisemista. Tutkimus on la…
Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes
ABSTRACT. Violence is a serious problem, and social and health care providers are in a key position for implementing successful interventions. This qualitative study of 6 focus groups with professionals (n = 30) examines the health care professionals’ ways of framing a domestic violence intervention. Of special interest here is how professionals see their own roles in the process of recognizing and helping victims of domestic violence. By using Erving Goffman's frame analysis, this study identifies several frames that either: a) emphasize the obstacles to intervention and justify nonintervention, or on the contrary, b) question these obstacles and find justifications for intervention. The p…
Rorschach Characteristics and Comparison of First-Episode Psychotic Patients in Finland and Spain
Identifier avec précision les troubles schizophréniques a toujours été un problème complexe et controversé. Les caractéristiques psychologiques de la schizophrénie ont donné lieu à un volume considérable de travaux et de débats. Ces dernières années sont apparus un nombre croissant d'articles portant sur les différences et similitudes des manifestations de la psychose selon les cultures, partant de l'idée que les caractéristiques de personnalité nationales pourraient contribuer aux tableaux psychopathologiques. Le but premier de cette étude est de mieux comprendre les troubles psychotiques par l'investigation de la structure de personnalité et du fonctionnement de patients faisant un premi…
Constructing Healing Dialogues in Group Treatment for Men Who Have Used Violence Against Their Intimate Partners
Although various “talking cure” treatments typically constitute an important part of practices in social work and mental health services, there are few studies on the actual “talk-within-the-cure.” This qualitative study examined talk in group treatment for men who had used violence against their intimate partners. Using the method termed Dialogical Investigations, the aim of the present study was to examine the construction of “healing dialogues,” that is, dialogues that promote change in clients, within treatment conversations. The results of the micro-analysis suggest that mutually responsive and constructive dialogical interaction and talk with symbolic language may support the emergenc…
Narratives of Burnout and Recovery from an Agency Perspective : A Two-Year Longitudinal Study
Abstract Purpose To provide knowledge about the recovery process during rehabilitation and two years later by exploring the manifestation of agency and spheres of meaning in the narratives of participants in a national rehabilitation course. Material and methods The subjects of the study were four participants in a national rehabilitation course, whose burnout levels had decreased between the initial and follow-up periods of the course. Semi-structured interviews on two occasions and an electronic questionnaire 1.5 years post rehabilitation comprised the main material. In addition, the BBI -15 (Bergen Burnout Indicator) and DEPS-screen were used. Results Thematic narrative analysis revealed…
Dialogues in partner abusive clients' group treatment: conversational tools used by counselors with differently motivated clients.
This qualitative study investigated talk and interaction as process factors potentially influencing outcomes in abuser group intervention. The findings showed that (a) abusers participate in group programs with considerably different degrees of motivation; (b) the interaction in abusers’ various stages of change is characterized by different qualities; and (c) group counselors face a challenge in adapting their ways of working to abusers’ various needs and backgrounds. The findings demonstrate the importance of attending to the interactional elements in abuser treatment programs and show the value of matching an abuser’s needs and degree of motivation with the timing of interventions. It is…
Loss of self-control as excuse in group-therapy conversations for intimately violent men.
This article examines the constructions of loss of self-control by male perpetrators of intimate violence in therapy-group conversations. It looks at discursive strategies used by therapists and clients in therapy-group negotiations concerning the issue of self-control. The data are part of a larger corpus of videotaped and transcribed recordings of treatment groups for male perpetrators and consists of four treatment group processes. The analysis concentrates on episodes of self-control talk where a participant referred to loss of self-control when accounting for his violent behavior. The loss of self-control was found to be a fundamental constituent of excuses and was used to account for …
Domestic Violence Interventions in Social and Health Care Settings: Challenges of Temporary Projects and Short-Term Solutions.
Social welfare service and health care providers are in a key position to implement successful domestic violence (DV) interventions. However, it is known that DV intervention and prevention work is often lacking in coordination and continuity. In addition, the limited resources, hectic work pace, and changing practices negatively affect the development of successful ways to prevent and intervene in DV. This qualitative study involving 11 focus groups, composed of social welfare and health care professionals ( n = 51) in a midsized Finnish hospital, examined the challenges and possibilities within DV interventions and the adoption of good practices produced by a DV intervention development …
Frame analysis of psychotherapists’ perspectives on the development of psychological disorders
AbstractThe development of psychological disorders has been explained by several psychological theories and remains under debate. Psychotherapists, however, have insights into the emergence and development of psychological disorders that stem from both theory and practice. The constantly evolving field of psychotherapy prompts reconsideration, specifically when psychotherapists’ views on the development of disorders impacts their treatment approach. In addition, theoretical orientation and years of clinical experience, while known to influence psychotherapists’ viewpoints also merit further study. Applying Erving Goffman’s frame analysis, semi structured interviews with psychotherapists wer…
Affective Arousal During Blaming in Couple Therapy: Combining Analyses of Verbal Discourse and Physiological Responses in Two Case Studies
Blaming one’s partner is common in couple therapy and such moral comment often evokes affective arousal. How people attune to each other as whole embodied beings is a current focus of interest in psychotherapy research. This study contributes to the literature by looking at attunement during critical moments in therapy interaction. Responses to blaming in verbal dialogue and at the level of the autonomic nervous system (ANS) were investigated in two couple therapy cases with a client couple and two therapists. Video-recorded couple therapy sessions were analyzed using discursive psychology and a narrative approach. The use of positioning, a discourse analytic tool, was also studied. ANS res…
The self-narrative and acute psychosis
The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.
Dominant Story, Power, and Positioning
From a narrative perspective, how we understand our life and tell stories about our lives is shaped and defined by cultural discourses. During these tellings, some stories become dominant while others become silenced. As well as reflecting cultural discourses, these local stories also reflect the positions embedded in these discourses.
Editorial: New approaches to understand domestic violence and reduce its prevalence
How do people talk decades later about their crisis that we call psychosis? : A qualitative study of the personal meaning-making process
Psychosis refers to a severe mental state that often significantly affects the individual’s life course. However, it remains unclear how people with the lived experiences themselves view these phenomena, as part of their life story. In order to evaluate this personal meaning-making process, we conducted in-depth life-story interviews with 20 people who had been diagnosed with non-affective psychosis 10 to 23 years previously in one catchment area. 35% of them were still receiving mental health treatment, and 55% of them were diagnosed with schizophrenia. Only a minority named their experiences as psychosis. On the basis of narrative analysis, two types of stories appeared to encompass how m…
Discussions of Fatherhood in Male Batterer Treatment Group
The aim of this study was to examine how men who have perpetrated violence toward their partners and participated in batterer group talked about being a father and how they perceived their own fatherhood. The discussion in the group was analyzed qualitatively by using the methods of content analysis. In traditional fatherhood, they talked about avoidant, passiveness, distant, indifference, and authoritative controlling ways of acting. These men also created an image of themselves as active and caring fathers, thus including empathy and nurture in the concept of fatherhood. This new fatherhood was considered an achieved goal and an objective for the men as being a father. Talking about fath…
Female survivors’ experiences of authorities’ actions in cases of partner stalking
Previous studies have shown that civil authorities fail to understand the nature of stalking and the harmful consequences it causes victims. The aim of this study was to investigate how the victims of partner stalking had perceived the actions of civil authorities and the stalking investigation process. The data were drawn from conversations among members of an internet-based peer support group for female victims of partner stalking. We identified four main categories of victims’ experiences pertaining to authorities’ actions and the investigation process: authorities’ problems in dealing with stalking, dissatisfaction with the investigation process, trust in the authorities and expectation…
Towards gender awareness in couple therapy and in treatment of intimate partner violence
Gender is the most pervasive classification of individuals and thus strongly defines couple relationships. Cultural discourses on couple relationships reproduce hierarchical gender differences, and couple distress is often linked to gendered power inequalities. At worst, gender is the basis for intimate partner violence (IPV). Generally, however, therapeutic interventions do not address the issues of gender and gendered power. This paper discusses the meaning and functions of gender in the context of couple therapy, in particular for IPV. It is argued that the therapist needs to be skilled in discursive deconstruction to be able not only to address the client’s situation as an individual ex…
Intimate Partner Violence in Finland
High prevalence of intimate partner violence against women and high levels of gender equality in Finland yield to what has been called the “Nordic paradox.” It has been argued that the high level of gender equality has caused the need for IPV interventions and especially the gendered perspective to be overlooked. However, there has been recent and ongoing development in IPV intervention and prevention in regard to perpetrator programs, couple therapy, and programs to address post-separation stalking. Training programs for social and healthcare professionals and the police have been developed, as well as for teachers and other professionals at school. We hope the current government’s new act…
Psychotherapists’ views on triggering factors for psychological disorders
AbstractTriggering factors play an important role in the development of psychological disorders. Practicing psychotherapists have valuable knowledge on psychological disorders and since their views on triggering factors have not been reported in the literature, triggers were addressed in this study from psychotherapists’ perspectives. The following three main issues were examined: definitions of triggers, examples of the most recurrent triggers and the idea of a common trigger for psychological disorders. Sixteen psychotherapists agreed to participate in the study. Semi-structured interviews were conducted in person and the data collected were analyzed using frame analysis. Frame analysis a…
Subjectively evaluated effects of domestic violence on well-being in clinical populations
Effects of domestic violence are reflected in victims' physical, psychological, and sexual health as well as in victims' subjective evaluations of health or subjective well-being. The principal aim of this study was to study the extent to which the consequences of domestic violence are reflected in patients' subjectively evaluated well-being, life management, and sense of security in an emergency department, a maternity department, and a reception unit of a psychiatric hospital. A questionnaire on the effects of domestic violence was administered to 530 patients. 61 patients reported either current or previous domestic violence that affected their current well-being and life management. Dom…
Making sense of domestic violence intervention in professional health care
Intervening in domestic violence in the health care and social service settings is a complex and contested issue. In this qualitative, multidisciplinary study, the barriers to but also the possibilities for health care professionals in encountering victims of violence were scrutinised. The focus was on omissions in service structure and practices. The data consisted of six focus group interviews with nurses, physicians, social workers and psychologists in specialist health care (n = 30) conducted in Finland in 2009. The aim was to explore professionals' processes of making sense of violence interventions and the organisational practices of violence interventions. Four types of framing of th…