Increasing responsibility, safety, and trust through a dialogical approach: A case study in couple therapy for psychological abusive behavior

This article reports an analysis of conjoint therapy for psychological intimate partner violence, treated via a dialogical approach. The article reviews current controversies surrounding this treatment modality and its outcome. The dialogical approach is presented as an appropriate method for analyzing and understanding the issue of violence, but it is emphasized that the focus on communication does not involve a return to a systemic perspective on intimate partner violence. Four important dimensions are identified as emerging in conjoint treatment for psychological intimate partner violence, namely responsibility, safety, trust, and the role of the therapists. The Dialogical Investigations…

Retrospective Experiences of First-Episode Psychosis Treatment Under Open Dialogue-Based Services: A Qualitative Study.

AbstractOpen Dialogue (OD) is an integrated approach to mental health care, which has demonstrated promising outcomes in the treatment of first-episode psychosis (FEP) in Finnish Western Lapland region. However, little is known how treatment under OD is retrospectively experienced by the service users themselves. To address this, twenty participants from the original Western Lapland research cohort diagnosed with psychosis (F20–F29) were asked about their treatment of FEP, initiated under OD 10–23 years previously. Thematic analysis was used to explore how the treatment was experienced. Most participants viewed network treatment meetings as an important part of their treatment, as they enab…

Family violence and mental health in a sample of Finnish health care professionals : the mediating role of perceived sleep quality

Background Family violence (FV) is a prevalent health issue around the world and health care services have an important role in both recognizing and treating the consequences of violence. However, FV experiences among health care professionals themselves have not been investigated much. We also lack specific knowledge on the associations between FV and mental health. Aim The purpose of the study was to investigate the prevalence and effects of FV in a sample of Finnish health care professionals. In addition to analysing direct connections between different types of FV and mental health, the mediating effect of sleep quality was also taken into account. Methods The study followed a cross‐sec…

Finnish Health Care Professionals’ Views of Patients Who Experience Family Violence

1. Inka Koistinen[1][1] 2. Juha Holma[1][1] 1. 1University of Jyvaskyla, Finland 1. Juha Holma, Department of Psychology, Psychotherapy Training and Research Center, University of Jyvaskyla, P.O. Box 35, Jyvaskyla, 40014 Finland. Email: juha.m.holma{at}jyu.fi The aim of this study was to examine the beliefs health care personnel have about patients who experience family violence. This was done by analyzing the positions constructed for such patients using content analysis. The data comprise six focus groups conducted with physicians, nurses, social workers, and psychologists working in a maternity unit, a psychiatric ward, and an emergency department. The research team collected the data in…

Ego Impairment Index (EII-2) as a predictor of outcome in short- and long-term psychotherapy during a 5-year follow-up

Objective This study examined the predictive ability of the Rorschach-based Ego Impairment Index (EII-2) on outcome of psychotherapy in different types and durations of therapy. Method A total of 326 outpatients suffering from depressive or anxiety disorders were randomized into receiving solution-focused (n = 97), short-term psychodynamic (n = 101), or long-term psychodynamic psychotherapy (n = 128). Psychotherapy outcome assessments during the 5-year follow-up period covered psychiatric symptoms, social functioning, and work ability. Results Lower EII-2 values, which indicate less problematic ego functioning, were found to predict faster improvement in both short-term therapies as compare…

Cognitive Deficits in Patients with First-Episode Psychosis as Identified by Exner’s Schizophrenia Index in Finland and Spain

Protocol for a participatory survey to investigate the long-term effectiveness of adult psychiatric services (PSILEAPS) : a prospective exploratory cohort study

Mental health research and practice is currently moving beyond a focus on group-level symptom reduction models. Hence, research and treatment increasingly emphasize the real-life individual needs of service users and their social networks. One example is the Open Dialogue approach (OD), which has demonstrated promising outcomes in the Finnish Western Lapland (WL) catchment area. Nevertheless, it is unclear how OD-based services have so far been maintained in WL. It is also unclear how the experiences of multi-disciplinary care teams, service users and their social network members differ, with regard to differing approaches to mental health treatment. More generally, there is a global need f…

The stability of severe thought disorders and mature thinking

AbstractThe aim of this study was to investigate whether severe formal thought disorders and mature thinking are stable among adoptees (=187) drawn from the Finnish adoptive family study of schizophrenia. A group of 93 adoptees genetically at high risk (HR) and 94 at low risk (LR) for schizophrenia were assessed blindly and reliably using the Index of Primitive Thought (IPT) and the Index of Integration (IOI). Two assessments of the IPT and the IOI were performed with the mean interval of 11 years. Comparisons of the IPT and the IOI mean scores were conducted both at baseline and at follow-up between adoptees at low and high genetic risk, gender, and psychiatric status. The main result was …

Entrevistas de Recuerdo Estimulado: ¿Cómo la entrevista de investigación puede contribuir a nuevas prácticas terapéuticas? [Stimulated Recall Interviews: How can the research interview contribute to new therapeutic practices?]

The subjective experiences of participants in couple therapy have been explored through Stimulated Recall Interviews (SRIs), in which both clients and therapists come individually to watch video clips of their therapy sessions. We believe SRIs offer a good resource for Practice Oriented Research (POR) by promoting meaningful, flexible interplay between scientific research and clinical practice. Team members have different roles, either as “insiders” or “outsiders” of the therapeutic setting. The potential benefits of these interviews are illustrated by a case study conducted within the Relational Mind research project, in which SRIs helped to promote the emergence of reflections. SRIs, hith…

Results of the Jyväskylä research project on couple therapy for intimate partner violence : topics and strategies in successful therapy processes

Despite controversy over the indications of couple therapy for IPV, current research has indicated some benefits. This article examines some crucial aspects when dealing with couple therapy for IPV, such as how dominance and power abuse are present, and which important issues should be taken into account during the therapeutic process and be brought up in therapeutic conversations. It also proposes strategies for therapists conducting couple therapy for IPV. Ten studies conducted within the Jyväskylä research project on couple therapy for IPV were reviewed. Findings highlighted the importance of the therapists’ awareness of the presence of violence, dominance and power during the sessions, …

Electrodermal activity in couple therapy for intimate partner violence

The aim of this study was to examine the extent to which intimate partner violence (IPV) is discussed in couple therapy, what the participants say about it and how, and how the participants’ electrodermal activity (EDA) is activated during these discussions. We studied four couples for whom IPV was an issue in dialog with their therapists. We used thematic analysis and examined the differences in EDA (measured as skin conductance responses, SCRs) between the participants. We found that although IPV was discussed relatively little in therapy, when the topic arose the victims took an active part in the discussion. We also found that the main themes were descriptions of IPV, explanations for I…

Lähisuhdeväkivallan kehystäminen erikoissairaanhoidossa : puuttumisen ja muutoksen mahdollisuudet

Lähisuhdeväkivaltaan puuttuminen terveydenhuollossa on haasteellinen ja kiistanalainen kysymys. Tässä artikkelissa käsittelemme lähisuhdeväkivallan kohtaamisen tapoja erikoissairaanhoidossa. Aineistona on kuusi erikoissairaanhoidon ammattilaisten fokusryhmähaastattelua. Taustateoriana ja menetelmänä käytämme Erving Goffmanin arkielämän vuorovaikutustilanteiden tutkimiseen kehittämää kehysanalyysia. Tarkastelemme, millaiset kehystämisen tavat estävät ja millaiset edistävät väkivallan tunnistamista ja siihen puuttumista. Aineistosta analysoimamme väkivaltaan puuttumattomuutta perustelevat kehykset ovat: 1) medikaalinen, 2) käytännöllinen, 3) individualistinen ja 4) psykologinen. Väkivaltaan p…

Psykoterapeuttikoulutusten järjestämisvelvollisuus puuttuu

How do health care services help and hinder recovery after a suicide attempt? A qualitative analysis of Finnish service user perspectives

Background Suicide attempt survivors are at high risk of re-attempts and suicide death. Previous research has shown that service users’ experiences of post-attempt care are related to future treatment engagement and re-attempts. In-depth understanding of how current services meet service users’ needs in the period immediately following a suicide attempt is thus imperative for the development of more effective tertiary prevention practices in real-life health care systems. Method In this qualitative study, Finnish suicide attempt survivors’ experiences of and perspectives on mental health services were explored through a semi-structured interview. Participants were seven female and seven mal…