Why Am I the Only One You’re Talking to, Talk to Them, They Haven’t Said a Word? : Pitfalls and Challenges of Having the Child in the Focus of Family Therapy

Children with conduct disorders are at risk of being positioned in the family therapy as ‘the problem’. This study describes how the difficulties were talked about and how the child coped in this situation. The results showed: the parents produced symptom-oriented problem talk about the child’s behavior, rendering systemic reformulation of the problem challenging. The negative interaction made the climate unsafe and impaired consideration of the child’s behavior as a meaningful way for the child to become seen and heard. This study enriches understanding of the therapeutic challenge therapists face with high-risk families from the very beginning of the treatment. peerReviewed

Significant Moments in a Couple Therapy Session: Towards the Integration of Different Modalities of Analysis

This chapter presents a couple therapy session from four different research perspectives: The verbal dialogue was analysed with the Dialogical Investigations of Happenings of Change method, the embodied reactions of each participant were analysed by examining the electrodermal activity of each participant, and nonverbal synchrony was observed between the participants. Stimulated Recall Interviews, conducted individually after the session, were used to gain insights on the participants’ thoughts and feelings concerning particular moments in the session. We wished to determine what could be learned from the embodied reactions of the participants in couple therapy, including whether the data o…

Psychometric properties of the Finnish version of the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE) questionnaire.

An increasing need exists for suitable measures to evaluate treatment outcome in adolescents. YP-CORE is a pan-theoretical brief questionnaire developed for this purpose, but it lacks studies in different cultures or languages.To explore the acceptability, factor structure, reliability, validity, and sensitivity to change of the Finnish translation of YP-CORE.The study was conducted at the Department of Adolescent Psychiatry, Helsinki University Central Hospital. A Finnish translation was prepared by a team of professionals and adolescents. A clinical sample of 104 patients was asked to complete the form together with BDI-21 and BAI, and 92 of them filled the forms again after a 3-month tre…

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…

Somatic experience of emotion in emotionally focused couple therapy: Experienced trainer therapists' views and experiences.

In general, arousal of emotions is often felt and expressed as a somatic experience in the body. In Emotionally Focused Couple Therapy (EFT), the deepening of emotional experiencing enables therapeutic change. This research explores the experiences of eight experienced EFT trainer therapists regarding their somatic experiences in their work with couples. Using interpretative phenomenological analysis of transcribed in-depth interviews, this research data yielded three core themes that captured therapists' experiences of using their own and couples' somatic experiences in therapy: (1) the importance and relevance of somatic experiences, (2) therapists' use of their own somatic experiences, a…

Ideological, Institutional and Affective Practices of Interpersonal Violence

The first chapter presents the book’s point of departure as well as its central concepts and structure. It outlines the current understandings of and theoretical approaches to the intersections of violence, gender and affect. The starting point is that gendered violence and violating practices are embedded in social structures of power and in inequalities, institutions, regimes and the symbolic order. They are manifested in human interaction as well as in cultural discourses and representations. The chapter also gives an overview of the abundant research and various perspectives involved in analysing the intersections of violence, gender and affect as well as the continuities and interconne…

Lähisuhdeväkivallan tunnistaminen ja ehkäisy edistävät hyvinvointia

Dealing with negative connotations in family therapeutic treatment of an enmeshed family: A case study

In psychotherapy the moments when negative connotations of diagnostic remarks become apparent are also the moments for change. To be able to use those moments for positive outcome calls for, according to this case study: 1) An inquiring approach and attitude to therapeutic work which translates to the challenging of basic hypotheses and the unambiguous meaning of diagnostic signs starting from the referral and continuing through the treatment process. 2) The integration of the nonverbal experiential technique with the verbal reflective approach, which can be conceptualized as a double description of the problem situation, and which allows reframing, or recontextualization. 3) A diagnostic c…

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

The Finnish Clinical Outcome in Routine Evaluation Outcome Measure psychometric exploration in clinical and non-clinical samples

The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consistency and convergent validity of the Finnish CORE-OM scores. Translation of the CORE-OM from English to Finnish was undertaken according to recommended protocols. Psychometric exploration was conducted in two samples: psychiatric patients (N = 201) and non-clinical participants (N = 209). Participation was voluntary and involved completion of all …

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 shift from monologue to dialogue in a couple therapy session: dialogical investigation of change from the therapists' point of view.

As part of a larger research project on couple therapy for depression, this qualitative case study examines the nature of dialogue. Drawing on Bakhtinian concepts, the investigation shows how the conversation shifts from a monologue to dialogue. Among the findings are: first, the process of listening is integral to the transforming experience. That is, the careful listening of the therapist can evoke new voices, just as the experience of one of the partners' "listening in" to the conversation between the other partner and the therapist can create movement and new trajectories. The latter is a qualitative difference between dialogic therapy with a couple and that with an individual. Second, …

sj-pdf-2-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-2-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

‘Can I tell?’ : Children’s participation and positioning in a secretive atmosphere in family therapy

As a multifaceted phenomenon, family secrets affect interaction in the therapeutic system. This qualitative study, applying the multi‐actor Dialogical Methods for Investigations of Happening of Change, explored how children participated and positioned themselves in family therapy in a climate of family secrets. The results showed that the children were active co‐participants in the complex dynamics of a secretive atmosphere, involving themselves in the paradoxical processes of reconstructing and deconstructing the secretive and unsafe climate. In family therapy, a child’s symptomatic behaviour can function as a visible ‘cover story’ for invisible constructions of secrets, preventing sensiti…

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…

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…

Children's disclosures of sexual abuse in a population-based sample

Most previous studies on disclosing child sexual abuse (CSA) have either been retrospective or focused on children who already have disclosed. The present study aimed to explore the overall CSA disclosure rate and factors associated with disclosing to adults in a large population-based sample. A representative sample of 11,364 sixth and ninth graders participated in the Finnish Child Victim Survey concerning experiences of violence, including CSA. CSA was defined as having sexual experiences with a person at least five years older at the time of the experience. Within this sample, the CSA prevalence was 2.4%. Children reporting CSA experiences also answered questions regarding disclosure, t…

On Heidegger’s Sofa: Some Remarks on Psychotherapy from Historical and Philosophical Points of View

AbstractOur starting point in this article is that the question of the essence of psychotherapy has to some extent been neglected. Its medical context has strengthened the tendency to interpret psychotherapy in general from a technical and overtly rationalistic standpoint. Instead, we would underline the importance of the philosophical and historical roots of all psychotherapies. In our view, it is imperative to acknowledge the antirationalistic underpinnings that have always informed the discipline. We show how speculative mysticism and the late philosophy of Martin Heidegger have proved to be indispensable tools in setting psychotherapies in their philosophical and historical context. Rob…

Dimensions of expertise in family therapeutic process

Aarno Laitila osoitti, että perheterapiatapahtumaa voidaan tarkastella keskustelussa, kanssakäymisessä ja vuorovaikutuksessa syntyvän asiantuntijuuden ja terapeutin henkilökohtaisesti työssä ja opiskelussa karttuneen asiantuntijuuden risteyksenä. Terapiakeskustelun vuorovaikutustilanteessa syntyy ja karttuu se tieto, jonka varassa hoito toteutuu, etenee ja on tuloksellista. Terapeutti on tuossa tilanteessa väistämättä eri asemassa kuin asiakkaansa, vaikka hoitotapahtuman järjestelyä ohjaakin asiakaslähtöisyys, tasaveroisuus ja läpinäkyvyys.Laitila tarkasteli kolmeen artikkelijulkaisuun, yhteen artikkelikäsikirjoitukseen ja näiden yhteenvetoon perustuvassa tutkimuksessaan asiantuntijatoiminn…

"You helped me out of that darkness" Children as dialogical partners in the collaborative post-family therapy research interview.

Applying Dialogical Methods for Investigations of Happening of Change (DIHC), this study investigated how children who had been diagnosed with an oppositional defiant or conduct disorder participated in a collaborative post‐therapy research interview and talked about their experiences of family therapy. The results showed that the children participated as dialogical partners talking in genuine, emotional, and reflective ways. Encountered as full‐membership partners, the children also co‐constructed meanings for their sensitive experiences. However, their verbal initiatives and responses appeared in very brief moments and could easily have been missed. The collaborative post‐therapy intervie…

Gendered Violence Online : Hate Speech as an Intersection of Misogyny and Racism

Social media has been adopted by radical right populists and alt-right demagogues as a platform for circulating misogynous and racist hate speech and affectively mobilising supporters. This chapter examines hate speech as a form of gendered and racist violence, focusing on social media posts by two influential right-wing populist politicians: Jussi Halla-aho, the leader of the Finns Party, and Donald Trump, the president of the United States. It demonstrates how these politicians intertwine misogyny and racism in blog posts and tweets that target women in particular. Their affective online communication is interpreted as a new form of violence. This digitally mediated violence, although a r…

Making sense of multi-actor dialogues in family therapy and network meetings.

In recent years, a number of family therapists have conceptualized psychotherapy as a dialogical activity. This view presents family therapy researchers with specific challenges, the most important of which is to find ways of dealing with the dialogical qualities of the multi-actor dialogues that occur, for example, in family therapeutic conversations. In this article, we propose some preliminary ideas concerning qualitative investigations of multi-actor dialogues. Our aim is to work toward an integration of Bakhtin’s theoretical concepts with good practices in qualitative research (e.g., dialogical tools and concepts of a narrative processes coding system) in order to make sense of family …

The added value of studying embodied responses in couple therapy research : A case study

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single‐case study comprise couple therapy process videotapes recorded in a multi‐camera setting, and measurements of participants’ SNS activity. The voluntary participants were a marital couple in their late thirties and two middle‐aged male psychotherapists. The division into topic segments showed how the key issue of seeking help, which was found to comprise three separate components, was repeatedly…

The Finnish Clinical Outcome in Routine Evaluation Outcome Measure: psychometric exploration in clinical and non-clinical samples

The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consistency and convergent validity of the Finnish CORE-OM scores. Translation of the CORE-OM from English to Finnish was undertaken according to recommended protocols. Psychometric exploration was conducted in two samples: psychiatric patients (N = 201) and non-clinical participants (N = 209). Participation was voluntary and involved completion of all …

“I feel many contradictory emotions” : Finnish mothers' discursive struggles with motherhood

Objective The aim of the study was to facilitate the understanding and interpretation of multiple aspects of working with mothers by examining Finnish mothers' mothering discourses and the interplay among these discourses. Background According to relational dialectics theory, discourses are systems of meaning that are coproduced in interaction. Although discursive research on motherhood has identified various discourses, research on the interplay among competing motherhood discourses is in its infancy. Method Qualitative questionnaire data from 479 Finnish mothers of infants were analyzed using contrapuntal analysis. Mothers' responses to three open-ended questions were analyzed inductively…

sj-pdf-3-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-3-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

Lapsen asemoituminen perheterapian vuorovaikutuksessa

Perheterapian ydinajatus kiteytyy sen dialogisuuteen, mutta lapsilla ei ole tasavertaista asemaa perheterapian vuorovaikutuksessa. Tutkimuksessa tarkastellaan, miten terapeuttisen systeemin aikuiset asemoivat uhmakkuus- tai käytöshäiriödiagnoosin saaneita lapsia perheterapiassa. Ilmiötä lähestytään vuorovaikutuksen ongelmatilanteiden ja lapsen näkökulman kautta. Aineisto koostuu yhdestä lastenpsykiatrian poliklinikalla ja yhdestä kotona toteutetun perheterapiaistunnon ääni- ja videotallenteista. Lapsi asemoitiin lasta itseään ja ei (lasta) itseään koskevan keskustelun sivustaseuraajaksi, selontekovelvolliseksi ja kuunteluvelvolliseksi. Aiheen muuttuessa sensitiivisemmäksi, saattoi tapahtua …

Facilitating joint attention with salient pointing in interactions involving children with autism spectrum disorder

Children with autism spectrum disorder (ASD) reportedly have difficulties in responding to bids for joint attention, notably in following pointing gestures. Previous studies have predominantly built on structured observation measures and predefined coding categories to measure children’s responsiveness to gestures. However, how these gestures are designed and what detailed interactional work they can accomplish have received less attention. In this paper, we use a multimodal approach to conversation analysis (CA) to investigate how educators design their use of pointing in interactions involving school-aged children with ASD or autistic features. The analysis shows that pointing had specifi…

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…

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 …

Children’s Disclosures of Physical Abuse in a Population-Based Sample

Few studies have explored the disclosure of child physical abuse although child sexual abuse disclosure has been widely studied and debated for years. The present study explores the characteristics of child physical abuse disclosures and compares them to previously published findings on child sexual abuse disclosure from the same data. The data consist of a representative sample of 11,364 sixth and ninth graders. Participants responded to a wide variety of questions concerning experiences of violence, including child physical abuse and child sexual abuse, in the Finnish Child Victim Survey conducted in 2013. Within this sample, the prevalence of child physical abuse was 4.1%. Children repo…

Narrative process modes as a bridging concept for the theory, research and clinical practice of systemic therapy

This article is concerned with the relationships which hold between the clinical practice and the theory of family therapy; and between these and academic research. These relationships are seen as tenuous and thin because, in the first place, there is a lack of rigorous theoretical underpinning; and second, the research methods employed do not fit in with current family therapy practice, and with the theory that underlies this practice. The role of the concept of narrative process modes is proposed as a bridging and mediating one. The external, internal and reflective narrative process modes are seen as relevant from the point of view of family therapy process research, and the clinical pra…

Somatic Interventions and Depth of Experiencing in Emotionally Focused Couple Therapy

Emotionally Focused Couple Therapy (EFT), an attachment-based couple therapy, views emotion as being central to the process of therapeutic change. As affect arousal of emotion is a somatic reaction, the purpose of this study was to focus on therapists’ interventions classified as noting and commenting on clients’ somatic cue of emotional experience, such as their facial expression or posture, in relation to depth of emotional experiencing demonstrated by clients in EFT couple therapy sessions. The sample included 13 therapists, each treating one couple during a single EFT training demonstration session. We coded therapists’ interventions (i.e., commenting on one partner’s somatic cue of emo…

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…

Initial-Stage Suicide Bereavement Experiences: A Case Study.

This study aimed to shed light on the initial-stage bereavement experiences of an individual bereaved by suicide, at three months from the loss of his spouse to suicide. A semi-structured in-depth interview was conducted with the individual, a man in his thirties. The data were analyzed using qualitative assimilation analysis, based on the Assimilation Model and the Assimilation of Problematic Experiences Scale (APES). The APES ratings of the interview revealed that the individual’s bereavement was associated with the earlier stages of APES (all scoring under 3.5). In addition, the swift and frequent fluctuations in the APES ratings gave indications that the bereavement was unstable and co…

The Added Value of Studying Embodied Responses in Couple Therapy Research: A Case Study.

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single-case study comprise couple therapy process videotapes recorded in a multi-camera setting, and measurements of participants' SNS activity. The voluntary participants were a marital couple in their late thirties and two middle-aged male psychotherapists. The division into topic segments showed how the key issue of seeking help, which was found to comprise three separate components, was repeatedly…

sj-pdf-2-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-2-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

The Finnish Clinical Outcome in Routine Evaluation Outcome Measure: psychometric exploration in clinical and non-clinical samples

The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consistency and convergent validity of the Finnish CORE-OM scores. Translation of the CORE-OM from English to Finnish was undertaken according to recommended protocols. Psychometric exploration was conducted in two samples: psychiatric patients (N = 201) and non-clinical participants (N = 209). Participation was voluntary and involved completion of all …

The Clip Approach : A Visual Methodology to Support the (Re)Construction of Life Narratives

Major life changes may cause an autobiographical rupture and a need to work on one’s narrative identity. This article introduces a new qualitative interview methodology originally developed to facilitate 10 prostate cancer patients and five spouses in the (re)creation of their life narratives in the context of a series of interventive interviews conducted over a timespan of several months. In “The Clip Approach” the interviewees’ words, phrases, and metaphors are reflected back in a physical form (“the Clips”) as visual artifacts that allow the interviewees to re-enter and re-consider their experience and life and re-construct their narratives concerning them. Honoring the interviewees as …

An interactional ‘live eye tracking’ study in autism spectrum disorder : combining qualitative and quantitative approaches in the study of gaze

Recent studies on gaze behaviours in individuals with autism spectrum disorder (ASD) have utilised “live eye tracking.” Such research has focused on generating quantitative eye tracking measurements, which provide limited (if any) qualitative contextual details of the actual interactions in which gaze occurs. This article presents a novel methodological approach that combines live eye tracking with qualitative interaction analysis, multimodally informed conversation analysis. Drawing on eye tracking and wide-angle video recordings, this combination renders visible some of the functions, or what gaze “does,” in interactional situations. The participants include three children with ASD and th…

Progress through the Early Stages of Assimilation in Play Therapy with a Traumatized Six-Year-Old Girl

We applied the assimilation of problematic experiences sequence (APES) to a six-year-old girl’s processing of traumatic experiences involving violence and death in play therapy. We analyzed the post-session notes from the first 34 sessions of a much longer treatment, during which the girl repeatedly enacted a drama we called the cottage play, involving characters assumed by the child and characters assigned to the therapist. We distinguished four phases based on changes in play themes. In phase 1, the girl expressed her need for safety in response to an overwhelming internal threat (APES stage 0, warded off/dissociated). In phase 2, she worked to escape and avoid the threat, referenced in t…

sj-pdf-3-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-3-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

Hiding Shame – A Case Study of Developing Agency

Abstract The hiding aspect of shame makes the study of shame difficult. In this article we aim to show through Hanna’s case study how shame manifests and develops during the course of one psychotherapy process. This will be done using Assimilation analysis (APES) and Dialogical Sequence Analysis (DSA) to show in detail one idiosyncratic developmental path through which the relationship toward the problematic shame experience changes and develops in psychotherapy. Results show how the manifestation of shame toward the problematic experience of being seen was present in the first moments of the first meeting, but also how during the sequence of sessions 7 – 9 Hanna’s relationship toward shame…

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…

Longitudinal Changes in Suicide Bereavement Experiences : A Qualitative Study of Family Members over 18 Months after Loss

Family members bereaved by their loved ones’ suicidal death normally undergo a complicated and lengthy bereavement process. In this qualitative case study, we explored longitudinal changes in the suicide bereavement process by applying assimilation analysis, based on the Assimilation Model (AM) and the Assimilation of Problematic Experiences Scale (APES), to longitudinal interview data collected from two Chinese suicide-bereaved individuals within the first 18 months after their loss. The results showed that over time the participants both progressed in adapting to their traumatic losses. Assimilation analysis both effectively elaborated the difference in the inner world of the bereaved and…

Cognition in Interaction : Challenges in Assessing Persons with Sensory and Multiple disabilities

This article reports a qualitative study of cognitive assessments of three teenagers with sensory and multiple disabilities, including moderate to profound developmental disability. The aim was to evaluate the possibilities for adapting standardized tests and the implementation of interactional partnership in assessment. Cognitive assessments were made with an individually-adapted psychological assessment tool, the Bayley Scales of Infant and Toddler Development. The assessment situations were video-recorded and analyzed based on sociocultural theories of early interaction, dynamic assessment, and the bodily-tactile modality of cognition. The results showed that the requirements for assessm…

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…

Impact of repeating somatic cues on the depth of experiencing for withdrawers and pursuers in emotionally focused couple therapy

Emotionally Focused Couple Therapy, an experiential modality, views emotion central to therapeutic change. In this exploratory study, we examined therapists' repetition of somatically focused interventions (therapist verbalizing somatic cues, such as facial expressions) and their impact on clients' emotional experiencing in-session. We also assessed difference for withdrawing versus pursuing partners. The sample included 13 EFT therapists who worked with one couple each for a single session. From transcripts we coded therapists' repetition of somatically focused interventions and clients' depth of experiencing pre-and post-intervention. Multilevel modeling demonstrated that a higher number …

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…

sj-pdf-1-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-1-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

sj-pdf-1-qhr-10.1177_1049732320982945 – Supplemental material for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives

Supplemental material, sj-pdf-1-qhr-10.1177_1049732320982945 for The Clip Approach: A Visual Methodology to Support the (Re)Construction of Life Narratives by Riikka Talsi, Aarno Laitila, Timo Joensuu and Esa Saarinen in Qualitative Health Research

Reporting, Reflecting and Recognising Emotions in Therapeutic Work with Domestic Violence Perpetrators : Experiences of the Jyväskylä Group Model

Emotions are central in therapeutic work, but interventions for violence vary in how they address emotions. While emotional work with perpetrators is often associated with ‘anger management’ and behavioural elements, a more comprehensive view of emotions might be beneficial in efforts to stop and prevent violent behaviour. Perpetrators’ self-regulation can be promoted by recognising and addressing primary feelings (vulnerability, fear, jealousy, etc.) that may manifest as anger and aggressive behaviour. However, this kind of therapeutic work with perpetrators of violence is also challenging for professionals. For example, when working towards ending violence, it is crucial to differentiate …

Play and liberty : A brief incursion into some ideological currents in the history of systems‐oriented family therapy

We reflect on family therapy and its history from two points of view, as an entity that becomes understood with the help of a twofold concept of a game, and a twofold concept of liberty. Systemic family therapy has always been comprehended with the help of game theory. Its development becomes more properly understood if we keep in mind that game itself is a dualistic concept entailing both a cultural and a logico-mathematical interpretation of a game. We show how cultural ethos has molded the ways how game metaphor have been implemented to systemic thinking. In the same manner we show how Isaiah Berlin's idea of two incompatible concepts of liberty helps to contextualize family therapy in a…

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…