Transcript
Page 1: LEARNING FROM OUR CLIENTS

LEARNING FROM OUR LEARNING FROM OUR CLIENTSCLIENTS

Eija-Liisa Rautiainen, Eija-Liisa Rautiainen,

Katharina Auberjonois and Katharina Auberjonois and

Monica HartzellMonica Hartzell

EFTA congress, Paris, 30.10.2010EFTA congress, Paris, 30.10.2010

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Co-research interviews Co-research interviews after couple therapy for after couple therapy for depressiondepression

Eija-Liisa RautiainenEija-Liisa Rautiainen

psychologist and family therapistpsychologist and family therapist

Kuopio University Hospital, FinlandKuopio University Hospital, Finland

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THE CONTEXT OF THE THE CONTEXT OF THE STUDYSTUDY Couple therapy was offered in psychiatric Couple therapy was offered in psychiatric

outpatient clinics for persons diagnozed outpatient clinics for persons diagnozed as depressed and their spousesas depressed and their spouses

Aim: To develop couple therapy for Aim: To develop couple therapy for depression in this context, to include the depression in this context, to include the therapists into research in a new waytherapists into research in a new way

Dialogical and reflective approach to Dialogical and reflective approach to couple therapy, no manual for the couple therapy, no manual for the therapiestherapies

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Depressed people are often helped Depressed people are often helped without attention paid to their familieswithout attention paid to their families

Depression is a huge problem, ways of Depression is a huge problem, ways of helping depressed persons need to be helping depressed persons need to be developed furtherdeveloped further

Collaborative approach to researchCollaborative approach to research– Bringing psychotherapy research Bringing psychotherapy research

near to the everyday clinical work, near to the everyday clinical work, listening to the users of the health listening to the users of the health care servicescare services

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THE INTERVIEWSTHE INTERVIEWS

Co-research interview method Co-research interview method developed by Tom Andersendeveloped by Tom Andersen

25 interviews, where the therapists 25 interviews, where the therapists and the couples were interviewed in and the couples were interviewed in the same room, each of them listening the same room, each of them listening when the others were interviewedwhen the others were interviewed

25 couples, 28 different therapists in 25 couples, 28 different therapists in three centersthree centers– Grounded Theory-analysisGrounded Theory-analysis

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QUESTIONS FOR QUESTIONS FOR THERAPISTSTHERAPISTSWhat did you have in mind when you asked What did you have in mind when you asked

these clients to come today?these clients to come today?What of your contributions to the therapy-What of your contributions to the therapy-

meetings do you think the clients meetings do you think the clients appreciated the most?appreciated the most?

Might there be something they would have Might there be something they would have liked to talk about but what was never liked to talk about but what was never discussed?discussed?

Where there times when you yourself had Where there times when you yourself had thoughts in your mind that you never thoughts in your mind that you never disclosed, but in hindsight think that might disclosed, but in hindsight think that might have been useful to talk about?have been useful to talk about?

If it had been possible to talk about that, how If it had been possible to talk about that, how might you have done it with them?might you have done it with them?

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Where there moments that you remember Where there moments that you remember as difficult for yourself as a therapist?as difficult for yourself as a therapist?

How did you overcome these difficulties?How did you overcome these difficulties?

Was this therapy similar to therapies you Was this therapy similar to therapies you have had with other clients, or was it have had with other clients, or was it different?different?

What have you learned from these clints?What have you learned from these clints?

What have you learned from each other What have you learned from each other as therapists?as therapists?

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QUESTIONS FOR QUESTIONS FOR CLIENTSCLIENTSWould you like to comment on what you Would you like to comment on what you

heard during the conversation between the heard during the conversation between the therapists and myself?therapists and myself?

They talked about this and this, what are They talked about this and this, what are your comments on that?your comments on that?

In addition to what the therapists talked, is In addition to what the therapists talked, is there something you would like to talk there something you would like to talk about?about?

Is there something particular you remember Is there something particular you remember from the therapeutic meetings?from the therapeutic meetings?

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Where there times you wanted to Where there times you wanted to talk about something you never talk about something you never got to talk about?got to talk about?

Where there times you tried to say Where there times you tried to say something they didnsomething they didn’’t hear?t hear?

What was most helpful for you?What was most helpful for you?

How was it helpful?How was it helpful?

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RESULTSRESULTS

Most of the couples found that couple Most of the couples found that couple therapy for depression had been helpfultherapy for depression had been helpful

Therapists' willingness to help, their ability to Therapists' willingness to help, their ability to ask good questions and make it possible for the ask good questions and make it possible for the spouses to talk in a new way had been helpfulspouses to talk in a new way had been helpful

Spouse's participation to the therapy had been Spouse's participation to the therapy had been valuablevaluable

– For some, getting help with relationship problems was centralFor some, getting help with relationship problems was central

– For others, having the spouse's support and recoveirng For others, having the spouse's support and recoveirng together was importanttogether was important

The couples and the therapists appreciated The couples and the therapists appreciated similar things in therapy (the collaborative similar things in therapy (the collaborative interviews)interviews)

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RESULTSRESULTS

Couple therapy had not always Couple therapy had not always worked wellworked well– Both couples and the therapists spoke about Both couples and the therapists spoke about

problems in the collaborationproblems in the collaboration

– Sometimes couple therapy had not helped Sometimes couple therapy had not helped with relationship problems, in other occasions with relationship problems, in other occasions the depressed person's situation had not the depressed person's situation had not become better become better

– Problems in therapeutic relationship, therapy Problems in therapeutic relationship, therapy got stuckgot stuck

– Confusion concerning couple therapyConfusion concerning couple therapy

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RESULTSRESULTS

Taking part to the study remained Taking part to the study remained the therapists of the importance the therapists of the importance of working with the families of the of working with the families of the people diagnozed as depressedpeople diagnozed as depressed

Therapists learned e.g. about the Therapists learned e.g. about the importance of the beginning of importance of the beginning of the therapy: talking about the the therapy: talking about the goals, listening to clients' hopes goals, listening to clients' hopes and obstacles for workingand obstacles for working

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EXPERIENCES OF THE EXPERIENCES OF THE INTERVIEWSINTERVIEWS Both the therapists and the clients found the Both the therapists and the clients found the

interviews interestinginterviews interesting It was also possible to talk about difficult It was also possible to talk about difficult

thingsthings The interviews were many times quite The interviews were many times quite

intensive experiencesintensive experiences The interviews sometimes reinforce familiar The interviews sometimes reinforce familiar

things for the participants, sometimes bring things for the participants, sometimes bring surprisessurprises

Good method for research, developing therapists' Good method for research, developing therapists' work and for therapists' trainingwork and for therapists' training

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Co-research interviews are a good Co-research interviews are a good opportunity for the therapists to learn opportunity for the therapists to learn from their clients.from their clients.– Open and collaborative situationOpen and collaborative situation– Research comes close to everyday workResearch comes close to everyday work– Reflective positions, separating listening Reflective positions, separating listening

and talkingand talking– Willingness to let the clients evaluate one's Willingness to let the clients evaluate one's

own work and evaluate it in the precense own work and evaluate it in the precense of the clients is needed from the therapistsof the clients is needed from the therapists

– In the interviews the therapists learn to In the interviews the therapists learn to talk about their own work in an open and talk about their own work in an open and respecting wayrespecting way

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PhD thesisPhD thesis

Coconstruction and collaboration in couple Coconstruction and collaboration in couple therapy for depression, therapy for depression, http://julkaisut.jyu.fi/?id=978-951-39-4034-8 – Rautiainen E-L & Aaltonen, J. (2010) Depression: Rautiainen E-L & Aaltonen, J. (2010) Depression:

The differing narratives of couples in couple The differing narratives of couples in couple therapy. The Qualitative Report, 15, therapy. The Qualitative Report, 15, 156-175156-175..

– Rautiainen, E-L., & Seikkula, J. (2009) Rautiainen, E-L., & Seikkula, J. (2009) Clients as Co-Clients as Co-researchers: How Do Couples Evaluate Couple researchers: How Do Couples Evaluate Couple Therapy for Depression? Journal of Systemic Therapy for Depression? Journal of Systemic Therapies, 28, 41-60.Therapies, 28, 41-60.

– Rautiainen, E-L., & Seikkula, J. (2010) Rautiainen, E-L., & Seikkula, J. (2010) Focusing on Focusing on therapists in co-research interviews: How do therapists in co-research interviews: How do therapists see couple therapy? Journal of Systemic therapists see couple therapy? Journal of Systemic Therapies, 29, 23-44.Therapies, 29, 23-44.


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