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Stödjande samtal som psykologisk behandling inom Barn- och ungdomspsykiatrin (BUP): en intervjustudie av hur kuratorer inom specialistsjukvård använder strukturerat samtal i arbetet med patienter och anhöriga
Umeå University, Faculty of Social Sciences, Department of Social Work.
Høgskolen i Østfold.
Karlstad universitet.
2015 (Swedish)In: Tidsskrift for psykisk helsearbeid, ISSN 1503-6707, E-ISSN 1504-3010, Vol. 12, no 3, p. 206-216Article in journal (Refereed) Published
Abstract [sv]

Trots den tydliga begreppsliga avgränsningen av vad stödjande samtal är och inte är, kvarstår det faktum att stödjande samtal som klinisk praxis inom Barn- och ungdomspsykiatrin (BUP) rymmer en mängd olika handlingar och förhållningssätt. Syftet med studien var att undersöka vad kuratorer inom BUP beskriver att de gör i praktiken när de har stödjande samtal med patienter och anhöriga. I denna studie intervjuades 11 yrkesverksamma kuratorer från Barn- och ungdomspsykiatrin (BUP) i västra Sverige. Fyra centrala teman beskrivs i resultatet: 1) Det värdefulla lyssnandet, 2) Arbetsallians, 3) Integrerad arbetsform, 4) Hopp. Det stödjande samtalet kan beskrivas som en behandlingsåtgärd med hög komplexitet. I åtgärden integreras grundläggande samtalsmetodik med aspekter från olika psykologiska teorier och metoder. I åtgärden integreras också kuratorns arbets- och livserfarenheter. Kuratorer inom BUP gör följande när det har stödjande samtal med patienter och anhöriga: De skapar förtroende och tillit mellan behandlare, patient och anhörig. De synliggör och bekräftar patientens psykiska lidande och de vardagsproblem som är knutna till deras svåra situation. De integrerar sina arbets- och livserfarenheter i mötet med patient och anhörig. De har en pragmatisk hållning till psykologisk teori. De inger hopp om förbättring av patientens psykiska lidande och vardagsproblem.

Abstract [en]

Supportive conversation as a clinical practice within the Child and Adolescent Psychiatric Services (CAP) accommodates a variety of actions and attitudes. The aim of this study was to examine what counsellors within CAP do when they have supportive conversations with patients and families. Eleven professional counsellors from the CAP were interviewed. Thematic analysis was chosen as the processing method of data. Four key themes were described in the results: 1) The valuable listening, 2) Work alliance, 3) Integrated working method and 4) Hope. The supportive conversations can be described as a treatment measure with high complexity. The measure integrates basic conversational methods with aspects from various psychological theories and methods. The measure also integrates the counsellor’s work and life experiences. This study introduces the concept of integrative counselling to summarise the counsellor’s work using supportive conversations within the CAP.

Place, publisher, year, edition, pages
2015. Vol. 12, no 3, p. 206-216
Keywords [en]
supportive conversation, child psychiatry, counsellor, treatment
Keywords [sv]
kurator, barn- och ungdomspsykiatri, psykologisk behandling, stödjande samtal
National Category
Social Work
Identifiers
URN: urn:nbn:se:umu:diva-133961OAI: oai:DiVA.org:umu-133961DiVA, id: diva2:1090224
Available from: 2017-04-23 Created: 2017-04-23 Last updated: 2018-09-03Bibliographically approved
In thesis
1. Psykiatriseringen av skolkaren: BUP och det institutionella omhändertagandet av ungdomar som inte går till skolan
Open this publication in new window or tab >>Psykiatriseringen av skolkaren: BUP och det institutionella omhändertagandet av ungdomar som inte går till skolan
2018 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Psychiatrization of the truant : child and adolescent psychiatry and the institutional care of young people who do not go to school
Abstract [en]

The main aim of the thesis was to investigate the nature of as well as critically review the institutional care of young people who do not go to school.

The thesis consists of four studies. The first three studies are based on different empirical materials such as electronical journals and administrative patient databases, qualitative interviews with social workers at Child and Adolescent Psychiatry (CAP), and with managerial representatives in School, social services and CAP. The fourth study is mainly theoretical and problematizes the results from the first three studies.

The results show several problematic aspects in the institutional care of young truants. When young truants enters CAP, a quick, and sometimes without psychological investigation, categorization is made with psychiatric terminology in the form of a diagnosis, and medicines are prescribed as treatment. Further, social workers, who shall have a systemic approach on family and relationships, seem to embrace a psychiatric diagnostic understanding of the problems. At the same time, it appears that school only has extra resources to help the truants if they have a psychiatric diagnosis. Although the idea of collaboration between different professionals is that several different perspectives should be used, the results shows that CAP's psychiatric perspective dominates.

The results of what happens to young people who do not go to school is discussed as an example of a special form of medicalization, in which social difficulties and existential problems are referred to psychiatry. It appears that help for them is completely individualised, by focusing on symptoms and diagnosis. What is not visible in this unilateral individualisation, for example, are organisational and educational problems in school, system problems in the family or among friends or lack of social contacts outside the family. By referring the truant to CAP can therefore miss further social circumstances in their life situation, which can have great importance in whether they attend school or not. Therefore, it is important to problematise this process of referring everything to psychiatry and to ask questions about what situations and events have contributed to this cultural pattern, which means that people's difficulties in life are increasingly being solved with diagnosis and medications.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 79
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 92
Keywords
Truancy, young people who do not go to school, institutional care, child and adolescent psychiatry, social services, school, collaboration, exclusion, psychiatrization
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-151437 (URN)978-91-7601-916-0 (ISBN)
Public defence
2018-09-28, Hörsal B, Samhällsvetarhuset, Umeå, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-09-07 Created: 2018-09-03 Last updated: 2018-10-16Bibliographically approved

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https://www.idunn.no/file/pdf/66800761/stdjande_samtal_som_psykologisk_behandling_inom_barn-_och_.pdf

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