What's on the therapist's mind? A grounded theory analysis of family therapist reflections during individual therapy sessions

Co-therapy in Open Dialogue: Transforming therapists' self in a shared space

The present study aimed to explore co-therapists' relationship and how therapists' individual presence influences this relationship in Open Dialogue. Although co-therapy is key in Open Dialogue network meetings, the processes of that relationship remain largely understudied. The study applied thematic analysis to semi-structured interviews with 20 Open Dialogue trained therapists working in public and private sectors internationally. The results indicate that therapists are present in a meeting with their experiencing and professional self. Specific co-therapy processes allow co-therapists to attune to one another verbally and physically, creating a shared space that promotes new common understandings, shared responsibility and ultimately a transformation of each therapist's self and practice. Trust between co-therapists seems to be a prerequisite for co-therapy to flourish. Results of the present study reveal a dynamic influence of co-therapy practice, in which co-therapy promotes a more dialogical personality and allows the therapists' own transformation, which in turn enables common understandings and sharing of responsibility. Considering the growing interest in dialogical approaches and Open Dialogue trainings, trainers, supervisors, and practitioners need to be aware of and attend to the dynamics of co-therapy relationship in order to care for themselves, their team and ultimately the networks they collaborate with.

Open Dialogue: A case study on the influence of sharing or withholding reflections during a network meeting

In Open Dialogue, sharing of reflections by professionals constitutes an important contribution to promoting a polyphonic dialogue between participants. In the inner dialogue, past and future influence the present moment. In this study, we explore the influence of sharing or withholding reflections by professionals on the interplay between inner and outer dialogue. A case study was used with a multi-perspective methodology, which combined video recordings of a network meeting and interviews by using video-stimulated recall with the clients separately, and social workers together afterward. We found that the sharing of reflections by professionals stimulates the inner dialogue and creates an opening for sharing these in the outer dialogue. In addition, we observed that when reflections are withheld, the client's inner dialogue still continues, but their inner dialogue was not shared in the outer dialogue.

Family Secrecy in Family Therapy Practice: An Explorative Focus Group Study

The aim of this focus group study was to explore the experiences of family therapists working with family secrecy. Our study highlights that family secrets present important and compelling challenges for family therapists. Furthermore, our study reveals that there seem to be some basic strategies family therapists use in dealing with these challenges in therapy sessions. One basic strategy is that family therapists try to guard their position of being a trustworthy therapist for each family member by avoiding becoming stuck in family secrecy. Furthermore, therapists explore ways to guide the family toward the disclosure of the secret in order to alleviate the toxicity of the secrecy. This highlights the importance of the systemic model and how influential this perspective is in family therapy practice. Some participants, however, have in addition a second strategy they sometimes use: talking with the family about secrecy without aiming to disclose the secret. In the discussion section of the article we reflect on the possibility that in the strategic choices family therapists make conceptual issues might be involved. Furthermore, we stress the importance of further research.

Understanding Therapists' Work With Suicidal Patients: An Examination of Qualitative Data

The collaborative assessment and management of suicidality (CAMS) serves as a framework for maintaining a collaborative relationship between the therapist and patient. This study used an original coding manual to examine responses to open-ended questions to better understand the ways in which therapists use CAMS collaboratively as well as their reasons for adhering (or not adhering) to certain aspects of the framework. Results suggest differences in treatment application based on therapist characteristics including amount of experience, intensity of training received, and experience of a patient suicide attempt. Implications of this research include informing therapists interested in using the CAMS framework about the specific ways in which implementation can be made collaborative. Further, this research helps to shed light on how experiencing a client's death by suicide can impact therapists' future work with suicidal clients.

Unraveling the Mobilization of Memory in Research With Refugees

In this article, we explore how narrative accounts of trauma are co-constructed through the interaction between researcher and participant. Using a narrative multiple-case study with Kurdish refugee families, we address how this process takes place, investigating how researcher and participants were engaged in relational, moral, collective, and sociopolitical dimensions of remembering, and how this led to the emergence of particular ethical questions. Case examples indicate that acknowledging the multilayered co-construction of remembering in the research relationship profoundly complicates existing deontological guidelines that predominantly emphasize the researcher's responsibility in sensitively dealing with participants' alleged autobiographical trauma narratives. Instead, our analysis invites qualitative researchers to engage in a continued, context-specific ethical reflection on the potential risks and benefits that are invoked in studies with survivors of collective violence.

Addressing the Person of the Therapist in Supervision: The Therapist's Inner Conversation Method

In this study a method of retrospective case supervision is presented aimed at helping the supervisee to become a better self-supervisor. The method pays special attention to the therapist's self-reflection and has the therapist's inner conversation as a central concept. The starting point of the method is an assignment in which the supervisee reflects on a case using a tape-assisted recall procedure. The method helps trainees to develop experiential expertise to become more flexible and effective therapists. A case example of one training group of novice family therapists illustrates the use of the method.

What Novice Family Therapists Experience During a Session… A Qualitative Study of Novice Therapists' Inner Conversations During the Session

"What do novice family therapists experience during a session with a couple or family?" This is the central question in this article. A videotape-assisted recall procedure was used to study novice family therapists' inner conversations. The therapists' reflections were analyzed using thematic analysis. This resulted in a coding system that distinguishes four main domains: (a) reflections concerning the self; (b) reflections about the therapy process; (c) reflections on emotions about the family members; and (d) managing the session as well as own emotions. The study furthermore revealed that during a session, novice family therapists experience strong emotions, such as self-criticism and irritation. Both emotions may encompass dangers, as well as opportunities for the therapeutic alliance and the process.

The interacting-reflecting training exercise: addressing the therapist's inner conversation in family therapy training

In recent years several authors have made a beginning in describing therapeutic conversations from a dialogical perspective. Training and supervision, however, have not yet been addressed from a dialogical perspective. In this article, an experiential training exercise is described that is focused on the basic dialogical skills of the trainee: respectful inquiry and constructive reflecting. Rather than teaching and instructing, this training exercise is aimed at staging a dialogue. The trainees are invited to take part in this dialogue, as they are encouraged to experiment with new positions and new ways of encountering others, and as their different voices tell of their experiences, of the things they have learned, and of the new perspectives that have opened up for them. Leaning on ideas about the therapist's inner conversation (Rober, 1999, 2005b) and stressing the importance of polyphony, dialogism, and tolerance for uncertainty, the training exercise described in this article is consistent with a dialogical and postmodernist frame, as described by Seikkula and Olson (2003).

Positioning in the therapist's inner conversation: a dialogical model based on a grounded theory analysis of therapist reflections

In recent years, a dialogical perspective has emerged in the family therapy field in which the therapist's inner conversation is conceptualized as a dialogical self. In this study, we analyze the data of a grounded theory study of therapist reflections and we portray the therapist's self as a dynamic multiplicity of inner positions embodied as voices, having dialogical relationships in terms of questions and answers or agreement and disagreement. We propose a descriptive model of the therapist's inner conversation with four positions. In this model, each of the four positions represents a concern of the therapist: attending to the client's process, processing the client's story, focusing on the therapist's own experience, and managing the therapeutic process. Detailed analyses of vignettes of therapist reflections illustrate the model, and implications of this model for training and supervision are considered.