Helge Holgersen

Staying close and reflexive: An explorative and reflexive approach to qualitative research on psychotherapy

Qualitative research has the potential to explore patient and therapist experiences of psychotherapeutic processes, as well as the challenges and opportunities inherent in relational and technical aspects of therapy. This paper examines explorative and reflexive ways of doing qualitative research on psychotherapy, based on the ontological and epistemological premises of hermeneutic phenomenology. An explorative–reflective thematic analysis is presented as a team-based approach, with a firm and transparent structure to the process of finding and interpreting experiential commonalities and differences in empirical material from semi-structured interviews. We use two examples of the interplay between phenomenological exploration and reflexivity from the interviews of two adolescent psychotherapy patients in a research project examining experiences of useful ways to establish a productive therapeutic relationship. A systematic way of conducting explorative–reflexive thematic analysis in a research team and with the assistance of computer software is described and discussed. It is emphasized that the procedures in themselves do not guarantee the result – they will only contribute if they also stimulate self-reflexivity and awareness of the researchers as interpreters of basically ambiguous human experience.

Why did I change when I went to therapy? A qualitative analysis of former patients' conceptions of successful psychotherapy

Abstract Aim: Much research has been undertaken to identify significant events and change processes in psychotherapy. Most of these studies use categories and concepts consonant with the researchers particular theoretical affiliation. But how do patients themselves, retrospectively, give meaning to what they felt most important for their realization of change? The present study sought to identify specific experiences and reflections of former psychotherapy patients who described their previous therapy as successful. Methods: Semi-structured, qualitative, in-depth interviews with ten former psychotherapy patients, recruited through an advertisement in a local newspaper. A descriptive and hermeneutically modified phenomenological approach was used to analyse interview transcripts, technically carried out with the assistance of Nvivo 8 software. Findings: The different ways the participants gave meaning to change processes and events clustered around the following themes: (i) Being in a relationship with a ...

“Balancing on Skates on the Icy Surface of Work”: A Metasynthesis of Work Participation for Persons with Psychiatric Disabilities

Purpose To explore how persons with psychiatric disabilities experience facilitators of and barriers to participation in paid work in transitional, supported, and open employment settings, in order to provide guidance for efforts to attract and retain these persons in gainful employment as a key dimension of recovery and community life. Methods A metasynthesis was conducted using 16 qualitative studies published between 1990 and 2011. Results Ten themes, two phases, and an overarching metaphor were identified. The first five themes describe facilitators of and impediments to getting a job (getting off the bench): (1) fighting inertia; (2) taking control; (3) encouraging peers; (4) disruptions related to the illness; (5) lack of opportunities and supports. The next five themes represent facilitators of and impediments to working (skating on the ice); (6) going mainstream; (7) social cohesion; (8) clarity in role and responsibilities; (9) environmental factors; (10) managing self-disclosure. We chose as our overarching metaphor “Balancing on Skates on the Icy Surface of Work,” as we view both iceskaters and workers with psychiatric disabilities as needing to achieve and maintain their balance while being “on the edge” between various extremities. Conclusion We have shown that, for persons with psychiatric disabilities to “get off the bench” and “onto the ice” of employment, they may need to be supported in finding and maintaining their balance in new situations through a combination of learning new skills and competencies (learning how to skate) while receiving in vivo assistance from empathic and knowledgeable supporters (being coached while on the ice).

Metasynthesis and Bricolage: An Artistic Exercise of Creating a Collage of Meaning

During the past decades, new approaches to synthesizing qualitative data have been developed. However, this methodology continues to face significant philosophical and practical challenges. By reviewing the literature on this topic, our overall aim in this article is to explore the systematic and creative research processes involved in the act of metasynthesizing. By investigating synthesizing processes borrowed from two studies, we discuss matters of transparency and transferability in relation to how multiple qualitative studies are interpreted and transformed into one narrative. We propose concepts such as bricolage, metaphor, playfulness, and abduction as ideas that might enhance understanding of the importance of combinations of scientific and artistic approaches to the way the synthesizer “puzzles together” an interpretive account of qualitative studies. This study can benefit researchers by increasing their awareness of the artistic processes involved in qualitative analysis and metasynthesis to expand the domain and methods of their fields.

Re-establishing contact: A qualitative exploration of how therapists work with alliance ruptures in adolescent psychotherapy

Abstract What challenges do therapists face when they experience ruptures in the working alliance in psychotherapy with adolescent clients; and what are their most typical strategies when they try to re-establish contact? These issues were explored through qualitative interviews with nine psychotherapists from outpatient child and adolescent psychiatric clinics in Bergen, Norway. A descriptive and hermeneutically informed phenomenological approach was used to analyse the interview transcripts. Most therapists/participants described that they would explore the reason for the rupture from the adolescents point of view, and all participants often understood ruptures in light of the adolescents’ need for autonomy. However, the participants differed strongly in how much they would focus on the relationship per se, on intrapsychic factors, or on the adolescents life outside therapy. For the therapists who regarded the relationship as something to be explored, client ambivalence to treatment was seen as someth...

Hope and recovery: a scoping review

Purpose – Hope is regarded as central to recovery processes. The phenomenon along with its implications for research and practice has, however, gained limited attention within the fields of mental health and substance use. The purpose of this paper is to explore how hope, and what may inspire it, is described within the literature by persons experiencing co-occurring mental health and substance use problems. Design/methodology/approach – The method chosen when conducting this literature review was a scoping study. This allows for a broad approach, aiming to examine research activity and identifying potential gaps within existing literature. Searches were conducted in EMBASE Ovid, PsychINFO Ovid, MEDLINE Ovid, CINAHL Ebsco, SveMed+ and Brithish Nursing Index. Findings – The authors included five articles and one book. None of these presented first-hand experiences of hope and there appears to be a gap in the literature. All included material underlined the importance of the phenomenon to those experiencing...

Former Child Soldiers’ Problems and Needs Congolese Experiences

With this article, we explore how staff working at transit centers and vocational training centers in the eastern Democratic Republic of the Congo experienced the problems and needs of former child soldiers. We argued that the staff’s experience of the children’s daily lives and their understanding of the sociocultural context of the conflict make their perspective a valuable source of information when trying to understand the phenomenon of child soldiering. Additionally, we reasoned that how the staff frame these children’s problems influences how they attempt to aid the children. We conducted 11 semistructured interviews and analyzed these using a hermeneutical-phenomenological approach. We clustered our findings around six themes: unfavorable contextual factors, acting as if still in the army, addiction, symptoms of psychopathology, social rejection, and reintegration needs. The overarching message we observed was that the informants experienced that former child soldiers require help to be transformed into civilians who participate proactively in their society.

Being candidates in a transitional vocational course: experiences of self, everyday life and work potentials

Most people with mental health problems want a paid job, but experience difficulties in obtaining one. In‐depth knowledge from service users is needed about what supports their work capacity and potentials. This qualitative study aimed to explore the occupational history of people with severe mental‐health problems and experiences of being candidates in a transitional employment course. Two in‐depth interviews with five candidates of this course were conducted. Four themes were developed: ‘all it takes to have a life’, ‘being on the right track’, ‘asking for feedback’, and ‘candidates – for what’? The participants in this study experienced this course as a possibility for exploring themselves, their everyday lives and work potentials. However, they perceived some of the program’s philosophy as unhelpful which highlights the significance of listening to the service users’ preferences. These findings suggest that further standardization of vocational‐rehabilitation programs in mental health may be counter‐productive.

Treatment Experiences of Child Sexual Offenders in Norway: A Qualitative Study

ABSTRACT This article is an attempt at gaining a better understanding of treatment of adults who have committed sexual offenses against children. In this study we aimed to explore what people who have committed sexual offenses against children find useful in therapy. The study was approached using qualitative methodology, and information was collected through semistructured interviews. Four male child sexual offenders were recruited from the Institute of Clinical Sexology and Therapy in Oslo, Norway. The informants were interviewed with a focus on what factors they found useful in therapy. Through an explorative, thematic analysis, five main themes were found. These themes include: “Why I started going to therapy,” “Why did I do it?” “Therapy as life,” “Previous and current relationships with others,” and “I lived in a fantasy world where everything was okay.” Based on this study and other earlier studies and theories it appears that the previously mentioned themes recur as important contributory factors in the treatment of child sexual offenders.