Karin Zetterqvist Nelson

Client-identified important events in psychotherapy: Interactional structures and practices

Abstract This study describes interactional structures and practices in client-identified important events in psychotherapy sessions. Twelve of 16 events from seven client–therapist dyads were found to contain disagreement. A turn-by-turn investigation using conversation analysis displayed three different ways that therapists used to handle disagreement. The first was to orient to the clients disagreement cues by inviting the client to elaborate his or her point and to establish a shared understanding. The second was to orient to the clients disagreement cues but define the therapists point of view as more relevant to the project at hand. The third was a single case where the therapist did not orient to the clients disagreement cues. The results suggest that disagreement patterns may be an interesting focus for further exploration of microprocesses within therapy sessions.

Efforts to maintain a ‘just great’ story: Lesbian parents’ talk about encounters with professionals in fertility clinics and maternal and child healthcare services

After lesbian couples have decided to become parents, their family-making journey entails a wide range of encounters with professionals in fertility clinics and/or in maternal and child healthcare services. The article presents the results of an analysis of 96 lesbian mothers’ interview talk about such encounters. In their stories and accounts, the interviewees draw on two separate and contradictory interpretative repertoires, the ‘just great’ repertoire and the ‘heteronormative issues’ repertoire. Throughout the interviews, the ‘just great’ repertoire strongly predominates, while the ‘heteronormative issues’ repertoire is rhetorically minimized. The recurrent accounts of health services as ‘just great’, and the mitigation of problems, are meaningful in relation to a broader discursive context. In a society where different-sex parents are the norm, the credibility of other kinds of parenthood is at stake. The ‘just great’ repertoire has a normalizing function for lesbian mothers, while the ‘heteronormative issues’ repertoire resists normative demands for adaptation.

‘A daddy is the same as a mummy’ : Swedish children in lesbian households talk about fathers and donors

The present article discusses how 12 children (five to eight years) in planned lesbian families talk about families, parents and specifically ‘daddies’ as such and not having a father themselves. Findings from child interviews demonstrate that the children described daddies as ‘the same’ as mummies, i.e. as having the same functions. This contrasts with previous research showing how children of heterosexuals often describe mothers and fathers as different. The children varied in terms of how they labelled donors. Some children adopted the denomination ‘daddy’, drawing on a paternity discourse, while others simply referred to him as ‘a man’.

Where is the child? A discursive exploration of the positioning of children in research on mental-health-promoting interventions

The present study explores the discursive positioning of children in research articles on mental-health-promoting interventions. The questions under investigation are: are children positioned as active or passive agents, are childrens health and wellbeing contextualised, and if so how? How is the child perceived; that is, how are age, gender, socioeconomic status, family structure, dis/ability, and so on accounted for? We found that the positioning of the child as passive and formed by adults prevails; health is largely individualised and decontextualised in that it is depicted as being contingent on the persons own capabilities. However, there are instances in which children are positioned as active subjects, their opinions are in focus, and their health and wellbeing are connected to social relations and context. We propose a more active discussion about how children and wellbeing are conceptualised in the outlining, implementation and research of public health interventions. Moreover, children--just like adults--should be increasingly regarded as service users who are entitled to have a say in matters that concern them.

The politics of reading and writing problems: changing definitions in Swedish schooling during the twentieth century

Reading and writing problems in school children has been the focus of a growing scientific interest regarding during the twentieth century. In search for definition, cause(s) and pedagogical interventions the subject is explored in medical, psychological and educational research. It is a field of knowledge characterized by scientific controversies and competing explanatory frames. In this article we approach the issue from a historic perspective. During the 20th century the development of compulsory schooling in Sweden three main periods can be discerned. Each is characterised by one specific explanatory framework dominating the educational policy discourse. These changing periods are related to both the increase of school participation during the first decades of the 20th century and the political ambitions associated with an education for all social classes. The politics of reading and writing problems mirrors a conflict not only about scholarly perspectives on reading and writing problems but also about the organization of welfare and system of education

Psychodynamics in child psychiatry in Sweden, 1945-85: from political vision to treatment ideology.

In this article, changing treatment ideologies and policies in child psychiatric outpatient services in Sweden from 1945 to 1985 are examined. The aim is to discuss the role played by psychoanalytic and psychodynamic thinking in this process of change. When mental health services for children were introduced in the mid-1940s, psychoanalytic thinking was intertwined with the social democratic vision of the Swedish welfare state in which children symbolized the future. In practice, however, treatment ideology was initially less influenced by psychoanalytic thinking. From the early 1960s, child psychiatric services expanded and the number of units increased. By then, the political vision had disappeared, but a treatment ideology began to evolve based on psychodynamic theories, which became dominant in the 1970s.

The Sandtray technique for Swedish children 1945–1960: diagnostics, psychotherapy and processes of individualisation

The present article examines the development of a diagnostic and therapeutic technique named The Sandtray at the Erica Foundation, a privately-run child counselling service in Stockholm. Originally it was called The World, developed by the British paediatrician and child psychiatrist Margaret Lowenfeld. In the 1930s it was imported to Sweden, where it gained a central position in child psychotherapy activities. The aim of the article is to discuss how The Sandtray was utilised at the Erica Foundation, both for diagnostic and therapeutic purposes. These two approaches are also discussed in relation to Foucauldian theories of the individualisation process. In the diagnostic practice the child was individually assessed and evaluated in relation to normative standards of scientific child developmental psychology, while in the therapeutic practice the individual child was through verbalisation techniques encouraged to reflect and demonstrate introspection as a subject. Two renderings of the individualisation of children are thus discerned in the utilisation of The Sandtray, one as a result of the disciplinary regime of the diagnostic practice, another through technologies of the self in the therapeutic practice. The latter also underwent a change with respect to how children were viewed. The emphasis on notions of children as different in comparison to adults was increasingly played down to the benefit of the notion of children as being the same.

Schoolgirls’ perspectives on self-disclosure in a group-based mental health intervention at school: acquiring friends or risking harassment?

The article draws on interviews with participants in a psychotherapeutic education programme, called Depression in Swedish Adolescents, which has seen wide distribution within Swedish schools. We d ...The article draws on interviews with participants in a psychotherapeutic education programme, called Depression in Swedish Adolescents, which has seen wide distribution within Swedish schools. We demonstrate how, in their accounts, self-disclosure in front of classmates is made into a central and both positive and problematic aspect of the programme. Sharing private matters in a group setting consisting of classmates might strengthen their interpersonal relations; but at the same time, it carries the risk of triggering already ongoing destructive interactions such as bullying and harassment. Voluntary participation, group composition and paying attention to how members respond to one another and make use of the private information shared stand out as important criteria to consider. However, in order to meet these criteria, an intervention involving self-disclosure in front of classmates needs to challenge the tradition in school of practising mandatory participation, as well as the class structures with their predefined group composition.

Here and now – there and then: Narrative time and space in intercountry adoptees’ stories about background, origin and roots:

Intercountry adoption policy emphasizes openness in relation to adoptees’ background. However, because intercountry adoption is a complex web of relations including individuals, institutions and countries, it is impossible to foresee what background, origin and roots will mean to the adopted individual. The present article examines what meanings adoptees themselves ascribe to background, origin and roots. A total of 22 internationally adopted men and women participated in focus group conversations. The participants were invited to discuss their diverse experiences and opinions on these matters and their stories were analyzed from a narrative perspective. The analysis focuses on how time and space were made significant in narratives about background, origin and roots. Two contrasting stories – the here-and-now narrative and the there-and-then narrative – are discerned, but further analysis of the narrative space and time dimensions shows a much more complex pattern beyond these extremes. Adoptee narratives characterized by an open time dimension deal with what could have happened, alternative lives, and the analysis shows how these alternative lives are storied and valued. Furthermore, when adoptees tell their stories about background and roots, ‘there’, that is the birth country, is ascribed different meanings. The analysis shows that the categorization of space as wide or narrow, in the sense of collective or personal, respectively, is useful in understanding the different approaches to background and roots. Based on the present results, we suggest that social workers may wish to organize their counseling along the time and space dimensions of adoptees’ narratives.

No one of importance: lesbian mothers' constructions of permamently anonymous sperm donors

The present study discusses how Swedish lesbian couples argue for their choice of permanently anonymous donors after conceiving at fertility clinics in Denmark. In a Swedish context, these women challenge both the established Swedish practice of identity-release donors and the previously common practice of lesbian mothers engaging in joint parenthood with gay fathers. Altogether 78 mothers have been interviewed. Discourse analysis show that the interviewees use two main constructions when talking about the permanently anonymous sperm donor: “the donor is not a father” and “the donor is the child’s other half”. The study shows how both these constructions serve to justify that the mothers are good parents. Central aspects in doing good parenthood is to have a close parent–child relationship, taking care of the child in everyday life and acknowledge the child’s future search for its identity.