Kerstin Neander

Important meetings with important persons : narratives from families facing adversity and their key figures

In this study families that have struggled with their relationships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the understanding they constructed of these beneficial processes. Interpretation according to Max van Manens hermeneutic-phenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about ‘emerging mutual trust’, which ‘overcomes obstacles’. The key figures or ‘important persons’ have a ‘clear orientation’ in their occupation and they work in ‘the essential everyday world’ to find and establish ‘contexts that nourish development’ in children and parents. The outcome of this is the creation of ‘new narratives’ that replace the old ones.

Being Me and Being Us - Adolescents' Experiences of Treatment for Eating Disorders

BackgroundThis qualitative study addresses adolescents’ perception of treatment for eating disorders. The importance of involving parents in treatment of young people with eating disorders, especially young people with Anorexia Nervosa, is emphasized in a number of studies. Even so, this form of treatment does not work for everybody, not even within a limited diagnostic group. Previous research has revealed that many young people are not entirely satisfied with their treatment. However, there is a lack of knowledge concerning the perspectives of adolescents in outpatient treatment, whose treatment often involves family. The aim of the present study was to investigate how young people with experience from adolescent outpatient treatment for eating disorders, involving family-based and individual based interventions, perceive their time in treatment.MethodsThis study was conducted using a hermeneutic phenomenological approach. Fifteen participants were recruited in collaboration with four specialized eating disorder units and interviewed with the purpose to gather narratives.ResultsThe analysis revealed that the adolescents sometimes felt more or less forced into treatment, and strong ambivalent feelings about if and how to participate in treatment permeated the adolescents’ narratives. The common factors which emerged in the narratives were assembled under the two major themes: Having to involve family in treatment - in one way or another and Making progress in treatment - a matter of trust.ConclusionsIt is of great importance to involve family in treatment in order to understand the problems of the adolescents in their context and be able to take advantage of the resource that parents constitute. However, in certain situations, it is necessary to prioritise individual treatment interventions so that instead of sorting out difficult family situations the therapist focuses on enhancing the young people’s resilience, thus enabling them to tackle problematic situations in life.

‘Hard work’ in a new context: Clients’ experiences of psychotherapy

The aim of this study was to describe and gain an understanding of clients’ experiences of psychotherapy contracts and processes in cognitive behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). Fourteen participants were interviewed after ending their psychotherapy. To get information richness they were selected with as great a variation as possible in relation to their life context. Qualitative content analysis was used to analyse the descriptions and the significance of the descriptions. Similarities between the two therapy orientations emerged throughout the informants’ experiences. These similarities were expressed in the two themes: The creation of a new context and The working method and the cooperation with the psychotherapist made up a whole. The psychotherapy process was described as ‘hard work’ in a new context, markedly different from the ordinary social context. From the informants’ perspective, the creation of a new context offered a possibility to give full attention, together with the psychotherapist, to oneself and to the problems one was grappling with. A salient feature was the informant’s responsibility for agreements in the psychotherapy contract, especially in relation to the number of sessions and the creation of cooperation with the psychotherapist. Irrespective of therapy orientation the therapeutic techniques were described as inextricably linked to the cooperation with the psychotherapist. An implication for practice and research from these findings is to give more weight to the influence of cooperation in psychotherapy techniques, irrespective of therapy orientation. Another implication is an awareness that the client’s knowledge of her/his difficulties, needs and desire for change, capacity to make an effort and to assume responsibility always have to be highlighted and have an impact on the psychotherapy contract and process.

A life put on hold: adolescents' experiences of having an eating disorder in relation to social contexts outside the family

Background As suffering from an eating disorder often entails restrictions on a person’s everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships. Purpose The aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family. Patients and methods This qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis. Results The adolescents’ descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context. Conclusion Young people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.