South London & Maudsley NHS Foundation Trust, London, UK.
Psychol Psychother. 2013 Sep;86(3):315-33. doi: 10.1111/j.2044-8341.2011.02061.x. Epub 2012 Feb 29.
This paper reports on a subset of findings from a wider ranging grounded theory analysis of therapy and recovery processes in psychosis. It describes therapist activities involved in maintaining an observational perspective during therapy and the links between these and other therapist activities.
Grounded theory was used to examine the qualitative data collected.
An initial sample of 19 taped therapy sessions and 23 interviews with psychologists and their clients was collected. This sample was extended through the collection of three further interviews with psychoanalytically aware psychologists. The data were analysed using grounded theory.
A grounded theory model of therapy processes in psychosis was developed that conceptualized therapist actions as providing an observational scaffold to support the client's efforts in moving to new perspectives on their situation. Consistent with the understanding of the core therapy activity as a dialogical process, this set of therapist actions was understood as occurring alongside other therapist activities involved in managing emotion and building a relationship in therapy.
The central activity of therapy in psychosis was understood as a dialogical process continuously negotiated between therapist and client in conversation and was conceptually summarized in the grounded theory as 'building bridges to observational perspectives'. However, the active and strategic efforts of psychologists to sustain the dialogue implied a particular assumption of responsibility for maintaining this process. In particular, therapists appeared to be 'working to maintain observational perspectives', 'managing emotion', and 'doing relationship' during the therapy conversation as part of the joint effort with clients to build bridges to new observational perspectives on distress and psychosis.
本文报告了更广泛的精神病治疗和康复过程扎根理论分析的一部分结果。它描述了治疗师在治疗过程中保持观察视角所涉及的活动，以及这些活动与其他治疗师活动之间的联系。
使用扎根理论来检查收集的定性数据。
收集了 19 次录音治疗会议和 23 次心理学家及其客户访谈的初始样本。通过收集三位具有精神分析意识的心理学家的进一步访谈，扩展了该样本。使用扎根理论分析数据。
开发了精神病治疗过程的扎根理论模型，该模型将治疗师的行动概念化为提供观察支架，以支持客户努力从新视角看待自己的情况。与将核心治疗活动理解为对话过程一致，这组治疗师的行动被理解为与治疗中涉及管理情绪和建立关系的其他治疗师活动同时发生。
精神病治疗的核心活动被理解为治疗师和客户在对话中不断协商的对话过程，并在扎根理论中被概念性地总结为“建立通向观察视角的桥梁”。然而，心理学家积极而策略地努力维持对话，意味着他们对维持这一过程承担了特殊的责任。特别是，治疗师在治疗对话中似乎“努力保持观察视角”、“管理情绪”和“建立关系”，这是与客户共同努力建立对痛苦和精神病的新观察视角的一部分。
