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在暴力极端化情况下的集体案例制定:培训中的批判性视角。

Collective case formulation in situations of violent radicalization: A critical perspective in training.

机构信息

Department of Anthropology, McGill University, Montreal, Quebec, Canada.

Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Chicoutimi, Quebec, Canada.

出版信息

Transcult Psychiatry. 2023 Apr;60(2):302-312. doi: 10.1177/13634615221134932. Epub 2023 Jan 11.

Abstract

Case formulation is used in clinical training to weave together theoretical perspectives and support a shared plan of action. Although a cornerstone of clinical practice, critical social theorists have highlighted the risks of depoliticizing political struggles and of reifying and fixing subjects when using psychopathology and case formulation to address situations of injustice. In the field of violent radicalization, this risk is increased by the extreme affects evoked by terror in practitioners and in societies. This article explores the challenges of training clinicians in the field of violent radicalization. It does so by analyzing a Community of Practice (CoP) that was developed to support practitioners involved in this domain of practice in Quebec, Canada. Four focus groups with CoP participants and participant observation of nine CoP meetings were conducted. Thematic and narrative analyses were used to explore the training potential of the CoP and to identify the discursive processes and group dynamics associated with this modality. Results indicate that the diversity of professional perspectives and social positionalities in the group plays a central role in helping participants become aware of their biases and in developing more complex understandings of cases and of their social embedding. Results also suggest that the collective holding of risk is key to preserve practitioners' investment in patients involved with violent radicalization. The sensitive issue of partnership between health and social services and security agencies is also addressed. Results suggest that CoPs with strong leadership allow for experiential training to enhance clinical and critical thinking.

摘要

案例制定在临床培训中用于将理论观点编织在一起,并为共同行动计划提供支持。尽管案例制定是临床实践的基石,但批判性社会理论家强调了在使用精神病理学和案例制定来解决不公正情况时,存在使政治斗争非政治化、使主体具体化和固定化的风险。在暴力激进化领域,恐怖主义在从业者和社会中引起的极端影响增加了这种风险。本文通过分析为加拿大魁北克省从事这一领域实践的从业者提供支持的实践共同体(CoP),探讨了在暴力激进化领域培训临床医生的挑战。共进行了四次与 CoP 参与者的焦点小组讨论和九次 CoP 会议的参与式观察。使用主题和叙事分析来探索 CoP 的培训潜力,并确定与这种模式相关的话语过程和群体动态。结果表明,小组中专业观点和社会定位的多样性在帮助参与者意识到自己的偏见以及对案例及其社会背景有更复杂的理解方面发挥了核心作用。结果还表明,集体承担风险对于维护从业者对涉及暴力激进化的患者的投入至关重要。健康和社会服务与安全机构之间的伙伴关系这一敏感问题也得到了解决。结果表明,具有强大领导力的 CoP 可以进行体验式培训,以增强临床和批判性思维。

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本文引用的文献

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Teaching clinical thinking to first-year medical students.向一年级医学生传授临床思维
Med Teach. 2009 Feb;31(2):105-11. doi: 10.1080/01421590802512979.

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