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功能性神经障碍:一项探索个体心理服务体验的定性研究。

Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services.

作者信息

Staton Amelia, Dawson David, Merdian Hannah, Tickle Anna, Walker Tammy

机构信息

University of Nottingham, Nottingham, UK.

University of Lincoln, Lincoln, UK.

出版信息

Psychol Psychother. 2024 Mar;97(1):138-156. doi: 10.1111/papt.12504. Epub 2023 Oct 6.

Abstract

OBJECTIVES

Individuals with a diagnosis of FND report experiencing stigma in medical settings, however, there is a paucity of research exploring their experiences in psychological services. The aim of this research was to explore experiences of accessing UK psychological services, from the perspective of those with FND.

METHODS

This study utilised a qualitative approach with data collected from semi-structured interviews (n = 15) and analysed using reflexive thematic analysis.

RESULTS

One superordinate theme, 'the stigmatised self within the therapeutic relationship', and five interrelated subthemes were identified: 'internalised stigma and self-doubt', 'selective disclosure to professionals', 'perceptions of psychological explanations', 'having to educate the professionals' and 'attunement and trust within the therapeutic relationship'. Positive therapeutic relationships were perceived to mitigate the impact of these perceived barriers. The conceptualisation of FND and the perception of how this was responded to by services and professionals was a central tenet throughout the related themes.

CONCLUSIONS

Intra-personal, interpersonal and organisational stigma impact access and engagement to psychological treatment. The findings of this study highlight the need for increased training provision for practitioners with a focus on actively challenging FND stigma within services at both an individual and systemic level.

摘要

目的

被诊断为功能性神经系统疾病(FND)的个体报告称在医疗环境中遭受耻辱感,然而,探索他们在心理服务中的经历的研究却很少。本研究的目的是从患有FND的个体的角度,探索他们获得英国心理服务的经历。

方法

本研究采用定性方法,通过半结构化访谈收集数据(n = 15),并使用反思性主题分析法进行分析。

结果

确定了一个上位主题,即“治疗关系中被污名化的自我”,以及五个相互关联的子主题:“内化的耻辱感和自我怀疑”、“对专业人员的选择性披露”、“对心理学解释的看法”、“必须对专业人员进行教育”以及“治疗关系中的协调与信任”。积极的治疗关系被认为可以减轻这些感知障碍的影响。FND的概念化以及服务机构和专业人员对此的反应方式在所有相关主题中都是一个核心原则。

结论

个人层面、人际层面和组织层面的耻辱感会影响心理治疗的获得和参与度。本研究结果强调,需要为从业者提供更多培训,重点是在个体和系统层面积极挑战服务机构内部对FND的耻辱感。

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