‘Somebody Watching You’: Impact of Reflecting Teams on Hope in Couple Relationships

Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients’ session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients.     

Talking about culture in social work encounters: immigrant families and child welfare in Finland

This article aims at analysing the ways in which people talk about ‘culture’ in social work encounters involving child welfare in immigrant families. The empirical material includes conversations between immigrant clients, their social workers and co-operating professionals at six Finnish social service offices, as well as interviews with the persons participating in these meetings. The theoretical and methodological frames of reference are social constructionism and discourse analysis. The study suggests three ways in which the concept of ‘culture’ is used by social workers and their clients: firstly, as a means of explaining ‘the ordinary and normal ways’ of raising children; secondly, as ‘a difficulty’ in the interaction between social workers and clients; and thirdly, as ‘a methodical tool’ in creating dialogue with clients. As far as the practical implications for social work are concerned, it is emphasized that in order to avoid ethnocentric practice or ‘culturalization’ of problems, it is important for social workers to be conscious of the various meanings of ‘culture’ both in their own practice and in the ways their clients employ cultural symbolism.     

‘I Thought We Came for Therapy!’: Autobiography Sessions in Couple Work

Each family builds up its own culture which is partially invisible to each of its members, and so I invite my couple clients to write their own autobiography as part of a move towards self‐differentiation. By emphasising difference in this way, I hope to allow my clients to feel OK about their discomfort, if any, with my ethnicity. I include vignettes to illustrate the process and client response.     

The ‘Sociology’ and ‘Anthropology’ of Berthold von Regensburg*

Abstract This article deciphers the views of the German thirteenth century preacher Berthold von Regensburg about ‘social nature’ as they are demonstrated in his sermon ‘Of the five talents’. Berthold von Regensburg interprets the Gospel parable (Matthew, 25: 14–30) quite freely, in accordance with the social realities of his own time. The ‘talents’ given by God to the human being are their personalities, social vocations, or offices, life-time, wealth, and love to their neighbours. Such an interpretation of the sacral text in the sermon read in a big South German town seems to be a kind of reflection of the burghers’ mentality. The hypothesis finds its further confirmation in other sermons in which he enumerates the professional groups of that society; this analysis is clearly town-oriented. A fuller context for this text is provided in the author's own work especially ‘Questions of Philosophy’Voprosi Philosophii (Moskva, 1990)     

Agency and clientship in public encounters: co‐constructing ‘neediness’ and ‘worthiness’ in shelter placement meetings

This article seeks to develop our understanding of the agency of vulnerable groups who at first sight may not seem to have much agency in their lives. It explores the co‐constructed nature of agency in three Danish homeless shelters. Unlike earlier interview‐based studies, our research is based on naturalistic data drawn from 23 video‐recorded placement meetings. Using concepts from Goffman, we examine how versions of the neediness and worthiness of homeless people are negotiated verbally and bodily between staff and clients. We find that homeless people have to juggle two partly contradictory roles when they are given or take the roles of either a (active) citizen or a (passive) client. Clientship is actively negotiated by both parties and demonstrates the agency of homeless people: they can collaborate with (as clients) or challenge (as citizens) the staff’s attempts to formulate solutions to their troubles. We further examine how the professional ideology of client centredness affects the meeting between the two parties. However, we show that, like any discourse, client centredness has no intrinsic meaning and is played out by actors in very different ways. In work with the homeless, the discourse of client centredness is related to discourses of ‘neediness’, ‘worthiness’ and ‘value for money’ that define agency in different ways and make three different client positions available: the resolute client, the acquiescent client and the passive client.     

Becoming ‘Real’ Entrepreneurs: Women and the Gendered Normalization of ‘Work’

This article focuses on the way in which women entrepreneurs legitimate their place in a gendered economy by reifying a divide between ‘real work’ and ‘not‐real work’. Using ethnographic approaches to follow the everyday lives of several women who own and operate small businesses in the USA, our article documents three gendering practices the women use for ‘becoming real workers:’ embodied, spatial and temporal. The study shows that women entrepreneurs become ‘productive workers’ by recasting reproductive work as non‐productive or not‐real work. At the end, we explore two possible alternative conceptualizations of ‘work’ that could contribute to dissolving this gendered divide.     

Examining the Incidence and Clients’ Experiences of Single Session Therapy in Italy: A Feasibility Study

Single session therapy (SST) postulates that one session can be sufficient for a client to take charge of the process and work toward their own solutions. Research has been conducted worldwide corroborating SST assumptions with several mental health conditions, but not in Italy. For the first time in Italy, this paper aims to explore: (1) if the most frequent number of sessions in traditional psychotherapy (not SST) is one (Study 1); and (2) the satisfaction of clients who attend SST services and the number who consider one session sufficient to address their presenting problem (Study 2). In Study 1, the records of 476 voluntary clients referred to three different traditional (not SST) psychological services in the west-central region of Latium, Italy, were retrospectively screened, and the number of sessions attended by each client recorded. In Study 2, 85 consecutive clients who voluntarily asked for SST with seven mental health professionals across Italy received a link to an online ad hoc survey, 1–3 weeks after the consultation, evaluating their experience. Study 1 found that the most frequent number of traditional psychotherapeutic (not intentionally SST) sessions was one (124 out of 476 clients (26%). Study 2 found that 44 out of 85 clients (52%) considered one session to be enough, as they felt better or much better and chose not to attend further sessions. Of those who asked for a second session (41 clients), 33 clients (80.5%) indicated that the first session was not enough and 8 clients (19.5%) wanted to address a new problem. These results converge with previous international studies and provide encouragement for the use of SST in both private and public psychological services to address the demand for timely mental health services in Italy. Further research is needed to support the efficacy of SST and to evaluate its cost-effectiveness.     

‘Workaholics’ and ‘whingeing women’: Theorising intimacy and emotion work — the last frontier of gender inequality?

In a variety of discourses and empirical studies it has been argued that compared with women, men show more reluctance to express intimate emotion in heterosexual couple relationships. Our paper attempts to theorise this gender asymmetry in intimate emotional behaviour as a sort of ‘emotional power’, within the wider context of continuing gender inequalities of resources and power in society. To the extent that men's role as breadwinner becomes their central life interest (they become ‘workaholics’), women are left with emotional responsibility for the private sphere, including the performance of the ‘emotion work’ necessary to maintain the couple relationship itself. Increasingly women's dissatisfaction in relationships (which men dismiss as unjustified ‘whingeing’) stems mainly from this unequal division. Yet many women still collude with male power by living the family ‘myth’ and ‘playing the couple game’; they perform emotion work on themselves to convince themselves that they are ‘ever so happy really’, thereby helping to reproduce their own false consciousness. This suggests that gender asymmetry in relation to intimacy and emotion work may be the last and most obstinate manifestation and frontier of gender inequality.     

Making It Real: Enhancing Curriculum Delivery Through the Use of Student-Generated Training Videos

ABSTRACT

This article describes and critiques the creation of a student-centered, reality-based training video undertaken by students and faculty from the departments of social work and visual arts at a northeastern university. There are several key and innovative aspects to this video. It is a collaboration between faculty and students of the schools of social work and the arts: social work students play themselves and students and affiliates of the school of the arts play clients and were responsible for all technical aspects of the video. The interactions portrayed are based on real social work student process recordings, and client-worker interactions are followed by a supervisory session, underscoring the importance of feedback for learning. The relevant literature on a variety of teaching techniques on which we based our work, including the use of role plays, simulated clients, and video technology, is reviewed. Social work educators are encouraged to develop their own videos depicting their students' unique experiences, using the interdisciplinary, collaborative, problem-based process presented. The technological capacity to deliver video on the web further enhances the accessibility and flexibility of this teaching strategy.     

Commentary on Studying Circular Questioning “In Situ”

In their discursive study of circular questioning in a systemic family therapy session, the authors raise some interesting perspectives on the original Milan therapy team's guidelines for the therapist as the conductor of therapy. By emphasizing circularity from a discourse point of view, they suggest these guidelines can be used to help family members hypothesize about their own perspectives on themselves and the other family members in circular terms, and, drawing upon Cecchin's notion of neutrality, by creating a state of curiosity in their talk and maybe in their minds. Their emphasis on circularity also helps us to become more sensitive to ways in which the natural recursion in language can help us to appreciate the new guiding lines circular questions can suggest with previously spoken elements. If we follow this line of argument, then circular questions can be seen as a critical part of a therapy we can call recursive family therapy in which we use the recursive element of all natural living languages to help our clients to recursively change their language and lives naturally.     

Establishing the Validity of the Affirmative Training Inventory: Assessing the Relationship between Lesbian,Gay, and Bisexual Affirmative Training and Students’ Clinical Competence

This study established the validity and factor structure of the Affirmative Training Inventory (ATI; T. S. Carlson, C. R. McGeorge & M. Rock, unpublished) as a measure of lesbian, gay, and bisexual (LGB) affirmative clinical training. Additionally, this study examined the latent associations among the subscales of the ATI and the Sexual Orientation Counselor Competency Scale ( Bidell, 2005 ) utilizing a sample of 248 master’s and doctoral couple and family therapy students. The findings from this study provide empirical support for the relationship between specific classroom‐related content associated with LGB affirmative therapy and students’ perceptions of their own ability to work competently with LGB clients. This study also found a positive association between the degree to which couple and family therapy programs adopt a LGB‐affirmative stance and students’ beliefs, knowledge, and skills associated with competent therapy with LGB clients.     

More than ‘information provider’ and ‘counselor’: Constructing and negotiating roles and identities of nurses in genetic counseling sessions

This paper contributes to research on genetic counseling by exploring the complexity of this activity from the angle of identity construction. We argue that an analysis of the processes through which healthcare providers construct and negotiate their roles and identities in these encounters may contribute to a better understanding of the complexities of genetic counseling. Drawing on more than 150 video‐recorded genetic counseling encounters between nurses and clients in Hong Kong, we illustrate that the discursive processes involved in the construction of the nurses' identities are complex, overlapping and at times contradictory as the nurses respond to the (sometimes) competing norms and expectations of their institution, their clients and their own. They manage to solve these tensions by drawing on the roles traditionally assigned to nurses in these encounters such as information provider and counselor, as well as creating the new roles of co‐decision maker and cultural broker/mediator.     

‘Bad Therapy’ as a Training Technique: An Empirical Analysis

The purpose of the present study was to gather empirical data to examine the usefulness of an intriguing training technique called “bad therapy”. The technique, developed by Lang (1980, 1982), is utilized in a role-play setting for experienced therapists who are having difficulty with specific clients showing little improvement. The therapist is instructed to disregard his or her usual style of treatment, and instead, within a role-play format with a colleague who plays the part of a client, to try an alternative style of treatment. This new treatment, termed “bad therapy”, instructs the therapist to try to make the client worse rather than better. Interestingly, reports from both the role-play therapist and client indicate that the “bad therapy” session was considered more beneficial than the therapist's usual mode of treatment. As well as empirically investigating Lang's assertion, the present study also attempted to look at different perspectives of bad therapy. Is “bad therapy” a directive to be harmful and destructive, or is it a suggestion to be more daring and to take more risks? Subjects were 56 therapists who formed twenty eight pairs of therapist-client dyads. First, each pair conducted a “session” where the therapist performed his or her typical therapy. Then, therapists in one group (N= 11) were given directives to try to make their clients worse rather than better (“destructive” set), while therapists in another group (N=11) were told to say and do things that they wished to, but never dared (“daring” set). Finally, six therapists were told to simply repeat their usual type of therapy (“control” set). Results indicated that clients perceived the destructive and daring groups differently with the daring group being perceived more favourably, yet more authoritarian. Similarly, therapists perceived the daring and control groups more positively than the destructive group. The results are discussed in terms of training techniques and current trends in psychotherapy.     

A Study of Clinical Change in Individual Career Counseling

This study examined the clinical significance of career counseling effects. Participants were 111 university students (83% women) who participated in individual career counseling sessions at their university. All participants completed the French version of the Outcome Questionnaire–30.2 (OQ‐30.2; Lambert, Finch, Okiishi, & Burlingame, 2005) immediately before the 1st session (pretest) and at the beginning of the last session (posttest). The OQ‐30.2 assesses 3 client life domains: subjective discomfort, problems in interpersonal relationships, and problems in social role satisfaction. Using Jacobson and Truax’s (1991) statistical approach to assessing clinical change, the authors compared clients’ pretest OQ‐30.2 scores with their posttest scores. Among clients with a “dysfunctional” score (n = 59) at the study’s inception, 34% recovered and 14% improved, whereas 41% of clients with functional scores (n = 52) at the study’s inception improved. The results suggest that individual career counseling can make a difference in the lives of many clients; they also highlight the importance of further outcome research that accounts for possible variability in clients’ responses to career counseling.     

“Do We Have A Customer?” — A Team Approach To Intake

This article examines some of the ambiguities surrounding requests for assistance in the voluntary sector. The authors have developed a team approach at the ‘intake’ stage for clients whose requests often demand a well-thought-out response in order, as Haley suggests we must, “to start well”. Some of the literature about ‘beginning with families’ is examined, and the complex issues of ‘engaging’ and ‘joining’ are discussed. It is suggested that not every ‘shopper’ is necessarily a ‘customer’ for our wares, but that they are almost certainly shopping for something. ‘Emergency’ and ‘crisis’ calls are distinguished, and different responses to each are indicated. Finally, the procedures used are described, within the context of this particular voluntary agency, so that readers may distinguish what could be applicable in different contexts.     

Response to “Becoming Visible: The Case of Collette”

The clinician’s experiences of race outside of the treatment room contribute to the formation of a racialized self, which influences clinical work with all clients notwithstanding race. Multiracial individuals at times must balance their external physical presentation—and the corresponding race-related categories that others place on them—with their own internally constructed racial identifications. The mechanisms of identification and disidentification can provide safety for the multiracial individual. How can clinicians effectively acknowledge their own identifications and disidentifications as lenses for seeing the multiracial person’s racialized self and selves so as to more effectively work with the multiracial?     

Fundamentals of Theory and Practice Revisited; The Reality of Voices: ‘Auditory Hallucinations’

This paper describes some recent developments in approaches to voice‐hearing and relates them to contemporary ideas about psychosis and therapy. The author looks at the growing body of work on cognitive behavioural therapy for psychosis. She examines the similarities and differences between these approaches and those of innovators like Marius Romme and Sandra Escher, Philip Thomas, Michael White and the Hearing Voices Network. The author describes some influences upon her own systemic practice with clients diagnosed with schizophrenia, in a Community Mental Health Team in Wales.