A qualitative case study of a Korean former addict’s existential self‐interpretation and identity transformation

This study explored the case of a former addict, focusing on his existential self‐interpretation and identity transformation process. This study began from the question of whether philosophical processes related to existential self‐interpretation could lead to the formation of the concept of bottoming out and of identity transformation. To answer this question, the study analyzed the case of a male in his mid‐forties who was addicted to drugs for approximately 30 years and has only recently maintained abstinence. The study used the phenomenological approach to determine the meaning drugs held for him in each stage, and what drug‐related identity he had in each stage. Further, this study identified the integrative implications of these meanings in terms of existential self‐interpretation and identity transformation. The four different identities the man identified for the four stages of his life were juvenile delinquent, gang member, half‐gangster, and breadwinner, and the associated meanings drugs had for him during each period were “glue,” “filthy,” “leeches,” and “abstinence,” respectively. Finally, this study elucidated the integration of these meanings through the hermeneutic circle, identified the social welfare implications of the findings, and developed educational recommendations.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Participation in Everyday Life Before and After a Housing Adaptation

Housing adaptation aims to enable clients to live independently in their own homes. Studies focusing on participation in everyday life following a housing adaptation are lacking and needed. This study aimed to explore housing adaptation clients' experiences of participation in everyday life before and after a housing adaptation, through the lens of a housing adaptation, using a qualitative follow-up design, with 11 participants. It was found that when the housing adaptation met the participants' needs, performance of activities improved and the housing adaptation opened doors to engagement and participation in everyday life. Thus, focus on performance and engagement in everyday life at the onset of the housing adaptation process, combined with regular follow-ups, may enhance participation.     

Open Dialogue: Frequently Asked Questions

Open Dialogue is an approach to working with people and their families experiencing psychosocial distress. Interest in Open Dialogue in Australia has been growing recently, raising questions about its adaption and implementation to local contexts. This article is an attempt to answer some of the frequently asked questions we have encountered in training and discussions about Open Dialogue. We attempt to provide responses to questions of how Open Dialogue is different to what is done already, how it fits with current approaches, how you know if you are doing it, whether it is passive or just about doing reflections, issues about including the social network, and concerns about the evidence base. This article aims to present a variety of viewpoints in relation to these questions and to hopefully further discussions on how Open Dialogue can be implemented and adapted to Australian health care and social care contexts.     

Exploring Shame,Guilt, and Risky Substance Use Among Sexual Minority Men and Women

This study examined the interrelations among shame-proneness, guilt-proneness, internalized heterosexism (IH), and problematic substance use among 389 gay, lesbian, and bisexual men and women. Problematic alcohol and drug use were positively related to shame-proneness and negatively related to guilt-proneness. Bisexuals reported riskier substance use behaviors, lower levels of guilt-proneness, and higher levels of IH than gay men and lesbians. Furthermore, study findings indicated that shame and IH are related. Additional investigations of these associations would supplement current understandings of sexual minority stress and advance the development of substance-related intervention and prevention efforts targeting sexual minorities.     

Insider/Outsider: A Muslim Woman's Adventure Practicing ‘Alongside’ Narrative Therapy

The following paper centres on my unique experience as a white Australian therapist who is able to sympathise with a Western world view while being immersed in an Islamic world view. The goal is to share my journey as a Muslim Australian via an auto‐ethnography reflexive method. Using diaries, intentional reflexive positioning, and multiple modes of supervision, I contemplate an Islamic identity and value system while negotiating poststructural therapies such as solution‐focused collaborative, and in particular, narrative therapy as viable approaches to working with the Muslim community. There are two inquiries which are of interest. The first is to reflexively describe the experience of being a Muslim practitioner and wondering whether core differences in epistemological views between social constructionism and Islamic doctrine can be overcome. Secondly, this enquiry explores Quranic guidelines about how to perceive ‘problems’ in life, based on the premise that understanding how an Islamic world view addresses life's troubles may add to deeper conceptions of the role of difficulties. I propose that adherent Muslims have a natural metaphorical way of thinking that connects with some of the poststructural therapeutic skills and techniques and at the same time draw on past Quranic solutions for contemporary problems. Little has been written on narrative therapy as a suitable approach to working with Muslim clients. In the current paper I review my personal experience as a veiled Muslim therapist striving to implement narrative therapy alongside an Islamic epistemology.     

Love in Times of Cholera: Systemic Reflections on Supporting Families Through the Journey(s) of Illness

This paper is the result of our increasing interest in the experience of illness in families and the concomitant reflections on how best to therapeutically support these families through this process. This interest led us to reflect on the nuanced way in which language establishes a play with the experience of illness, a play that can amplify or reduce its effects. Such an interplay in turn led us to consider the valuable role that family therapists have in helping families and treating practitioners to create a safe space for conversation about illness. Further questions are also explored in relation to whether there is a role for family therapists in facilitating the interface between our clinical practice with clients and the wider treating medical community. And, if so, what shape would such an interface take? Considerations at this level would include the anticipation of psychological reactions to diagnosis of chronic and life‐threatening illnesses, in particular the importance of ‘normalisation’ of the psychological reactions to such chronic and/or life threatening diagnoses; the complex dynamics emerging from the interface between the effects of illness in the subjectivity of the ill person and the grief experienced by the other family members; different family members’ narratives of the illness; relevant community contexts; and, lastly, ways to help the family members and/or the ill person navigate the medical system including the use of second opinions, cyberspace information, and other systems in their ecology, such as the spiritual dimension. Some aspects of children's narratives of illness are also identified. The paper has been organised around the dialogue that the authors had around one of their clinical cases.     

Family Therapy and the Pedagogy of the Oppressed: Therapeutic Use of Songs in Apartheid South Africa

A central issue for family therapy is the critical question of how to define its role in influencing social change. Family therapy has tended to focus on how to liberate and empower individual clients, not communities, from the travails of tradition. This article highlights social change mechanisms implemented by the oppressed majority in South Africa during the apartheid period. It draws inspiration from the pedagogy of the oppressed articulated by Steve Biko and other members of his generation. This enabled the Black majority in South Africa ‘to name their world by reflecting on their conditions, imagining a better world, and then taking action to create it’ (Freire, 1968, p. 253) through the use of revolutionary songs that resulted in the collapse of the cruel apartheid system. The implications for family therapy are discussed.