The Psychological Battle for Control: A Qualitative Study of Health-care Professionals' Understandings of the Treatment of Anorexia Nervosa

This paper reports a qualitative, idiographic study, which intensively examines a multidisciplinary team of clinicians' subjective understandings and experiences of treating young people with anorexia nervosa. The study employs semi-structured interviews and interpretative phenomenological analysis, these methods enabling individual clinicians' perspectives to be explored in depth and retained within the analysis. The analysis focuses on the salient higher-order theme of control which emerges as central to understanding the treatment of the anorexic child. Three control-related themes are used to illustrate the multiplicity of meanings and experiences which are relevant to this team of health-care professionals. It is suggested that this paper makes three important contributions to the current eating disorder literature: illuminating the multi-faceted nature of the construct control; highlighting the importance of therapists' subjective understandings and experiences; and illustrating the value of qualitative methods for clinically relevant research. © 1997 John Wiley & Sons, Ltd.     

“Battling something bigger than me”: A phenomenological investigation of generational trauma in African American women

The lived experiences of eight African American women college students were explored from an interpretive phenomenological analytic framework. The researchers identified six main themes about participants and their reported family dynamics: (a) collectivistic yet disconnected, (b) avoidance, (c) functioning in dysfunction, (d) gendered differences, (e) motivation to change the family's homeostasis, and (f) talking about generational trauma as a motivator to repair communication. Implications for culturally responsive counseling and generational trauma-informed counselor training are discussed.     

Being a mother with anorexia: A phenomenological study of seeking and receiving professional support for white heterosexual women in the UK

Mothers are currently under-represented in the literature on anorexia, including research on treatment, with most research focussed on female adolescents. This raises questions about how adult women and particularly those who are mothers, experience eating disorder treatment. This study provides a phenomenological exploration of lived experiences of seeking and receiving professional help and interactions with health professionals for six white heterosexual mothers who experienced anorexia while raising their children. Four themes are reported that capture the women's diverse experiences of seeking and receiving support for anorexia: (1) conflict between mothering and seeking help; (2) experiences of feeling blamed, poorly treated or misunderstood by health professionals; (3) positive experiences of seeking and receiving support; and (4) the importance of ongoing support. The women's experiences suggest that healthcare professionals should adopt a more holistic approach that acknowledges the subjective reality of the client (including their mother status) when working with mothers experiencing anorexia.     

Mobility and migration experiences of transnational coaches within the Israeli handball context

ObjectivesDespite a growing body of literature on athletes' migration, the mobility and migration experiences of coaches have received limited attention. In this study, we explored the mobility and migration experiences of transnational coaches operating within the Israeli handball context.DesignA qualitative study was conducted, underpinned by our relativist ontology and a constructionist epistemological position.MethodsEight male professionals (e.g., national team coaches, senior team coaches, youth coaches), working (currently, or most recently) in national teams and clubs, who migrated to Israeli handball within the past five years were interviewed. A thematic analysis, integrating inductive and deductive reasoning, was applied in data analysis. Meticulousness was enhanced by focusing on a worthy topic, maintaining credibility, critical friends, producing generalization, and making a significant contribution.ResultsThe analysis yielded raw-data codes, further organized into lower-order themes and three higher-order themes reflecting transnational coaches' migration and mobility experiences within the Israeli handball context, including (a) cultural transition, (b) cultural adaption, and (c) coaches' personal insights about mobility and migration. The findings are conceptually analyzed and discussed in relation to the previous research on coaches' career migration.Discussion and conclusionThe findings emphasize the complexity of the migration process, accompanied by varying motivations, demands and barriers, active decision-making; all within the framework of cultural adaptation. The participants endorsed a transnational coaching career, driven by their open-mind mentality and personal-professional growth.     

Men and Menstruation: A Qualitative Exploration of Beliefs,Attitudes and Experiences

Our article presents the findings from a study exploring men’s attitudes towards and perceptions of menstruation. Using a social constructionist framework, we analyzed 48 Australian men’s written accounts in response to an anonymous online questionnaire which explored messages they received about menstruation growing up as well as their current attitudes towards, and experiences with, menstruation. Respondents were 18–69 years-old; most were Caucasian and in an intimate relationship, and they varied considerably in terms of educational attainment. Thematic analysis yielded four themes: (a) managing the stigma of menstruation, (b) talking menstruation today—open and closed communication, (c) menstruation is part of relationships, and (d) menstruation and social commentary. These findings shed light on how boys learn about menstruation and how men’s role in menstruation is constructed, emphasizing the educational, relational, and socio-political contexts in which these attitudes are created. Researchers, health care providers, and educators could use our findings to create more effective reproductive health education programs. Improving communication between parents and children may encourage a more balanced view towards menstruation, working towards reducing the stigma commonly experienced by girls and women.     

Parenting a Child with Phenylketonuria (PKU): an Interpretative Phenomenological Analysis (IPA) of the Experience of Parents

Phenylketonuria (PKU) is a rare inherited metabolic disorder which can cause neurological damage if left untreated. PKU is identified through newborn screening in developed countries, and treatment begins immediately to prevent these severe consequences. When a child is diagnosed, parents must assume immediate responsibility for the management of PKU and prevention of neurological damage. Quantitative studies have identified significant psychosocial stressors for parents, but little is known about how the parents experience this process. This study aimed to explore the experiences of parents of children with PKU under the age of two. It is the first study to examine these experiences in this way. Seven parents were interviewed about their experiences, and interpretative phenomenological analysis was used to analyse the data. Three main themes were identified: control, striving for normality and acceptance of PKU as a continuum. Links between the themes and processes underpinning the results were explored with relation to existing literature and theories from a clinical psychology perspective. The role of acceptance of PKU was central to the parent’s experiences. Clinical implications and suggestions for further research are discussed.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

American Indian Researcher Perspectives on Qualitative Inquiry About and Within American Indian Communities

It is presumed that Indigenous researchers are optimally positioned to conduct research about or within their own or other Indigenous communities. However, these researchers may still experience challenges, barriers, and distressing events that are important to identify. Qualitative inquiry may be a particularly vulnerable context for Indigenous researchers given the nature of data collection methods and an emphasis on researcher–participant relationships. This paper details the personal reflections of two American Indian (AI) researchers who carried out qualitative research focused on AI issues and/or communities. The first project examined undergraduate students’ opinions of the use of AI imagery in the form of a race‐based university mascot. The second was a study of the mental health needs of AI youth and families in an urban community. Several themes characterized both of their experiences and might be generalizable to others working in these contexts: (a) coping with racism and microaggressions; (b) the role and impact of identity politics; (c) community insider/outsider tension; and (d) managing personal distress associated with the research topics and process. These themes are discussed to illuminate ways that Indigenous researchers, engaged in research on Indigenous topics and/or with Indigenous communities, are challenged and affected by their work.     

Spiritual Transformation: A Phenomenological Study Among Recovering Substance Abusers

As a complement to an earlier quantitative investigation, this qualitative study was concerned with describing the lived experience of spiritual transformation within the context of a 12-month resident substance abuse recovery program called the Lazarus Project, which is sponsored by a southern U.S. Pentecostal-based congregation. We conducted phenomenological interviews with 10 participants (eight European-Americans; two African-Americans) who had been in the program from six to nine?months and asked that they describe their most important spiritual experiences that brought about change. A hermeneutical analysis found that a pattern of five overlapping themes emerged consistently across all 10 protocols to describe the meaning of the experience of spiritual transformation for these participants. The themes were: (1) “Sick and Tired”, (2) Unmerited Love, (3) “I’m Changing,” (4) Fast/Gradual, and (5) Destiny. The themes are discussed from an existential perspective and related to the literature on spiritual transformation as well as the earlier quantitative study at the Lazarus Project.     

Relational recovery after infidelity as a dual process: A model based on the experiences of female injured partners

In the literature, relational recovery after infidelity is often described as a process going through different consecutive stages towards a reconciliation. We interviewed 25 injured partners and invited them to look back and talk about what helped them to recover from the pain and the conflicts caused by the relational infidelity of their partner. From their stories—through thematic analysis—four themes emerged: 1. talking, 2.the truth, 3. trust and 4. ethical imbalance. It furthermore struck us how the participants described their recovery process as an experience of being oscillated between connection and disconnection. These findings pointed us in the direction of developing a dual process model that fits with our participants' experiences of recovering after infidelity, while emphasizing the dynamic nature of their stories.     

Gendered themes in family reminiscing

Previous research conducted in laboratory settings has shown reliable gender differences in autobiographical memory. However, these studies have primarily focused on structural or emotional aspects of memory narratives told to an unfamiliar experimenter. The present study extends this literature by investigating gender differences in social references and interpersonal themes in parent-child narratives about the past. Participants were 17 white, middle-class children and their mothers and fathers, who were interviewed when children were 40 and 70 months of age. Parent-child narratives about shared activities in the past, as well as narratives about parents' own childhood, were examined. Results indicated that when discussing shared events, both parents talked in similar ways across children, although fathers referred to self more than mothers. However both parents referred to their girls more than their boys. Regarding event themes, parents discussed more social events with girls than with boys. Children themselves showed different gendered patterns; girls mentioned self and others, and relationships more than boys did, and children mentioned self and others more often when talking with fathers than with mothers. With respect to narratives about parents' childhood experiences, however, no gender differences were observed, save that parents referred to others more often in retrospective narratives told to girls than to boys. These findings suggest that gendered behaviours are best understood within the specific contexts and purposes of relational interactions.     

An Exploration of Young Clients' Experiences in Counseling With Post‐Master's Counselors

This phenomenological study adds to current literature about clients' meaningful experiences in counseling by exploring the experiences of eight young clients (ages 8–18) in individual counseling with post‐master's counselors in an outpatient setting. Interviews with these clients revealed the following six themes: (a) the process of growth, (b) having a safe place to talk, (c) counselor accepts and meets the client where they are, (d) counseling is a team effort, (e) supportive accountability from the counselor, and (f) understanding self and others. The final theme includes two subthemes: learning coping and emotion management skills, and learning better ways to communicate and behave. Findings and implications for counselors are discussed.     

Responding to Disaster-Related Loss and Grief: Recovering From the 2013 Flood in Southern Alberta,Canada

Applying a loss and grief perspective, this article explores lived experiences and perceptions of social workers and human service professionals who provided psychosocial supports and services to children, youth, and families recovering from the 2013 flood in southern Alberta, Canada. Five interrelated themes emerged from the analysis: (a) challenges with providing services while experiencing personal loss; (b) lack of funding for long-term postdisaster psychosocial recovery; (c) parenting in the context of disaster-related loss; (d) children’s and youth’s experiences of disaster-related loss and grief; and (e) the impact of the flood on family socioeconomic status. Recommendations for research, education and practice are discussed.     

“It Makes Me Worry About Her Future Pain:” A Qualitative Investigation of White Mothers of Non-White Children

In the United States, increasing numbers of White women are mothering children of color. Little is known about their psychosocial experiences of racially socializing non-White children within a culture that transmits socially constructed meanings about race. Such messages influence employment and quality and access to health care. Thirteen White mothers of non-White children (school age to adulthood) residing in the U.S. were interviewed. Their psychosocial experiences and racial socialization practices were explored. Through an analysis of transcribed interviews and interview notes, seven themes emerged: (1) Looking Like a Family and Looking Alike; (2) Mothering as Vulnerability; (3) Teen Daughters’ Perceptions of Black Men as Undesirable and Frightening; (4) Exposing Children to Culture; (5) Children and Mothers’ Experiences as “Other”; (6) Hostility from Black Women; and (7) Not Talking About Race. Study's limitations and future research are discussed.     

Experiences of Countertransference: Reports of Clinical Psychology Students

While historically linked with psychoanalysis, countertransference is recognised as an important component of the experience of therapists, regardless of the therapeutic modality. This study considers the implications of this for the training of psychologists. Fifty‐five clinical psychology trainees from four university training programmes completed an anonymous questionnaire that collected written reports of countertransference experiences, ratings of confidence in managing these responses, and supervision in this regard. The reports were analysed using a process of thematic analysis. Several themes emerged including a desire to protect or rescue clients, feeling criticised or controlled by clients, feeling helpless, and feeling disengaged. Trainees varied in their reports of awareness of countertransference and the regularity of supervision in this regard. The majority reported a lack of confidence in managing their responses, and all reported interest in learning about countertransference. The implications for reflective practice in postgraduate psychology training are discussed.     

When lying changes memory for the truth

In the legal field, victims and offenders frequently lie to avoid talking about serious incidents, such as past experiences of sexual abuse or criminal involvement. Although these individuals may initially lie about an experienced event, oftentimes these same people eventually abandon their lies and are forthcoming with what truly happened. To date, it is unclear whether such lying affects later statements about one’s memory for the experienced event. The impetus of the present review is to compile the current state of knowledge on the effects of lying on memory. Based on existing literature, we will describe how deceptive strategies (e.g., false denials) regarding what is remembered may affect memory in consequential ways, such as forgetting of details, falsely remembering features that were not present, or a combination of both. It will be argued that the current literature suggests that mnemonic outcome is contingent on the type of lie and we will propose a theoretical framework outlining which forms of lying likely result in certain memory outcomes. Potential avenues of future research also will be discussed.     

An Exploration of the Experience of Huntington’s Disease in Family Dyads: An Interpretative Phenomenological Analysis

Huntington’s disease (HD) is a hereditary, late onset, neurodegenerative disorder. Children of affected parents have a 50 % chance of inheriting HD. Research into the psychological consequences of HD for the family has focussed on individual family members, but little is known about the ways in which its impact is jointly experienced by members of these families. This is particularly important due to the hereditary nature of HD. To address this, the current study examined the experiences of dyads within affected families. Seven parent/adult child dyads were interviewed jointly about their experiences and relationships with their family and each other and interpretative phenomenological analysis was used to analyse the resultant data. Identified themes were: “A spectre hanging over us”: HD as a presence within the family, “Us against the world”: Protection, knowledge and control, and “That could be me in 50 years”: Cyclical changes in identity and role. These findings are examined in relation to previous research and indicate the need for an increased understanding of the needs of HD families. Clinical implications and suggestions for further research are discussed.