Iraqi refugee men’s experiences of psychotherapy: clinical implications and the proposal of a pluralistic model

The psychotherapy experiences of a sample of Iraqi refugee men, in later stages of exile, were explored with the aim of shedding some light on how this client group can experience therapy. Ten adult male Iraqi refugees – who had lived in Sweden for at least five years and had been psychotherapy clients at some point during that time – were recruited for this study. Using individual semi-structured interviews (in Arabic), three main areas were explored with each participant: (1) reasons for seeking psychotherapy; (2) perceptions of the psychotherapy professional; and (3) experiences of the psychotherapy process and outcome. The interviews were then translated into English, transcribed, and then analysed using Interpretative Phenomenological Analysis (IPA). Most participants/clients described exile-related stressors as their main reason for seeking psychotherapy, but some described distress due to a combination of pre-migration trauma and post-migration stress. They also found some aspects of therapy to be positive (mainly verbalising ones thoughts and feelings, and feeling less marginalised) and some negative (mainly experiencing racist or culturally insensitive treatment by therapists, and experiencing a lack of competence and transparency in therapists). The findings were explored in terms of clinical implications and a pluralistic model was proposed to address the identified needs.     

Redefining unforgiveness: Exploring victims’ experiences in the wake of unforgiven interpersonal transgressions

This study explored victims’ experiences in the aftermath of unforgiven offenses. Semi-structured interviews with 13 individuals discussing two unforgiven offenses revealed considerable variability in the experiences of unforgiveness, suggesting that unforgiveness may be more multifaceted than previously believed. In addition to the negative emotions and rumination previously posited to characterize unforgiveness, novel themes emerged describing unforgiving cognitions (e.g., the offense is unforgiveable) and construals of the offender. Participants varied along each dimension, resulting in a range of outcomes (e.g., forgiveness, lingering personal distress, finding peace without forgiving). Implications for conceptualizing unforgiveness and counseling those who struggle with unforgiven offenses are discussed.     

Teachers’ reactions to experiences of violence: an attributional analysis

Violence perpetrated against teachers is prevalent and has the potential to adversely affect teachers’ well-being, efficacy, and longevity in the profession. In this study, we examined teachers’ reactions after having experienced violence, specifically examining the roles of attributional processes. In collaboration with the American Psychological Association, National Education Association, and American Federation of Teachers, data were collected via a survey instrument from teachers across the United States. We examined responses from 2505 participants who described the most upsetting incident of violence that had been perpetrated against them in their roles as teachers. We examined predictors of (1) communicating with others after the incident and (2) implementing intervention strategies with the perpetrators of violence. Emotions were tested as mediators of the relations between attributions and outcomes. Results indicated that characterological and behavioral self-blame were predictive of negative affect, which in turn predicted the majority of outcomes. Study limitations and implications for research and practice are discussed.     

Parents’ experiences of family food routines in adolescent elite-level swimming

ObjectiveParents have an important role in their child’s food routines and eating behaviour and face additional demands when that child is an athlete. Yet little is known about how parents manage providing food for their athletic child, in addition to the wider family, within the context of elite-level youth sport.MethodsSemi-structured interviews were conducted with sixteen parents (mothers = 11; fathers = 5) of elite level adolescent swimmers (i.e., competing at UK national level or above; child mean age = 15.4 years) to explore their experiences of family food routines and eating behaviour. Reflexive Thematic Analysis was used to analyse the data.ResultsParents outlined the importance of ‘optimal’ fuelling for their athletic child. Parents had an active role in their child’s eating behaviour and shaping their food choices but expressed uncertainty regarding the volume of food their child should consume and concerns regarding their child’s future relationship with food. Meticulous organisational and logistical strategies were employed to meet the extensive food requirements of their adolescent elite swimmer in the face of intensive training schedules. Such schedules also impacted food routines for the wider family (i.e., fewer family mealtimes), and on the quality of parents’ own diets.ConclusionThe findings highlight that clearer guidance is needed for parents of elite adolescent swimmers in relation to quantities of food intake and how to support a positive future relationship with food (specifically during any periods of transition in their training or out of the sport). The findings also identify a novel organisational stressor for parents in elite youth sport, in managing and prioritising their own diet. Further research is needed to explore the extent to which parental diet may be impacted by supporting an adolescent athlete.     

Bittersweet: a qualitative exploration of mothers’ experiences of raising a single surviving twin

Loss of a child from a multiple birth pregnancy is not uncommon yet the idiographic experience of parents who have lost a single twin from a multiple birth pregnancy is underexplored. This novel study sought to explore the experiences of mothers bereaved after loss of a twin from a multiple birth pregnancy, focusing on the dual challenges of parenting and grieving. Eighteen mothers at least 12 months post loss were recruited from a private UK based Facebook page dedicated to supporting parents after loss from a multiple birth. Eligible mothers completed an independent qualitative open-ended survey to explore maternal experiences of loss. Data were analysed using Thematic Analysis. Findings represented a sense of duality for participants, with mothers experiencing conflict between roles and identities as well as the nature of their loss. Key themes identified include ‘Narrating a story of family and loss’, ‘Finding a place for the twins within the family’ and ‘A changing sense of self’. Findings fit with theoretical conceptualisations of bereavement that acknowledge retaining relationships with the deceased. Practically, suggestions for supporting mothers to identify stock answers to often asked questions about family make up were suggested.     

The experiences and understandings of obesity: Families’ decisions to attend a childhood obesity intervention

Objectives: This study investigated the families’ experiences of a childhood obesity intervention and sought to understand factors that influence attendance and lifestyle behaviours.

Design: Eleven semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis.

Results: Four themes emerged highlighting the differences and similarities between attendees and non-attendees perceptions of childhood obesity, perceptions of the intervention, practical barriers and overcoming hurdles to attending and, availability and suitability of local facilities.

Conclusions: The findings relate to identity and health communication. For some families attending an obesity intervention may challenge social and individual identities, which may have an impact on subsequent behavioural decisions. Those who attend the obesity intervention may experience a shift in identity, which may or may not initially be perceived as a positive outcome. Public Health and those involved in treatment interventions should aim to bridge the gap between people’s in-group identities and those associated with particular lifestyle behaviours. In order to be effective, services must meet the needs of their clients and address any preconceived negative perceptions by carefully considering how health information is presented, how it is understood and most importantly how identity may affect motivation to engage in, and sustain, new behaviours.     

Early childhood mental health consultation: Care providers’ experiences of the consultative relationship

This article presents findings from a qualitative research study exploring child care teachers’ experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers’ personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant–consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC.     

Exploring a sample of university students’ perceptions of menstruation

This study aimed to explore how a sample of young South African women constructed their perceptions of menstruation. The sample comprised 16 racially/ethnically diverse female university students (blacks = 4, whites = 2, coloured = 8; Christians = 11; Muslims = 5; aged 18 to 23 years). They participated in one of three focus group discussions on their constructions of menstruation. Findings from the discourse analysis indicated that the women perceive social control experiences of their menstruation—even in the context of medical understandings.     

Exploring Maternal Grief: A Mixed-Methods Investigation of Mothers’ Responses to the Death of a Child From Cancer

This study investigated the meaning-making phenomena underlying the responses of 13 bereaved mothers to the death of a child from cancer. Using a mixed-methods research design incorporating constructivist data collection methods, we found specific characteristics, coping processes, and factors to distinguish adaptive as opposed to complicated grief responses to this type of loss. However, the findings did not distinguish the bereaved mothers themselves as “adaptive” or “complicated grievers,” as they all evidenced both types of responses to their loss within or across different datasets. Despite this finding, the mothers’ results varied in terms of the proportions of adaptive as compared to complicated grief responses to their loss, which in turn were related to features of their self-construing, change or reinforcement of their world assumptions, ongoing relationship to their child and others in their social world, and management of loss- and restoration-oriented coping. Results suggest the utility of constructivist and cognitive coping models and methods in illuminating the experience of parental bereavement.     

Couple and family therapists’ experiences with Telehealth during the COVID-19 pandemic: a phenomenological analysis

In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants’ initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients’ privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients’ raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a “participant observer” to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care.

     

Framework analysis: a worked example of a study exploring young people’s experiences of depression

Framework analysis is an approach to qualitative research that is increasingly used across multiple disciplines, including psychology, social policy, and nursing research. The stages of framework analysis have been described in published work, but the literature is lacking in articles describing how to conduct it in practice, particularly in the field of psychology, where researchers may be working as part of a team. Having used framework analysis on a study exploring adolescents’ experiences of depression, we faced various challenges along the way and learned from experience how to use this approach to qualitative analysis. In this reflective article, we describe a worked example of using framework, which we hope will assist other researchers in deciding if this approach is suitable for their own research, and will provide guidance on how one might go about conducting framework analysis when working as part of a research team. We conclude that framework is a valuable contribution to qualitative methods in psychology, offering a pragmatic, flexible and rigorous approach to data analysis.     

Effects of work–family culture on employee well-being: Exploring moderator effects in a longitudinal sample

This present panel study had three aims: (1) to shed new light on the work–family culture (WFC)–well-being (work–family conflict, work engagement, job exhaustion) linkage by investigating lagged associations between the phenomena; (2) to consider the multidimensional nature of WFC by specifying whether its lagged effects on well-being would vary by its dimensions; and (3) to explore whether the positive aspects of WFC would prevent its negative ones from spilling over into employee well-being. The study was based on a 2-year longitudinal sample (N = 409) gathered among Finnish health care workers. The results showed that WFC was a bidimensional construct containing both negative (work–family barriers) and positive (work–family support) facets. Only its positive facets (work–family support) showed a lagged negative effect on the outcomes studied (work–family conflict). No signs of moderator effects were observed.     

What’s a coach to do? Exploring coaches’ perspectives of body image in girls sport

Adolescent athletes report body image concerns that negatively impact their sport experiences and participation. The coach’s perspective may be informative to how the context of sport perpetuates, supports, or protects from negative body image. Yet few coaches are represented in this area of research. The purpose of the present study was to explore coaches’ perceptions of body image in girls sport. Thirteen coaches with an average of 10 years of experience working with girls in primarily non-aesthetic team sports were interviewed. Based on inductive thematic analysis, coaches’ perceptions of the athletes’ body image concerns were reflected in four themes labelled (i) body image: the ‘elephant’ on the field (i.e., identifying the unspoken nature of body image), (ii) agents of body image in sport (i.e., parents, coaches, and media), (iii) skill over appearance (i.e., focusing on athletic skill and competence), and (vi) systemic strategies. This last theme offers several considerations for improving the sport context with a lens to improve body image. Of relevance, it was apparent that all coaches operationalized body image as predicated on appearance, body shape, and weight and this narrow simplistic perception could guide future programs and practices. Taken together, findings highlight the need to intervene with coaches to provide adequate support and education on body image in girls sport.     

Leroy C. Edozien: Self-determination in health care: a property approach to the protection of patients’ rights

Theoretical Medicine and Bioethics -     

“Weathering the storm:” Mothers’ and fathers’ experiences of parenting a preterm infant

Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers’ and fathers’ lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers’ and fathers’ experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.     

Framing cognition: Dewey’s potential contributions to some enactivist issues

It is well known that John Dewey was very far from embracing the traditional idea of cognition as something happening inside one’s own mind and consisting in a pictorial representation of the alleged purely external reality out there. His position was largely convergent with enactivist accounts of cognition as something based in life and consisting in human actions within a natural environment. The paper considers Dewey’s conception of cognition by focusing on its potential contributions to the current debate with enactivism. It claims that Dewey’s anti-substantial, continuistic, and emergentistic conception of the mind as a typically human conduct pulls the rug out of the idea of cognition as representation, as well as pushes the current discussion towards a serious reconsideration of representationalist assumptions about conceptuality and language. The paper emphasises that Dewey—differently from enactivists—frames the role of cognition within experience: he argues that cognition concerns those intermediate phases of our experiences of the world which are characterised by an indeterminate or troubled situation, because he claims that human beings’ interactions with their own environment are qualitatively richer and broader than cognition, including as they do many different and intertwined modes of experience. Finally, the author suggests that a coherent development of Dewey’s lines of thought should avoid rigid distinctions and hierarchies between lower and higher degrees of cognition in humans, which are still maintained in certain forms of radical enactivism. Differently, we should consider the impact of the cultural and broadly linguistic configuration of the human–environment even on perception, motor action, and affective sensibility.