Parenting After a Natural Disaster: A Qualitative Study of Norwegian Families Surviving the 2004 Tsunami in Southeast Asia

How do parents support their children after a high-impact disaster? To answer this question, face-to-face interviews were conducted with 51 Norwegian parents. These parents and children were all severely exposed to the trauma of the tsunami disaster. The analyses show how parents interpret their children’s signs of distress, as well as their own strategies of support in the aftermath. The main strategies described by the parents were watchful waiting, careful monitoring of the children’s reactions and a sensitive timing when providing support. Such monitoring, and interpretation of signs of distress, served as an aid for the parents in determining what needs their children had and what support they therefore needed to provide. A range of support strategies were employed, including re-establishing a sense of safety, resuming normal roles and routines, and talking to their children. Parents who were themselves severely impacted by the disaster reported a reduced ability to assess their children’s reactions and thereby were unable to provide optimal care in the aftermath. Interestingly, the parents’ support strategies mirror the early intervention recommendations put forward in the NICE guidelines and in the Psychological First Aid guidelines which is a well accepted and promising practice for helping children after disasters.     

Coming to an end: A case study of an ambiguous process of ending psychotherapy

Aim: When the duration of therapy is not preset and the outcome is a matter for negotiation, the decision to end psychotherapy will be an experiential concern for the two participants. This case study draws attention to how ambiguities may be settled in a process where ending is initiated by the therapist and resisted by the client. Method and analysis: The actual case was strategically selected as exceptional owing to a combination of circumstances. The client and the therapist had developed a ‘good enough’ alliance (WAI) and reached a ‘good enough’ outcome (OQ‐45), and still the client felt she was far from finished. A close inspection of interactional data in sessions together with both clients' and therapists' reflections in post‐therapy interviews elicited information about both substantial content and structural aspects of this complicated process of ending. Findings and discussion: The discrepancy between therapist and client was not addressed, but rather postponed and revisited again later. Structural elements like preparations for a break for vacations and reducing the frequency of sessions were used to test experiential qualities, such as how the client managed life without therapy. Carefully preserving a ‘good enough’ emotional bond through the negotiations seemed important to both parties. Significantly, the client's autonomy was interpreted as the final proof of improvement and the client came to a point where she could affirm that she had got better only by accepting that treatment was coming to an end.     

Predictors of posttraumatic growth following bone marrow transplantation for cancer.

There is growing recognition that the experience of cancer can have a positive as well as a negative psychological impact. This longitudinal study sought to identify predictors of posttraumatic growth among cancer patients (N=72) undergoing bone marrow transplantation. Greater posttraumatic growth in the posttransplant period was related to younger age; less education; greater use of positive reinterpretation, problem solving, and seeking alternative rewards as coping strategies in the pretransplant period; more stressful appraisal of aspects of the transplant experience; and more negatively biased recall of pretransplant levels of psychological distress. Findings partially support J. A. Schaefer and R. H. Moos's (1992) model of life crises and personal growth and also suggest that temporal self-comparisons contribute to the experience of posttraumatic growth.