Double helix of research and practice—developing a practice model for crisis resolution and home treatment through participatory action research

Over the last five years Crisis Resolution/Home Treatment (CR/HT) teams have been established in Norway. These teams provide an alternative to in-patient acute care services offering assessment as well as direct care. This paper addresses a method of examining the nature of practice models that are being developed in a CR/HT team incorporating the philosophy of open dialogue and the open lifeworld approach. The overall design of this research is action research applying a cooperative inquiry perspective. Multistage focus group interviews are used as a method for generating data, followed by phenomenological–hermeneutic approach in analyzing the data. Three themes were identified: (a) “keeping the dialogue open” referring to the emphasis of openness in dialogues and opening up for a variety of perspectives on what's going on; (b) “tolerance of uncertainty” referring to the need to accept and deal with uncertainty and multiplicity; and (c) “nurturing everyday life issues” referring to the emphasis on illustrating clinical situations in detail through remaking of stories. The on-going co-processes of research and practice was a double helix that links the happenings in the practice with the findings in the research revealing the knowledge in practice and further developing that knowledge

“Hitting the wall”: Lived experiences of mental health crises

Background : As Norway moves toward the provision of home-based crisis response, knowledge is needed about understandings of mental health crisis and effective ways of addressing crises within the home. Objective : To elicit and learn from service users’ experiences about the subjective meanings of crisis and what kind of help will be most effective in resolving mental health crises. Theoretical : A phenomenological-hermeneutic cooperative inquiry method was used to elicit and analyse focus group responses from mental health service users who had experienced crises. Results : Findings clustered into three themes: (1) Crisis as multifaceted and varied experiences; (2) losing the skills and structure of everyday life; and (3) complexities involved in family support. Conclusion : Several aspects of crises require an expansion of the biomedical model of acute intervention to include consideration of the personal and familial meaning of the crisis, attention to the home context, and activities of daily living that are disrupted by the crisis, and ways for the person and the family to share in and learn from resolution of the crisis

“It is not just about doing or saying the right things”: Working systemically with parents whose children are placed in public care

This article explores the possibilities of a systemic approach in the support of parents whose children are placed in public care. The article is based on a qualitative study interviewing six parents who have received support from Norwegian Family Counselling Services (FCS) and seven systemic family therapists from FCS. Both groups were interviewed individually and in focus groups. The findings suggest that parents experienced less judgement from therapists in FCS than from caseworkers in CPS. Even if it could be challenging, the systemic therapists found a systemic approach useful to help parents develop agency and make meaning of their lives, as the parents struggled to have agency and understand why their children were placed in care. The article concludes that systemic approaches can be useful in these cases, combined with appropriate child protection interventions as necessary