How Couple Therapists Manage Asymmetries of Interaction in First Consultations

The study demonstrates how asymmetries in therapists' affiliations with spouses emerge and are addressed in couple therapy. A total of 4 video-recorded couple therapy first sessions were subjected to conversation analysis. The moment-by moment interactions that contribute to one sided affiliation, as well as the therapists' ways of managing such asymmetry, are described in detail. Asymmetries of affiliation regularly co-occur with the exclusion of 1 spouse from the interaction. Asymmetries of affiliation and participation can be addressed by 2 types of action by the therapist: (a) In counterbalancing moves, the therapist shifts their affiliation back to the spouse that was neglected. (b) In systemic couple-directed interventions, the therapist creates symmetry of affiliation and participation not only by attending to the individual spouses but also by addressing the couple as a single social unit. The observations are discussed in the light of the concept of split alliance and alliance ruptures, as well as in the context of research into affiliation as a generic property of social interaction.Peer reviewe

Przeżycia i emocje towarzyszące studentom pierwszego roku magisterskich studiów logopedycznych : nauczanie problemowe na Uniwersytecie Jagiellońskim

Nauczanie problemowe (ang. Problem-based Learning) wywarło w ostatnich latach duży wpływ na światową dydaktykę akademicką, w tym na dydaktykę logopedyczną. W Polsce zauważalnym trendem w kształceniu uniwersyteckim staje się przechodzenie od form tradycyjnych, czyli wykładów i ćwiczeń, do metody problemowej. Wciąż brakuje jednak badań adaptacji metody problemowej w warunkach polskich, w tym badań dotyczących odbioru takiej formy kształcenia przez studentów. W artykule przedstawiono badania jakościowe dotyczące przeżyć i emocji, jakie towarzyszyły sześciorgu studentom (próba celowa) pierwszego roku magisterskich studiów logopedycznych na Uniwersytecie Jagiellońskim podczas wyboru studiów w formacie metody problemowej, studiowania oraz planowania pracy w zawodzie logopedy. Fenomenologiczna analiza wywiadów pogłębionych pozwoliła wyłonić tematy wiodące i peryferyjne, które mogą stać się podstawą działań zmierzających do poprawy odbioru nauczania problemowego przez studentów logopedii.Problem-based Learning (PBL) has had a significant impact on tertiary education programs around the world in recent years, including programs in speech-language pathology. In Poland, the change from traditional teaching forms, such as lectures and classes, to problem-based tutorials has been a noticeable trend. There is a scarcity of research devoted to PBL adapta-tions in Poland, including research on student reception of this approach to education. The present study describes the experiences and emotions accompanying a purposive sample of six participants, first-year students of Master’s speech therapy studies at Jagiellonian University, at the time of enroll-ing in the PBL program, during their studies and when they consider their future work as speech therapists. The phenomenological analysis of in-depth interview data has made it possible to identify several lead and peripheral themes which can become the basis of actions aimed at improving stu-dent response to problem-based learning in speech pathology education

Practices of Claiming Control and Independence in Couple Therapy With Narcissism

Four couple therapy first consultations involving clients with diagnosed narcissistic problems were examined. A sociologically enriched and broadened concept of narcissistic disorder was worked out based on Goffman's micro-sociology of the self. Conversation analytic methods were used to study in detail episodes in which clients resist to answer a therapist's question, block or dominate the development of the conversation's topic, or conspicuously display their interactional independence. These activities are interpreted as a pattern of controlling practices that were prompted by threats that the first couple therapy consultation imposes upon the clients' self-image. The results were discussed in the light of contemporary psychiatric discussions of narcissism; the authors suggest that beyond its conceptualization as a personality disorder, narcissism should be understood as a pattern of interactional practices.Peer reviewe

The experience of trauma and the attachement perception : a comparison of hospitalized adolescents with untreated ones

Celem pracy była próba przedstawienia powiązań pomiędzy doświadczeniem traumy w relacji z rodzicami a percepcją więzi u młodzieży, która w związku z kryzysem psychicznym została hospitalizowana w stacjonarnym oddziale psychiatrycznym. Określenie różnic było możliwe dzięki porównaniu grupy klinicznej z grupą młodzieży nieleczonej. Istotne było również zastosowanie narzędzia dotyczącego wydarzeń traumatycznych (CTQ).Aim: To bring us closer the problem of interaction between the experience of trauma in relationship with parents and perception of attachment of adolescent patients from a psychiatric hospital. To compare two groups - clinical with untreated adolescents Method: Seventy people were examined. The clinical group consisted of thirty inpatients of child and adolescent psychiatric hospital. The control group consisted of forty secondary school students. The method was based on the use of questionnaires to survey the perception of relationships (PBI) and trauma (CTQ). Results: The study showed difference in traumatic experiences between adolescent patients of a psychiatric hospital and the control group. The study identified more emotional neglect in clinical group. The study identified a slight difference in attachment perception. The study indicated connection between trauma and the perception of attachment. Conclusions: The reporting of trauma, signification of traumatic experience and perception of parental protection are relevant factors in risk of psychiatric hospitalization in adolescenc

Mutual assessment of their marital relationship by parents of female patients with eating disorders

Aim: The goal of this study was to assess the perception of marital relationship and its mutual connections by parents of (female) patients diagnosed with eating disorders. Data from: 54 (female) patients diagnosed with restrictive anorexia nervosa (ANR), 22 with binge-purge anorexia nervosa (ANBP), 36 with bulimia (BUL), and two control groups: 36 (female) patients diagnosed with depressive disorders (DEP) and 85 Krakow schoolgirls (NOR). Material and method: The study employed the Dyadic Relations Scale, a part of the Family Assessment Measure (Polish version). Results: Wives in the BUL group, compared to wives in the NOR group, rated their husbands worse when assessing their husbands in terms of how well they functioned in the marital relationship, their performance of duties, affective involvement, and the integrity of values and rules of conduct. Wives in the ANR group, compared to wives in the NOR group, negatively rated the affective involvement of their husbands in the marital relationship. Husbands in the DEP group, compared to husbands in the NOR group, rated their wives worse when assessing their wives’ general functioning in the marital relationship, degree of communication within it, degree of understanding, how well they performed their spousal duties, and the coherence of their system of values and rules of conduct. The image of the marital relationship held by parents of Krakow schoolgirls was characterized by a strong correlation, in contrast to the image of the relationship held by parents of (female) patients, regardless of the nature of the diagnosis. Conclusions: Comparison of the results of parents of (female) patients with eating disorders and parents of (female) patients with a diagnosis of major depressive disorder revealed no difference in the image of the marital relationship, whether in the mutual assessment of spouses towards each other or in connection with the assessments

Family therapy process : works on the Polish versionof SCORE-15 tool

Aim. The aim of the paper is to demonstrate progress of the works on the Polish version of SCORE-15 and the results of the preliminary data analysis of changes in the process of family therapy, obtained with this tool. The works on the Polish version, ongoing since 2010, were inspired by the Research Committee European Family Therapy Association EFTA. Since the Polish version of SCORE-15 will be make public and published on EFTA website in the near future, therefore, it is important that people interested in the tool know the context of its development. Methods. The Polish version of SCORE-15, the tool designed to examine the process of family therapy, was used. Results. The comparison of the results obtained by family members before the first family session and before the fourth one and psychotherapists’ assessments show that the perception of the weight of the problem with which the family members came to therapy is indeed significantly lower already after three sessions of family therapy. Additionally, the obtained results show great coherence of the assessment of the family therapy progress in families and their therapists. Conclusions. The preliminary analysis of data obtained during the research project conducted in Outpatient Family Therapy Clinic, Department of Adult, Child and Adolescent Psychiatry, University Hospital in Krakow and in Laboratory of Psychology and Systemic Psychotherapy, Department of Child and Adolescent Psychiatry, Jagiellonian University Medical College between 2010 and 2014 revealed that SCORE-15 is a useful tool in research on changes in the systemic family therapy process

The association between self-image and defence mechanisms in a group of adolescent patients receiving psychiatric treatment

Aim. The aim of the study was to explore the relationship between various areas of selfimage and defence mechanisms in adolescents. The study included a division into groups according to whether or not they were receiving psychiatric treatment. Methods. Data were obtained from two groups: a clinical group (30 persons), consisting of adolescent patients of the Adolescent Inpatient Ward of the Child and Adolescent Psychiatry Clinic and a control group (40 persons), adolescents attending upper secondary school. The Defence Style Questionnaire DSQ-40 and the Offer Self Image Questionnaire were used in the study. Results. Results showed no differences, in the maturity levels of the defence mechanisms, between the two groups. Subjects from the clinical group had a significantly lower self-image of themselves than subjects from the control group.. In both groups, the use of mature defence mechanisms was accompanied by a positive self-image, while the use of less mature defence mechanisms was associated with a lower self-image. Comparison of the groups revealed different relationships between the aspects of self-image and used defence mechanisms, in particular the mechanism of projection. Number of significant correlations was greater in the clinical group. Conclusions. In the context of lower self-image, the study revealed the importance of such defence mechanisms as projection, acting out, somatization or schizoid fantasies. The obtained results seem to confirm a hypothesis that the assessment of the maturity of defence mechanisms in the period of adolescence is less clear and clinically useful

The paradox of disengagement : Bodily displays of inattention in couple therapy

Using concepts developed by Goffman and the theory of inter-corporeality, this paper describes non-speaking spouses' responses to complaints made about them by the other spouse in the context of couple therapy first consultations. While the turn-taking system of couple therapy effectively precludes the possibility of a direct verbal response, non-speaking spouses often display bodily their disengagement from their spouse's talk. Using multimodal conversation analysis as the method, we show the repertoire of such disengagement behaviors and trace the moment-by-moment contexts in which they arise. While disengagement behaviors embody their producer's inattention to their spouse's talk, at the same time, they are, paradoxically, interactional moves produced in the presence of others, conveying their producer's negative stance to the ongoing talk. We argue that the timing of these disengagement practices involves anticipation of the direction of talk: non-speaking spouses display disengagement in moments when the speaking spouse's talk takes a direction toward an intensification of complaints about them.Peer reviewe

Changes in the clinical picture of conduct disorders in adolescents hospitalised for mental health reasons in 1990–2015. A comparative study

Aim: The study has been aimed at comparing the group of patients diagnosed with conduct disorders hospitalised at the Department of Adolescent Psychiatry of the University Hospital in Krakow in the period of 1990–1991 with the corresponding group of patients hospitalised in the period of 2014–2015, in terms of the clinical picture, family status and the frequency and characteristics of their hospital stays. Material and method: The medical records of patients hospitalised in the period of 1990–1991 and 2014–2015 diagnosed with conduct disorders were used as the research material. The records were analysed in terms of the demographic and hospitalisation data, the patients’ care status, their exposure to abuse as well as selected symptoms related to conduct disorders in adolescents. Results: The obtained results have demonstrated the number of hospital admissions due to conduct disorders to have increased over three times over the period analysed. Also, the medical records covering the period of 2014–2015 showed a statistically significant greater number of patients with an unstable care status, greater prevalence of suicidal attempts and greater prevalence of self-harming behaviours compared to the medical records covering the period of 1990–1991. Conclusions: The observed increased frequency of hospital admissions of adolescents with conduct disorders may be associated with the increased prevalence of impulsive self-destructive behaviours such as self-harm and suicidal attempts in this population. The decline in care stability (despite the lack of clarity concerning the extent and the nature of this phenomenon in a wider population) and the associated decreased efficiency of the care system in the case of a crisis such as exacerbating impulsive self-destructive behaviour in adolescents create circumstances in which interventional psychiatric hospitalisation becomes inevitable. In light of the obtained results and the preliminary hypotheses regarding their causes, an additional question arises regarding the efficiency and availability of outpatient mental health care, auxiliary mental health services for patients from the studied population and their families, who should be considered the forefront of the possible and necessary therapeutic measures to be taken