Clinical child psychology and psychiatry · 2019
Obstacles and facilitators of therapeutic alliance among adolescents with anorexia nervosa, their parents and their psychiatrists: A qualitative study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Sibeoni Jordan, Verneuil Laurence, Poulmarc'h Léa, Orri Massimiliano, Jean Elise, Podlipski Marc-Antoine, Gérardin Priscille, Révah-Lévy Anne
Аннотация
BACKGROUND: Therapeutic alliance is one of the most important aspects of treatment of adolescents with anorexia nervosa. Little is known about the facilitators and obstacles of its process in this situation. We aimed to explore the experience of therapeutic alliance in inpatient treatment among adolescents with anorexia nervosa, their parents and their psychiatrists.
METHODS: This qualitative study, using semi-structured interviews, took place in France. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic.
RESULTS: Forty-one participants were included, 15 teenaged girls, 18 parents and 8 psychiatrists. Analysis showed two themes: (1) what facilitates an alliance in treatment - with four facilitators: (a) human qualities, (b) an active role in the treatment, (c) taking time and (d) taking care of the entire family and (2) what impedes an alliance in treatment with four obstacles: (a) being too close or too distant, (b) focusing on weight, (c) control and constraints and (d) psychiatrization.
CONCLUSION: Collaborative work between paediatricians and psychiatrists could facilitate therapeutic alliance with parents. Definition of therapeutic alliance in this situation should be enlarged to include the adolescent-parent relationship. It is necessary to construct specific items to integrate these specific aspects to existing scales.
METHODS: This qualitative study, using semi-structured interviews, took place in France. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic.
RESULTS: Forty-one participants were included, 15 teenaged girls, 18 parents and 8 psychiatrists. Analysis showed two themes: (1) what facilitates an alliance in treatment - with four facilitators: (a) human qualities, (b) an active role in the treatment, (c) taking time and (d) taking care of the entire family and (2) what impedes an alliance in treatment with four obstacles: (a) being too close or too distant, (b) focusing on weight, (c) control and constraints and (d) psychiatrization.
CONCLUSION: Collaborative work between paediatricians and psychiatrists could facilitate therapeutic alliance with parents. Definition of therapeutic alliance in this situation should be enlarged to include the adolescent-parent relationship. It is necessary to construct specific items to integrate these specific aspects to existing scales.