The use of qualitative methods in a case by case study of fifteen psychotherapies with children allowed for inquiries into how the working alliance can be established when children are involved. Therapy hours were recorded, and the children's, their caregivers' and the therapists' views about what happened during therapy were collected at the end of therapy and at one year follow-up. The referral to psychotherapy was a suspicion of sexual abuse. The results show how the working alliance is related to not only the child's, but also the caregiver's understanding of the ARTICLE KEY WORDS: therapeutic alliance child psychotherapy sexual abuse 1 at Bobst Library, New York University on February 5, 2015 qsw.sagepub.com Downloaded fromtherapeutic process. This includes sharing an understanding of the therapeutic goals and tasks, the emotional bond, and how the caregivers become involved and support their children's participation in therapy. An expanded understanding of Bordin's concept of the working alliance along two dimensions is suggested: the first one is from an adult to a child deduced understanding of the therapeutic process that bears in mind the child's capacity for understanding complex change processes, and the second is from a dyadic to a systemic understanding of the alliance.
This paper reports from a project investigating reactions within families when intra‐familial child sexual abuse was suspected, and family members’ responses to a therapeutic approach. Data were obtained from therapeutic sessions and follow‐up interviews with mothers, children and alleged perpetrators. Before treatment the mothers felt uncertain as to how to interpret the children’s unclear signs. The children had severe symptoms, but had seldom disclosed abuse. The alleged perpetrators were often not informed about the suspicions. The families were in a state of crisis and shock, and communication within the family was characterized by uncertainty about what to talk about and whether the suspicions should be shared. In most cases after treatment the conflicts had been reduced, the children had few symptoms, supervised contact had been established, and the clients were satisfied with the treatment. One conclusion is that therapeutic sessions, where family members share information about concerns and take part in the decisions of how to protect children, seem relevant and helpful to the clients in unclear abuse cases.
The aim of this study was to investigate aspects of nondisclosure in a sample of 55 student therapists, working within a group format of supervision. The study constituted one part of a larger study, with the other, parallel part addressing nondisclosure in supervisors. The participants were recruited from seven university-based training clinics in Norway and Denmark. The supervisees answered a questionnaire comprising 11 items about nondisclosure in supervision. The items were answered in a yes/no format, and the respondents were invited to provide examples and justifications for their answers to each item. The examples and justifications provided were analysed in accordance with Hill's guidelines for consensual qualitative research. The study confirmed significant nondisclosure by supervisees in a number of important areas. A high percentage found it difficult to talk about topics related to the supervisory relationship, fearing that they would hurt their supervisor or be met with criticism or interpretation. They were also reluctant to talk to their supervisors about professional matters, particularly related to the perceived incompetence of their supervisors and their expectancy of non-constructive criticism. They felt that their supervisors withheld feedback on their work, as well as advise on what to do, and would like more of this. Several of them thought of the lack of feedback as a conscious strategy helping the students to find out for themselves. A rather striking finding was that a high number of students experienced that the groups became more closed throughout the supervision, and blamed their supervisors for inadequate handling of the group process. This is an issue that needs further exploration.
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