Watson, Rachel (2017) An examination of the ways in which power arises, and is managed, between systemic psychotherapists and parents working together in a social care context. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

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Abstract

This study aims to understand and describe some of the ways in which power arises, and is managed, between clinicians who are systemic psychotherapists and the parents they are working with in a social care context. Examining their interactions in detail, particularly their talk, aims to do this. Interest in the questions arose from my own practice as a systemic psychotherapist working in children's social care, with a focus on complex neglect, where I identified challenges to ef[ective practice that were related to that context. My initial ideas were about power being a particularly salient issue in each of these challenges in one way or another, and I wanted to examine and extend this area of interest using qualitative research methods. Conversation Analysis (CA) is used here to examine the power dynamics at the heart of therapeutic work in this social care context. The primary overall objective of the study is to understand how power dynamics are managed to enable interventions aimed at reducing risk in families to be effective, by answering the following questions: L What is happening in moment-by-moment interactions between parents and systemic psychotherapists talking together, when the talk is taking place because of issues regarding risk to children? How are power dynamics being spoken about, negotiated, or managed in this high-risk context? 2. What is happening in moment-by-moment interactions between parents and systemic psychotherapists when talk that may lead to change, and reduce the risk to children, can be identified and seems to be being mutually created, understood and agreed between them? How are power dynamics being spoken about, negotiated, or managed in this particular high risk context? I examine 3 sessions, with 3 different sets of parents and systemic psychotherapists, in detail. I argue that power can be made useful when it is arising as authority that is jointly created between parents and therapists. I contend that the findings show how systemic approaches and practice can uniquely contribute to safeguarding work in contexts where issues of power prevail. I consider how the systemic practitioners in the study show their ability to deal with the power differentials arising, and develop relationships, that lead to effective and ethical working. I show how combining systemic and CA frameworks allow these abilities to be seen, and identified. These abilities are reflective of the systemic theoretical base, and systemic techniques enable these theories to be put to use. I show how these elements of practice enable complex processes between people to be negotiated. I argue how systemic approaches could contribute to mentalization-based approaches more than they do presently, and specifically when working with 'hard to reach' families. I argue that other therapeutic approaches such as these would benefit from dealing with the concept of power more explicitly, and benefit from understanding and utilising systemic approaches and practices in more depth to do so. I also use this understanding of what is happening in the relational systemic approach to examine the often-used concept of 'disguised compliance'. I make an argument for a more relational use of the term than is sometimes suggested. All of the above areas have implications for practice, and for the training and supervision of systemic psychotherapists, and other practitioners working in a social care context.

Item Type:	Thesis (DSysPsych)
Additional Information:	A thesis submitted in partial fulfilment of the requirements of the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust for the Professional Doctorate in Systemic Psychotherapy
Uncontrolled Keywords:	Professional Doctorate in Systemic Psychotherapy, Qualitative Research, Conversation Analysis, Safeguarding
Subjects:	Couple & Family Therapies > Systemic Family Therapy Psychological Therapies, Psychiatry, Counselling > Patient/Therapist Interaction Research, Tests, Assessments > Psychotherapy Research Social Welfare > Social Work
Department/People:	Children, Young Adult and Family Services Research
Related URLs:	Organisation
URI:	https://repository.tavistockandportman.ac.uk/id/eprint/1843

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