Family therapists’ experiences of working with adolescents who self-harm and their families: A grounded theory study

Richardson, Colette (2014) Family therapists’ experiences of working with adolescents who self-harm and their families: A grounded theory study. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

PDF (Richardson (Family))
Richardson, C - Family.pdf - Published Version

Download (2MB) | Preview


This study is a qualitative enquiry into family therapists’ experiences of working with young people who self-harm and their families. To date, in spite of self-harm being a serious public health concern, there is relatively little exploration of the subject in family therapy literature. The study attempts to describe, understand and illuminate family therapists’ experiences: the therapeutic issues encountered, the stances adopted in response to the issues encountered, and the emotional impact on the therapist of working with this client group. A total of nine experienced family therapists participated in semi-structured interviews. The study employed a grounded theory method for data analysis. The analysis yielded a theory of therapists’ experiences that included a Core Category and three Main Categories. The Core Category that emerged was: •Cultivating the Practice of Hope – Withstanding the Pull to Hopelessness. The three Main Categories were: •Making the Situation Safe •Conversing Therapeutically – The Practice of Hope •Team and Organisational Processes: Supporting Therapists. The Core Category is the central feature of this theory. It proposes that the central concern for the therapist is how to stay engaged with the family and the young person in the context of serious risk of self-harm and in situations where change is difficult to achieve and hopelessness can pervade. The therapist has to try to understand and make sense of family members’ distress, and be touched by and open to their feelings of despair and hopelessness without becoming overwhelmed and despairing themselves. The therapist response to this dilemma is the stance of hopefulness. It is both a therapeutic stance and orientation, and is enacted in practice through finding ways to cultivate hope in the therapeutic encounter. While the Core Category is the central ‘story’ the three Main Categories are linked to the Core Category. The Main Category, Making the Situation Safe describes the initial stage of the work, with its focus on ensuring the safety of the young person. The Main Category, Conversing Therapeutically – the Practice of Hope describes how the therapists enacted the ‘practice of hope’. The Main Category, Team and Organisational Processes: Supporting Therapists describes how the context in which the therapists work, the nature of relationships, the team and organisational structures, play a critical role in supporting therapist hope, so that they can withstand the pull to hopelessness. This study aims to make a contribution towards articulating a framework for family therapy with adolescents who self-harm and introduces a new vocabulary – the language of hope and hopelessness.

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
Subjects: Children, Young People and Developmental Pyschology > Adolescents- Psychology
Disabilities & Disorders (mental & physical) > Self Harm
Couple & Family Therapies > Systemic Family Therapy
Psychological Therapies, Psychiatry, Counselling > Family Therapies
Research, Tests, Assessments > Grounded Theory
Department/People: Children, Young Adult and Family Services

Actions (Library Staff login required)

View Item View Item