No abstract

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.

Personal narratives from ten children who all claimed to have been sexually abused were analyzed and compared to narratives of stressful events the children produced in therapy sessions. The narratives were compared to each other along the following dimensions: level of elaboration, narrative structure, contextual embeddedness, and causal coherence. Each child's attempt to find purpose and resolution was also analyzed. The stressful event narratives were generally more elaborate, more structured, and more contextually embedded and coherent than the sexual abuse narratives. Very few of the sexual abuse narratives contained resolutions or causal connections that are considered important for contributing to meaningmaking. It is suggested that in order to understand the difficulties children face, a narrative perspective needs to include the emotional significance of the events to be narrated, and a trauma perspective must include the cultural impact of the event. A theory that intends to understand children's narration difficulties should encompass both these perspectives. (Narratives, Child sexual abuse, Traumas) Narrative Inquiry : (), -.  - ⁄ - - © John Benjamins Publishing Company  Svein Mossige et al.

The high drop-out rate and modest outcome for men in treatment for intimate partner violence (IPV) have highlighted the question of how therapists can establish an effective working alliance with these clients. The aim of this study was to conceptualize the variety of ways in which male clients using violence against a female partner might present themselves to form a working alliance that might appeal to them. We studied how 20 men voluntarily in individual IPV treatment contributed at the beginning of therapy to forming an alliance with therapists skilled in such treatment. The first therapy session in 10 drop-out and 10 completed cases was transcribed verbatim and analyzed qualitatively, following guidelines drawn from the constructionist grounded theory. The analysis resulted in a conceptual model of gateways and invitations to an alliance. Gateways are themes that have the potential to open a path toward collaboration on personal change. Each of the three gateways identified, comprised solide and weak invitations to an alliance: (a) presenting reasons for seeking treatment-as their own choice, as avoidance, or as a mistake; (b) presenting notions of change-as their own need to change their violent behavior, as ambivalence toward the project, or as a need to change the partner; and (c) disclosing and describing violence-as a personal narrative, as a scene, as a fragment of their life, or as something else. Implications for therapists' understanding of clients' motivational goals, negotiation of alliance, and disclosure of violence early in therapy are discussed.