Exploring the Therapeutic Family Intervention of Commendations

Abstract

Offered in this article are interpretations that emerged in a qualitative, interpretive study focused on the family intervention called a "commendation." The tradition of philosophical hermeneutics informs and shapes the analysis of the data. Research participants include a heterosexual couple and a nurse who engaged in therapeutic conversations focused on difficulties with Internet pornography. Data sources include videotapes of clinical sessions, documentation, and research interviews. Isolated segments of clinical videotape are shared with the couple to prompt their memory of commending practices that emerged in clinical sessions. Commendations are not experienced by this couple as gentle and warm but instead as extremely provocative, albeit constructive. This study illuminates the complex, contextual nature of commending practice and suggests that the noticing of strengths and resources contains much more than the spoken word.

Percepções da família da criança com doença crônica frente às relações com profissionais da saúde

“…It is carried out in the context in which s/he can recognize how the family perceives and acts in the world, its beliefs, values and needs, elements that guide care. Therefore, the challenge is for professionals to recognize that communication is itself a therapy (18) .…”

“…They favor the discovery of capabilities and resources, making their potential known, and intentionally using them. Therefore, professional interactions can promote resilience (3,18) .…”

“…To promote this sharing of suffering and support, the therapy of group meetings is recommended, albeit little used (18) : one international study states that its use is only 4.8% (19) . Health professionals should value these spaces with the intention of amplifying social support (20) .…”

The Illness Beliefs Model

“…Family Systems Nursing values collaborative, nonhierarchical relationships between the patient/family and nurse and a belief in the legitimacy of multiple realities (Maturana & Varela, 1992). A strengths-based orientation of the nurse moves the therapeutic conversation toward individual and family competencies and strengths rather than deficits and pathology (Houger Limacher & Wright, 2006). The uniqueness of the IBM within the Family Systems Nursing framework is a focus on the beliefs at various systems levels with intent to soften illness suffering through the interventions of creating a context for changing beliefs, distinguishing illness beliefs, challenging constraining beliefs, and strengthening facilitating beliefs (Bell & Wright, 2011;Wright & Bell, 2009).…”

Relationships: The Heart of the Matter in Family Nursing

“…We focused our early work on examining the process of therapeutic change in family nursing practice (Wright et al, 1996), and since then a number of investigators have also studied the nature and process of family nursing interventions by asking what is happening within or "inside" the interventions in the nurse-family relationship: Fabie Duhamel (Duhamel, 1994;Duhamel & Dupuis, 2004;Duhamel & Talbot, 2004), Lori Houger Limacher (Limacher, 2003(Limacher, , 2008Limacher & Wright, 2006), Deborah McLeod (McLeod, 2003McLeod & Wright, 2008), Nancy Moules (2000, 2002), Dianne Tapp (1997, Carole Robinson (Robinson, 1994(Robinson, , 1998Robinson & Wright, 1995), and Lorraine Thirsk (2009).…”