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- Armelius, K., et al.
(författare)
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Staff members' feelings toward psychiatric patients related to their own and the patient's self-image and gender
- 2003
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 44:2, s. 69-77
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Tidskriftsartikel (refereegranskat)abstract
- The relation between staff members' feelings toward a patient and their own and the patient's self-image in different gender combination groups was studied. Staff at 16 psychiatric treatment homes for patients with severe psychopathology reported their feelings toward their patients on a number of occasions. At the start of treatment, both staff members and patients rated their self-images using the Structural Analysis of Social Behavior (SASB). Male staff seemed less influenced by the patient, with their feelings relating mainly to aspects of their own self-image, while the feelings of the female staff were more related to the patient's self-image. The patient's diagnosis was less important for a staff member's feelings than that member's self-image. Generally, the relation between feelings and self-image was stronger for negative feelings. The results point to the importance of understanding more about the influence of staff members' self-structure on their negative feelings toward their patients and how this relates to both the staff member's and patient's gender.
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2. |
- Holmqvist, Rolf, 1948-, et al.
(författare)
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Associations between psychiatric patients' self-image, staff feelings towards them, and treatment outcome
- 2004
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 128:1, s. 89-102
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Tidskriftsartikel (refereegranskat)abstract
- Interpersonal theory, as well as relational models of psychoanalytic and cognitive therapy, posits the importance for positive treatment outcome of the therapist's becoming emotionally involved in the patient's interpersonal patterns. Using the same data as in this study, we have previously found associations between psychiatric patients' self-image and the staff's feelings towards them, and differential associations between staff feelings and outcome for different diagnostic groups. The purpose of the present study was to analyze potential connections between patients' self-image, staff feelings, and outcome. Twice a year, staff at small psychiatric units reported their feelings towards 63 psychotic and 21 borderline patients who had rated their self-image at the beginning of the treatment using the Structural Analysis of Social Behavior (SASB) introject and parent images. Feelings reported on the two first occasions at the beginning of the treatment were used. Outcome was assessed after 5 years. Correlation analyses found different associations between patient self-image and staff feelings for patients with favorable and less favorable outcome. The results indicated for psychotic patients associations between positive outcome and less distant staff feelings connected with the patient's freedom-giving introject, less unfree staff feelings connected with a negative image of mother and less positive feelings connected with a positive image of father. For the borderline patients, positive outcome was associated with the fact that a negative image of mother did not evoke helpful staff feelings, a positive image of the patient himself or herself did not evoke helpful staff feelings and a controlling image of father-evoked distant feelings. © 2004 Elsevier Ireland Ltd. All rights reserved.
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3. |
- Holmqvist, Rolf, 1948-
(författare)
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Associations between staff feelings toward patients and treatment outcome at psychiatric treatment homes
- 2000
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Ingår i: Journal of Nervous and Mental Disease. - : Ovid Technologies (Wolters Kluwer Health). - 0022-3018 .- 1539-736X. ; 188:6, s. 366-371
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents, as part of a national Swedish research project, a study of associations between staff feelings toward patients and treatment outcome at 23 small psychiatric inpatient units. The outcome was measured with a composite scale based on structured interviews. Staff feelings were reported on a feeling checklist. Few and scattered correlations were found between staff feelings and treatment outcome when the whole group of patients was analyzed together. More meaningful patterns were found when data for psychotic and borderline patients were analyzed separately. For psychotic patients, positive outcome was associated with low levels of negative feelings throughout treatment. For borderline patients, positive outcome was associated with negative feelings at the beginning of treatment, followed by strong positive feelings in the later part. Staff feelings were more strongly associated with outcome for borderline patients than for psychotic patients. Patients with different structural diagnoses need different kinds of staff 'feeling milieus'.
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4. |
- Holmqvist, Rolf, 1948-, et al.
(författare)
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Countertransference feelings and the psychiatric staff's self-image
- 2000
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Ingår i: Journal of Clinical Psychology. - 0021-9762 .- 1097-4679. ; 56:4, s. 475-490
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a study of associations between psychiatric staff's habitual feelings towards their patients and the staff's self-image. At 22 psychiatric treatment homes for psychotic and other severely disturbed patients, 163 male and female staff recurrently rated their feelings towards the individual patients on a feeling checklist. At the beginning of the study period, they also rated different aspects of their self-image (the introject and the mother and father images) using Structural Analysis of Social Behavior (SASB). Over time and over patient, correlations between the individual staff ratings on the feeling checklist and ratings on the SASB were studied for all staff and for male and female staff separately. The analyses showed a number of associations between the staff's feelings and aspects of their self-image. Staff who habitually tended to feel helpful and autonomous towards their patients had a more positive image of mother, whereas staff who tended to feel more rejecting, unhelpful, and controlled had a combination of negative images of mother and father and a protecting introject. Some notable differences between male and female staff were found. Overall, self-image accounted for larger proportions of the male staff's feelings than of the female staff's. Negative feelings for male staff were associated more-with a critical father image, whereas for female staff these feelings were associated more with an image of the father as a freedom giving. (C) 2000 John Wiley and Sons, Inc.
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6. |
- Holmqvist, Rolf, 1948-
(författare)
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On the importance of congruence between psychiatric staff and patient about the patient's status.
- 2000
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Ingår i: International Journal of Psychiatric Nursing Research. - 0968-0624. ; 5:3, s. 622-637
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the usefulness of a method for comparing the congruence of the staff's and the patients' perceptions of the patients' well-being. At a psychiatric rehabilitation clinic, a comparison was made between the patients' and the staff's views of the patients' well-being. The staff and the patients completed questionnaires about the patients' well-being on ten occasions during a 5-year period. Through a principal components analysis of the questionnaire scores, two conceptually similar dimensions (health-illness, and contact-distance) were identified on each set of scores. The staff and patient ratings on the two dimensions could thus be compared. During the time of the study, a reorganisation of the clinic was made. This made it possible to compare older and newer units. The results indicated that the staff at long-existing units rated the patients' health as lower than the patients did, whereas the staff at newer units rated the patients' health as better than the patients did. The staff at units where the patients lived in their own apartments saw the patients as less contact-seeking than the patients did, and the staff at in-patient units saw the patients as more contact-seeking than the patients did. The two-dimensional PC-models made it possible to visually illustrate the developments for three individual patients. The results thus showed that the method is useful for research purposes as well as for clinical evaluations. In the final section, problems and assets of the method are discussed.
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7. |
- Holmqvist, Rolf, 1948-, et al.
(författare)
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Patients' relationship episodes and therapists' feelings
- 2002
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 75:4, s. 393-409
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Tidskriftsartikel (refereegranskat)abstract
- The idea that psychotherapists' feelings may reflect some aspect of the content in the patients' material has long been clinically accepted but on the whole poorly systematically studied. The aim of this study was to analyse associations between relationship episodes told by patients at evaluation interviews, and therapists' subsequent feelings towards the patients. In total, 28 psychotherapies with nine psychotherapists were studied. Before therapy started, the clients were interviewed separately by the eventual therapist and a second interviewer and six relationship episodes were written down by the interviewers. During the therapy, the therapists reported their feelings on a 'feeling checklist' after each therapy session. In a first analysis, the relationship episodes were categorized according to the CCRT system. The results indicated only scattered associations between CCRT categories and therapist feelings. The results were, however, difficult to interpret as it was found that the therapists' feeling patterns were quite homogenous for each therapist. Considering this, qualitative analyses were made of six therapies carried out by two therapists. These analyses revealed different but theoretically plausible patterns between the feelings attributed to the persons in the patients' relationship episodes and the therapists' subsequent feelings towards the patients. The results were interpreted as a confirmation of the purported relations between patient relationship episodes and therapist feelings, but also as pointing to the need to develop the understanding of these patterns. It seems particularly important to emphasize the importance of the therapist's own habitual feeling patterns when the impact of the patient's internalized relationship patterns on countertransference reactions is evaluated.
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8. |
- Holmqvist, Rolf, 1948-
(författare)
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Patterns of consistency and deviation in therapists' countertransference feelings
- 2001
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Ingår i: Journal of Psychotherapy Practice and Research. - 1055-050X. ; 10:2, s. 104-116
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Tidskriftsartikel (refereegranskat)abstract
- The author addressed the question of consistency in psychotherapists' countertransference feelings. Research findings have indicated that the therapist's own personal feeling style may be more important than the patient's impact on the therapist's feelings. In this study, the feelings of 9 psychotherapists toward 28 patients were followed by using checklist self-report after each session during moderately long psychotherapies. ANOVAs and discriminant analyses showed that the therapists were very consistent in their feeling style over different patients and over time. The consistency in feelings toward the individual patients was smaller. Deviations from consistency are analyzed, and their importance for the understanding of different aspects of the countertransference is discussed. It is suggested that a meaningful use of the countertransference concept ought to be based on systematic identifications of recurrent and deviant patterns in the therapist's reactions.
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9. |
- Holmqvist, Rolf, 1948-, et al.
(författare)
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Psychiatric patients' self-image and staff feelings towards them related to gender combinations
- 2004
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Ingår i: Psychoanalytic Psychotherapy. - : Informa UK Limited. - 0266-8734 .- 1474-9734. ; 18:2, s. 182-201
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Tidskriftsartikel (refereegranskat)abstract
- Psychiatric patients' influence on therapists' feelings has received much clinical attention but scant interest among empirical researchers. In this study, the staff at 25 small psychiatric treatment units for mainly psychotic patients reported their feelings towards the patients twice a year over 5 years. At intake, the patients completed the self-rating version of the Structural Analysis of Social Behavior (SASB) protocol, a circumplex model intended to capture internalized perceptions of self and others. The instrument included ratings of the introject and ratings of how the individual remembered that mother and father had treated him or her in childhood. Correlations between the patients' SASB scores and the staff members' average feelings towards the patients were assessed. The associations varied in the different gender combinations, but some overarching patterns were found. Patients scoring high on both the spontaneous and the controlling introject evoked accepting staff feelings, and patients reporting low scores on both these SASB aspects evoked rejecting feelings. These associations were interpreted as reflecting influence from the patients' engagement in and struggle with themselves on the treatment process. Staff identification with a parent figure was particularly evident in the female staff-male patient combination, where the patient's positive image of mother was associated with positive staff feelings towards the patient. © 2004 The Association for Psychoanalytic Psychotherapy in the NHS.
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