L’importance de la voix pour accompagner, accueillir et résonner avec le patient dans le travail transculturel

IF 0.5 4区 医学 Q4 PSYCHIATRY Annales medico-psychologiques Pub Date : 2024-09-01 DOI:10.1016/j.amp.2024.05.009
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Abstract

The human voice is an often underestimated tool in clinical practice and psychosocial studies and research. Paradoxically, despite being a primary means of expressing emotions and sharing intimate feelings, the human voice is often neglected in clinical psychotherapeutic work. Despite its importance for psychotherapists, psychiatrists, and caregivers, a lack of theories and deeper explorations of its potential impedes its explicit utilization in the mental health care environment. This article focuses on the importance of the caregiver's voice when working with patients from different cultures and languages, particularly in transcultural clinics, such as transcultural consultations, which emphasize the therapeutic characteristics of the voice that clinicians often overlook. The authors examined the clinical intuition of experienced caregivers, including nurses, psychologists, and psychiatrists, who work with patients from diverse cultural and linguistic backgrounds. The prosody and musical elements of the spoken voice play a particularly important role in these clinical settings that transcend language barriers. Through a qualitative inductive study involving six experienced clinicians, the authors developed themes highlighting the importance of the caregiver's voice. These themes were based on the experiences and clinical anecdotes of participants specializing in transcultural therapeutic approaches, accustomed to collaborating with interpreters who bridge the language divergence between French and the patients’ native languages. The transcultural consultation constitutes a unique therapeutic approach comprising a team of co-therapists with diverse cultural backgrounds and languages, along with patients, their family members, and professionals providing administrative, medical, or psychological help. The principal therapist is responsible for setting the stage for the consultation and may invite co-therapists to share mental images or proposals while listening to the patient. In this group setting, attentiveness to the voice is crucial, as it provides the therapist with direct audible cues from the patient, and it is also what the patient receives from the caregivers. Before language is translated by an interpreter, the patient perceives the sound of the therapist's voice, its musicality, prosody, and conveyed emotions. The results of this qualitative study suggest that the therapist's voice in a transcultural clinical setting is essential in creating a positive work environment, conveying good intentions to patients, and establishing a therapeutic alliance through prosodic elements. Furthermore, the voice plays an important implicit and explicit role for the participants in this study. They note that their voice unconsciously varies, and they can use it explicitly as a therapeutic tool to create an impulse or mood. Important aspects of the patient-caregiver relationship can be exclusively transmitted by the tone of the voice and by the musicality of the linguistic content of statements made by the caregiver, who wields an important clinical tool that is often taken for granted. The study also highlighted the important contrast between the explicit role of the caregiver's voice as a conscious therapeutic tool and the implicit, unconscious influence on the caregiver's voice linked to the relationship with patients. Further interdisciplinary studies of the human voice as a tool in a clinical and psychotherapeutic context are therefore essential, and the transcultural approach could inspire future research.

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声音在跨文化工作中陪伴、欢迎病人并与病人产生共鸣的重要性
在临床实践和社会心理研究中,人类的声音往往被低估。矛盾的是,尽管人类的声音是表达情感和分享亲密感受的主要手段,但在临床心理治疗工作中却常常被忽视。尽管人声对心理治疗师、精神科医生和护理人员非常重要,但缺乏对人声潜力的理论和深入探索,阻碍了人声在心理健康护理环境中的明确应用。本文重点探讨了护理人员在与来自不同文化和语言的患者合作时声音的重要性,特别是在跨文化诊所,如跨文化咨询中,强调声音的治疗特性,而临床医生往往忽视了这一点。作者研究了经验丰富的护理人员(包括护士、心理学家和精神科医生)的临床直觉,他们与来自不同文化和语言背景的患者共事。在这些跨越语言障碍的临床环境中,语音的前奏和音乐元素发挥着尤为重要的作用。通过一项由六位经验丰富的临床医生参与的定性归纳研究,作者提出了强调护理人员声音重要性的主题。这些主题基于参与者的经验和临床轶事,他们擅长跨文化治疗方法,习惯于与翻译合作,在法语和患者母语之间架起语言沟通的桥梁。跨文化会诊是一种独特的治疗方法,由具有不同文化背景和语言的合作治疗师团队、患者、患者家属以及提供行政、医疗或心理帮助的专业人员组成。主要治疗师负责为会诊创造条件,并可邀请合作治疗师在倾听患者倾诉的同时分享心理图像或建议。在这种小组环境中,对声音的关注至关重要,因为它为治疗师提供了来自患者的直接声音提示,同时也是患者从护理人员那里接收到的信息。在口译员翻译语言之前,患者会感知治疗师的声音、其音乐性、前奏和传达的情感。这项定性研究的结果表明,在跨文化临床环境中,治疗师的声音对于营造积极的工作环境、向患者传达良好意愿以及通过前奏元素建立治疗联盟至关重要。此外,对本研究的参与者来说,声音还扮演着重要的隐性和显性角色。他们指出,他们的声音会无意识地发生变化,他们也可以明确地将声音作为一种治疗工具来营造一种冲动或情绪。病人与护理人员之间关系的重要方面可以完全通过语音语调和护理人员陈述的语言内容的音乐性来传递,护理人员掌握着一种重要的临床工具,而这种工具往往被认为是理所当然的。这项研究还强调了护理人员的声音作为有意识的治疗工具所发挥的显性作用与护理人员的声音在与病人的关系中受到的隐性、无意识影响之间的重要对比。因此,有必要进一步开展跨学科研究,将人的声音作为临床和心理治疗背景下的一种工具,而跨文化研究方法可以为未来的研究提供启发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annales medico-psychologiques
Annales medico-psychologiques 医学-精神病学
CiteScore
1.30
自引率
33.30%
发文量
196
审稿时长
4-8 weeks
期刊介绍: The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique. The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.
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