«Fra tvang til dialog» – en kvalitativ casestudie om ny praksis i en psykiatrisk sikkerhetsavdeling [“From coercion to dialogue” – A qualitative case study about a new practice in one forensic mental health unit]

Abstract

A forensic mental health unit in Norway has developed a new treatment approach that emphasizes not only relational and communicative aspects but also reflective processes and socializing. The idea behind this new approach was to facilitate the transformation of standard services characterized by isolation and coercion. The aim of this case study is to explore and describe how a patient and his clinicians experienced this new practice. The method is qualitative, applying a phenomenological-hermeneutical approach with an explorative and descriptive design. Two focus group interviews with the clinicians and one individual interview with a patient were conducted in developing data. Thematic analysis was used and three major themes were identified: 1) New academic positions and practices were developed. Humanity, togetherness, and not being alone were important aspects of this theme. 2) Professionalism took a new form. Reflecting team, thematic violence, and strengthening the patient’s responsibility were main issues. 3) New forms of collaboration were developed. Training in independency, togetherness, and collaboration served as subthemes here. The study indicates opportunities and relevance for a more humanistic and inclusive treatment approach in forensic mental health units, one that focuses on strengthening the user involvement.