接受痛苦现实的同伴支持:精神科同伴小组讨论中的专业知识和经验分享。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Pub Date : 2024-05-01 Epub Date: 2023-02-27 DOI:10.1177/13634593231156822
Elina Weiste, Melisa Stevanovic, Lise-Lotte Uusitalo, Hanna Toiviainen
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引用次数: 0

摘要

以同伴为基础的干预措施越来越多地被用于提供心理健康服务,以帮助患病者重新审视自己的处境,并接受自己的疾病是其生命故事的一部分。在这些干预措施中,被称为 "经验专家"(EbE)的同伴支持者的角色介于同伴互助和半专业服务提供之间,他们面临着平衡不对称的专业关系与互惠、互利、平等关系的挑战。本文研究了在精神科服务的同伴小组中,EbE 在回应客户关于其个人痛苦经历的故事时如何应对这一挑战。研究结果表明,心理咨询师是如何通过两种谈话方式来回应服务对象的经验分享的。在第一种回应类型中,EbEs 强调互惠的经验分享,鼓励客户接受自己的疾病。这引起了客户的相互归属感和更多的问题谈话。在第二种反应类型中,心理咨询师降低了经验分享的互惠性,建议客户如何在日常生活中接受自己的疾病。这被认为与客户的问题描述关联性较小,序列也就结束了。这两种反应类型都涉及到需要在互动中处理的认识不对称问题。根据我们的分析,以经验为基础的半专业性专业知识涉及到持续的认识论紧张关系,因为参与者要努力保持以同伴为基础的经验分享和从属关系的相互取向。
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Peer support for accepting distressing reality: Expertise and experience-sharing in psychiatric peer-to-peer group discussions.

Peer-based interventions are increasingly used for delivering mental health services to help people with an illness re-examine their situation and accept their illness as part of their life story. The role of the peer supporter in these interventions, known as experts-by-experience (EbE), is situated between mutual peer support and semi-professional service delivery, and they face the challenge of balancing an asymmetric, professional relationship with a reciprocal, mutuality-based, equal relationship. This article investigates how EbEs tackle this challenge when responding to clients' stories about their personal, distressing experiences in peer-based groups in psychiatric services. The results show how the EbEs responded to their clients' experience-sharing with two types of turns of talk. In the first response type, the EbEs highlighted reciprocal experience-sharing, nudging the clients toward accepting their illness. This invoked mutual affiliation and more problem-talk from the clients. In the second response type, the EbEs compromised reciprocal experience-sharing and advised clients on how to accept their illness in their everyday lives. This was considered less affiliative in relation to the client's problem description, and the sequence was brought to a close. Both response types involved epistemic asymmetries that needed to be managed in the interaction. Based on our analysis, semi-professional, experience-based expertise involves constant epistemic tensions, as the participants struggle to retain the mutual orientation toward peer-based experience-sharing and affiliation.

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来源期刊
Health
Health Multiple-
CiteScore
4.90
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0.00%
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0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
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