General adult psychiatrists' experiences of systemic family therapy : an interpretative phenomenological analysis

Austen, Amanda (2016) General adult psychiatrists' experiences of systemic family therapy : an interpretative phenomenological analysis. Doctoral thesis, Birkbeck, University of London.

Abstract

Does Systemic Family Therapy (SFT) make sense to general adult psychiatrists? SFT is both a theoretical position and a form of psychotherapy. It has been evolving within mental health practice in the UK since the 1950’s. Though it is now to be found more often in child and adolescent mental health services, it has its roots in adult mental health. This in-depth qualitative study is an investigation of how registered psychiatrists working in adult services in the UK make sense of SFT. As the training and experiences of SFT vary for psychiatrists working in adult mental health services, this study explores those experiences, and the meaning psychiatrists have of them, including what they have taken into current working practice. This study therefore attempts to contribute to our understanding of the relation between the disciplines of psychiatry and SFT, and how psychiatrists use SFT in their practice. The research used semi-structured interviews with six qualified psychiatrists working in adult services within a London Mental Health Trust to explore the lived experiences each had of SFT. These interviews were recorded, transcribed and then analysed using Interpretative Phenomenological Analysis (IPA). The participants welcomed the opportunity to share and think about SFT in their practice and experience. The four main themes that emerged from the analysis were The Past in the Present and the Future, the impact and relevance of SFT training; Proximity and distance, exploring the range and limits of accessing SFT concepts and provision; Anxiety and Uncertainty; Position of SFT in mental health services. These master themes explore the participant’s recall of their experience of SFT both in their psychiatric training and in their subsequent working practice. They illuminate how these experiences relate to psychiatrists’ sense of SFT as a broader set of theories about human relations and mental health. The findings highlight the different ways psychiatrists made sense of, and utilized, SFT in their practice. The analysis of the interviews also reveals support for the trend towards incorporation of systemic thinking in mental health practice and training more generally. The discussion focuses on the aspects of nostalgic remembrance of experiences that no longer feel accessible within psychiatric practice; the experience of learning as a mental health practitioner; and the embeddedness of SFT in present work and the workplace, in relation to existing literature and theory. The conclusion offers reflections on the research process and insights into the applicability of the findings to mental health training, service development, and particularly how SFT thinking and skills can be taught in a more accessible way to other mental health professionals. KEYWORDS: Psychiatry, IPA, Training, Nostalgia, Systemic Family Therapy, Psychotherapy.

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