'It takes some time to get into the rhythm - and to slow the flow of thought': A qualitative study about experience of time and narrative in psychological interventions in general practice
'It takes some time to get into the rhythm - and to slow the flow of thought': A qualitative study about experience of time and narrative in psychological interventions in general practice
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DOI：
10.1177/1363459310369080
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发表时间：
2010-07-01
期刊：
影响因子：
2.1
通讯作者：
Reventlow, Susanne
中科院分区：
文献类型：
--
作者：
Davidsen, Annette Sofie;Reventlow, Susanne
全科医生 (GP) 治疗 90% 以上的精神疾病患者。时间限制常常被视为他们参与心理治疗的障碍。本研究旨在探讨全科医生在提供“谈话治疗”时的时间体验，并分析时间如何影响常规咨询中情绪问题的治疗。选择了定性方法，数据包括对 14 名全科医生的访谈以及对 4 名参与者实践中连续咨询的观察。通过解释现象学分析进行分析。十一名参与者进行了谈话治疗，其中五名（有治疗意识的参与者）经常进行。时间出现了三个方面：（1）时间表的时间顺序； （2）另一种节奏和思绪的内心时间； (3) 反复会面进行短暂磋商的纵向时间促进了信任关系，问题逐渐被披露并产生了叙述。对于治疗参与者来说，可以在常规咨询中确定相同的时间方面。压力和繁重的工作量抵消了对内心时间的感知。可以应用来自心理治疗思维的时间和叙事理论，形成与无意识和叙事时间的联系，并可能在一般实践中变得更加明确。对不同时间方面的认识对于改善初级保健中的心理健康治疗是必要的。然而，确保必要工作条件的政治和组织意愿对于最佳待遇同样重要。
General practitioners (GPs) treat more than 90 per cent of patients with mental disease. Time restriction is often seen as a hindrance to their engagement in psychological treatment. This study aimed to explore GPs' experiences of time when delivering 'talking therapy' and to analyse how time influenced the treatment of emotional problems in routine consultations. A qualitative approach was chosen, the data consisted of interviews with 14 GPs and observation of consecutive consultations in four of the participants' practices. Analysis was made by Interpretative Phenomenological Analysis. Eleven participants delivered talking therapy, five (therapeutically minded participants) often. Three aspects of time emerged: (1) the chronological time of the schedule; (2) the inner time with another rhythm and flow of thought; (3) the longitudinal time where meeting repeatedly for short consultations promoted a trusting relationship where problems were disclosed gradually and a narrative was created. With therapeutic participants the same aspects of time could be identified in routine consultations. Stress and a heavy workload counteracted the perception of inner time. Theories of time and narrative from psychotherapeutic thinking could be applied, form links to the unconscious and the narrative time and could possibly be made more explicit in general practice. Awareness of the different time aspects is necessary for improving the treatment of mental health in primary care. Political and organizational willingness to secure the necessary working conditions is, however, equally important for optimal treatment.