The map of competencies in systemic therapy: A qualitative study of the systemic competencies in child and adolescent mental health that target the associated abnormal psychosocial situations

Abstract

The overarching aim of this research project is to identify a comprehensive and detailed outline of the systemic therapist competences in the Norwegian child and adolescent mental health (BUP) that target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations in the multiaxial classification of child and adolescent psychiatric disorders/axis 5 (ICD-10). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, fieldwork observations of the therapists (participants) in practice and an analysis of the Norwegian Directorate of Health’s guidelines for child and adolescent mental health institutions. The specific research questions for this research project are: 1. In the context of child and adolescent mental health, what are the different competences in a systemic family therapy approach that address the associated abnormal psychosocial situations? 2. What are the legally binding requirements in the Norwegian Directorate of Health’s (2008) guidelines for child and adolescent mental health? 3. How does systemic family therapy interconnect with the Norwegian Directorate of Health`s (2008) guidelines for child and adolescent mental health? Grounded theory (GT) was chosen as the main methodology for this study. During the analysis, the following six overarching categories were identified: (1): legally binding requirements; (2) the importance of ethical and contextual awareness in systemic therapy; (3) the systemic therapist’s stance; (4) therapeutic processes; (5) therapeutic practices; and (6) session-specific features. Challenges, such as limiting the systemic approach to six overarching competences, are discussed alongside this study’s strengths and limitations, and suggestions for future research are presented. The detailed outline of the systemic therapist competences and the legally binding requirements in the Norwegian Directorate of Health’s guidelines was compiled into a “map of competences”. The findings show that the legally binding requirements interconnect and overlap with the identified systemic competences, although their wording and their inclusion of diagnosis can challenge the systemic ideas of using a non-pathologizing language. The map of competences is intended to be applied as a tool for clinical supervision, clinical practice, education and training in family therapy. This research may also facilitate a “bridge-building process” between mental health and postmodern systemic ideas.