MÖTET SOM HANTVERK: ALLIANS SOM FÖRÄNDRINGSKRAFT En kvalitativ studie om behandlares kliniska arbete med föräldrar för att främja barn och ungas psykiska hälsa.

Sammanfattning

In response to the increasing mental health challenges among children and adolescents in Sweden, primary care services like First-line Mental Health (UPH), have been established to provide easy access to support. Within this medical context, professional practitioners, such as healthcare social workers, psychologists and nurses play a vital role, often balancing support and focus for the child with work involving the whole family. However, navigating the therapeutic alliance while addressing the need for parental change remains a complex challenge. The aim of this study is to gain a deeper understanding of practitioners experiences in establishing and maintaining a therapeutic alliance with parents within a first-line mental health context. Furthermore, the study explores how these professionals balance the tension between validating parents and addressing the need for change in parental functioning.The study used a qualitative approach, based on semi-structured interviews with five mental-health professionals working within UPH in Western Sweden. The data was analyzed using thematic analysis and interpreted through theories of social constructionism and systemic theory. The findings reveal that alliance building is a skilled clinical craft, characterized by joining, which is a process where the professional tunes into the family’s perspective and way of interaction and the creation of a secure base. A key part of this work is to reduce the "expert role" by using humor and showing a sense of shared humanity. This craftmanship is done to help parents feel less shame about needing help with their parenting. Systemic strategies are also used to change the focus from the individual child's problems to the family as a whole, making the parents the primary agents of change. The study concludes that this clinical craft is essential for creating a working relationship that allows for both support and change within the framework of first-line mental health.