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首页> 外文期刊>Journal of Eating Disorders >“As long as they eat”? Therapist experiences, dilemmas and identity negotiations of Maudsley and family-based therapy for anorexia nervosa
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“As long as they eat”? Therapist experiences, dilemmas and identity negotiations of Maudsley and family-based therapy for anorexia nervosa

机译：“只要他们吃”？治疗师经验，毛泽东和基于家族治疗的厌食症治疗的体验，困境和身份谈判

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Maudsley Family Therapy and its manualised version Family-Based Therapy for Anorexia Nervosa (FBT-AN) have accrued the most significant research evidence-base for the treatment of adolescent Anorexia Nervosa (AN). A tradition of seeking augmentations for this treatment has also been established to enhance efficacy. There exists, however, a gap in the uptake of this form of manualised treatment into the "real world" of clinicians who work with adolescent AN. This research study investigated the key experiences and identity negotiations of a group of nine Australian clinicians who were interested in contributing to research into ways that Maudsley and FBT-AN might be improved. Nine clinicians, who at the time of the interview practised or had previously practised, FBT-AN participated in a semi-structured interview. A critical discursive analysis of interview transcripts generated a thematic map of these therapists' experiences and identity negotiations in their practice of FBT-AN. These therapists experienced the structure of FBT-AN as both a secure map for therapy, yet also constraining at times, in their work with adolescents and their families. Additionally, their professional identities were both invested and troubled by the identity position of themselves as evidence-based practitioners, particularly where evidence-based practice (EBP) meant strict fidelity to the manual and restrained them from tailoring a broader range of therapeutic interventions to an individual adolescent and their family. Within their narratives, these therapists refashioned alternative identity positions around what it meant to be an evidence-based practitioner through listening to and drawing on their clinical expertise of what works in therapeutic practice with an individual adolescent and their family. These therapists narratives highlight the power of the dominant discourse of EBP that works to privilege the research evidence over other forms of evidence that include clinician expertise and client preferences. The dilemmas faced by these therapists questioned not only the strict application of FBT-AN for adolescent AN across diverse therapeutic contexts, but also the effects of supervisory practices that paralleled this strict fidelity to the model. Further research is needed into therapeutic interventions and supervisory practices that give greater scope for clinicians to draw on their expertise in the flexible tailoring of treatments to the unique needs and preferences of the individual adolescent and their family.
机译：Maudsley家庭疗法及其手工大小的厌食神经科（FBT-AN）的系列疗法已归因于治疗青少年厌食症（AN）的最重要的研究依据。还建立了寻求这种治疗的增强的传统，以提高疗效。然而，存在这种形式的临床医生的临床医生的形式的缺口差距。该研究研究了一群有九名澳大利亚临床医生的主要经验和身份谈判，他们有兴趣为毛泽东和FBT-AN进行改进的方式进行研究。九名临床医生，在采访时练习或以前练习，FBT-AN参加了半结构化面试。对面试成绩单的批判性话语分析产生了对FBT-AN的实践中这些治疗师经验和身份谈判的主题地图。这些治疗师经历了FBT-A的结构，作为治疗的安全地图，也有时在与青少年和家人一起使用的时间。此外，他们的专业身份都被投资和困扰着自己作为基于证据的从业者的身份状况，特别是在基于循证的实践（EBP）的情况下对手册的严格保真度并限制了更广泛的治疗干预措施个人青少年和他们的家人。在他们的叙述中，这些治疗师通过听取和借鉴他们与个人青少年和家庭的治疗实践中的临床专业知识来缩回替代身份的替代身份态度。这些治疗师叙述突出了ebp主导话语的力量，这些话语致力于在其他形式的证据中特权，包括临床医生专业知识和客户偏好。这些治疗师面临的困境不仅质疑FBT-A在各种治疗背景中的FBT-AN的严格应用，而且对该模型的严格保真度并联的监督实践的影响。需要进一步的研究进入治疗性干预和监督实践，为临床医生提供更大的范围，以利用他们对个人青少年及其家庭的独特需求和偏好的灵活剪裁的专业知识。

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