Kerstin Neander - Academia.edu (original) (raw)

Papers by Kerstin Neander

The aim of this study was to explore parents ’ and therapists’ experiences of treatment processes... more The aim of this study was to explore parents ’ and therapists’ experiences of treatment processes in early childhood inter-ventions. The parents and their therapists reflected on their experiences in joint interviews. The interpretation led to the crystallization of five central themes. The starting point was marked by ‘parents ’ fear versus professional(s’) confidence’. This formed the background against which both parties aimed at ‘making sense of the situation’. The subsequent therapeutic process was characterized by the parents ’ and the professionals ’ ‘striving for reciprocal responsiveness ’ and it led to the ‘alteration of inner images’. Finally the two parties made a ‘retrospective reflection on the nature of the relation’. Together these themes constitute the co-creation KEY WORDS: client’s perspective early childhood intervention investigative partnership Marte Meo method therapeutic relationship treatment processes

Fathers' involvement in parent-child interaction interventions : a prospective, naturalistic ... more Fathers' involvement in parent-child interaction interventions : a prospective, naturalistic study

Qualitative Social Work, 2006

In this study families that have struggled with their relationships to their children have identi... more In this study families that have struggled with their relationships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the understanding they constructed of these beneficial processes. Interpretation according to Max van Manen's hermeneuticphenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about 'emerging mutual trust', which 'overcomes obstacles'. The key figures or 'important persons' have a 'clear orientation' in their occupation and they work in 'the essential everyday world' to find and establish 'contexts that nourish development' in children and parents. The outcome of this is the creation of 'new narratives' that replace the old ones.

In this study families that have struggled with their relation-ships to their children have ident... more In this study families that have struggled with their relation-ships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the under-standing they constructed of these beneficial processes. Interpretation according to Max van Manen’s hermeneutic-phenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about ‘emerging mutual trust’, which ‘overcomes obstacles’. The key figures or ‘important persons ’ have a ‘clear orientation ’ in their occu-pation and they work in ‘the essential everyday world ’ to find and establish ‘contexts that nourish development ’ in children and parents. The outcome of this is the creation of ‘new narratives ’ that replace the old ones. KEY...

Artikeln bygger pa data hamtade fran en svensk effektstudie av Trygghetscirkeln. Utvarderingar gj... more Artikeln bygger pa data hamtade fran en svensk effektstudie av Trygghetscirkeln. Utvarderingar gjorda av gruppledare och 25 foraldrar presenteras tillsammans med forandringar av foraldrars inre rep ...

Projektet avsag att prova ett anknytningsbaserat foraldrastodsprogram, Trygghetscirkeln (COS-P), ... more Projektet avsag att prova ett anknytningsbaserat foraldrastodsprogram, Trygghetscirkeln (COS-P), vars mal ar att hjalpa foraldrar att na fordjupad forstaelse for barns behov av kanslomassigt stod f ...

Journal of Multidisciplinary Healthcare, 2018

Background: As suffering from an eating disorder often entails restrictions on a person's everyda... more Background: As suffering from an eating disorder often entails restrictions on a person's everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships. Purpose: The aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family. Patients and methods: This qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis. Results: The adolescents' descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context. Conclusion: Young people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.

Scandinavian Journal of Psychology, 2017

K. (2017). Adding "Circle of Security-Parenting" to treatment as usual in three Swedish infant me... more K. (2017). Adding "Circle of Security-Parenting" to treatment as usual in three Swedish infant mental health clinics. Effects on parents' internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology. This study presents effects of adding Circle of Security-Parenting (COS-P) to an already established comprehensive therapeutic model for early parentchild intervention in three Swedish infant mental health (IMH) clinics. Parents' internal representations and quality of parent-infant interaction were studied in a clinical sample comprised of 52 parent-infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU) supplemented with COS-P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS-P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA), significantly increased over time in the COS-P group. Improvements in the TAU-group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS-P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS-P in IMH treatment.

Neander, Kerstin (2009). Indispensable Interaction. Parents' perspectives on parent-child interac... more Neander, Kerstin (2009). Indispensable Interaction. Parents' perspectives on parent-child interaction interventions and beneficial meetings. Örebro Studies in Medicine 36. 89 pp. The aim of this thesis was (a) to describe families taking part in parent-child interaction interventions and examine short term and long term changes in their problem loads, (b) to examine the parents' perspectives on what persons and contexts within and outside the intervention they considered beneficial for the child or the family and (c) to examine the understanding that the parents and key figures generated of these processes in joint interviews. The parents in the 101 families who took part in the intervention showed considerable problem loads at the outset of treatment, and the children displayed problems of a nature and degree otherwise found in psychiatric populations, with a dominance of aggressive behaviour. There was a clear trend towards a positive development after six months for parents and children, and this positive development was reinforced after 18 months. There were few unplanned interruptions of the treatment. In the families with two biological parents, all the mothers and 89% of the fathers participated in treatment. The fathers' average problem load was lower than that of the mothers, and their improvements were less extensive. The fathers attributed the improvement to the treatment, but also highlighted, to a greater extent than the mothers, outside contributing factors to the improvement. Parents described persons who had been of special importance for the family and for the development of the children, both within the framework of the intervention and in several other contexts such as preschool, child health care and social services. In subsequent joint interviews with the parents and these key persons it transpired that when the parents perceived that e.g. the teacher, the social worker, or the nurse was guided by good intentions, confident relations could develop even though conditions in other respects were unpromising. Expressions of personal commitment from these "important persons" overcame obstacles such as the parents' or children's previous negative experiences. These "important meetings" contributed to the creation of more positive (self)images of the children and/or the parents. At the outset of treatment in the parent-child interaction interventions there was a "gap" between the parents and their family therapists, caused by the parents' fear and an unequal power balance, but both the parents and the therapists contributed to bridging this gap. An image of the good therapist emerged as being "normal, friendly, knowledgeable, and capable of admitting that he/she might be wrong". The conclusions are that these parent-child interaction interventions have reached both mothers, fathers and children beset by considerable difficulties in relation to interaction, offering them a treatment which an overwhelming majority of the families have chosen to follow through and which has made a difference to the families. The empirical material as a whole highlights the significance of beneficial relationships, not only within the intervention but also in other professional contexts, for the enhancing of children's development.

Journal of eating disorders, 2015

This qualitative study addresses adolescents' perception of treatment for eating disorders. T... more This qualitative study addresses adolescents' perception of treatment for eating disorders. The importance of involving parents in treatment of young people with eating disorders, especially young people with Anorexia Nervosa, is emphasized in a number of studies. Even so, this form of treatment does not work for everybody, not even within a limited diagnostic group. Previous research has revealed that many young people are not entirely satisfied with their treatment. However, there is a lack of knowledge concerning the perspectives of adolescents in outpatient treatment, whose treatment often involves family. The aim of the present study was to investigate how young people with experience from adolescent outpatient treatment for eating disorders, involving family-based and individual based interventions, perceive their time in treatment. This study was conducted using a hermeneutic phenomenological approach. Fifteen participants were recruited in collaboration with four special...

Qualitative Social Work, 2008

The aim of this study was to explore parents' and therapists' experiences of treatment pr... more The aim of this study was to explore parents' and therapists' experiences of treatment processes in early childhood interventions. The parents and their therapists reflected on their experiences in joint interviews. The interpretation led to the crystallization of five central themes. The starting point was marked by 'parents' fear versus professional(s') confidence'. This formed the background against which both parties aimed at 'making sense of the situation'. The subsequent therapeutic process was characterized by the parents' and the professionals' 'striving for reciprocal responsiveness' and it led to the 'alteration of inner images'. Finally the two parties made a 'retrospective reflection on the nature of the relation'. Together these themes constitute the co-creation of a therapeutic process by bridging a gap that is created by fear, by power differentials and by differences in familiarity with the context. The ...

Qualitative Social Work, 2012

... Article 'Hard work' in a new context: Clients' experie... more ... Article 'Hard work' in a new context: Clients' experiences of psychotherapy Mona Wilhelmsson Go¨stas O¨ rebro University, Sweden Britt Wiberg Umeå University, Sweden Kerstin Neander and Lars Kjellin O¨ rebro University, Sweden ...

Child and Adolescent Psychiatry and Mental Health, 2009

Background: The aim of the study was to describe families with small children who participated in... more Background: The aim of the study was to describe families with small children who participated in parent-child interaction interventions at four centres in Sweden, and to examine long term and short term changes regarding the parents' experience of parental stress, parental attachment patterns, the parents' mental health and life satisfaction, the parents' social support and the children's problems. Methods: In this longitudinal study a consecutive sample of 101 families (94 mothers and 54 fathers) with 118 children (median age 3 years) was assessed, using self-reports, at the outset of the treatment (T1), six months later (T2) and 18 months after the beginning of treatment (T3). Analysis of the observed differences was carried out using Wilcoxon's Signed-Rank test and Cohen's d. Results: The results from commencement of treatment showed that the parents had considerable problems in all areas examined. At the outset of treatment (T1) the mothers showed a higher level of problem load than the fathers on almost all scales. In the families where the children's problems have also been measured (children from the age of four) it appeared that they had problems of a nature and degree otherwise found in psychiatric populations. We found a clear general trend towards a positive development from T1 to T2 and this development was also reinforced from T2 to T3. Aggression in the child was one of the most common causes for contact. There were few undesired or unplanned interruptions of the treatment, and the attrition from the study was low. Conclusion: This study has shown that it is possible to reach mothers as well as fathers with parenting problems and to create an intervention program with very low dropout levels-which is of special importance for families with small children displaying aggressive behaviour. The parents taking part in this study showed clear improvement trends after six months and this development was reinforced a year later. This study suggests the necessity of clinical development and future research concerning the role of fathers in parent-child interaction interventions.

The aim of this study was to explore parents ’ and therapists’ experiences of treatment processes... more The aim of this study was to explore parents ’ and therapists’ experiences of treatment processes in early childhood inter-ventions. The parents and their therapists reflected on their experiences in joint interviews. The interpretation led to the crystallization of five central themes. The starting point was marked by ‘parents ’ fear versus professional(s’) confidence’. This formed the background against which both parties aimed at ‘making sense of the situation’. The subsequent therapeutic process was characterized by the parents ’ and the professionals ’ ‘striving for reciprocal responsiveness ’ and it led to the ‘alteration of inner images’. Finally the two parties made a ‘retrospective reflection on the nature of the relation’. Together these themes constitute the co-creation KEY WORDS: client’s perspective early childhood intervention investigative partnership Marte Meo method therapeutic relationship treatment processes

Fathers' involvement in parent-child interaction interventions : a prospective, naturalistic ... more Fathers' involvement in parent-child interaction interventions : a prospective, naturalistic study

Qualitative Social Work, 2006

In this study families that have struggled with their relationships to their children have identi... more In this study families that have struggled with their relationships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the understanding they constructed of these beneficial processes. Interpretation according to Max van Manen's hermeneuticphenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about 'emerging mutual trust', which 'overcomes obstacles'. The key figures or 'important persons' have a 'clear orientation' in their occupation and they work in 'the essential everyday world' to find and establish 'contexts that nourish development' in children and parents. The outcome of this is the creation of 'new narratives' that replace the old ones.

In this study families that have struggled with their relation-ships to their children have ident... more In this study families that have struggled with their relation-ships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the under-standing they constructed of these beneficial processes. Interpretation according to Max van Manen’s hermeneutic-phenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about ‘emerging mutual trust’, which ‘overcomes obstacles’. The key figures or ‘important persons ’ have a ‘clear orientation ’ in their occu-pation and they work in ‘the essential everyday world ’ to find and establish ‘contexts that nourish development ’ in children and parents. The outcome of this is the creation of ‘new narratives ’ that replace the old ones. KEY...

Artikeln bygger pa data hamtade fran en svensk effektstudie av Trygghetscirkeln. Utvarderingar gj... more Artikeln bygger pa data hamtade fran en svensk effektstudie av Trygghetscirkeln. Utvarderingar gjorda av gruppledare och 25 foraldrar presenteras tillsammans med forandringar av foraldrars inre rep ...

Projektet avsag att prova ett anknytningsbaserat foraldrastodsprogram, Trygghetscirkeln (COS-P), ... more Projektet avsag att prova ett anknytningsbaserat foraldrastodsprogram, Trygghetscirkeln (COS-P), vars mal ar att hjalpa foraldrar att na fordjupad forstaelse for barns behov av kanslomassigt stod f ...

Journal of Multidisciplinary Healthcare, 2018

Background: As suffering from an eating disorder often entails restrictions on a person's everyda... more Background: As suffering from an eating disorder often entails restrictions on a person's everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships. Purpose: The aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family. Patients and methods: This qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis. Results: The adolescents' descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context. Conclusion: Young people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.

Scandinavian Journal of Psychology, 2017

K. (2017). Adding "Circle of Security-Parenting" to treatment as usual in three Swedish infant me... more K. (2017). Adding "Circle of Security-Parenting" to treatment as usual in three Swedish infant mental health clinics. Effects on parents' internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology. This study presents effects of adding Circle of Security-Parenting (COS-P) to an already established comprehensive therapeutic model for early parentchild intervention in three Swedish infant mental health (IMH) clinics. Parents' internal representations and quality of parent-infant interaction were studied in a clinical sample comprised of 52 parent-infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU) supplemented with COS-P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS-P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA), significantly increased over time in the COS-P group. Improvements in the TAU-group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS-P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS-P in IMH treatment.

Neander, Kerstin (2009). Indispensable Interaction. Parents' perspectives on parent-child interac... more Neander, Kerstin (2009). Indispensable Interaction. Parents' perspectives on parent-child interaction interventions and beneficial meetings. Örebro Studies in Medicine 36. 89 pp. The aim of this thesis was (a) to describe families taking part in parent-child interaction interventions and examine short term and long term changes in their problem loads, (b) to examine the parents' perspectives on what persons and contexts within and outside the intervention they considered beneficial for the child or the family and (c) to examine the understanding that the parents and key figures generated of these processes in joint interviews. The parents in the 101 families who took part in the intervention showed considerable problem loads at the outset of treatment, and the children displayed problems of a nature and degree otherwise found in psychiatric populations, with a dominance of aggressive behaviour. There was a clear trend towards a positive development after six months for parents and children, and this positive development was reinforced after 18 months. There were few unplanned interruptions of the treatment. In the families with two biological parents, all the mothers and 89% of the fathers participated in treatment. The fathers' average problem load was lower than that of the mothers, and their improvements were less extensive. The fathers attributed the improvement to the treatment, but also highlighted, to a greater extent than the mothers, outside contributing factors to the improvement. Parents described persons who had been of special importance for the family and for the development of the children, both within the framework of the intervention and in several other contexts such as preschool, child health care and social services. In subsequent joint interviews with the parents and these key persons it transpired that when the parents perceived that e.g. the teacher, the social worker, or the nurse was guided by good intentions, confident relations could develop even though conditions in other respects were unpromising. Expressions of personal commitment from these "important persons" overcame obstacles such as the parents' or children's previous negative experiences. These "important meetings" contributed to the creation of more positive (self)images of the children and/or the parents. At the outset of treatment in the parent-child interaction interventions there was a "gap" between the parents and their family therapists, caused by the parents' fear and an unequal power balance, but both the parents and the therapists contributed to bridging this gap. An image of the good therapist emerged as being "normal, friendly, knowledgeable, and capable of admitting that he/she might be wrong". The conclusions are that these parent-child interaction interventions have reached both mothers, fathers and children beset by considerable difficulties in relation to interaction, offering them a treatment which an overwhelming majority of the families have chosen to follow through and which has made a difference to the families. The empirical material as a whole highlights the significance of beneficial relationships, not only within the intervention but also in other professional contexts, for the enhancing of children's development.

Journal of eating disorders, 2015

This qualitative study addresses adolescents' perception of treatment for eating disorders. T... more This qualitative study addresses adolescents' perception of treatment for eating disorders. The importance of involving parents in treatment of young people with eating disorders, especially young people with Anorexia Nervosa, is emphasized in a number of studies. Even so, this form of treatment does not work for everybody, not even within a limited diagnostic group. Previous research has revealed that many young people are not entirely satisfied with their treatment. However, there is a lack of knowledge concerning the perspectives of adolescents in outpatient treatment, whose treatment often involves family. The aim of the present study was to investigate how young people with experience from adolescent outpatient treatment for eating disorders, involving family-based and individual based interventions, perceive their time in treatment. This study was conducted using a hermeneutic phenomenological approach. Fifteen participants were recruited in collaboration with four special...

Qualitative Social Work, 2008

The aim of this study was to explore parents' and therapists' experiences of treatment pr... more The aim of this study was to explore parents' and therapists' experiences of treatment processes in early childhood interventions. The parents and their therapists reflected on their experiences in joint interviews. The interpretation led to the crystallization of five central themes. The starting point was marked by 'parents' fear versus professional(s') confidence'. This formed the background against which both parties aimed at 'making sense of the situation'. The subsequent therapeutic process was characterized by the parents' and the professionals' 'striving for reciprocal responsiveness' and it led to the 'alteration of inner images'. Finally the two parties made a 'retrospective reflection on the nature of the relation'. Together these themes constitute the co-creation of a therapeutic process by bridging a gap that is created by fear, by power differentials and by differences in familiarity with the context. The ...

Qualitative Social Work, 2012

... Article 'Hard work' in a new context: Clients' experie... more ... Article 'Hard work' in a new context: Clients' experiences of psychotherapy Mona Wilhelmsson Go¨stas O¨ rebro University, Sweden Britt Wiberg Umeå University, Sweden Kerstin Neander and Lars Kjellin O¨ rebro University, Sweden ...

Child and Adolescent Psychiatry and Mental Health, 2009

Background: The aim of the study was to describe families with small children who participated in... more Background: The aim of the study was to describe families with small children who participated in parent-child interaction interventions at four centres in Sweden, and to examine long term and short term changes regarding the parents' experience of parental stress, parental attachment patterns, the parents' mental health and life satisfaction, the parents' social support and the children's problems. Methods: In this longitudinal study a consecutive sample of 101 families (94 mothers and 54 fathers) with 118 children (median age 3 years) was assessed, using self-reports, at the outset of the treatment (T1), six months later (T2) and 18 months after the beginning of treatment (T3). Analysis of the observed differences was carried out using Wilcoxon's Signed-Rank test and Cohen's d. Results: The results from commencement of treatment showed that the parents had considerable problems in all areas examined. At the outset of treatment (T1) the mothers showed a higher level of problem load than the fathers on almost all scales. In the families where the children's problems have also been measured (children from the age of four) it appeared that they had problems of a nature and degree otherwise found in psychiatric populations. We found a clear general trend towards a positive development from T1 to T2 and this development was also reinforced from T2 to T3. Aggression in the child was one of the most common causes for contact. There were few undesired or unplanned interruptions of the treatment, and the attrition from the study was low. Conclusion: This study has shown that it is possible to reach mothers as well as fathers with parenting problems and to create an intervention program with very low dropout levels-which is of special importance for families with small children displaying aggressive behaviour. The parents taking part in this study showed clear improvement trends after six months and this development was reinforced a year later. This study suggests the necessity of clinical development and future research concerning the role of fathers in parent-child interaction interventions.