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A client’s experience of being heard and understood by a social worker contributes to not only fostering alliance and positive outcomes in practice, but also positioning the client as the knower of...

As therapy progresses, alliances become more complex and are constantly negotiated. Analyzing transcripts from video-taped actual therapy sessions, this article examines how a client and th...

Ruptures, including racial microaggressions, are inevitable in therapy. Because they are subtle and subject to alternative explanations, identifying and illustrating racial microaggressions have be...

With increasing diversity in therapeutic dyads, there has been renewed attention to the process of ‘joining’ in cross-cultural encounters. Inspired by discourse analysis, we conducted a close reading of therapy transcripts between a Pakistani immigrant mother-daughter dyad and a Canadian white female therapist in an outpatient clinic. Our findings illustrate detailed discursive interactions for joining techniques – selective joining, confirmation, and tracking – (1) where the therapist facilitates joining moments with the family and (2) where the same techniques are used to preclude further exploration of the family's cultural views. Consequently, the joining process is at times limited by the therapist's enactment of her own assumptions about the family's culture. Due to the doxic nature of cultural assumptions, a discursive analysis may help to prevent therapists from silencing their clients’ cultural voices and to be more reflexive of their assumptions, thus promoting joining. Practitioner points Joining in family therapy is a dynamic process The detailed analysis of joining moments can serve as an example for training therapists to examine their moment-to-moment responses to culturally diverse clients Therapeutic constructs/techniques (e.g. joining) cannot be decontextualized or conceptualized as apolitical and acultural Critical reflexivity may prevent therapists from unknowingly oppressing culturally diverse clients’ experiences and cultural identities

Epistemic injustice occurs when therapists implicitly and explicitly impose professional and institutional power onto clients. When clients have a diagnosis of schizophrenia, this very fact further complicates and highlights the power disparity within the helping relationship. Inspired by the work of critical philosopher Miranda Fricker on epistemic injustice, and using critical theories of language and knowledge, this article analyzes audiotaped session transcripts between a client with a history of psychosis and a social worker in an outpatient mental health agency. Findings illustrate two main discursive interactional patterns in everyday clinical social work encounters: (1) how the therapist's utterances claim disciplinary power and construct the client's testimony in alignment with an institutional agenda, while pre-empting the client's lived experience; and (2) how the client, though actively resisting, is managed to perform the identity of being a mentally ill person. The authors close with suggestions of how to avoid these mishaps and work toward epistemic justice in mental health practice.

The aim of this study was to identify types of family support desired by young adults with eating disorders during the transfer of care from paediatric to adult eating disorders programs. Using constant comparative analysis, two salient themes from qualitative interviews with 15 young adults were identified: (a) uncertainty about the role of parents in maintaining recovery during the transfer; and (b) the need for parental support, defined as assistance with eating and maintenance of recovery. Young adults voiced that parental emotional involvement and assistance with navigating adult care services is critical to their successful transfer between the two systems of care.

The study's objective was to identify systemic facilitators and barriers of transferring young adults (ages 17-21) with eating disorders from pediatric to adult health and mental health services. Qualitative interviews were conducted and three themes emerged: (a) difficulties navigating care during the transfer period; (b) challenges achieving and maintaining recovery due to systemic barriers after the transfer of care;and (c) recommendations for facilitating the transfer between systems of care. From the perspective of young adults with eating disorders our study shows that the transition to adult care services may be improved with increased coordination, communication, and collaborative partnerships between pediatric and adult providers.