The First Meeting at Child and Adolescent Psychiatry

Abstract: Children and parents who visited child and adolescent psychiatry (CAP) for the first time were interviewed in the presence of their therapists about the first meeting. The interview was intended to make the attendants describe in their own words what the meeting was like for them. The interview was repeated after six months to get complementary information. Research assistants, reflectors, helped the interviewer to prevent from bias and to hold on to the theme.The grounded theory approach was utilised in papers I, II, and III, and qualitative content analysis was used in paper IV.Children appreciated the therapist being in an active as well as in a more passive but alert position, moving between asking adjusted questions and including the parents. The therapists’ skill of listening was also important to them.For the parents, it was important what happened between their child and the therapists. They questioned their own role and presence. Also, they focused on the plan for the meeting and for the coming process. Certain things that happened in the dialogue were useful after the meeting. The results indicate that what was helpful was connected to family therapy matters rather than psychiatric ones.The therapists balanced between a psychiatric and a family therapeutic position, and it was a dilemma for them how to best fulfil their assignment in the organisation as they perceived it.Two competing discourses were found in the first meeting; Structuring, which stood for structure, planning and expertise, while Collaboration represented negotiations of how to work together, empowerment and emotional aspects. The Structuring discourse tended to dominate. Both discourses consisted of valuable elements that needed to be included to ensure that the atmosphere would not be too strict or too flexible.The findings are tentative because of the lack of studies to compare to, and because of the few interviews made.