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Systemisk/narrativ gruppebehandling af Binge Eating Disorder –– Dekonstruktion af et behandlingskoncept



Birgitte Hartvig Schousboe er psykolog på Psykoterapeutisk Center Stolpegård, Stolpegårdsvej 20, 2820 Gentofte

  • Page: 5-25
  • Published on Idunn: 2010-04-27

Artiklen beskriver gruppeterapi på systemisk/narrativt grundlag til patienter med Binge Eating Disorder (BED). Den beskriver, hvordan en problemmættet historie omkring BED-gruppen blev dekonstrueret ved at ændre behandlingens udformning og eksperimentere med socialkonstruktionistiske ideer og metoder. Teamet omkring gruppen har arbejdet med at styrke patienternes vidende position ved bl.a. at inddrage diætistens vidende position via kostvejledning i gruppen. Dette har ført til en fælles vidende position blandt patienterne og en styrkelse af terapeuternes ikke-vidende position. Artiklen beskriver desuden gode erfaringer med at introducere navngivning af problemet i forbindelse med eksternalisering, fordi det underminerer en uhensigtsmæssig vægttabsdiskurs. Terapeuterne har arbejdet med at integrere spørgsmålene fra outsider witness i de reflekterende processer i en mindre struktureret form, hvilket har fremmet konsolideringen af foretrukne historier i gruppens refleksioner og styrket terapeuternes evne til at facilitere processen. Nøgleord: Binge Eating Disorder, systemisk narrativ terapi, grupppe

Systemic/narrative group psychoterapy for patients with Binge Eating Disorder (BED)

This article describes group psychotherapy for patients with Binge Eating Disorder (BED) based on systemic and narrative principles. By changing the way the treatment program was presented to the participants and by making the treatment itself more collaborative, the team deconstructed the problem-saturated story around this group. The team especially focused on the knowing position of the patients e.g. by introducing group counselling by the dietician. This has strengthened what the author has called a shared knowing position among the participants in the group and supported the not-knowing position of the therapists. Subsequently the author describes the satisfactory results of the therapist introducing the definition of the problem during the process of externalising conversations despite warnings against expert definitions, probably because this practice undermines society’s dominant discourse about weight loss. Finally the team has experimentally integrated reflecting processes with the four steps of outsider witness in a less structured form. This has strengthened the group’s reflections and thus the therapists’ ability to facilitate this process.

Keywords: Binge Eating Disorder, systemic narrativ psychotherapy, group
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