An Exploratory Study of a Reflecting Team’s Influence on the Family Meaning System in The Self-Harm Intervention Family Therapy (SHIFT) Trial

Introduction: The study aimed to explore a Reflecting Teams (RT) influence on the family meaning system in The Self-Harm Intervention Family Therapy (SHIFT) Trial where the referral problem is adolescent self-harm.

Method: A multiple case study design was undertaken to examine the practice and influence of a RT across three different families by comparison of the pre and post RT dialogues and the discursive strategies utilised by the RT. An original analytical strategy was implemented, derived from Discursive Psychology, the pragmatic application of Positioning Theory and the Semantic Polarities Model, to capture subtle shifts within the family meaning system from recorded family therapy sessions.

Results: The RT was instrumental in guiding and reinforcing the therapist’s influence; acting as a consultative team, a supervisory resource and a collaborative partner. The RT influenced change across cases through a range of discursive strategies: collaborative co-positioning of the family and therapy team, adopting an expert position regarding the management of risks and areas of continuing concern and also emphasising and reinforcing family strengths, progress, and resilience. Findings suggest that the RT may have a differential influence depending on the stage and context of therapy.

Discussion: These novel findings are discussed in the context of existing literature and the specific contribution of the current study regarding adaptations to RT practice in response to the management of risk and stage of therapy. Limitations of the current research design are indicated with recommendations for future research.