Tavistock Systemic Doctoral Research Theses.

FTSRC logo small Doctoral systemic and family therapy research carried out on the Professional Doctorate in Systemic Psychotherapy at the Tavistock. Many full texts available.

Doctorate in Systemic Psychotherapy. Doctorate thesis. Tavistock/UEL

This qualitative research project examines family members' conceptualisation of parental mental health problems from a child mental health context. Different constructions of these problems held within the family, and the connections that these may have to parents' concerns about their children, are explored through an interpretative phenomenological analysis of seventeen semi-structured interviews with family members from eight families. Multiple perspectives are brought to this systemic exploration through examination of three inter-related points of view within the family (parent-patient, other-adults and young people) and across two services' cultures through four Focus Group discussions held with professionals in both adult and child services.

This thesis argues that family members' ideas about the causes of parental mental health problems are significantly influenced by the ways in which different constructions of the problems relate to powerful emotional states, such as guilt, blame, fear and shame. This is implicated in parents' ideas about children's problems, which are primarily attributed to the effects on them of parents' difficulties and to fears about the inter-generational transferability of mental health problems. The role that professional approaches play in enhancing these fears are highlighted and discussed in relation to practice. A dissonance is noted between the meanings that participants hold about their experiences and the medical discourse of explanation. Findings point to the over-arching importance of keeping the whole family in mind highlighting indications for practice in both adult and child services and at their interface. This research underscores the value of listening to service users' views and points to further research in this important field.

Doctorate in Systemic Psychotherapy. Tavistock / UEL Doctoral thesis.
This thesis is a qualitative study of child protection cases that the responsible caseworkers have found difficult to handle and in which the professional interventions to date have not been judged sufficient or effective. The study is a rhetorical Discourse analysis and the data analysed is transcriptions of internal case conferences in three different Norwegian child protection groups.

My research focus has been on how the cases are constructed or constituted by the professionals who are responsible for the cases at the time of the discussions and how the versions about the cases are developed through the discussions among the group members. Focus has been on features of the talk and argumentation, how versions are established through description and on the specific terms and categories that are used in these descriptions.

Doctorate in Systemic Psychotherapy. Tavistock / UEL Doctoral thesis.

There is a wealth of literature and statistics documenting the fact that Black boys of African, African-Caribbean and Mixed-Race heritage are disproportionately represented in the exclusion figures in schools in England.   The literature, predominately, directs our attention to sociological, psychological and intellectual theories that seek to explain this phenomenon.   Consequently schools have developed a wide range of intervention strategies that fit with these explanations.  One example of this is the provision of mentoring projects for black boys which seeks to address the issue from psychological and sociological perspectives. 

These theories and explanations encourage schools and policy makers to focus on individuals ie the children, the parents, the teachers but not necessarily what informs their perceptions of each other and how these perceptions influence the patterns of relationships that give rise to ways of interacting that are labeled as problematic.

This study sets out to examine how a Relational Consultation Model could be a resource for primary schools.  The Model comprises a questionnaire called an Appreciative Relational Inquiry Map (the ‘Map’).  It uses Milan and Post-Milan Interviewing techniques (Palazzolli et al 1980, Penn 1982, Tomm 1985, 1988(a), 1988(b) and a Reflecting Team conversation (Andersen 1987, 1992) to gather data which is analysed using an interpersonal communication theory called Co-ordinated Management of Meaning (CMM)  (Cronen & Pearce 1985, Cronen et al 1982, Oliver 1992, Oliver et al 2003, Pearce 1999).

It provides a structure that facilitates family therapists in the exploration of the experiences of black boys excluded from school; their parents and teachers with the aim of promoting a working partnership between the three that would lead to a reduction in the kind of behaviours that resulting in exclusion.

The research was carried out in two schools in an inner city London borough.  It tells the story of two boys who were the subject of a number of fixed term exclusions, their mother and their teacher.  The data is presented in the form of two case studies.  

A major implication of the findings is the need to address the barriers of silence in which talk about race and colour is enveloped and the nature of conversations that make this an area of both visibility and invisibility.

Azzopardi, Charlie (2007) Expectations of marriage before and after the first year of marriage among Maltese Catholic couples. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text not yet available from this repository.

Øfsti, Anne Kyong Sook (2008) Some call it love: Exploring Norwegian systemic couple therapists' discourses of love, intimacy and sexuality. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust.

Ayo, Yvonne (2017) Ways in which the cultural identities of mixed heritage individuals are maintained in mixed ethnicity stepfamilies. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Persuad, Kamala Jeanette (2017) In the margins: Black, Asian and Minority Ethnic women’s narratives of recovering from an eating disorder. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Singh, Reenee (2007) The process of family talk across culture. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust.

Doctorate In Systemic Psychotherapy. Tavistock/UEL. Doctoral Thesis

My research explores the ways in which African Caribbean families communicate with each other and the outside world in the context of living in England.  This research interest is heavily influenced by my experience of migration to England.  As an African Caribbean person on arrival in England my voice was met with mockery and often resulted in confusion.  My professional experience of working within a Child and Adolescent Mental Health service highlighted a limited understanding of African Caribbean migrants and their descendants, and the extent to which they have to negotiate their lived experience.

My research questions are:
How do first generation Caribbean migrants tell their stories of migration and integration? How do they construct, contest, negotiate identities within this?

What if any stories, sayings from the Caribbean do they draw on to help them navigate their new context?

How does the next generation negotiate, construct, context identities within these stories/experiences?

The methodology section is divided into two distinct areas, the theory and the practical application.  The focus is on post-modernist ideas of social construction and the critique of power in relation to the research process. In this I acknowledge the constitutive role of storytelling for the human experience.  Using a semi-structured schedule, I interviewed two generations in an intergenerational dyad.  The requirements were that one generation had to be a first generation migrant and the other had to be a second generation migrant or later.  This allowed for sharing of stories in the presence of the next generation where meaning could be made together. 

The data has been analysed using the Big and Small Story in Narrative Inquiry.  This process is akin to the therapeutic process where we engage both the story of how we came to therapy (presenting issue) but pay attention to the manner and style in which this story is told, what identities are being claimed, what’s being deferred or avoided in the telling. I discovered that the African Caribbean person is a highly politicised human being for whom the racialised and cultural context is a significant part of life. I set out my key findings using the positions of three types of archetypal themes: the trickster, passer/conformer and resister/revolutionary.  These were used to capture different ways people responded to power within their daily life.

The most significant part of my findings is Dubois’ (1903) concept of double consciousness.  This idea describes the way black people carry their negotiations with power.  There is a sense that they are constantly having to think about what is acceptable to the power base and how can this be negotiated. Interestingly, the African Caribbean people in my study didn’t name racism, oppression, or politics, so the practitioner has to.  I invite practitioners to support what is being called ‘anti colonial practice’ (Heath, 2018).  This practice acknowledges that the colonial presence is still active and to really undo this we have to engage in purposeful direct action.  This requires a kind of “self-reflexivity plus”.  This means engaging in the language of the clients, thinking about your actions with other critical thinkers, questioning your questions with yourself and others, and working with a transparency where we can see whether you have been helpful.

Doctorate in Systemic Psychotherapy. Tavistock / UEL. 2004

Background and Aims:

The study explores the experience of female monozygotic twins and how these experiences may be related to the development of anorexia nervosa. The study presents the stories of the twins, from the twin perspective, the mothers perspective and where relevant the clinician perspective. The qualitative analysis of Interpretative Phenomenological Analysis (Smith et al) used was adapted to suit the needs of the study, which was to present, and interpret the voice of each of the twins, within a systemic frame work.

Design and Participants:

This study was a case series design with each case study including a set of twins, their mother and where relevant a clinician. This included a set of twins where both had a diagnosis of anorexia nervosa; a set of twins where one had a diagnosis of anorexia nervosa and one had a diagnosis of depression; a set of twins where one had a diagnosis of depression and one had no diagnosis; and a set of twins where both twins had no diagnosis.

Measures:

The measures used were the ‘Telephone Zygosity Questionnaire’ (TZQ) developed by Peeters et al; the ‘Sibling Inventory of Differential Experience’ (SIDE) developed by Daniels & Plomin; self designed semi structured interview schedule. The interviews were transcribed and analyzed using Interpretive Phenomenological Analysis (IPA) using some Grounded Theory techniques.

Results:

The main themes that emerged were around the issues of comparison, the twin relationship, enforced togetherness or separation of the twin pair, and how much of an “issue” being a twin was for the twins themselves. Jealousy and competitiveness seems to be more destructive when it originates from within the twinship. The twin relationship does not seem to be understood in the treatment setting.

Implications:

These findings suggest that a better understanding is required of the twin relationship for the twin who is seen on their own within treatment settings. In addition treatment/therapy training establishments need to address issues around relationships for treatment directed at twins.

See theses below

Doctorate in Systemic Psychotherapy. Tavistock / UEL. Doctorate Thesis. 2005

Eight Shona women, aged between twelve and fifty-five years old, and from different social contexts in Zimbabwe, were asked to tell their stories about mothering girls whose biological mothers have died of AIDS.

Their narratives are situated in a context of constant and unprecedented change, and in which the women have also lost children, siblings, parents and other relatives.  They describe how they are redefining themselves with their remaining family members, and communities, in a context of extreme economic and social collapse.

Any conversations about AIDS are severely constrained by stigma and taboo and the women are faced with the dilemmas of re-storying family life, fraught with danger of distressing themselves and those they talk with.  Their narratives focus on strategies for survival, managing newly created families, and preparing the girls for adulthood in the context in which sex is dangerously associated with death.

Interview contexts had to be selected carefully, so that participants felt safe and empowered. The challenge for the researcher, who was of a different culture, social status and language base, was to attend to intellectual and emotional processes which influenced the way in which she witnessed, heard and represented the stories.

Interpreters were coached in interviewing, and their interpretations were examined with a view to minimizing linguistic and semantic misunderstandings.

Whilst dimensions of language, culture and context influenced the presenting and hearing of the narratives, this study highlighted the importance of attending to the process of data collection in research, as much as the analysis and interpretation of findings. 

Doctorate in Systemic Psychotherapy. Doctorate Thesis. 2004.

This research shows how kinship care is a small but significant way of caring for children in British society today, a safety net family response to the needs of children to be looked after following the absence or inability of their birth parents. I explore through discourse and rhetorical analysis of interviews and therapy sessions with carers and their families, the process of negotiating entitlements in kinship care, recognising the dilemmas with which families can struggle as they draw on conflicting understandings of family relationships, family ties and parental authority in making decisions about the children they care for. I make use of the Co-ordinated Management of Meaning framework to consider how families draw on these discourses from personal, family and cultural levels of meaning as they work through the family changes involved in setting up and day-to-day experience of kinship care. I show that justificatory discourses of mothering and fathering, at times increase the likelihood of discord unless families are able to hold a complementary rather than conflictual perception of the multiple attachments, authorities and relationships involved in kinship care.

The centrality of such discourses in carers’ accounts contrasts with the marginalisation of discourses of loss and protest, the latter being more audible in the analysis of therapy sessions where I was able to hear the voices of the children and young people present. In systemic therapy contested meanings of family members’ experiences and resulting dilemmas of how to act are analysed, showing how their exploration and deconstruction in therapy can enable families to hear each others’ accounts and to consider how to move on with their lives together.

See also publication

Ziminski, J. (2007) Systemic practice with kinship care families. Journal of Social Work Practice 21, 2, 239–250.

Ziminski, Jeanne (2014) The wider family context of kinship care. In: Inside kinship care: Understanding family dynamics and providing effective support. Jessica Kingsley, London, pp. 79-93. ISBN 9781849053464 Full text not yet available from this repository.

See theses below

Doctorate in Systemic Psychotherapy. Doctorate Thesis. Tavistock / UEL. 2000.

In this thesis I describe a study of a small group of transgendered adolescents and their parents, referred to a specialist NHS service.   This was a qualitative study based on interviews with seven adolescents, all with a diagnosis of gender dysphoria of childhood, and on separate interviews with thirteen parents. I looked specifically at how the adolescents and parents build an intelligible account of the young person’s gender identity development, how their accounts interact with their coping behaviour, how they manage communication about the gender issues, and how they believe that these issues have impacted on relationships within the family.  

The first person reports were analysed using Grounded Theory methodology.   Into this methodology I incorporated a concern with researcher reflexivity and a commitment to a narrative/constructionist approach. There were several suggestive findings in a number of domains:  how communication is managed with great care in the interview families, with people tending to build their accounts in solitary ways; how the young people and their parents recognise that their response to the transgenderism is a deeply moral issue concerned with their worth as people, and involving them in providing accounts that attempt to explicate the young person’s departure from ‘normal’ development; how an active approach to coping by parents is associated with greater acceptance of the child’s cross-gender identification; how a biological explanation of the cause of transgenderism prevailed amongst the adolescents and the more accepting parents; how the young people are preoccupied with changing the body, and reject self-reflexivity around their gender identity development. The limitations of the study are discussed, reflexivity issues are explored and ideas for further research are proposed.   The implications of the study for therapeutic work with transgendered adolescents and their parents are elaborated. 

See also publication.

Wren, Bernadette (2012) Researching the moral dimension of first-person narratives. Qualitative Research in Psychology, 9 (1). pp. 47-61. ISSN 1478-0887 (Print), 1478-0895 (Online) Full text not yet available from this repository.

Wren, Bernadette (2014) Thinking postmodern and practising in the enlightenment: Managing uncertainty in the treatment of children and adolescents. Feminism & Psychology 24(2):271-291

See theses below

Doctorate in Systemic Psychotherapy. Doctorate Thesis. Tavistock/UEL 2005

This qualitative research explores the process of change in parent-infant psychotherapy. Two mothers suffering from emotional breakdowns in the perinatal period agreed for their therapy to be analysed. The treatment model involved the use of video-observation (Beebe, 2003). In many of the therapy sessions the mothers were filmed interacting with their babies for five minutes. In the following session the mother watched the video. From this observer position, the mothers were invited to comment freely on what they observed. The research question investigated how occupying this observer position influenced the therapeutic process.

The data consisted of fifty transcribed psychotherapy sessions; the method of analysis chosen was a form of theme analysis. The findings suggest that parent-infant psychotherapy enhanced the parents’ reflective functioning (Fonagy, Steele, Steele, Leigh, Kennedy, & Mattoon, 1995; Slade, 2002), and the use of video facilitated the process. At the start of therapy both mothers were vulnerable and heavily defended and their defensive processes impacted upon their babies. The findings illustrate that the therapy helped modify their defensive responses and this brought relief for their babies. The mothers’ reflexive capacities grew and their relationships with their babies became more rewarding.

The efficacy of the video occurred within a structured, trustworthy therapeutic relationship which was theoretically informed by systemic and psychoanalytic understandings. The research concluded that unless such a relationship is in place, the use of video in the way described should be considered with caution.

Also see publication

Jones, A. (2006) Levels of change in parent-infant psychotherapy. Journal of Child Psychotherapy, 32/3: 295-311.

Anthias, Louise (2015) Constructing personal and couple narratives in late stage cancer: A narrative analysis. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Down, Gwynneth (2007) Understanding roles and relationships in the care of ill children: A systemic analysis. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. 

Fletcher, Paul (2014) I know you can't see it but it hurts: A research study of the experiences of young people, their parents and healthcare professionals who live and work with medically unexplained physical symptoms. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Mason, Barry (2003) The development of a relational approach to the understanding, treatment and management of chronic pain.  DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full test available.

Hickman, Susan Mary (2014) Shared understandings? The interface between systemic psychotherapists and the family courts. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Guregård, Suzanne (2009) Open dialogue across cultures: Establishing a therapeutic relationship with the refugee family. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust.

Doctorate in Systemic Psychotherapy. Tavistock / UEL. Doctorate Thesis. 2003.

This is a qualitative and exploratory study, from a systemic therapeutic point of view, of the links between public and private discourses in the explanations young people in Harare, Zimbabwe, give of their deliberate self harm. The study is concerned with establishing the variety of forms in which relationships may be perceived between individual adolescent narratives of despair (and consequently self harm) and a broader social and cultural context. In regard to this study postcolonial theory in relation to southern Africa is used as a privileged explanatory construct, not because young people themselves find such theoretical models to be useful therapeutically, but because as the researcher I have found it a useful means with which to connect private and public discourses. Colonial process in relation to Zimbabwe is described and explored. The theoretical work of Achille Mbembe is foregrounded in this. The eleven young people who participated in the study are described, as are the transcript and research narratives they provided. Methodologies used were a theoretical analysis, Interpretative Phenomenological Analysis and Narrative Analysis. These analysises show a textured picture of young people struggling to voice painful emotion in elational contexts which are also heavily impacted by colonial history and traumatic process, and suggest self harm moving from expression to coping mechanism. These descriptions are related to systemic theory and practice, as well as to the Zimbabwean crisis.

McCann, Damian (2011) What does violence tell us about gay male couple relationships? DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

Doctorate of  Systemic Psychotherapy. Tavistock & University of East London. Dec 2006

This study examines the factors and processes by which individual women identify their sexual orientation. The subject of women’s sexuality and sexual orientation development is analysed from different theoretical perspectives in the literature review, with particular focus being placed on contributions made by  Systemic Psychotherapy. 

Using the Interpretative Phenomenological Approach and principles derived from Grounded Theory and Memory Work, the research study analyses the views of women across the sexual orientation range, which have been obtained through  interviews. It also examines ideas derived from critical discussions with different practitioners and clinicians on the subject. While the study focuses on the women’s individual ideas and thoughts, it adopts  a broader perspective on the role played by wider systemic factors such as relevant historical events, the socio - political milieu, the question of the influence of biological factors on sexual orientation development, as well as the role played by the family, the wider community, work and friendship networks. 

The  study  is qualitative in nature. It is aimed at trying to reach an understanding of how these women experience their sexual development, how they negotiate related changes within their lives and the meanings made of these events. Writers within the Systemic psychotherapy field have called attention to the fact that Systemic Psychotherapy has been slow to address issues to do with sex and sexuality issues.

The study is aimed at opening up theoretical and clinical practice discussions on the subject of women’s sexuality, rather than make generalisations about women.  It is hoped that the issues raised in the study,  as well as the debates and dilemmas highlighted,  will be used as a platform from which to continue the enquiry with the hope of encouraging further research and theory development. 

Roman-Morales, Monica (2017) Intersectionality in the construction of authority: A systemic supervisor’s perspective. DSysPsych thesis, Tavistock and Portman NHS Foundation Trust. Full text available

See theses below

Doctorate In Systemic Psychotherapy. Tavistock/UEL. Doctoral Thesis. 2020.

DeRue (2011) finds that the literature on leadership emphasizes dominant discourses in which the personality characteristics, ability and leadership behaviour of the individual leader are central because these are important influences on employees. Ancone & Backman (2008) and Heifetz (1994) find the same trend in their review of leadership research between 2003 and 2008. For example, 84% of leadership research focuses on the leader as an individual with formal authority. However, researchers have recognized that leadership is about managing complexity and social dynamics that are context dependent.

This thesis explores how participants in a systemic leadership programme experience their learning process. The following research questions were investigated: (1) How do leaders in systemic leadership programmes construct new meaning for leadership? and (2) How do systemic leadership programmes affect the co-creation of leadership practice, and how do they affect participants’ personal discourses about their leadership? Data were collected through sixteen qualitative in-depth interviews with twelve participants and five days of fieldwork observations of leadership training. A discourse psychology analysis led to the identification of three main discourses: (1) The discourse of embodied leadership training, (2) The discourse of relational leadership and its challenges, and (3) The discourse of power and hierarchy in leadership. The research suggests that systemic approaches will humanize leadership, as people will experience and be part of continuous development, both individually and as part of something greater than themselves. A systemic approach to leadership is more flexible and dynamic than other contextual frameworks. This systemic approach to leadership training utilized actual everyday contexts that guide practice for how leaders and co-workers’ function at work. The findings of this study show that this systemic approach acts as a “bridge builder” between the dominant individualistic discourses and a more complex contextual approach.



Research references

We include research which is directly relevant and useful to family therapy and systemic practice, and to the families, individuals and communities...

Other Systemic Doctorate and PhD Research Theses

Titles and links to Systemic Doctorate and Phd Theses carried out at other Institutes and Universities