How Do Collaborative Approaches Shape Power Dynamics in Therapeutic Relationships? Evidence From Recovery-Oriented...

Area of Science:

• Mental Health Services Research
• Social Psychology
• Qualitative Research Methods

Background:

• Recovery-oriented mental health services prioritize collaboration and user involvement.
• Understanding power dynamics within these collaborative relationships is crucial but underexplored.
• This study investigates the interactive production and negotiation of power in therapeutic relationships.

Purpose of the Study:

• To explore how power dynamics are interactionally produced, negotiated, and made visible.
• To analyze the enactment of power within collaborative recovery-oriented therapeutic relationships.
• To contribute a qualitative framework for understanding power as a relational process.

Main Methods:

• 15 service users and 15 facilitators from an Italian mental health service participated.
• Data included 30 individual and 15 dyadic interviews, with dyadic interviews observing interaction.
• A narrative-interactional framework analyzed co-construction, confirmation, redirection, and constraint of participants' narratives.

Main Results:

• Four patterns of power dynamics were identified: parity-oriented, declared parity with dominance, non-categorizable, and acknowledged dominance.
• Parity-oriented dyads showed reciprocal narrative completion and mutual recognition.
• Other dyads revealed asymmetrical narrative control despite declared collaboration; professional roles did not solely determine power enactment.

Conclusions:

• Collaboration in recovery-oriented relationships is not solely based on declarations or roles but on situated interactional practices.
• Analysis of situated interaction reveals how participants make space for, limit, complete, or authorize each other's accounts.
• The study provides a qualitative framework for analyzing power as a negotiated, relational process in therapeutic settings.