How do clients agentively manage or negotiate their moral identities while in therapeutic convers...

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How do clients agentively manage or negotiate their moral identities while in therapeutic conversation? by Mind Map: How do clients agentively manage or negotiate their moral identities while in therapeutic conversation?

1. Current therapies

1.1. cognitive-behavioural therapy

1.2. Individual vs. group

1.3. self-help

1.4. 12-step

1.5. social constructionist

1.5.1. solution-focused brief therapy

1.5.2. narrative therapy

1.5.3. motivational interviewing

2. Sociocultural/Symbolic Elements

2.1. Gender

2.1.1. stereotypical roles

2.1.1.1. caregiver

2.1.1.2. provider

2.2. Media

2.2.1. Glamorized portrayal (poker shows)

2.2.2. Negative (intervention, cinema)

2.3. Oppression

2.4. Peer pressure

2.5. Race

2.6. Shame/Guilt

2.7. Social acceptance

2.8. Socioeconomic status (SES)

2.9. Stigma

2.9.1. societal

2.9.2. self

2.9.3. professional

2.9.4. therapeutic

2.9.5. religious

2.9.6. multiple

2.10. Use of labels

3. Types of Gambling

3.1. Poker

3.2. Video lottery terminals

3.3. Horse/dog

3.4. Online

3.5. Casino games

3.6. Lottery

3.7. Sports

4. Revelations

4.1. Client

4.1.1. "Keeping a therapy journal helped me in recovery"

4.1.2. "Further meetings/conferences between client and counsellors"

4.1.3. New appreciation for therapeutic intention of counsellors"

4.1.4. "Need to take responsibility for own actions"

4.2. Counsellor

4.2.1. "Important to use common language with this client population"

4.2.2. "Not all gambling activities are the same"

4.2.3. Acknowledgement of reasons for client resistance

4.2.4. Need to increase research into therapy for problem gamblers

4.2.5. "Better understanding of how culture impacts recovery for problem gamblers"

4.2.6. "It is not enough to say that I am a trained counsellor"

4.2.7. Need to challenge existing literature on PG"

4.2.8. Client inclusion in setting therapeutic goals

4.2.9. Further training in order to work with PG population

4.2.10. Learning from clients

4.2.11. Importance of client feedback

4.2.12. Ability to see uniqueness of client issues not 'condition'

4.2.13. Increasing awareness of multiple stigmas attached to problem gambling

5. Client Agency

5.1. "I am not an addict"

5.2. "It is not their role to make me better"

5.3. "Resistance is not resistance"

5.4. Acceptance

5.5. Asserting individuality

5.6. Changing focus/topics

5.7. Conflict

5.8. Contrary positions

5.9. Correcting the therapist

5.10. Disagreement

5.11. Giving and taking advice from other gamblers

5.12. Interference

5.13. Interrupting

5.14. Moral accountability

5.15. Moral management

5.16. Offering counter points

5.17. Personal responsibility

5.18. Placating

5.19. Realizing own strength

5.20. Reframing issue

5.21. Refusal

5.22. Rising to challenges/realizing personal strength

5.23. Showing frustration

5.24. Taking a stand

5.25. Therapeutic negotiation

5.26. Use of anger

5.27. Using different language

5.28. Using silence

6. Related Discourses

6.1. 12-Step discourse

6.1.1. "Keeping up with the Joneses"

6.1.2. Powerlessness

6.1.3. "Hitting rock bottom:

6.1.4. Sense of community

6.2. Disease

6.3. Dominant Addiction

6.3.1. Being an "addict"

6.3.2. Pathology

6.3.3. Medicalization

6.4. Empowerment

6.5. Health & Illness

6.6. Identity

6.6.1. Identity work

6.6.2. Public vs. private

6.6.3. Personal identity

6.6.4. Stigmatized identity

6.7. Institutional

6.8. Morality

6.8.1. addiction

6.8.2. problem gambling

6.9. Normality

6.9.1. Stereotypes

6.9.2. 'Myth' of the problem gambler

6.9.3. Deviancy of PB

6.10. Postmodernism

6.11. Recovery

6.12. Relationship

6.13. Religion

6.14. Resiliency

6.15. Resistance

6.16. Sobriety/Abstinence

6.17. Success

6.18. Therapy

6.18.1. Willingness vs. wilfullness

6.18.2. Meaning-making

6.18.3. Pain vs. suffering

6.18.4. Curiosity

6.18.5. Use of mindfulness

6.18.6. Humor

6.18.7. Triggers

6.19. Treatment

7. Emerging Questions

7.1. Are attitudes towards problem gamblers different according to the discipline of the health care practitioner?

7.2. Are the emerging types of gambling more damaging?

7.3. Are there alternatives to therapy for the problem gambler?

7.4. Can action research help facilitate positive change for problem gamblers?

7.5. How do clients support views of themselves that are not always available in sessions?

7.6. How does a counselllor repair a ruptured therapeutic alliance with this population?

7.7. I s there any acknowledged personal growth from the PB clients as a result of engagement in therapy?

7.8. Is it possible to separate problem gambling from addiction?

7.9. Is online couneelling a viable option for some problem gamblers?

7.10. Is there a split between academia and practice in this field?

7.11. What constitutes conversational agency in this investigation?

7.12. What is the impact of the changes in the DSM for clients?

7.13. What role does natural recovery play in answering the research question?

7.14. Why is there such little mention of discursive therapies?

8. Collective Human Elements/Actors

8.1. 12-step programs

8.1.1. Lifering

8.1.2. Umbrella

8.1.3. GA

8.1.4. NA

8.1.5. AA

8.2. Academics/reserachers

8.3. Canadian health care system

8.4. Discourse Interest Group: University of Calgary

8.5. Employee assistance counselling (EAP)

8.6. Government

8.7. Health care practitioners

8.7.1. Registered clinical counsellors

8.7.2. Psychiatrists

8.7.3. Psychologists

8.7.4. General practitioners

8.7.5. Social workers

8.7.5.1. Nurse therapists

8.7.6. Nurse therapists

8.8. Other problem gamblers

8.9. Problem gamblers

8.10. Supports

8.10.1. Family

8.10.1.1. Parents

8.10.1.2. Partner

8.10.1.3. Children

8.10.1.4. Siblings

8.10.1.5. Extended family

8.10.2. Peers

8.10.2.1. Coworkers

8.10.2.2. Friends

8.11. Therapeutic alternatives

8.12. Vancouver Island Health Authority (VIHA)

8.13. Workplace

8.14. Workplace

9. Spacial elements

9.1. Groupspace

9.2. Casinos

9.3. Office

9.4. Furniture

9.5. Distance traveled for help

9.6. Clinic

9.7. Waiting rooms

9.8. Victoria, BC

9.9. Downtown

9.10. Racetrack

9.11. Hospital

9.12. Church

9.13. Public vs. private

10. Temporal Elements

10.1. Follow-up sessions

10.2. Single sessions

10.3. Short vs. long term therapy

10.4. Accumulation of financial burden

10.4.1. Bankruptcy

10.5. Maturation of client

10.6. Changes in lifestlye

10.7. Increase/decrease in gambling behaviour

10.8. Changes in perception of self over time

10.9. Type of gambling influenced by age and income

10.10. Client change

10.11. Decline in personal health

10.12. Relapse

11. Major/Contested Issues

11.1. Client

11.1.1. Safety

11.1.2. Openness of therapist

11.1.3. "I knew nothing about the therapist"

11.1.4. Counsellor background

11.1.5. Counselling showing empathy

11.1.6. Cousellor education

11.1.7. "I felt like I did something bad"

11.1.8. Being 'fixed' not 'helped

11.1.9. Counsellor competency

11.1.10. "Harming' vs. 'helping'

11.1.11. Judgment

11.1.12. Trust

11.1.13. "Coaching' vs. 'counselling'

11.1.14. Being understood

11.1.15. Confusion about therapeutic process

11.1.16. Personal ability to verbalize concerns (Shyness)

11.1.17. Relevancy of therapeutic conversation

11.1.18. Importance of personal story/narrative

11.2. Counsellor

11.2.1. "reckless" clients

11.2.2. "what the textbook says vs. what actually happens in therapy"

11.2.3. challenging client behaviour

11.2.4. "Firing" clients

11.2.5. Sticking to therapeutic plan

11.2.6. Need for empirically-supported treatment

11.2.7. Evidence of "other" addictions

11.2.8. Expectations of clinic

11.2.9. View that practitioner is responsible for changing clients

11.2.10. Client indifference

11.2.11. Keeping clients accountable

11.2.12. Comfort over not being liked by clients

11.2.13. Other presenting concerns

11.2.14. "Healthy" therapeutic dialogue

11.3. Shared

11.3.1. Being "out of sync"

11.3.2. Is problem gambling a mental health issue?

11.3.3. Age discrepancy of client/counsellor

11.3.4. Directive vs. client centered approach

11.3.5. Impact of substance use

11.3.6. Homework

11.3.7. Personality mismatch

11.3.8. Congruency b/n values and beliefs

11.3.9. Previous counselling/ counsellors

11.3.10. Expectation of results

11.3.11. Awareness of various types of gambling

11.3.12. Diagnosis

11.3.13. Readiness for change

11.3.14. "Teaching' ciient

11.3.15. Severity of problem

12. Political Elements

12.1. Billing

12.2. Client rights

12.3. Culture/subcultures

12.4. Decline in government spending on health care issues

12.5. Ethical responsibilities

12.6. Harm-reduction

12.7. Lack of clear regulation of treatment services

12.8. Systematic inequalities

12.9. The economy

13. Non-Human Elements

13.1. Participation screening for study

13.2. Participant recruitment for study

13.3. Focus groups

13.4. Individual interviews

13.5. Teleconference

13.6. Digital recorder

13.7. Internet

13.8. Emails

13.9. Primary researcher memos

13.10. Primary researcher journal

13.11. Member/accuracy checks

13.12. Consultation

13.13. Medication

13.14. Drugs/alcohol

14. Individual Actors

14.1. Academic supervisor

14.2. Colleagues

14.3. Erving Goffman

14.4. Participant clients

14.5. Participants therapists

14.6. Primary researcher

14.7. Stakeholders

14.8. Workplace coordinator

15. Other kinds of elements

15.1. Barriers to treatment

15.2. Ability to pay for sessions

15.3. Mood

15.3.1. Sadness

15.3.2. Fear

15.3.3. Apprehension

15.3.4. Depression

15.3.5. Anxiety

15.4. Emotions

15.5. Types of gambling

15.6. Stress