How Do Collaborative Approaches Shape Power Dynamics in Therapeutic Relationships? Evidence From Recovery‐Oriented Mental Health Services.
Introduction: Recovery‐oriented mental health services emphasise collaboration, empowerment and service‐user involvement. However, less is known about how power is enacted within relationships described as collaborative. This study explores how power dynamics are interactionally produced, negotiated...
| Publicado en: | Health Expectations Vol. 29; no. 3; pp. 1 - 17 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194811316&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194811316 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13696513 EVY jtl: Health Expectations issn: 13696513 maglogo: Y pubinfo: dt: Jun2026 vid: 29 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 194811316 194811316 194811316 10.1111/hex.70707 194811316 ppf: 1 ppct: 16 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: How Do Collaborative Approaches Shape Power Dynamics in Therapeutic Relationships? Evidence From Recovery‐Oriented Mental Health Services. aug: au: Faccio, Elena Rocelli, Michele Binaggia, Lorenzo Giolli, Elisa Romaioli, Diego Chiara, Giacomo Agostini, Claudio Vitelli, Roberto Aquili, Ludovica affil: Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy sug: subj: Mental Disorders Therapy Power Group Dynamics Therapeutic Alliance Recovery Mental Health Services Physician-Patient Relations Human Funding Source Italy Male Female Adult Middle Age Qualitative Studies Semi-Structured Interview Audiorecording Descriptive Statistics Thematic Analysis Interrater Reliability Social Dominance Narratives Professional Role Cooperative Behavior Patient Participation Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Introduction: Recovery‐oriented mental health services emphasise collaboration, empowerment and service‐user involvement. However, less is known about how power is enacted within relationships described as collaborative. This study explores how power dynamics are interactionally produced, negotiated and made visible within recovery‐oriented therapeutic relationships. Methods: The study involved 15 service users from an Italian recovery‐oriented mental health service and 15 facilitators identified by them as significant to their recovery. Data comprised 30 individual interviews and 15 dyadic interviews. Dyadic interviews served both to gather participants' accounts and to observe how the relationship was narratively enacted in interaction. Transcripts were analysed through a narrative‐interactional framework informed by Gubrium and Holstein's approach, with attention to narrative activation, composition, performance, collaboration and control. Coding focused on both what participants said about the relationship and how they co‐constructed, confirmed, redirected or constrained each other's narratives. Results: Four interpretive patterns were identified: parity‐oriented dynamics, declared parity with observed dominance, non‐categorizable dynamics, and acknowledged dominance. These patterns are better understood as heuristic configurations rather than definitive typologies. Parity‐oriented dyads were characterised by reciprocal narrative completion, mutual recognition and flexible turn‐taking. In other dyads, participants described the relationship as collaborative, while interaction showed more asymmetrical narrative control. One dyad displayed acknowledged directiveness, experienced by the service user as supportive rather than coercive. Across cases, professional role alone did not explain how power was enacted. Conclusion: Collaboration in recovery‐oriented relationships cannot be inferred from participants' declarations or professional role categories alone. Rather, it needs to be examined through the situated interactional practices by which participants make space for, limit, complete or authorise one another's accounts. The study contributes a qualitative framework for analysing power as a relational and negotiated process within therapeutic relationships. Patient or Public Contribution: Individuals with lived experience were actively involved in interpreting the research findings through discussion and feedback sessions. A final dissemination meeting with participants enabled the validation of these interpretations and contributed to concluding reflections on the practical implications for mental health services. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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