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Sample records for therapist performance rtp

  1. Performance Monitoring for Nuclear Safety Related Instrumentation at PUSPATI TRIGA Reactor (RTP)

    International Nuclear Information System (INIS)

    Zareen Khan Abdul Jalil Khan; Ridzuan Abdul Mutalib; Mohd Sabri Minhat

    2015-01-01

    The Reactor TRIGA PUSPATI (RTP) at Malaysia Nuclear Agency is a TRIGA Mark II type reactor and pool type cooled by natural circulation of light water. This paper describe on performance monitoring for nuclear safety related instrumentation in TRIGA PUSPATI Reactor (RTP) of based on various parameter of reactor safety instrument channel such as log power, linear power, Fuel temperature, coolant temperature will take into consideration. Methodology of performance on estimation and monitoring is to evaluate and analysis of reactor parameters which is important of reactor safety and control. And also to estimate power measurement, differential of log and linear power and fuel temperature during reactor start-up, operation and shutdown .This study also focus on neutron power fluctuation from fission chamber during reactor start-up and operation. This work will present result of performance monitoring from RTP which indicated the safety parameter identification and initiate safety action on crossing the threshold set point trip. Conclude that performance of nuclear safety related instrumentation will improved the reactor control and safety parameter during reactor start-up, operation and shutdown. (author)

  2. Study on Reactor Performance of Online Power Monitoring in PUSPATI TRIGA Reactor (RTP)

    International Nuclear Information System (INIS)

    Zareen Khan Abdul Jalil Khan; Ridzuan Abdul Mutalib; Mohd Sabri Minhat

    2014-01-01

    The Reactor TRIGA PUSPATI (RTP) at Malaysia Nuclear Agency is a TRIGA Mark II type reactor and pool type cooled by natural circulation of light water. This paper describe on reactor performance of online power monitoring based on various parameter of reactor such as log power, linear power, period, Fuel and coolant temperature and reactivity parameter with using neutronic and other instrumentation system of reactor. Methodology of online power estimation and monitoring is to evaluate and analysis of reactor power which is important of reactor safety and control. Neutronic instrumentation system will use to estimate power measurement, differential of log and linear power and period during reactor operation .This study also focus on noise fluctuation from fission chamber during reactor operation .This work will present result of online power monitoring from RTP which indicated the safety parameter identification and initiate safety action on crossing the threshold set point trip. Conclude that optimization of online power monitoring will improved the reactor control and safety parameter of reactor during operation. (author)

  3. Steganography using RTP packets

    OpenAIRE

    Pontón Loaiza, Melina Marcela

    2014-01-01

    En tiempos actuales, donde la mayoría de las comunicaciones se realizan a través de medios digitales, la privacidad y seguridad al transmitir información pueden ser fácilmente vulnerables. La esteganografía, siendo la ciencia de ocultar comunicaciones secretas en medios aparentemente inocentes, nos puede ayudar a alcanzar este propósito. El objetivo del presente trabajo es el de actualizar y mejorar la herramienta esteganográfica stegan RTP, además de analizar las diferentes maneras en que la...

  4. Neutronics calculation of RTP core

    Science.gov (United States)

    Rabir, Mohamad Hairie B.; Zin, Muhammad Rawi B. Mohamed; Karim, Julia Bt. Abdul; Bayar, Abi Muttaqin B. Jalal; Usang, Mark Dennis Anak; Mustafa, Muhammad Khairul Ariff B.; Hamzah, Na'im Syauqi B.; Said, Norfarizan Bt. Mohd; Jalil, Muhammad Husamuddin B.

    2017-01-01

    Reactor calculation and simulation are significantly important to ensure safety and better utilization of a research reactor. The Malaysian's PUSPATI TRIGA Reactor (RTP) achieved initial criticality on June 28, 1982. The reactor is designed to effectively implement the various fields of basic nuclear research, manpower training, and production of radioisotopes. Since early 90s, neutronics modelling were used as part of its routine in-core fuel management activities. The are several computer codes have been used in RTP since then, based on 1D neutron diffusion, 2D neutron diffusion and 3D Monte Carlo neutron transport method. This paper describes current progress and overview on neutronics modelling development in RTP. Several important parameters were analysed such as keff, reactivity, neutron flux, power distribution and fission product build-up for the latest core configuration. The developed core neutronics model was validated by means of comparison with experimental and measurement data. Along with the RTP core model, the calculation procedure also developed to establish better prediction capability of RTP's behaviour.

  5. The Effects of Response Effort on Safe Performance by Therapists at an Autism Treatment Facility

    Science.gov (United States)

    Casella, Sarah E.; Wilder, David A.; Neidert, Pamela; Rey, Catalina; Compton, Megan; Chong, Ivy

    2010-01-01

    The effects of response effort on safe behaviors (i.e., glove wearing, hand sanitizing, and electrical outlet replacement) exhibited by therapists at an autism treatment center were examined. Participants were exposed to 2 or 3 levels of effort (i.e., high, medium, low) for each dependent variable. Results showed increased safe performance during…

  6. Propose Reactor Control and Monitoring System for RTP

    International Nuclear Information System (INIS)

    Mohd Sabri Minhat; Izhar Abu Hussin; Mohd Idris Taib; Mohd Khairulezwan Abdul Manan; Nurfarhana Ayuni Joha

    2011-01-01

    Reactor control and monitoring system is a one of the important features used in reactor. The control and monitoring must come together to provide safety, excellent performance and reliable in nuclear reactor technology application. Objectives of this technical paper are to design and propose reactor control system and reactor monitoring system in Research Reactor (RTP) for Reactor Upgrading Project. (author)

  7. The Family Therapist as Intermediary

    Science.gov (United States)

    Hurvitz, Nathan

    1974-01-01

    The family therapist performs specific activities associated with his functions as a therapist, consultant, and intermediary. The intermediary function is based upon concepts associated with symbolic interactionism. (Author)

  8. Bullying among radiation therapists: effects on job performance and work environment.

    Science.gov (United States)

    Trad, Megan; Johnson, Jordan

    2014-01-01

    To identify the effects of workplace bullying in the radiation therapy department on job performance and explore the environment and morale of individuals who work with a bully. A quantitative research study was designed to assess the prevalence and effects of bullying in the radiation therapy workplace. A total of 308 radiation therapists participated in the study for a return rate of 46%. Of those, 194 indicated that workplace bullying was present either in their current workplace or in a previous radiation therapy environment and that it negatively affected job performance and satisfaction. Findings of this study indicate a need for evaluation of the radiation therapy workplace, education on how to identify and prevent bullying behavior, and better communication among members of the radiation therapy environment. Participants indicated that working in a hostile environment led to forgetfulness, ineffective communication, and perceived discrepancies in promotion and treatment by management. Any bullying behavior contributes to an overall toxic work environment, which is unhealthy and unsafe for patients and therapists. Those who manage therapists should promote a culture of safety and embrace their staff's independence.

  9. Thermal stress during RTP processes and its possible effect on the light induced degradation in Cz-Si wafers

    Science.gov (United States)

    Kouhlane, Yacine; Bouhafs, Djoudi; Khelifati, Nabil; Guenda, Abdelkader; Demagh, Nacer-Eddine; Demagh, Assia; Pfeiffer, Pierre; Mezghiche, Salah; Hetatache, Warda; Derkaoui, Fahima; Nasraoui, Chahinez; Nwadiaru, Ogechi Vivian

    2018-04-01

    In this study, the carrier lifetime variation of p-type boron-doped Czochralski silicon (Cz-Si) wafers was investigated after a direct rapid thermal processing (RTP). Two wafers were passivated by silicon nitride (SiNx:H) layers, deposited by a PECVD system on both surfaces. Then the wafers were subjected to an RTP cycle at a peak temperature of 620 °C. The first wafer was protected (PW) from the direct radiative heating of the RTP furnace by placing the wafer between two as-cut Cz-Si shield wafers during the heat processing. The second wafer was not protected (NPW) and followed the same RTP cycle procedure. The carrier lifetime τ eff was measured using the QSSPC technique before and after illumination for 5 h duration at 0.5 suns. The immediate results of the measured lifetime (τ RTP ) after the RTP process have shown a regeneration in the lifetime of the two wafers with the PW wafer exhibiting an important enhancement in τ RTP as compared to the NPW wafer. The QSSPC measurements have indicated a good stable lifetime (τ d ) and a weak degradation effect was observed in the case of the PW wafer as compared to their initial lifetime value. Interferometry technique analyses have shown an enhancement in the surface roughness for the NPW wafer as compared to the protected one. Additionally, to improve the correlation between the RTP heat radiation stress and the carrier lifetime behavior, a simulation of the thermal stress and temperature profile using the finite element method on the wafers surface at RTP peak temperature of 620 °C was performed. The results confirm the reduction of the thermal stress with less heat losses for the PW wafer. Finally, the proposed method can lead to improving the lifetime of wafers by an RTP process at minimum energy costs.

  10. Clinical instructors' perceptions of behaviors that comprise entry-level clinical performance in physical therapist students: a qualitative study.

    Science.gov (United States)

    Jette, Diane U; Bertoni, Alicia; Coots, Renee; Johnson, Heidi; McLaughlin, Catherine; Weisbach, Cody

    2007-07-01

    The purpose of this study was to qualitatively explore clinical instructors' (CIs) perceptions of students' behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making. The participants were 21 physical therapists who were CIs for physical therapist students. Using a grounded theory approach, we conducted interviews, asking the question, "What is it about students' performance that makes you see them as entry-level therapists?" We determined common themes among the interviews and developed a schema to explain the decision-making process. Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students' ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective "gut feeling" that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as "mentored independence." Participants reported evaluating students' performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.

  11. Concurrent design of an RTP chamber and advanced control system

    Energy Technology Data Exchange (ETDEWEB)

    Spence, P. [Sandia National Labs., Livermore, CA (United States); Schaper, C. [Microelectronics Control and Sensing, Inc., Mountain View, CA (United States); Kermani, A. [CVC Products, Inc., Fremont, CA (United States)

    1995-12-31

    A concurrent-engineering approach is applied to the development of an axisymmetric rapid-thermal-processing (RTP) reactor and its associated temperature controller. Using a detailed finite-element thermal model as a surrogate for actual hardware, the authors have developed and tested a multi-input multi-output (MIMO) controller. Closed-loop simulations are performed by linking the control algorithm with the finite-element code. Simulations show that good temperature uniformity is maintained on the wafer during both steady and transient conditions. A numerical study shows the effect of ramp rate, feedback gain, sensor placement, and wafer-emissivity patterns on system performance.

  12. Evaluation of a performance appraisal framework for radiation therapists in planning and simulation

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Jillian, E-mail: jillian.becker@health.qld.gov.au [Radiation Oncology Mater Centre, South Brisbane, Queensland (Australia); Bridge, Pete [School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland (Australia); Brown, Elizabeth; Lusk, Ryan; Ferrari-Anderson, Janet [Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland (Australia); Radiation Oncology Mater Centre, South Brisbane, Queensland (Australia)

    2015-06-15

    Constantly evolving technology and techniques within radiation therapy require practitioners to maintain a continuous approach to professional development and training. Systems of performance appraisal and adoption of regular feedback mechanisms are vital to support this development yet frequently lack structure and rely on informal peer support. A Radiation Therapy Performance Appraisal Framework (RT-PAF) for radiation therapists in planning and simulation was developed to define expectations of practice and promote a supportive and objective culture of performance and skills appraisal. Evaluation of the framework was conducted via an anonymous online survey tool. Nine peer reviewers and fourteen recipients provided feedback on its effectiveness and the challenges and limitations of the approach. Findings from the evaluation were positive and suggested that both groups gained benefit from and expressed a strong interest in embedding the approach more routinely. Respondents identified common challenges related to the limited ability to implement suggested development strategies; this was strongly associated with time and rostering issues. This framework successfully defined expectations for practice and provided a fair and objective feedback process that focussed on skills development. It empowered staff to maintain their skills and reach their professional potential. Management support, particularly in regard to provision of protected time was highlighted as critical to the framework's ongoing success. The demonstrated benefits arising in terms of staff satisfaction and development highlight the importance of this commitment to the modern radiation therapy workforce.

  13. Evaluation of a performance appraisal framework for radiation therapists in planning and simulation

    International Nuclear Information System (INIS)

    Becker, Jillian; Bridge, Pete; Brown, Elizabeth; Lusk, Ryan; Ferrari-Anderson, Janet

    2015-01-01

    Constantly evolving technology and techniques within radiation therapy require practitioners to maintain a continuous approach to professional development and training. Systems of performance appraisal and adoption of regular feedback mechanisms are vital to support this development yet frequently lack structure and rely on informal peer support. A Radiation Therapy Performance Appraisal Framework (RT-PAF) for radiation therapists in planning and simulation was developed to define expectations of practice and promote a supportive and objective culture of performance and skills appraisal. Evaluation of the framework was conducted via an anonymous online survey tool. Nine peer reviewers and fourteen recipients provided feedback on its effectiveness and the challenges and limitations of the approach. Findings from the evaluation were positive and suggested that both groups gained benefit from and expressed a strong interest in embedding the approach more routinely. Respondents identified common challenges related to the limited ability to implement suggested development strategies; this was strongly associated with time and rostering issues. This framework successfully defined expectations for practice and provided a fair and objective feedback process that focussed on skills development. It empowered staff to maintain their skills and reach their professional potential. Management support, particularly in regard to provision of protected time was highlighted as critical to the framework's ongoing success. The demonstrated benefits arising in terms of staff satisfaction and development highlight the importance of this commitment to the modern radiation therapy workforce

  14. Commercial aspects of rapid thermal processing (RTP)

    International Nuclear Information System (INIS)

    Graham, R.G.; Huffman, D.R.

    1996-01-01

    In its broadest sense, Rapid Thermal Processing (RTP TM ) covers the conversion of all types of carbonaceous materials to liquid fuels, high quality fuel gases, and chemicals. Commercial RTP TM activities (including the actual implementation in the market as well as the short-term R and D initiatives) are much narrower in scope, and are focused on the production of high yields of light, non-tarry liquids (i.e. 'bio-crude') from biomass for fuel and chemical markets. RTP TM is not an incineration process. In commercial applications, it is simply the liquification of biomass by the addition of heat at atmospheric pressure in the absence of air or oxygen. There is no direct combustion in the conversion unit. In effect, wood is converted to liquid wood, bagasse to liquid bagasse, straw to liquid straw, etc. The liquid is pourable and pumpable at room temperature, and has approximately the same heating value as the feedstock entering the conversion unit. The typical liquid yield from a representative hardwood at 10 - 15 % moisture content is about 73 % by mass in industrial operations. In general, the yield increases slightly with an increase in feedstock cellulose composition and slightly decreases with an increase in feedstock lignin composition. However, the energy yield remains approximately constant since lignin-derived liquids have a higher energy content than cellulose-derived liquids. RTP TM was commercialised in 1989 after about 10 years of research, development and demonstration. Current product applications include boiler fuel and food chemicals. It is important to note that the primary liquid product or 'bio-crude' is essentially the same whether it is destined for the fuel or the food chemicals markets. refs

  15. Radiation therapists' perceptions of the minimum level of experience required to perform portal image analysis

    International Nuclear Information System (INIS)

    Rybovic, Michala; Halkett, Georgia K.; Banati, Richard B.; Cox, Jennifer

    2008-01-01

    Background and purpose: Our aim was to explore radiation therapists' views on the level of experience necessary to undertake portal image analysis and clinical decision making. Materials and methods: A questionnaire was developed to determine the availability of portal imaging equipment in Australia and New Zealand. We analysed radiation therapists' responses to a specific question regarding their opinion on the minimum level of experience required for health professionals to analyse portal images. We used grounded theory and a constant comparative method of data analysis to derive the main themes. Results: Forty-six radiation oncology facilities were represented in our survey, with 40 questionnaires being returned (87%). Thirty-seven radiation therapists answered our free-text question. Radiation therapists indicated three main themes which they felt were important in determining the minimum level of experience: 'gaining on-the-job experience', 'receiving training' and 'working as a team'. Conclusions: Radiation therapists indicated that competence in portal image review occurs via various learning mechanisms. Further research is warranted to determine perspectives of other health professionals, such as radiation oncologists, on portal image review becoming part of radiation therapists' extended role. Suitable training programs and steps for implementation should be developed to facilitate this endeavour

  16. Assessing Therapist Competence: Development of a Performance-Based Measure and Its Comparison With a Web-Based Measure.

    Science.gov (United States)

    Cooper, Zafra; Doll, Helen; Bailey-Straebler, Suzanne; Bohn, Kristin; de Vries, Dian; Murphy, Rebecca; O'Connor, Marianne E; Fairburn, Christopher G

    2017-10-31

    Recent research interest in how best to train therapists to deliver psychological treatments has highlighted the need for rigorous, but scalable, means of measuring therapist competence. There are at least two components involved in assessing therapist competence: the assessment of their knowledge of the treatment concerned, including how and when to use its strategies and procedures, and an evaluation of their ability to apply such knowledge skillfully in practice. While the assessment of therapists' knowledge has the potential to be completed efficiently on the Web, the assessment of skill has generally involved a labor-intensive process carried out by clinicians, and as such, may not be suitable for assessing training outcome in certain circumstances. The aims of this study were to develop and evaluate a role-play-based measure of skill suitable for assessing training outcome and to compare its performance with a highly scalable Web-based measure of applied knowledge. Using enhanced cognitive behavioral therapy (CBT-E) for eating disorders as an exemplar, clinical scenarios for role-play assessment were developed and piloted together with a rating scheme for assessing trainee therapists' performance. These scenarios were evaluated by examining the performance of 93 therapists from different professional backgrounds and at different levels of training in implementing CBT-E. These therapists also completed a previously developed Web-based measure of applied knowledge, and the ability of the Web-based measure to efficiently predict competence on the role-play measure was investigated. The role-play measure assessed performance at implementing a range of CBT-E procedures. The majority of the therapists rated their performance as moderately or closely resembling their usual clinical performance. Trained raters were able to achieve good-to-excellent reliability for averaged competence, with intraclass correlation coefficients ranging from .653 to 909. The measure was

  17. RTP/I Payload Type Definition for Chat Tools

    OpenAIRE

    Vogel, Jürgen

    2001-01-01

    This document specifies an application-level protocol (i.e., payload type) for chat tools using the Real Time Protocol for Distributed Interactive Media (RTP/I). RTP/I defines a standardized framing for the transmission of application data and provides protocol mechanisms that are universally needed for the class of distributed interactive media. A chat tool provides an instant messaging service among an arbitrary number of users. This documents specifies how to employ a chat tool with RTP/I ...

  18. Refraction, scattering, absorption and mode conversion of ECRH waves in RTP

    International Nuclear Information System (INIS)

    Smits, F.M.A.; Oomens, A.A.M.; Bank, S.L.; Bongers, W.A.; Polman, R.W.; Schueller, F.C.

    1993-01-01

    A diagnostic, TraP, has been installed which measures the Transmitted Power fraction of one of the two additional Electron Cyclotron Heating sources on the RTP tokamak (R=0.72 m, B 0 ≤2.5 T, a=0.164 m). The ECH power (60 GHz, 180 kW) of this source is launched in O-mode radially from the low field side into RTP. TraP is installed opposite to this launcher at the high field side to measure the transmitted power fraction. With TraP, studies on the refraction, scattering, absorption and mode conversion of the incoming beam have been performed. (orig.)

  19. Ab- initio investigation of physical properties of KTP and RTP

    Directory of Open Access Journals (Sweden)

    Marzieh Ghoohestani

    2017-09-01

    Full Text Available In this work,the physical properties of  KTP and RTP single-crystals have been investigated by performing accurate total energy calculations in the framework of density functional theory by using the full-potential linearized augmented plane wave method. The effects of Rb substitution on structural, electronic and optical properties of KTP are discussed. The structural properties have been calculated by using different exchange correlation including LDA, PBE, WC and PBEsol. Also PBEsol approximation and and more accurate approximation mBJ are employed to calculate the energy gap values. The Pseudoinversion values of both crystals have been calculated by using PseudoSymmetry software . Rb substitution effect on pseudosymmetry of KTP and also relation between second-order susceptibility of crystals and the Pseudoinversion values are discussed. The optical coefficients such as refractive index, birefringence values and absorption coefficients have been calculated by using the dielectric function. The anisotropy in the linear optical properties of KTP and RTP crystals have been demonstrated. Then calculated results have been compared.

  20. Assessment of Power Quality Problems for TRIGA PUSPATI Reactor (RTP)

    International Nuclear Information System (INIS)

    Mohd Fazli Zakaria; Ramachandaramurthy, V.K.

    2016-01-01

    The electrical power systems are exposed to different types of power quality disturbances. Investigation and monitoring of power quality is necessary to maintain accurate operation of sensitive equipment especially for nuclear installations. This paper will discuss the power quality problems observed at the electrical sources of PUSPATI TRIGA Reactor (RTP). Assessment of power quality requires the identification of any anomalous behavior on a power system, which adversely affects the normal operation of electrical or electronic equipment. A power quality assessment involves gathering data resources; analyzing the data (with reference to power quality standards) then, if problems exist, recommendation of mitigation techniques must be considered. Field power quality data is collected by power quality recorder and analyzed with reference to power quality standards. Normally the electrical power is supplied to the RTP via two sources in order to keep a good reliability where each of them is designed to carry the full load. The assessment of power quality during reactor operation was performed for both electrical sources. There were several disturbances such as voltage harmonics and flicker that exceeded the thresholds. (author)

  1. Safety Management at PUSPATI TRIGA Reactor (RTP)

    International Nuclear Information System (INIS)

    Ligam, A.S.; Zarina Masood; Ahmad Nabil Abdul Rahim

    2011-01-01

    Adequate safety measures and precautions, which follow relevant safety standards and procedures, should be in place so that personnel safety is assured. Nevertheless, the public, visitor, contractor or anyone who wishes to enter or be in the reactor building should be well informed with the safety measures applied. Furthermore, these same elements of safety are also applied to other irradiation facilities within the premises of Nuclear Malaysia. This paper will describes and explains current safety management system being enforced especially in the TRIGA PUSPATI Reactor (RTP) namely radiation monitoring system, safety equipment, safe work instruction, and interconnected internal and external health, safety and security related departments. (author)

  2. Commercial aspects of rapid thermal processing (RTP)

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R G; Huffman, D R [Ensyn Technologies Inc., Greely, ON (Canada)

    1997-12-31

    In its broadest sense, Rapid Thermal Processing (RTP{sup TM}) covers the conversion of all types of carbonaceous materials to liquid fuels, high quality fuel gases, and chemicals. Scientifically, it is based on the general premise that products which result from the extremely rapid application of heat to a given feedstock are inherently more valuable than those which are produced when heat is applied much more slowly over longer periods of processing time. Commercial RTP{sup TM} activities (including the actual implementation in the market as well as the short-term R and D initiatives) are much narrower in scope, and are focused on the production of high yields of light, non-tarry liquids (i.e. `bio-crude`) from biomass for fuel and chemical markets. Chemicals are of significant interest from an economical point of view since they typically have a higher value than fuel products. Liquid fuels are of interest for many reasons: (1) Liquid fuels do not have to be used immediately after production, such as is the case with hot combustion gases or combustible gases produced via gasification. This allows the decoupling of fuel production from the end-use (ie. the conversion of fuel to energy). (2) The higher energy density of liquid fuels vs. that of fuel gases and solid biomass results in a large reduction in the costs associated with storage and transportation. (3) The costs to retrofit an existing gas or oil fired combustion system are much lower than replacement with a solid fuel combustor. (4) In general, liquid fuel combustion is much more efficient, controllable, and cleaner than the combustion of solid fuels. (5) The production of liquid `bio-crude` permits the removal of ash from the biomass prior to combustion or other end-use applications. (6) Gas or liquid fuel-fired diesel or turbine engines cannot operate commercially on solid fuels. Although wood represents the biomass which is of principal commercial interest (including a vast array of wood residues

  3. Commercial aspects of rapid thermal processing (RTP)

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R.G.; Huffman, D.R. [Ensyn Technologies Inc., Greely, ON (Canada)

    1996-12-31

    In its broadest sense, Rapid Thermal Processing (RTP{sup TM}) covers the conversion of all types of carbonaceous materials to liquid fuels, high quality fuel gases, and chemicals. Scientifically, it is based on the general premise that products which result from the extremely rapid application of heat to a given feedstock are inherently more valuable than those which are produced when heat is applied much more slowly over longer periods of processing time. Commercial RTP{sup TM} activities (including the actual implementation in the market as well as the short-term R and D initiatives) are much narrower in scope, and are focused on the production of high yields of light, non-tarry liquids (i.e. `bio-crude`) from biomass for fuel and chemical markets. Chemicals are of significant interest from an economical point of view since they typically have a higher value than fuel products. Liquid fuels are of interest for many reasons: (1) Liquid fuels do not have to be used immediately after production, such as is the case with hot combustion gases or combustible gases produced via gasification. This allows the decoupling of fuel production from the end-use (ie. the conversion of fuel to energy). (2) The higher energy density of liquid fuels vs. that of fuel gases and solid biomass results in a large reduction in the costs associated with storage and transportation. (3) The costs to retrofit an existing gas or oil fired combustion system are much lower than replacement with a solid fuel combustor. (4) In general, liquid fuel combustion is much more efficient, controllable, and cleaner than the combustion of solid fuels. (5) The production of liquid `bio-crude` permits the removal of ash from the biomass prior to combustion or other end-use applications. (6) Gas or liquid fuel-fired diesel or turbine engines cannot operate commercially on solid fuels. Although wood represents the biomass which is of principal commercial interest (including a vast array of wood residues

  4. Assessing Therapist Competence : Development of a Performance-Based Measure and Its Comparison With a Web-Based Measure

    NARCIS (Netherlands)

    Cooper, Zafra; Doll, Helen; Bailey-Straebler, Suzanne; Bohn, Kristin; de Vries, Dian; Murphy, Rebecca; O'Connor, Marianne E; Fairburn, Christopher G

    2017-01-01

    BACKGROUND: Recent research interest in how best to train therapists to deliver psychological treatments has highlighted the need for rigorous, but scalable, means of measuring therapist competence. There are at least two components involved in assessing therapist competence: the assessment of their

  5. Shielding Calculations for PUSPATI TRIGA Reactor (RTP) Fuel Transfer Cask with Micro shield

    International Nuclear Information System (INIS)

    Nurhayati Ramli; Ahmad Nabil Abdul Rahim; Ariff Shah Ismail

    2011-01-01

    The shielding calculations for RTP fuel transfer cask was performed by using computer code Micro shield 7.02. Micro shield is a computer code designed to provide a model to be used for shielding calculations. The results of the calculations can be obtained fast but the code is not suitable for complex geometries with a shielding composed of more than one material. Nevertheless, the program is sufficient for As Low As Reasonable Achievable (ALARA) optimization calculations. In this calculation, a geometry based on the conceptual design of RTP fuel transfer cask was modeled. Shielding material used in the calculations were lead (Pb) and stainless steel 304 (SS304). The results obtained from these calculations are discussed in this paper. (author)

  6. Clinical experience of rehabilitation therapists with chronic diseases: a quantitative approach.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.

    1998-01-01

    Objectives: To provide an overview of the numbers of patients with selected chronic diseases treated by rehabilitation therapists (physical therapists, occupational therapists, exercise therapists and podiatrists). The study was performed to get quantitative information on the degree to which

  7. Reactor TRIGA PUSPATI (RTP) spent fuel pool conceptual design

    International Nuclear Information System (INIS)

    Mohd Fazli Zakaria; Tonny Lanyau; Ahmad Nabil Ab Rahim

    2010-01-01

    Reactor TRIGA PUSPATI (RTP) is the one and only research reactor in Malaysia that has been safely operated and maintained since 1982. In order to enhance technical capabilities and competencies especially in nuclear reactor engineering a feasibility study on RTP power upgrading was proposed to serve future needs for advance nuclear science and technology in the country with the capability of designing and develop reactor system. The need of a Spent Fuel Pool begins with the discharge of spent fuel elements from RTP for temporary storage that includes all activities related to the storage of fuel until it is either sent for reprocessed or sent for final disposal. To support RTP power upgrading there will be major RTP systems replacement such as reactor components and a new temporary storage pool for fuel elements. The spent fuel pool is needed for temporarily store the irradiated fuel elements to accommodate a new reactor core structure. Spent fuel management has always been one of the most important stages in the nuclear fuel cycle and considered among the most common problems to all countries with nuclear reactors. The output of this paper will provide sufficient information to show the Spent Fuel Pool can be design and build with the adequate and reasonable safety assurance to support newly upgraded TRIGA PUSPATI TRIGA Research Reactor. (author)

  8. Progress and Overview on Neutronics Modelling Development in RTP

    International Nuclear Information System (INIS)

    Mohamad Hairie Rabir; Muhammad Rawi Mohamed Zin; Julia Abdul Karim

    2016-01-01

    Reactor calculation and simulation are significantly important to ensure safety and better utilization of a research reactor. The Malaysian PUSPATI TRIGA Reactor (RTP) achieved initial criticality on June 28, 1982. The reactor is designed to effectively implement the various fields of basic nuclear research, manpower training, and production of radioisotopes. Since early 90s, neutronics modelling were used as part of its routine in-core fuel management activities. The are several computer codes have been used in RTP since then, based on 1D neutron diffusion, 2D neutron diffusion and 3D Monte Carlo neutron transport method. This paper describes current progress and overview on neutronics modelling development in RTP. Several important parameters were analysed such as k_e_f_f, reactivity, neutron flux, power distribution, B_e_f_f, and fission product build-up for the latest core configuration. The developed core neutronics model was validated by means of comparison with experimental and measurement data. Along with the RTP core model, the calculation procedure also developed to establish better prediction capability of RTP behaviour. (author)

  9. Development of the RTP crystal applications for Q-switching operation and second harmonics generation

    International Nuclear Information System (INIS)

    Alnayli, R.Sh.

    2010-01-01

    Complete text of publication follows. A dialed theoretical studies on performances of the ideal RTP crystal for the electro optical applications as Q-switching laser operation and for nonlinear optics application as second harmonics generation are accomplished in this paper. Single or pair RTP crystal of excellent quality with dimensions 5 x 5 x 7.5 mm 3 have proposed as element model to combined Q-switching operation and frequency doublers for 1.06 μm wave length laser. In order to get and interpolate the optimum conditions to combined both of these operations by application this RTP model. The main am of this work was investigated the most influent parameters on the performance of the electro optical Q-switching laser operation such as, the voltage requirement, contrast and extinction ratios, the birefringence effective and withstand threshold on the other hand the influences of the ray walk off, thermal effective on the efficiency of the second harmonics generation as well are investigated. The results were satisfied for the goals of this paper.

  10. Airborne ocean water lidar (OWL) real time processor (RTP)

    Science.gov (United States)

    Hryszko, M.

    1995-03-01

    The Hyperflo Real Time Processor (RTP) was developed by Pacific-Sierra Research Corporation as a part of the Naval Air Warfare Center's Ocean Water Lidar (OWL) system. The RTP was used for real time support of open ocean field tests at Barbers Point, Hawaii, in March 1993 (EMERALD I field test), and Jacksonville, Florida, in July 1994 (EMERALD I field test). This report describes the system configuration, and accomplishments associated with the preparation and execution of these exercises. This document is intended to supplement the overall test reports and provide insight into the development and use of the PTP. A secondary objective is to provide basic information on the capabilities, versatility and expandability of the Hyperflo RTP for possible future projects. It is assumed herein that the reader has knowledge of the OWL system, field test operations, general lidar processing methods, and basic computer architecture.

  11. Radiation therapists' perceptions of the minimum level of experience required to perform portal image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rybovic, Michala [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: mryb6983@mail.usyd.edu.au; Halkett, Georgia K. [Western Australia Centre for Cancer and Palliative Care, Curtin University of Technology, Health Research Campus, GPO Box U1987, Perth, WA 6845 (Australia)], E-mail: g.halkett@curtin.edu.au; Banati, Richard B. [Faculty of Health Sciences, Brain and Mind Research Institute - Ramaciotti Centre for Brain Imaging, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: r.banati@usyd.edu.au; Cox, Jennifer [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: jenny.cox@usyd.edu.au

    2008-11-15

    Background and purpose: Our aim was to explore radiation therapists' views on the level of experience necessary to undertake portal image analysis and clinical decision making. Materials and methods: A questionnaire was developed to determine the availability of portal imaging equipment in Australia and New Zealand. We analysed radiation therapists' responses to a specific question regarding their opinion on the minimum level of experience required for health professionals to analyse portal images. We used grounded theory and a constant comparative method of data analysis to derive the main themes. Results: Forty-six radiation oncology facilities were represented in our survey, with 40 questionnaires being returned (87%). Thirty-seven radiation therapists answered our free-text question. Radiation therapists indicated three main themes which they felt were important in determining the minimum level of experience: 'gaining on-the-job experience', 'receiving training' and 'working as a team'. Conclusions: Radiation therapists indicated that competence in portal image review occurs via various learning mechanisms. Further research is warranted to determine perspectives of other health professionals, such as radiation oncologists, on portal image review becoming part of radiation therapists' extended role. Suitable training programs and steps for implementation should be developed to facilitate this endeavour.

  12. Temperature uniformity control in RTP using multivariable adaptive control

    Energy Technology Data Exchange (ETDEWEB)

    Morales, S.; Dahhou, B.; Dilhac, J.M. [Centre National de la Recherche Scientifique (CNRS), 31 - Toulouse (France); Morales, S.

    1995-12-31

    In Rapid Thermal Processing (RTP) control of the wafer temperature during all processing to get good trajectory following, together with spatial temperature uniformity, is essential. It is well know as RTP process is nonlinear, classical control laws are not very efficient. In this work, the authors aim at studying the applicability of MIMO (Multiple Inputs Multiple Outputs) adaptive techniques to solve the temperature control problems in RTP. A multivariable linear discrete time CARIMA (Controlled Auto Regressive Integrating Moving Average) model of the highly non-linear process is identified on-line using a robust identification technique. The identified model is used to compute an infinite time LQ (Linear Quadratic) based control law, with a partial state reference model. This reference model smooths the original setpoint sequence, and at the same time gives a tracking capability to the LQ control law. After an experimental open-loop investigation, the results of the application of the adaptive control law are presented. Finally, some comments on the future difficulties and developments of the application of adaptive control in RTP are given. (author) 13 refs.

  13. Paleoclassical transport explains electron transport barriers in RTP and TEXTOR

    Energy Technology Data Exchange (ETDEWEB)

    Hogeweij, G M D [FOM-Institute for Plasma Physics Rijnhuizen, Association EURATOM-FOM, PO Box 1207, NL-3430 BE Nieuwegein (Netherlands); Callen, J D [University of Wisconsin, Madison, WI 53706-1609 (United States)

    2008-06-15

    The recently developed paleoclassical transport model sets the minimum level of electron thermal transport in a tokamak. This transport level has proven to be in good agreement with experimental observations in many cases when fluctuation-induced anomalous transport is small, i.e. in (near-)ohmic plasmas in small to medium size tokamaks, inside internal transport barriers (ITBs) or edge transport barriers (H-mode pedestal). In this paper predictions of the paleoclassical transport model are compared in detail with data from such kinds of discharges: ohmic discharges from the RTP tokamak, EC heated RTP discharges featuring both dynamic and shot-to-shot scans of the ECH power deposition radius and off-axis EC heated discharges from the TEXTOR tokamak. For ohmically heated RTP discharges the T{sub e} profiles predicted by the paleoclassical model are in reasonable agreement with the experimental observations, and various parametric dependences are captured satisfactorily. The electron thermal ITBs observed in steady state EC heated RTP discharges and transiently after switch-off of off-axis ECH in TEXTOR are predicted very well by the paleoclassical model.

  14. Neutron flux and power in RTP core-15

    Energy Technology Data Exchange (ETDEWEB)

    Rabir, Mohamad Hairie, E-mail: m-hairie@nuclearmalaysia.gov.my; Zin, Muhammad Rawi Md; Usang, Mark Dennis; Bayar, Abi Muttaqin Jalal; Hamzah, Na’im Syauqi Bin [Nuclear and reactor Physics Section, Nuclear Technology Center, Technical Support Division, Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor (Malaysia)

    2016-01-22

    PUSPATI TRIGA Reactor achieved initial criticality on June 28, 1982. The reactor is designed to effectively implement the various fields of basic nuclear research, manpower training, and production of radioisotopes. This paper describes the reactor parameters calculation for the PUSPATI TRIGA REACTOR (RTP); focusing on the application of the developed reactor 3D model for criticality calculation, analysis of power and neutron flux distribution of TRIGA core. The 3D continuous energy Monte Carlo code MCNP was used to develop a versatile and accurate full model of the TRIGA reactor. The model represents in detailed all important components of the core with literally no physical approximation. The consistency and accuracy of the developed RTP MCNP model was established by comparing calculations to the available experimental results and TRIGLAV code calculation.

  15. Database of Samples Irradiated at Reactor TRIGA PUSPATI (RTP)

    International Nuclear Information System (INIS)

    Muhd Husamuddin Abdul Khalil; Mohd Amin Sharifuldin Salleh; Julia Abdul Karim

    2011-01-01

    Evaluation has been made to data of irradiated samples for the type of sample requested for activation at RTP. Sample types are grouped with percentage of total throughputs to rule out the weight percent of every respective group. The database consists of radionuclide inventory of short and long half-life and high activity radionuclides such as Br and Au have been identified and that database has been constructed using a user-friendly Microsoft Access. Through this, trend of gamma exposure will easily be evaluated at experimental facilities and could ensure radiological effect towards safety and health is limited per Radiation Protection (Basic Safety Standard) Regulation 1988. This database places an important parameter to improve management system in acquiring information of the samples irradiated at RTP and will enhance the safety assurance and reliability of the experimental design basis. (author)

  16. Fuel transfer cask concept design for reactor TRIGA PUSPATI (RTP)

    International Nuclear Information System (INIS)

    Ahmad Nabil Ab Rahim; Phongsakorn Prak; Tonny Lanyau; Mohd Fazli Zakaria

    2010-01-01

    Reactor Triga PUSPATI (RTP) has been operated since 1982 till now. For such long period, the organization feels the need to upgrade the power from 1 MW to 3 MW which involved changing new fuels. Spent fuels will be stored in a Spent Fuel Pool. The process of transferring spent fuels into Spent Fuels Pool required a fuel transfer cask. This paper discussed the design concept for the fuel transfer cast which is essential equipment for reactor upgrading mission. (author)

  17. The Therapist's Feelings

    Science.gov (United States)

    Silvestre, Rafaela Luisa Silva; Vandenberghe, Luc

    2008-01-01

    The present article discusses possible uses of the therapist's feelings to enhance treatment following Kohlenberg and Tsai's conceptualization of the therapist-client relationship. Four vignettes from a case study involving a couple are used as illustrative material. It is argued that the therapist's feelings can serve as clues for identifying…

  18. Critical features of peer assessment of clinical performance to enhance adherence to a low back pain guideline for physical therapists: a mixed methods design.

    Science.gov (United States)

    Maas, Marjo J M; van Dulmen, Simone A; Sagasser, Margaretha H; Heerkens, Yvonne F; van der Vleuten, Cees P M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J

    2015-11-12

    Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a low back pain guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. Participants observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. Participants performed three roles: physical therapist, assessor, and patient. This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of participants. Dutch physical therapists working in primary care (n = 49) organized in communities of practice (n = 6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which participants were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in

  19. Measurement and simulation of thermal neutron flux distribution in the RTP core

    Science.gov (United States)

    Rabir, Mohamad Hairie B.; Jalal Bayar, Abi Muttaqin B.; Hamzah, Na'im Syauqi B.; Mustafa, Muhammad Khairul Ariff B.; Karim, Julia Bt. Abdul; Zin, Muhammad Rawi B. Mohamed; Ismail, Yahya B.; Hussain, Mohd Huzair B.; Mat Husin, Mat Zin B.; Dan, Roslan B. Md; Ismail, Ahmad Razali B.; Husain, Nurfazila Bt.; Jalil Khan, Zareen Khan B. Abdul; Yakin, Shaiful Rizaide B. Mohd; Saad, Mohamad Fauzi B.; Masood, Zarina Bt.

    2018-01-01

    The in-core thermal neutron flux distribution was determined using measurement and simulation methods for the Malaysian’s PUSPATI TRIGA Reactor (RTP). In this work, online thermal neutron flux measurement using Self Powered Neutron Detector (SPND) has been performed to verify and validate the computational methods for neutron flux calculation in RTP calculations. The experimental results were used as a validation to the calculations performed with Monte Carlo code MCNP. The detail in-core neutron flux distributions were estimated using MCNP mesh tally method. The neutron flux mapping obtained revealed the heterogeneous configuration of the core. Based on the measurement and simulation, the thermal flux profile peaked at the centre of the core and gradually decreased towards the outer side of the core. The results show a good agreement (relatively) between calculation and measurement where both show the same radial thermal flux profile inside the core: MCNP model over estimation with maximum discrepancy around 20% higher compared to SPND measurement. As our model also predicts well the neutron flux distribution in the core it can be used for the characterization of the full core, that is neutron flux and spectra calculation, dose rate calculations, reaction rate calculations, etc.

  20. Assessment and mitigation of power quality problems for PUSPATI TRIGA Reactor (RTP)

    Science.gov (United States)

    Zakaria, Mohd Fazli; Ramachandaramurthy, Vigna K.

    2017-01-01

    An electrical power systems are exposed to different types of power quality disturbances. Investigation and monitoring of power quality are necessary to maintain accurate operation of sensitive equipment especially for nuclear installations. This paper will discuss the power quality problems observed at the electrical sources of PUSPATI TRIGA Reactor (RTP). Assessment of power quality requires the identification of any anomalous behavior on a power system, which adversely affects the normal operation of electrical or electronic equipment. A power quality assessment involves gathering data resources; analyzing the data (with reference to power quality standards) then, if problems exist, recommendation of mitigation techniques must be considered. Field power quality data is collected by power quality recorder and analyzed with reference to power quality standards. Normally the electrical power is supplied to the RTP via two sources in order to keep a good reliability where each of them is designed to carry the full load. The assessment of power quality during reactor operation was performed for both electrical sources. There were several disturbances such as voltage harmonics and flicker that exceeded the thresholds. To reduce these disturbances, mitigation techniques have been proposed, such as to install passive harmonic filters to reduce harmonic distortion, dynamic voltage restorer (DVR) to reduce voltage disturbances and isolate all sensitive and critical loads.

  1. Study of Physical Protection System at PUSPATI TRIGA Reactor (RTP)

    International Nuclear Information System (INIS)

    Ligam, A.S.; Ina, I.; Zarina Masood

    2016-01-01

    Physical protection program at PUSPATI TRIGA Reactor (RTP) which is located at Nuklear Malaysia, Bangi Complex has been strengthened and upgraded from time to time to accommodate current situation needs. However, there is always room for improvement. Hence, study have been made to look deeper into physical protection components such as delay systems, external sensors, PPS intruder alarm sensors, use of video system, personnel security or insider threats, access control operation system operation rules and security culture that may need to take into consideration. (author)

  2. The effect of rater training on scoring performance and scale-specific expertise amongst occupational therapists participating in a multicentre study

    DEFF Research Database (Denmark)

    Hansen, Tina; Elholm Madsen, Esben; Sørensen, Annette

    2016-01-01

    Gill Ingestive Skills Assessment (MISA) they observe, interpret and record occupational performance of dysphagic clients participating in a meal. This is a highly complex task, which might introduce unwanted variability in measurement scores. A 2-day rater training programme was developed and this builds...... of the training on scoring performance and scale-specific expertise amongst raters. METHOD: During 2 days of rater training, 81 occupational therapists (OTs) were qualified to observe and score dysphagic clients' mealtime performance according to the criteria of 36 MISA-items. The training effects were evaluated...... deficient mealtime performance appeared most difficult to score. The OTs scale-specific expertise improved significantly (knowledge: Z = -7.857, p performance when using the Danish MISA as well as their perceived...

  3. Development of film dosimetric measurement system for verification of RTP

    International Nuclear Information System (INIS)

    Chen Yong; Bao Shanglian; Ji Changguo; Zhang Xin; Wu Hao; Han Shukui; Xiao Guiping

    2007-01-01

    Objective: To develop a novel film dosimetry system based on general laser scanner in order to verify patient-specific Radiotherapy Treatment Plan(RTP) in three-Dimensional Adaptable Radiotherapy(3D ART) and Intensity Modulated Radiotherapy (IMRT). Methods: Some advanced methods, including film saturated development, wavelet filtering with multi-resolution thresholds and discrete Fourier reconstruction are employed in this system to reduce artifacts, noise and distortion induced by film digitizing with general scanner; a set of coefficients derived from Monte Carlo(MC) simulation are adopted to correct the film over-response to low energy scattering photons; a set of newly emerging criteria, including γ index and Normalized Agreement Test (NAT) method, are employed to quantitatively evaluate agreement of 2D dose distributions between the results measured by the films and calculated by Treatment Planning System(TPS), so as to obtain straightforward presentations, displays and results with high accuracy and reliability. Results: Radiotherapy doses measured by developed system agree within 2% with those measured by ionization chamber and VeriSoft Film Dosimetry System, and quantitative evaluation indexes are within 3%. Conclusions: The developed system can be used to accurately measure the radiotherapy dose and reliably make quantitative evaluation for RTP dose verification. (authors)

  4. Practical Application of Monte Carlo Code in RTP

    International Nuclear Information System (INIS)

    Mohamad Hairie Rabir; Julia Abdul Karim; Muhammad Rawi Mohamed Zin; Na'im Syauqi Hamzah; Mark Dennis Anak Usang; Abi Muttaqin Jalal Bayar; Muhammad Khairul Ariff Mustafa

    2015-01-01

    Monte Carlo neutron transport codes are widely used in various reactor physics applications in RTP and other related nuclear and radiation research in Nuklear Malaysia. The main advantage of the method is the capability to model geometry and interaction physics without major approximations. The disadvantage is that the modelling of complicated systems is very computing-intensive, which restricts the applications to some extent. The importance of Monte Carlo calculation is likely to increase in the future, along with the development in computer capacities and parallel calculation. This paper presents several calculation activities, its achievements and challenges in using MCNP code for neutronics analysis, nuclide inventory and source term calculation, shielding and dose evaluation. (author)

  5. Characterization of the RTP slideaway regime and its fast electron population

    International Nuclear Information System (INIS)

    Schokker, B.C.; Vries, P.C. de; Oomens, A.A.M.; Schueller, F.C.; Lopes Cardozo, N.J.

    1994-01-01

    Slideaway discharges in RTP (R 0 = 0.72 m, a = 0.16 m) have been analyzed. Slideaway discharges are characterized by an increase of the plasma energy content and of the electron cyclotron emission over the Ohmic values, bursts of emission around the lower hybrid frequency, and the occurrence of the Parail-Pogutse instability. The motivation for this investigation is twofold. Firstly, improved confinement is observed. Secondly, the large nonthermal electron population observed can be compared to predictions of the Parail-Pogutse instability theory. Measurements have been performed with magnetics, Thomson scattering (TVTS), ECE low and high field side (lfs and hfs) X-mode and O-mode emission viewing absorbers, soft X-ray tomography, and rf radiometry. The effects of ECRH on slideaway properties have been studied. (author) 4 refs., 4 figs

  6. RTP as an Optional Service: It's Alive, But Is It Well?

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, Charles; Barbose, Galen; Neenan, Bernie

    2006-03-10

    Economists have advocated for real-time pricing (RTP) of electricity on the basis of the gains in economic efficiency that would result from charging customers the contemporaneous marginal cost of supplying electricity instead of the average cost. In recent years, RTP has also become the subject of interest in a variety of policy contexts, including integrated resource planning initiatives, ongoing efforts to improve efficiency and reliability in competitive electricity markets, and implementation of default service in states with retail choice. Most experience with RTP has been as an optional service, that is, a self-selecting alternative to the standard utility service. By our count, approximately 70 utilities in the U.S. offered an optional RTP program at some point over the past 20 years. However, many programs are now defunct. In 2003, 47 utilities in the U.S. were still offering an optional RTP program, on either a pilot or permanent basis (see Figure 1). In addition, 10 utilities in states with retail choice currently offer RTP as the default service for large customers that are not under contract with a competitive supplier. Another two utilities have received regulatory approval to do so in the next few years. Although the results of a few optional RTP programs have been publicized, the vast majority of programs have operated in relative obscurity. To provide a wider perspective on utility and customer experience with RTP, we surveyed 43 optional RTP programs offered in 2003. We interviewed RTP program managers and other utility staff, and reviewed publicly available sources, including key regulatory documents and program evaluations. Based on this research, we identified trends related to RTP program history and outlook, program design and implementation, customer participation, and participant price response. The results are both surprising and instructive. We conclude that RTP is indeed alive but is not prospering as well it could. Thus, we offer a

  7. Find a Therapist

    Science.gov (United States)

    ... My ADAA Blog Home / Find Help Print | Email Find a Therapist Zip Code: Radius: 5 Miles 10 ... personal referrals. We supply information to help you find local mental health services and resources that allow ...

  8. Hardware design for new instrumentation and control system of RTP

    International Nuclear Information System (INIS)

    Mohd Idris Taib; Izhar Abu Hussin; Zareen Khan Abdul Jalil Khan; Mohd Dzul Aiman Aslan; Mohd Khairulezwan Abdul Manan; Nurfarhana Ayuni Joha; Mohd Sabri Minhat

    2010-01-01

    The design for New Instrumentation and Control system of RTP are proposed. Physical system is modular-based, comprise of several cabinets such as Reactor Protection System 1 and 2, Control Console, Information Console 1 and 2 as well as Communication Console. Reactor Protection System automatically will shut-down reactor whenever safety limit setting was approach. Control console is where the reactor operator actually controls the reactor with control the movement of control rods. Information Consoles using Liquid Crystal Display to monitor the reactor parameters. Communication Console is where the communication tools such as telephone and intercom are located. This new system will incorporated analog, digital and computer-based. Reactor Protection System will use all analog system. Reactor Control System and Reactor Monitoring System will use analog as well as computer-based system. Wide-range channel will use digital signal processor as a main component. Controlling control rod movement is using control rod button via microprocessor-based control rod controller. Automatic Flux Controller is using embedded computer for flexibility of programming. Data Acquisition System is using Programmable Logic Controller and Industrial Computer. The main software for this system will be developed using WinCC software. (author)

  9. Return to play and performance after anterior cruciate ligament reconstruction in the National Basketball Association: surgeon case series and literature review.

    Science.gov (United States)

    Nwachukwu, Benedict U; Anthony, Shawn G; Lin, Kenneth M; Wang, Tim; Altchek, David W; Allen, Answorth A

    2017-09-01

    To investigate return to play (RTP) and functional performance after anterior cruciate ligament reconstruction (ACLR) in National Basketball Association (NBA) players and to perform a systematic review of the literature to understand RTP after ACLR in professional basketball. NBA players undergoing ACLR between 2008 and 2014 by two surgeons were identified. RTP and performance were assessed based on a review of publically available statistics. A systematic review of the literature was performed using the MEDLINE database. Inclusion criteria were: English language, ACL surgery outcome, professional basketball and RTP outcome. We reviewed studies for RTP rates and RTP performance. Our study included 12 professional basketball players with NBA level experience. Eleven of the 12 players returned to their prior level of play. Eight of the 9 (88.9%) players actively playing in the NBA returned to play in the NBA at a mean 9.8 months. Among players returning to NBA play, during RTP season 1, mean per game statistics decreased for the following: minutes, points, rebounds, assists, steals, blocks, turnovers and personal fouls - none of these changes reached statistical significance. Player efficiency ratings significantly declined from pre-injury (12.5) to the first RTP season (7.6) (p = 0.05). By RTP season 2, player performance metrics approximated pre-injury levels and were not significantly different. Six studies met inclusion criteria; reported RTP rates ranged from 78-86%. Identified studies similarly found a decline in functional performance after RTP. There is a high rate (89%) of return to NBA play for NBA players undergoing ACLR. After RTP, however, there is a quantitative decline in initial season 1 RTP statistics with a significant decrease in player efficiency rating. By RTP season 2, performance metrics demonstrated an improvement compared to RTP season 1 but did not reach pre-injury functional performance, though performance metrics are not significantly

  10. Find a Physical Therapist

    Science.gov (United States)

    ... our resources for healthy running. Go There » Why Physical Therapy? Avoid Opioids Benefits of Physical Therapy About PTs & PTAs Did You Know? Patient ... There are numerous benefits to treatment by a physical therapist. Go There » For Patients Choosing Your PT ...

  11. Understanding paediatric rehabilitation therapists' lack of use of outcome measures.

    Science.gov (United States)

    King, Gillian; Wright, Virginia; Russell, Dianne J

    2011-01-01

    Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.

  12. Child's Play: Therapist's Narrative

    Science.gov (United States)

    Reddy, Rajakumari P.; Hirisave, Uma

    2014-01-01

    Play has been recognized as an essential component to children's healthy development. Schools of play therapy differ philosophically and technically, but they all embrace the therapeutic and developmental properties of play. This case report is an illustration of how a 6-year-old child with emotional disorder was facilitated to express concerns in child-centered play therapy. The paper discusses the therapist's narration of the child's play. PMID:24860228

  13. An Overview of Ageing Management Programme for PUSPATI TRIGA Reactor (RTP)

    International Nuclear Information System (INIS)

    Syahirah Abdul Rahman; Mohamad Azman Che Mat Isa; Mohd Zaid Mohamed

    2011-01-01

    The PUSPATI TRIGA reactor (RTP) at Malaysian Nuclear Agency which has been operating for 29 years now faces increasingly serious aging problems. Many components are obsolete whereas genuine parts are no longer in the market. Currently, the aging problem is addressed through periodic maintenance on all systems, structures and components (SSC). As a holistic measure, the Aging Management Program (AMP) was formulated to solve the problems from the grassroots. This paper describes the first stage of the AMP which identifies the strengths and capabilities. This includes identifying the types of aging, responsible parties and relationship between aging problems and safety of RTP. (author)

  14. Conceptual design of reactor TRIGA PUSPATI (RTP) spent fuel storage rack

    International Nuclear Information System (INIS)

    Tonny Lanyau; Mohd Fazli Zakaria; Zaredah Hashim; Ahmad Nabil Ab Rahim; Mohammad Suhaimi Kassim

    2010-01-01

    PUSPATI TRIGA Reactor (RTP) is a pool type research reactor with 1MW thermal power. It has been safely operated since 28 June 1982. During 28 years of safe operation, there are several systems and components of the RTP that have been maintained, repaired, upgraded and replaced in order to maintain its function and safety conditions. RTP has been proposed to be upgraded so that optimum operation of RTP could be achieved as well as fulfill the future needs. Thus, competencies and technical capabilities were needed to design and develop the reactor system. In the meantime, there is system or component need to be maintained such as fuel elements. Since early operation, most of the fuel elements still can be used and none of the fuel elements was replaced or sent for reprocessing and final disposal. Towards the power upgrading, preparation of spent fuel storage is needed for temporary storing of the fuels discharged from the reactor core. The spent fuel storage rack will be located in the spent fuel pool to accommodate the spent fuels before it is send to reprocessing or final disposal. This paper proposes the conceptual design of the spent fuel storage rack. The output of this paper focused on the physical and engineering design of the spent fuel storage. (author)

  15. Core Calculation of 1 MWatt PUSPATI TRIGA Reactor (RTP) using Monte Carlo MVP Code System

    Science.gov (United States)

    Karim, Julia Abdul

    2008-05-01

    The Monte Carlo MVP code system was adopted for the Reaktor TRIGA PUSAPTI (RTP) core calculation. The code was developed by a group of researcher of Japan Atomic Energy Agency (JAEA) first in 1994. MVP is a general multi-purpose Monte Carlo code for neutron and photon transport calculation and able to estimate an accurate simulation problems. The code calculation is based on the continuous energy method. This code is capable of adopting an accurate physics model, geometry description and variance reduction technique faster than conventional method as compared to the conventional scalar method. This code could achieve higher computational speed by several factors on the vector super-computer. In this calculation, RTP core was modeled as close as possible to the real core and results of keff flux, fission densities and others were obtained.

  16. Core Calculation of 1 MWatt PUSPATI TRIGA Reactor (RTP) using Monte Carlo MVP Code System

    International Nuclear Information System (INIS)

    Karim, Julia Abdul

    2008-01-01

    The Monte Carlo MVP code system was adopted for the Reaktor TRIGA PUSAPTI (RTP) core calculation. The code was developed by a group of researcher of Japan Atomic Energy Agency (JAEA) first in 1994. MVP is a general multi-purpose Monte Carlo code for neutron and photon transport calculation and able to estimate an accurate simulation problems. The code calculation is based on the continuous energy method. This code is capable of adopting an accurate physics model, geometry description and variance reduction technique faster than conventional method as compared to the conventional scalar method. This code could achieve higher computational speed by several factors on the vector super-computer. In this calculation, RTP core was modeled as close as possible to the real core and results of keff flux, fission densities and others were obtained

  17. Managing RTP Console Upgrading Project: Best Practice for Nuclear Malaysia as TSO in Supporting NPP Development

    International Nuclear Information System (INIS)

    Nurfarhana Ayuni Joha; Syahirah Abdul Rahman; Izhar Abu Hussin

    2011-01-01

    Human Resource Development (HRD) is required for Nuclear Power Programme (NPP). To be a Technical Support Organisation (TSO) for NPP, Nuclear Malaysia should be ready to take the responsibility in supporting Nuclear Regulatory Agency (NRA) and NPP Operators. In nurturing Nuclear Malaysia as TSO, the prime important and focus of HRD for the NPP is the reactor engineering technology. Nuclear Malaysia gives various phases of supports needed to build NPP such as during siting, design, planning, licensing, construction, commissioning, operation and maintenance in its own way and capability. The current Nuclear Malaysia unique approach is the TRIGA PUSPATI reactor (RTP) upgrading project. Research reactor plays an important role in Research and Developpement organization as a nuclear facility to assist the development of NPP. Therefore, upgrading the research reactor is needed to build the skills and gain knowledge of workers to work safely. After 29 years of operation, the RTP system is facing aging problems due to many components in the reactor are outdated. Therefore, immediate action should be carried out to mitigate the aging factor of the reactor to prevent the worsening of the aging problem, and to prevent untoward incident from happening. Action should also cover short and long term planning to prevent current situation from recurring. Currently, RTP is upgrading its console from analog to digital system. One of the achievements in this console upgrading project is the development and implementation of project management. This paper comprises the overview on the RTP console upgrading project, the project management and how this project can lead Nuclear Malaysia to be a good TSO for the development of NPP. (author)

  18. Recent results on electron cyclotron current drive and MHD activity in RTP

    NARCIS (Netherlands)

    Donne, A.J.H.; Schuller, F.C.; Oomens, A.A.M.; de Baar, M.R.; Barth, C.J.; Beurskens, M.N.A.; Box, F.M.A.; van Gelder, J.F.M.; Grobben, B.J.J.; Groot, de B.; Herranz, J.M.; Hogeweij, G.M.D.; Hokin, S.A.; Howard, J.; Hugenholtz, C.A.J.; Karelse, F.A.; de Kloe, J.; Kruijt, O.G.; Kuyvenhoven, S.; Lok, J.; Cardozo, N.J.L.; van der Meiden, H.J.; Meijer, F.G.; Montvai, A.; Oyevaar, T.; Pijper, F.J.; Polman, R.W.; Rommers, J.H.; Salzedas, F.; Schokker, B.C.; Smeets, P.H.M.; Tanzi, C.P.; Tito, C.J.; Verhaag, G.C.H.M.; Westerhof, E.

    1997-01-01

    The RTP tokamak (R = 0.72 m, a = 0.164 m, B-phi < 2 5.T, I-p = < 150 kA) is equipped with three gyrotrons (2 x 60 GHz, 180 kW, 100 ms each; 1 x 110 GHz, 500 kW, 200 ms) for electron cyclotron heating (ECH) and current drive (ECCD). The power from one of the 60 GHz gyrotrons is launched via an

  19. Conceptual design of fuel transfer cask for Reactor TRIGA PUSPATI (RTP)

    Energy Technology Data Exchange (ETDEWEB)

    Muhamad, Shalina Sheik [Prototype and Plant Development Center, Technical Support Division, Malaysian Nuclear Agency, Bangi, 43000, Kajang, Selangor (Malaysia); Hamzah, Mohd Arif Arif B. [Prototype and Plant Development Center, Technical Support Division Malaysian Nuclear Agency, Bangi, 43000, Kajang, Selangor (Malaysia)

    2014-02-12

    Spent fuel transfer cask is used to transfer a spent fuel from the reactor tank to the spent fuel storage or for spent fuel inspection. Typically, the cask made from steel cylinders that are either welded or bolted closed. The cylinder is enclosed with additional steel, concrete, or other material to provide radiation shielding and containment of the spent fuel. This paper will discuss the Conceptual Design of fuel transfer cask for Reactor TRIGA Puspati (RTP)

  20. Brain Gain Malaysia (BGM): Feasibility Studies to Upgrading the Power of TRIGA PUSPATI Reactor (RTP)

    International Nuclear Information System (INIS)

    Naim Shauqi Hamzah; Mohd Fairus Abdul Farid; Julia Abdul Karim

    2011-01-01

    BGM Programme introduced by MOSTI has give the opportunities for Reactor Technology Division to get the expertise from Romania for upgrading the power output of RTP. 2 and a half months programme include expertise development in neutronic fields and thermal hydraulics and also introduction of reactor technology to IPTA and IPTS students. This programme also benefited the staffs of BTR as activities conducted intensively and hands-on to make the researchers can improved their knowledge on related computer code effectively. (author)

  1. Photoelectric properties of variably RTP processed CIGS{sub 2} solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Riediger, Julia; Ohland, Joerg; Knipper, Martin; Parisi, Juergen; Riedel, Ingo [Energy and Semiconductor Research Laboratory, Department of Physics, University of Oldenburg (Germany); Mainz, Roland; Merdes, Saoussen; Klaer, Joachim [Helmholtz-Zentrum Berlin fuer Materialien und Energie GmbH, Berlin (Germany)

    2011-07-01

    The open circuit voltage V{sub oc} of CuInS{sub 2} solar cells was found to improve via incorporation of gallium. The Cu(In,Ga)S{sub 2} absorber of the samples studied in this work was prepared by sputtering (Cu,Ga) and In precursors subsequently sulfurized via rapid thermal processing (RTP) in sulfur vapor. Distinctive top/bottom CuInS{sub 2}/CuGaS{sub 2} segregation has been observed which extent depends on the substrate temperature and holding time of the temperature during RTP-process. The insufficient gallium accumulation at the surface impedes high values of V{sub oc}.We studied the consequences of RTP-process parameter variation in regard of the interdiffusion of CuInS{sub 2} and CuGaS{sub 2}. Quantum efficiency (QE) and temperature-/illumination-dependent current-voltage (IV) profiling have been carried out for differently processed samples. These measurements provide the minimum band gap E{sub g} of the graded absorber layer, the temperature dependent V{sub oc} and the activation energy E{sub a} for carrier recombination. Drive level capacitance (DLCP) profiling reveals the spatially resolved in-depth variation of the doping/defect concentration close to the space charge region.

  2. Dental therapists: a global perspective.

    Science.gov (United States)

    Nash, David A; Friedman, Jay W; Kardos, Thomas B; Kardos, Rosemary L; Schwarz, Eli; Satur, Julie; Berg, Darren G; Nasruddin, Jaafar; Mumghamba, Elifuraha G; Davenport, Elizabeth S; Nagel, Ron

    2008-04-01

    In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.

  3. The development of quality assurance program in Reactor TRIGA PUSPATI (RTP)

    International Nuclear Information System (INIS)

    Rosli Darmawan; Mohd Rizal Mamat; Mohamad Zaid Mohamad; Mohd Ridzuan Abdul Mutalib

    2007-01-01

    One of the trivial issues in the operation of Nuclear Reactor is the safety of the system. Worldwide publicity on a few nuclear accidents as well as the notorious Hiroshima and Nagasaki bombing has always bring about general public fear on anything related to nuclear. IAEA has always emphasized on the assurance of nuclear safety for all nuclear installations and activities. According to the IAEA safety guides, all research reactors are required to implement quality assurance programs to ensure the conduct of operations are in accordance with the safety standards required. This paper discusses the activities carried out toward the establishment of Quality Assurance Program for Reaktor TRIGA PUSPATI (RTP). (Author)

  4. Redistribution of dopant and impurity concentrations during the formation of uniform WSi2 films by RTP

    International Nuclear Information System (INIS)

    Siegal, M.P.; Santiago, J.J.

    1988-01-01

    Secondary ion mass spectroscopy has been used to study the effects of rapid thermal processing on the formation of tetragonal tungsten disilicide thin films on Si(100), p-type 5 Ω . cm wafers. The substrates were chemically etched, followed by an RF sputter deposition of 710A W metal. The samples were then fast radiatively processed in an RTP system for time intervals ranging from 15 to 45 seconds at high temperature (--1100 0 C) under high vacuum. The redistribution of the boron dopant concentration profile is described in this paper

  5. The concept of caring: Perceptions of radiation therapists

    International Nuclear Information System (INIS)

    Bolderston, Amanda; Lewis, Donna; Chai, Martin J.

    2010-01-01

    Aims: This study explores radiation therapists' understanding and interpretations of the concept of caring within their profession. Background: Health professions' concepts of care have been explored in disciplines such as nursing and medicine. However, there has been little previous attempt to describe what caring means to radiation therapists. Methods: A qualitative phenomenological approach was used and 27 radiation therapists were interviewed in four focus groups. Discussions were transcribed and analysis was performed to identify themes from the data. Results: Three overarching themes emerged from the data: human connection established between radiation therapists and patients, technical care as the use of technology and procedures in treatment planning and delivery, and the therapist's unique identity as compared to other professions. Conclusions: The concept of care was seen by radiation therapists primarily as a supportive relationship with the patient but they were unable to agree if the technical aspects and procedures were considered a part of caring. Further research is needed to further examine the connection between technology and care.

  6. My Therapist is a Student? The Impact of Therapist Experience and Client Severity on Cognitive Behavioural Therapy Outcomes for People with Anxiety Disorders.

    Science.gov (United States)

    Mason, Liam; Grey, Nick; Veale, David

    2016-03-01

    Allocation of trainee therapist cases is often performed based on intuition and clinical circumstances, with lack of empirical evidence on the role of severity of presenting problem. This has the potential to be anxiety-provoking for supervisors, trainees and service users themselves. To determine how therapist experience interacts with symptom severity in predicting client outcomes. An intention-to-treat analysis of annual outcome data for primary and secondary care clients seen by a specialist anxiety disorders service. 196 clients were stratified into mild, moderate and baseline severe symptoms of anxiety (GAD-7) and depression (PHQ-9). We measured percentage change on these measures, as well as number of sessions and therapy dropout. We also examined rates of reliable and clinically significant change on disorder-specific measures. We hypothesized that qualified therapists would achieve better outcomes than trainees, particularly for severe presentations. Overall, outcomes were comparable between trainee and qualified therapists on all measures, and trainees additionally utilized fewer therapy sessions. There was however an interaction between anxiety severity (GAD-7) and therapist group, such that severely anxious clients achieved greater symptom improvement with qualified as compared to trainee therapists. Further, for trainee but not qualified therapists, baseline anxiety was negatively associated with rate of reliable and clinically significant change on disorder-specific measures. These findings indicate generally favourable outcomes for trainee therapists delivering manualized treatments for anxiety disorders. They additionally suggest that trainee therapists may benefit from additional support when working with clients that present with severe anxiety.

  7. American Society of Hand Therapists

    Science.gov (United States)

    ... ago RT @vicstar141 : #PROUD to launch the #handtherapy shop pilot @ChelwestFT today during #FabChangeWeek ! Improving availability of reh… https://t.co/iF8nnyjK7I — 1 day 11 hours ago #Job opportunity: Physical Therapist Outpatient - Agile Physical Therapy - Palo ...

  8. Training Therapists about Client Expectations of Psychotherapy.

    Science.gov (United States)

    Soley, Georgia; Marshall, Renee; Chambliss, Catherine

    Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…

  9. Vaporization Rate Analysis of Primary Cooling Water from Reactor PUSPATI TRIGA (RTP) Tank

    International Nuclear Information System (INIS)

    Tonny Anak Lanyau; Mohd Fazli Zakaria; Yahya Ismail

    2011-01-01

    Primary cooling system consists of pumps, heat exchangers, probes, a nitrogen-16 diffuser and associated valves is connected to the reactor TRIGA PUSPATI (RTP) tank by aluminium pipes. Both the primary cooling system and the reactor tank is filled with demineralized light water (H 2 O), which serves as a coolant, moderator as well as shielding. During reactor operation, vaporization in the reactor tank will reduce the primary water and contribute to the formation of vapor in the reactor hall. The vaporization may influence the function of the water subsequently may affect the safety of the reactor operation. It is essential to know the vaporization rate of the primary water to ensure its functionality. This paper will present the vaporization rate of the primary cooling water from the reactor tank and the influence of temperature of the water in the reactor tank to the vaporization rate. (author)

  10. Experimental results on pellet injection and MHD from the RTP tokamak

    International Nuclear Information System (INIS)

    Oomens, A.A.M.; Kloe, J. de; Salzedas, F.J.B.

    2001-01-01

    The ablation of hydrogen pellets has been studied in the Rijnhuizen Tokamak Project RTP with a diagnostic with high spatial and temporal resolution. It has been observed that (part of the) ablation cloud drifts away from the pellet in opposite direction. These drifts occur in semi-periodical bursts. A summary of a detailed analysis of this drift of the cloud and its implications for the fueling profile is presented. Stabilization of m/n=2/1 tearing modes preceding density limit disruptions, has been studied with modulated and continuous ECRH. The results indicate that EC heating of the islands under these conditions is very inefficient. The time dependence of the growth rate of the precursor mode is first algebraic, but becomes exponential in a later phase. (author)

  11. Measurement of electron density profiles by soft X-ray tomography on the RTP tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Cruz, D.F. da; Donne, A.J.H.; Lyadina, E.S.; Rutteman, R.H.; Tanzi, C.P. [FOM-Instituut voor Plasmafysica, Rijnhuizen (Netherlands)

    1993-12-31

    Tomographic diagnosis of the soft x-ray emissivity profile is a powerful method for studying several plasma parameters. The x-ray emissivity is a complicated function of plasma quantities like the electron density and temperature, and the impurity content in the plasma. These quantities can be studied separately provided that information is available on the remaining parameters. Soft x-ray emissivity profiles have already been used successfully in other machines to determine local values of impurity densities and the effective charge Z{sub eff}. In the RTP tokamak the electron density profile has been inferred from a modelling of the x-ray emissivity in situations where information is available on the electron temperature profile, the value of Z{sub eff}, and the relative proportion of the impurities. The method can be useful for the study of hollow density profiles that cannot be properly reconstructed by Abel inversion of interferometer or reflectometer data. (author) 7 refs., 2 figs.

  12. Measurement of electron density profiles by soft X-ray tomography on the RTP tokamak

    International Nuclear Information System (INIS)

    Cruz, D.F. da; Donne, A.J.H.; Lyadina, E.S.; Rutteman, R.H.; Tanzi, C.P.

    1993-01-01

    Tomographic diagnosis of the soft x-ray emissivity profile is a powerful method for studying several plasma parameters. The x-ray emissivity is a complicated function of plasma quantities like the electron density and temperature, and the impurity content in the plasma. These quantities can be studied separately provided that information is available on the remaining parameters. Soft x-ray emissivity profiles have already been used successfully in other machines to determine local values of impurity densities and the effective charge Z eff . In the RTP tokamak the electron density profile has been inferred from a modelling of the x-ray emissivity in situations where information is available on the electron temperature profile, the value of Z eff , and the relative proportion of the impurities. The method can be useful for the study of hollow density profiles that cannot be properly reconstructed by Abel inversion of interferometer or reflectometer data. (author) 7 refs., 2 figs

  13. Evaluation of dose exposure from irradiated samples at TRIGA PUSPATI reactor (RTP)

    International Nuclear Information System (INIS)

    Muhd Husamuddin Abdul Khalil; Julia Abdul Karim; Naim Syauqi Hamzah; Mohamad Hairie Rabir; Mohd Amin Sharifuldin Salleh

    2010-01-01

    An evaluation has been made to data of irradiated samples for the type of sample requested for activation at RTP. Sample types are grouped with percentage of total throughputs to rule out the weight percent of every respective group. The database consists of radionuclide inventory of short, intermediate and long half-life and high activity radionuclides such as Br and Au have been identified. Evaluation of gamma exposure using Micro shield has also been made to pattern the trend of gamma exposure at experimental facilities and to ensure radiological effect towards safety and health is limited per Radiation Protection (Basic Safety Standard) Regulation 1988. This analysis places an important parameter to improve the design accuracy of shielding design in assuring safety, reliability and economy. (author)

  14. Application of Code Of Conduct on the Safety of Research Reactor (RTP)

    International Nuclear Information System (INIS)

    Ligam, A.S.; Ahmad Nabil Abd Rahim; Zarina Masood

    2014-01-01

    The implementation and the practices of the effective safety system at research reactors are important to ensure that the worker, public and environment do not receive any abnormal causes. Many international safety related support agencies for research reactor such as International Atomic Energy Agency (IAEA) providing guidelines that can be applied to enhance and strengthen the enforcement of safety namely Code of Conduct on the Safety of Research Reactor (IAEA/CODEOC/RR/2006). The excellent safety management, reliability, and maintainability of RTP reactor structures, coupled with personnel numerous lessons and experiences learned, Reactor TRIGA PUSPATI research reactor providing Nuclear Malaysia personnel and visitor the very safe working and visiting environment. This paper will discuss the status, practices and improvement strategies over the past few years. (author)

  15. Study on external dose around the Reactor TRIGA PUSPATI (RTP) Facility: A proposal

    International Nuclear Information System (INIS)

    Hairul Nizam Idris

    2012-01-01

    In order to meet the requirement of the recent regulation (AELB-BSRP 2010), it is absolutely necessary to re-execute the in-situ and accumulated external dose assessment at the surrounding area of the Reactor TRIGA PUSPATI (RTP) facility. A number of strategic locations will be identified for the points of the dose mapping. Selection of these measurement points will be base on certain factor such as physical shielding thickness, occupancy of the workers, and others. Then, several survey meters and dosimeter will be chosen base on measuring method, reactor radiation spectra energy, type of radiation and etc. The result obtained will be compared with action values or limits given by AELB- BSRP 2010 and also can be used as baseline data or report for future reference. (author)

  16. Optical absorption and emission characteristics of Pr{sup 3+}-doped RTP glasses

    Energy Technology Data Exchange (ETDEWEB)

    Murthy, D.V.R. [Department of Physics, Sri Venkateswara University, Tirupati 517 502 (India); Jamalaiah, B.C. [Department of Physics, Sree Vidyanikethan Engineering College, Tirupati (India); Sasikala, T. [Department of Physics, Sri Venkateswara University, Tirupati 517 502 (India); Rama Moorthy, L., E-mail: lrmphysics@yahoo.co.i [Department of Physics, Sri Venkateswara University, Tirupati 517 502 (India); Jayasimhadri, M.; Jang, Kiwan; Lee, Ho Sueb [Department of Physics, Changwon National University, Changwon (Korea, Republic of); Yi, Soung Soo [Department of Photonics, Silla University, Pusan 617-736 (Korea, Republic of); Jeong, Jung Hyun [Department of Physics, Pukyong National University, Pusan 608-737 (Korea, Republic of)

    2010-02-15

    Judd-Ofelt (J-O) parameters are calculated for Pr{sup 3+}ions doped alkaline earth potassium titanium phosphate (RTP, where R=Mg, Ca, Sr) glasses. The best fit for the oscillator strengths has been obtained by omitting the {sup 3}H{sub 4}->{sup 3}P{sub 2} hypersensitive transition. In all the three glasses, the J-O parameters follow the same trend as OMEGA{sub 2}OMEGA{sub 6}. These J-O intensity parameters are then used to compute the radiative properties such as the radiative transition probabilities (A{sub R}), branching ratios (beta{sub R}) and radiative lifetimes (tau{sub R}) for the observed fluorescence bands. The fluorescence spectra obtained upon 445 nm excitation exhibited an intense emission band centered at 484 nm ({sup 3}P{sub 0}->{sup 3}H{sub 4}), four medium intense bands at 525 nm ({sup 3}P{sub 1}->{sup 3}H{sub 5}), 598 nm ({sup 1}D{sub 2}->{sup 3}H{sub 4}), 608 nm ({sup 3}P{sub 0}->{sup 3}H{sub 6}) and 641 nm ({sup 3}P{sub 0}->{sup 3}F{sub 2}) and one weak band at 669 nm ({sup 3}P{sub 1}->{sup 3}F{sub 3}). The experimental branching ratios (beta{sub exp}) obtained from steady state fluorescence are compared with the calculated values. The decay curves measured from the {sup 3}P{sub 0} excited metastable state are found to be single exponential in all the glasses. The gain bandwidths (sigma{sub e}xDELTAlambda{sub P}) and optical gain (sigma{sub e}xtau{sub m}) parameters suggest that the RTP glasses could be used for laser active materials to emit intense blue emission at 484 nm.

  17. The TRPC2 channel forms protein-protein interactions with Homer and RTP in the rat vomeronasal organ

    Directory of Open Access Journals (Sweden)

    Brann Jessica H

    2010-05-01

    Full Text Available Abstract Background The signal transduction cascade operational in the vomeronasal organ (VNO of the olfactory system detects odorants important for prey localization, mating, and social recognition. While the protein machinery transducing these external cues has been individually well characterized, little attention has been paid to the role of protein-protein interactions among these molecules. Development of an in vitro expression system for the transient receptor potential 2 channel (TRPC2, which establishes the first electrical signal in the pheromone transduction pathway, led to the discovery of two protein partners that couple with the channel in the native VNO. Results Homer family proteins were expressed in both male and female adult VNO, particularly Homer 1b/c and Homer 3. In addition to this family of scaffolding proteins, the chaperones receptor transporting protein 1 (RTP1 and receptor expression enhancing protein 1 (REEP1 were also expressed. RTP1 was localized broadly across the VNO sensory epithelium, goblet cells, and the soft palate. Both Homer and RTP1 formed protein-protein interactions with TRPC2 in native reciprocal pull-down assays and RTP1 increased surface expression of TRPC2 in in vitro assays. The RTP1-dependent TRPC2 surface expression was paralleled with an increase in ATP-stimulated whole-cell current in an in vitro patch-clamp electrophysiological assay. Conclusions TRPC2 expression and channel activity is regulated by chaperone- and scaffolding-associated proteins, which could modulate the transduction of chemosignals. The developed in vitro expression system, as described here, will be advantageous for detailed investigations into TRPC2 channel activity and cell signalling, for a channel protein that was traditionally difficult to physiologically assess.

  18. Relationship Between Performance Evaluation and Therapists\\' Job Motivation of Rehabilitation Centers and Public Hospitals of Tehran Based on Herzbergs´ Two-Factor Model

    Directory of Open Access Journals (Sweden)

    Elahe Abolhoseini

    2018-01-01

    Conclusion It seems that with regard to the difficulty of rehabilitation therapists’ job, it is essential that necessary training for supervisors and managers and directors are organized in order to achieve organizational objectives by taking advantage of the performance standards and evaluation criteria. This will lead to an increase in the rehabilitation therapists’ job motivation and provide for them work progress and greater encouragement.

  19. The effect of RTP (Radon Thoron Progeny) and dust loading on the design of an alarm system for airborne plutonium particulates

    International Nuclear Information System (INIS)

    Pai, H.L.; Sun, L.C.

    2004-01-01

    If the alpha method is adopted, the main problem for determining airborne plutonium particulates is the overlapping of the alpha spectrum between Pu and RTF (radon thoron progeny). The order of magnitude estimation establishes that RTP is more than 20 times higher than Pu. Therefore a method of discriminating RTP is required. The primary methods of discrimination are the aerosol size and the alpha spectrum methods. If the alpha spectrum method is adopted, the formation of the low energy tail of RTP should be investigated. Preliminary study indicates that the low energy tail is related to the air gap and dust loading. (author)

  20. Patient-Therapist Identification in Relation to Both Patient and Therapist Variables and Therapy Outcome

    Science.gov (United States)

    Melnick, Barry

    1972-01-01

    The results of the study confirmed the hypothesis that greater patient identification with the therapist, as defined by increased similarity between the patient's and therapist's semantic differential ratings, moderately correlated with more successful therapy outcome. (Author)

  1. What Influences Patient-Therapist Interactions in Musculoskeletal Physical Therapy? Qualitative Systematic Review and Meta-Synthesis.

    Science.gov (United States)

    O'Keeffe, Mary; Cullinane, Paul; Hurley, John; Leahy, Irene; Bunzli, Samantha; O'Sullivan, Peter B; O'Sullivan, Kieran

    2016-05-01

    Musculoskeletal physical therapy involves both specific and nonspecific effects. Nonspecific variables associated with the patient, therapist, and setting may influence clinical outcomes. Recent quantitative research has shown that nonspecific factors, including patient-therapist interactions, can influence treatment outcomes. It remains unclear, however, what factors influence patient-therapist interaction. This qualitative systematic review and meta-synthesis investigated patients' and physical therapists' perceptions of factors that influence patient-therapist interactions. Eleven databases were searched independently. Qualitative studies examining physical therapists' and patients' perceptions of factors that influence patient-therapist interactions in musculoskeletal settings were included. Two reviewers independently selected articles, assessed methodological quality using the Critical Appraisal Skills Programme (CASP), and performed the 3 stages of analysis: extraction of findings, grouping of findings (codes), and abstraction of findings. Thirteen studies were included. Four themes were perceived to influence patient-therapist interactions: (1) physical therapist interpersonal and communication skills (ie, presence of skills such as listening, encouragement, confidence, being empathetic and friendly, and nonverbal communication), (2) physical therapist practical skills (ie, physical therapist expertise and level of training, although the ability to provide good education was considered as important only by patients), (3) individualized patient-centered care (ie, individualizing the treatment to the patient and taking patient's opinions into account), and (4) organizational and environmental factors (ie, time and flexibility with care and appointments). Only studies published in English were included. A mix of interpersonal, clinical, and organizational factors are perceived to influence patient-therapist interactions, although research is needed to identify

  2. Ascorbate attenuates pulmonary emphysema by inhibiting tobacco smoke and Rtp801-triggered lung protein modification and proteolysis.

    Science.gov (United States)

    Gupta, Indranil; Ganguly, Souradipta; Rozanas, Christine R; Stuehr, Dennis J; Panda, Koustubh

    2016-07-19

    Cigarette smoking causes emphysema, a fatal disease involving extensive structural and functional damage of the lung. Using a guinea pig model and human lung cells, we show that oxidant(s) present in tobacco smoke not only cause direct oxidative damage of lung proteins, contributing to the major share of lung injury, but also activate Rtp801, a key proinflammatory cellular factor involved in tobacco smoke-induced lung damage. Rtp801 triggers nuclear factor κB and consequent inducible NOS (iNOS)-mediated overproduction of NO, which in combination with excess superoxide produced during Rtp801 activation, contribute to increased oxido-nitrosative stress and lung protein nitration. However, lung-specific inhibition of iNOS with a iNOS-specific inhibitor, N6-(1-iminoethyl)-L-lysine, dihydrochloride (L-NIL) solely restricts lung protein nitration but fails to prevent or reverse the major tobacco smoke-induced oxidative lung injury. In comparison, the dietary antioxidant, ascorbate or vitamin C, can substantially prevent such damage by inhibiting both tobacco smoke-induced lung protein oxidation as well as activation of pulmonary Rtp801 and consequent iNOS/NO-induced nitration of lung proteins, that otherwise lead to increased proteolysis of such oxidized or nitrated proteins by endogenous lung proteases, resulting in emphysematous lung damage. Vitamin C also restricts the up-regulation of matrix-metalloproteinase-9, the major lung protease involved in the proteolysis of such modified lung proteins during tobacco smoke-induced emphysema. Overall, our findings implicate tobacco-smoke oxidant(s) as the primary etiopathogenic factor behind both the noncellular and cellular damage mechanisms governing emphysematous lung injury and demonstrate the potential of vitamin C to accomplish holistic prevention of such damage.

  3. Density limit investigations near and significantly above the Greenwald limit on the tokamaks TEXTOR-94 and RTP

    International Nuclear Information System (INIS)

    Rapp, J.; Koslowski, H.R.; Pospieszczyk, A.; Salzedas, F.; Vries, P.C. de; Schueller, F.C.; Hokin, S.; Messiaen, A.M.

    2001-01-01

    Ignition scenarios like those developed for ITER require plasma densities which will be close or above the Greenwald limit. Generally it is observed that exceeding this limit may lead to a degradation of plasma confinement or to a violent end of the discharge. The achievable density limit and the related processes, such as radiative instabilities and MHD phenomena, which eventually lead to disruption, have been investigated in the limiter tokamaks TEXTOR-94 and RTP. (author)

  4. Customer response to day-ahead wholesale market electricity prices: Case study of RTP program experience in New York

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, C.; Hopper, N.; Sezgen, O.; Moezzi, M.; Bharvirkar, R.; Neenan, B.; Boisvert, R.; Cappers, P.; Pratt, D.

    2004-07-01

    There is growing interest in policies, programs and tariffs that encourage customer loads to provide demand response (DR) to help discipline wholesale electricity markets. Proposals at the retail level range from eliminating fixed rate tariffs as the default service for some or all customer groups to reinstituting utility-sponsored load management programs with market-based inducements to curtail. Alternative rate designs include time-of-use (TOU), day-ahead real-time pricing (RTP), critical peak pricing, and even pricing usage at real-time market balancing prices. Some Independent System Operators (ISOs) have implemented their own DR programs whereby load curtailment capabilities are treated as a system resource and are paid an equivalent value. The resulting load reductions from these tariffs and programs provide a variety of benefits, including limiting the ability of suppliers to increase spot and long-term market-clearing prices above competitive levels (Neenan et al., 2002; Boren stein, 2002; Ruff, 2002). Unfortunately, there is little information in the public domain to characterize and quantify how customers actually respond to these alternative dynamic pricing schemes. A few empirical studies of large customer RTP response have shown modest results for most customers, with a few very price-responsive customers providing most of the aggregate response (Herriges et al., 1993; Schwarz et al., 2002). However, these studies examined response to voluntary, two-part RTP programs implemented by utilities in states without retail competition.1 Furthermore, the researchers had limited information on customer characteristics so they were unable to identify the drivers to price response. In the absence of a compelling characterization of why customers join RTP programs and how they respond to prices, many initiatives to modernize retail electricity rates seem to be stymied.

  5. Conceptual design of reactor TRIGA PUSPATI (RTP) spent fuel pool cooling system

    International Nuclear Information System (INIS)

    Tonny Lanyau; Mazleha Maskin; Mohd Fazli Zakaria; Mohmammad Suhaimi Kassim; Ahmad Nabil Abdul Rahim; Phongsakorn Prak Tom; Mohd Fairus Abdul Farid; Mohd Huzair Hussain

    2012-01-01

    After undergo about 30 years of safe operation, Reactor TRIGA PUSPATI (RTP) was planned to be upgraded to ensure continuous operation at optimum safety condition. In the meantime, upgrading is essential to get higher flux to diversify the reactor utilization. Spent fuel pool is needed for temporary storage of the irradiated fuel before sending it back to original country for reprocessing, reuse after the upgrading accomplished or final disposal. The irradiated fuel elements need to be secure physically with continuous cooling to ensure the safety of the fuels itself. The decay heat probably still exist even though the fuel elements not in the reactor core. Therefore, appropriate cooling is required to remove the heat produced by decay of the fission product in the irradiated fuel element. The design of spent fuel pool cooling system (SFPCS) was come to mind in order to provide the sufficient cooling to the irradiated fuel elements and also as a shielding. The spent fuel pool cooling system generally equipped with pumps, heat exchanger, water storage tank, valve and piping. The design of the system is based on criteria of the primary cooling system. This paper provides the conceptual design of the spent fuel cooling system. (author)

  6. Interpretation of measured data and the resolution analysis of the RTP 4-channel pulsed radar

    International Nuclear Information System (INIS)

    Pavlo, P.

    1993-01-01

    The resolution of a 4-channel pulsed radar being built at Rijnhuisen for the RTP tokamak is analyzed. The achievable resolution mainly depends on the accuracy of the time-of-flight measurements and the number of sampling frequencies; since the technological solution and the configuration have already been set, emphasis is put on interpretation of the measured data (the inversion problem) and minimization of the overall error. For this purpose, a specific neural network - the Multi Layer Perceptron (MLP) - has successfully been applied. Central density in the range of 0.2-0.6 x 10 20 m -3 was considered, i.e., one above the critical density for all four frequencies but not so high as to restrict the measurements to just the edge of the plasma. By balancing the inversion error and the time measurement error, for a wide class of density profiles the overall error in estimating the reflection point position of between 0.72 cm (for the lowest frequency) and 0.52 cm (for the highest frequency) root mean square was obtained, assuming an RMS error of 70 ps in the time of flight measurements. This is probably much better than what could be obtained by the Abel transform. Moreover, mapping with the MLP is considerably faster, and it should be considered for routine multichannel pulsed radar data processing. (author) 2 tabs., 4 figs., 6 refs

  7. Optimal RTP Based Power Scheduling for Residential Load in Smart Grid

    Science.gov (United States)

    Joshi, Hemant I.; Pandya, Vivek J.

    2015-12-01

    To match supply and demand, shifting of load from peak period to off-peak period is one of the effective solutions. Presently flat rate tariff is used in major part of the world. This type of tariff doesn't give incentives to the customers if they use electrical energy during off-peak period. If real time pricing (RTP) tariff is used, consumers can be encouraged to use energy during off-peak period. Due to advancement in information and communication technology, two-way communications is possible between consumers and utility. To implement this technique in smart grid, home energy controller (HEC), smart meters, home area network (HAN) and communication link between consumers and utility are required. HEC interacts automatically by running an algorithm to find optimal energy consumption schedule for each consumer. However, all the consumers are not allowed to shift their load simultaneously during off-peak period to avoid rebound peak condition. Peak to average ratio (PAR) is considered while carrying out minimization problem. Linear programming problem (LPP) method is used for minimization. The simulation results of this work show the effectiveness of the minimization method adopted. The hardware work is in progress and the program based on the method described here will be made to solve real problem.

  8. 'Non-local' response of RTP ohmic plasmas to peripheral perturbations

    International Nuclear Information System (INIS)

    Galli, P.; Gorini, G.; Mantica, P.; Hogeweij, G.M.D.; Kloe, J. de; Lopes Cardozo, N.J.

    1999-01-01

    A 'non-local' response of the plasma core triggered by peripheral plasma perturbations other than laser ablation is found in the RTP tokamak. Oblique pellet injection (OPI) has been used to induce fast cooling of the peripheral plasma. In response, an inward cold pulse (T e drop) and a slightly delayed core T e rise are observed. A somewhat similar 'non-local' response is observed when the peripheral plasma is heated by modulated electron cyclotron heating or by fast current ramps, i.e. the core temperature drops in response to the peripheral heating. The plasma conditions for the occurrence of the 'non-local' response have been investigated. The core T e rise following OPI is associated with the formation of a large temperature gradient in the region 1 e rise is largest at low electron density and for large pellet deposition radii. Above a critical density the T e rise disappears and only the (weaker) drop in core T e is observed. Time dependent transport simulations show that the propagation of the inward cold pulse is consistent with local transport, while the core T e rise is a slower phenomenon requiring a large transient drop of χ e in the region 1 < q < 2. (author)

  9. A Feminist Family Therapist Behavior Checklist.

    Science.gov (United States)

    Chaney, Sita E.; Piercy, Fred P.

    1988-01-01

    Developed Feminist Family Therapist Behavior Checklist to identify feminist family therapy skills. Used checklist to rate family therapy sessions of 60 therapists in variety of settings. Checklist discriminated between self-reported feminists and nonfeminists, between men and women, and between expert categorizations of feminist and nonfeminist…

  10. Characteristic Study of the Al 6061 T-6 used in RTP Primary Cooling System Using Scanning Electron Microscope (SEM)

    International Nuclear Information System (INIS)

    Tonny Anak Lanyau; Yusof Abdullah; Tom, P.P.

    2011-01-01

    Reactor TRIGA PUSPATI (RTP) is the only nuclear research reactor in Malaysia. Since the first criticality on 28th June 1982, RTP has been going through the safe operation and well maintenance. Along the period of operation almost 30 years, some of the reactor system and component has been refurbished, upgraded and replaced to ensure the functionality and safety to the reactor itself as well as to protect personnel and environment. Primary cooling system is to provide the sufficient cooling to the reactor by removal of the heat generated in the reactor core through the heat transfer process in the heat exchanger. In 2009, RTP has been undergoing the primary cooling system upgrades. Primary cooling system components including aluminium pipes has been dismantled and replaced with the new system. As a part of the ageing management programme and radiation damage study, the disposed aluminum pipes were taken and used in this study. Scanning Electron Microscope (SEM) is used to study the surface topography and elemental composition in conjunction of energy dispersive x-ray spectroscopy analysis. This paper presents the study that has been conducted. (author)

  11. Is low therapist empathy toxic?

    Science.gov (United States)

    Moyers, Theresa B; Miller, William R

    2013-09-01

    One of the largest determinants of client outcomes is the counselor who provides treatment. Therapists often vary widely in effectiveness, even when delivering standardized manual-guided treatment. In particular, the therapeutic skill of accurate empathy originally described by Carl Rogers has been found to account for a meaningful proportion of variance in therapeutic alliance and in addiction treatment outcomes. High-empathy counselors appear to have higher success rates regardless of theoretical orientation. Low-empathy and confrontational counseling, in contrast, has been associated with higher drop-out and relapse rates, weaker therapeutic alliance, and less client change. The authors propose emphasis on empathic listening skills as an evidence-based practice in the hiring and training of counselors to improve outcomes and prevent harm in addiction treatment. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. The working practices and job satisfaction of dental therapists: findings of a national survey.

    Science.gov (United States)

    Gibbons, D E; Corrigan, M; Newton, J T

    2000-10-28

    To describe the working practices and level of job satisfaction of dental therapists in the United Kingdom. Postal questionnaire survey of 380 dental therapists registered with the General Dental Council. Only 13% of dental therapists are also qualified as dental hygienists. Around 75% of those registered with the GDC are currently employed as dental therapists. Of those not currently working as dental therapists most were either working as hygienists or caring for their children at home. Over 90% of those working as therapists are employed within the Community Dental Service. About half work part-time. Part-time working is more common among respondents with childcare responsibilities. Most dental therapists are employed in clinical roles, and perform a limited range of treatments. A small proportion appear to have been asked to undertake duties which are not currently legal for them to perform. Three-quarters of those who were currently working as dental therapists had taken career breaks at some point, the most common reasons for such a break being a change in career and/or child rearing. The respondents expressed a high level of job satisfaction, particularly among older dental therapists. Dental therapy offers a potentially rewarding career in terms of job satisfaction. Any planned increase in the numbers of training places for dental therapists should their role be expanded, for example to include working in general dental practice, would need to take cognisance of the high rate of part-time working and the proportion who could be expected to take career breaks at some point in their working lives, as is the case with female dental practitioners.

  13. Factors affecting physical therapists' job satisfaction: questionnaire survey targeting first-year physical therapists.

    Science.gov (United States)

    Kota, Munetsugu; Kudo, Hiroyuki; Okita, Kazuhiko

    2018-04-01

    [Purpose] The survey aimed to clarify the factors that affect physiotherapists' job satisfaction. [Subjects and Methods] To examine factors affecting physical therapists' job satisfaction using a cross-sectional study with a questionnaire survey. Subjects were 193 first-year physical therapists who participated in a newcomer orientation at Hiroshima Prefectural Physical Therapy Association. The questionnaire comprised items concerning physical therapists' satisfaction with their work, motives for becoming physical therapists, education in school, internships, the workplace, and comfort in the workplace. [Results] Subjects were divided into two groups according to their satisfaction with their occupation. The "high satisfaction" group included 157 subjects, and the group "low satisfaction" group included 36 subjects. Using logistic regression analysis, items concerning comfort in the workplace, motives for becoming physical therapists, and learning in school were analysed. [Conclusion] Factors affecting physical therapists' job satisfaction were primarily influenced by previous experience and working conditions.

  14. Research attitudes and experiences of radiation therapists

    International Nuclear Information System (INIS)

    Scutter, Sheila; Halkett, Georgia

    2003-01-01

    An important factor in professional status is the ongoing development of the area as a result of research findings. However, involvement by radiation therapists in research, publication and higher degree study is limited. The aim of the current study was to investigate the attitudes of radiation therapists towards research, and to investigate the major factors contributing to their limited participation in research. To achieve this, an anonymous questionnaire was developed and distributed to radiation therapists working at the Royal Adelaide Hospital (RAH). The study found that radiation therapists at the RAH are interested in research but there are several factors that limit their involvement. These factors include limited knowledge about research processes, lack of support and lack of time to undertake research. Copyright (2003) Australian Institute of Radiography

  15. Taking Your Child to a Therapist

    Science.gov (United States)

    ... through tough times like: family problems school problems bullying health problems They help with feelings like: sadness anger ... Therapy for ADHD School Counselors Finding Low-Cost Mental Health Care Going to a Therapist Why Do People ...

  16. [Characteristics of art therapists in rehabilitative therapy].

    Science.gov (United States)

    Oster, Jörg

    2017-09-01

    Characteristics of art therapists in rehabilitative therapy Objectives: This study examines the sociodemographic, qualification- and activity-related characteristics of art therapists working in the field of rehabilitation. In 2013, an analysis of occupational groups was carried out in Germany, with the objective of describing the art therapists working there.A total of 2,303 complete datasets were submitted. From this group, those therapists mainly working in the field of rehabilitation/follow-up care/participation of disabled persons (according to Social Security Code VI and IX, n = 302) were selected and described. Most art therapists are female (average age 45 years) and largelywork part-time. Music and art therapy are the most common venues.More than 80% have a graduate degree. Methods of quality management are used.More than half of the therapists working in rehabilitation hospitals are employed in the field of psychosomatic medicine. Both individual and group therapy (each patient attending 1-2 times a week) are common. The results provide an overview of art therapy in the field of rehabilitation and show the spread in rehabilitation. Further research is indicated.

  17. Non-invasive thermal profiling of silicon wafer surface during RTP using acoustic and signal processing techniques

    Science.gov (United States)

    Syed, Ahmed Rashid

    Among the great physical challenges faced by the current front-end semiconductor equipment manufacturers is the accurate and repeatable surface temperature measurement of wafers during various fabrication steps. Close monitoring of temperature is essential in that it ensures desirable device characteristics to be reliably reproduced across various wafer lots. No where is the need to control temperature more pronounced than it is during Rapid Thermal Processing (RTP) which involves temperature ramp rates in excess of 200°C/s. This dissertation presents an elegant and practical approach to solve the wafer surface temperature estimation problem, in context of RTP, by deploying hardware that acquires the necessary data while preserving the integrity and purity of the wafer. In contrast to the widely used wafer-contacting (and hence contaminating) methods, such as bonded thermocouples, or environment sensitive schemes, such as light-pipes and infrared pyrometry, the proposed research explores the concept of utilizing Lamb (acoustic) waves to detect changes in wafer surface temperature, during RTP. Acoustic waves are transmitted to the wafer via an array of quartz rods that normally props the wafer inside an RTP chamber. These waves are generated using piezoelectric transducers affixed to the bases of the quartz rods. The group velocity of Lamb waves traversing the wafer surface undergoes a monotonic decrease with rise in wafer temperature. The correspondence of delay in phase of the received Lamb waves and the ambient temperature, along all direct paths between sending and receiving transducers, yields a psuedo real-time thermal image of the wafer. Although the custom built hardware-setup implements the above "proof-of-concept" scheme by transceiving acoustic signals at a single frequency, the real-world application will seek to enhance the data acquistion. rate (>1000 temperature measurements per seconds) by sending and receiving Lamb waves at multiple frequencies (by

  18. A space-time tomography algorithm for the five-camera soft X-ray diagnostic at RTP

    Energy Technology Data Exchange (ETDEWEB)

    Lyadina, E.S.; Tanzi, C.P.; Cruz, D.F. da; Donne, A.J.H. [FOM-Instituut voor Plasmafysica, Rijnhuizen (Netherlands)

    1993-12-31

    A five-camera soft x-ray with 80 detector channels has been installed on the RTP tokamak with the object of studying MHD processes with a relatively high poloidal mode number (m=4). Numerical tomographic reconstruction algorithms used to reconstruct the plasma emissivity profile are constrained by the characteristics of the system. Especially high poloidal harmonics, which can be resolved due to the high number of cameras, can be strongly distorted by stochastic and systematic errors. Furthermore, small uncertainties in the relative position of the cameras in a multiple camera system can lead to strong artefacts in the reconstruction. (author) 6 refs., 4 figs.

  19. Perception and use of balance measures for stroke patients among physical therapists in South Korea

    OpenAIRE

    Jang, Ho Young; Kim, You Lim; Lee, Suk Min

    2017-01-01

    [Purpose] The purpose of this study looked into physical therapists? perception and use of balance measures for stroke patients. [Subjects and Methods] Three hundred eighty two physical therapists who understood the purpose of this study, agreed on their participation in this study, were treating or treated stroke patients. A Cross-sectional study based on self-administered questionnaire that had a total of 41 questions was performed in South Korea. 382 questionnaires were used for analysis. ...

  20. Three perspectives on physical therapist managerial work.

    Science.gov (United States)

    Schafer, D Sue

    2002-03-01

    The nature of managerial work in the commercial sector has not been studied since the 1970s, and little is known about the work of managers in the health care sector. In this study, the perceived importance of managerial role and skill categories among 3 groups of physical therapists were studied to better understand the work priorities of physical therapist managers. Two groups of subjects were physical therapist managers in hospitals or private practices. A third group consisted of faculty members in professional physical therapist education programs. Respondents (n=343) rated the importance of 75 managerial activities. Responses related to 16 predetermined work categories were placed in rank order by group. A multivariate analysis of variance (MANOVA) was used to identify differences among groups. All groups identified communication, financial control, entrepreneur, resource allocator, and leader as the 5 most important categories and rated technical expert and figurehead as least important. The MANOVA showed differences between faculty members and private practice managers in 15 work categories, between hospital-based managers and private practice managers in 9 categories, and between faculty members and hospital-based managers in 8 categories. Work setting appears to have an impact on level of importance placed on managerial work categories. The strongest candidates for "universal" physical therapist managerial work categories were communication, financial control, and resource allocator.

  1. A prototype computer network service for occupational therapists.

    Science.gov (United States)

    Hallberg, N; Johansson, M; Timpka, T

    1999-04-01

    Due to recent reforms, the demands on the people working in community-oriented health care service are increasing. The individual providers need professional knowledge and skills to perform their tasks quickly and safely. The individuals are also confronted with new tasks and situations of which they lack experience. At the same time, the resources for education and development are decreasing. The aim of this paper is to describe the implementation of a prototype computer network service to support occupational therapists in their daily work. A customized Quality Function Deployment (QFD) model, including participatory design elements, was used for: (a) identification of the occupational therapists' needs; and (b) for the transformation of these needs to prioritized design attributes. The main purpose of the prototype was to improve the visualization of the design attributes that were found to support the occupational therapists. An additional purpose was to be able to evaluate the design attributes and further improve them. The specific aim of this article is to describe the initial prototype with respect both to the tools and the information content.

  2. A Survey On Burnout And Related Factors Among Occupational Therapists In Iran

    Directory of Open Access Journals (Sweden)

    Mina Mozayan

    2012-04-01

    Full Text Available Background and Aim: High levels of job stress experienced over time, as well as personal frustration and inadequate coping skills, can lead to the syndrome known as burnout. In it has been shown in several surveys that high job stress in occupational therapists could lead to the burnout syndrome. Since few studies have been conducted in Iran concerning burnout in occupational therapists, we felt the necessity of performing this study to make Iranian therapists more aware of the syndrome and its related factors.Materials and Method: A cross sectional survey was carried out on 87 Iranian occupational therapists in the current study. A questionnaire consisting of two parts (demographic dates & maslach burnout inventory was sent to all therapists who were members of medical organization.Results: 80.4% of therapists reported mild to moderate symptoms of burnout, while nobody has reported severe burn out. Low job satisfaction (P value=0.038 and job experience less than 5 years (P value=0.049 were the two variables associated significantly with burnout.Conclusion: In the present study high rate prevalence of burnout shows that occupational therapists in Iran are not in a good health state and it can indicate that Iran health system should pay more attention to this group. According to our study the early years of a therapist’s carrier are the period when the therapist is at risk of burnout. So we believe that students should be given more information about burnout syndrome and its coping mechanisms during their education at the university.

  3. The experiences of private somatology therapists on their self-management in a private practice

    Directory of Open Access Journals (Sweden)

    Karien Richter

    2013-07-01

    Full Text Available Somatology therapists have a demanding occupation, both physically and emotionally. Long working hours coupled with handling clients on a daily basis, notwithstanding the strain of ensuring high quality client care, are all aspects that place pressure on the therapist. These aspects, in the backdrop of a lack of self-management of a therapist, could result in impaired judgement and substandard performance in the workplace. The purpose of this study included exploring and describing the experiences of private somatology therapists in self-management, from which recommendations for improved self-management within private somatology practices were described. For the purpose of this study, self-management was defined as a method of managing not only the interaction with clients and work stressors, but also the feelings of the therapists, by practising a variety of techniques such as self-discipline. A descriptive, exploratory and contextual qualitative design was followed. The accessible population consisted of therapists (n = 15 practising at six private somatology facilities in the Pretoria North region. Purposeful sampling was followed. Ten individual unstructured interviews as well as a pilot study were conducted in which field notes were taken. Open-coding data analysis identified four themes with subthemes. Lincoln and Guba’s model was used to ensure trustworthiness and ethical considerations were followed throughout the process. Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment which we call the somatology practice.

  4. Physical therapists familiarity and beliefs about health services utilization and health seeking behaviour.

    Science.gov (United States)

    Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad

    2018-02-21

    Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.

  5. The knowledge of the inhabitants of Lesser Poland about the profession of an occupational therapist

    Directory of Open Access Journals (Sweden)

    Żmudzińska Urszula Ż

    2017-12-01

    Full Text Available Introduction: A contemporary model of occupational therapy differs from the previous model which was common in Poland in previous years. Therefore, the opinions of the society concerning the profession of an occupational therapist are constantly changing. Material and methods: The research included 244 inhabitants of Lesser Poland aged between 25 and 65 employed in various professions. A questionnaire regarding occupational therapy and the profession and competences of occupational therapists was applied in the study. Results: The presented results show that the job of an occupational therapist is perceived as a needed profession both by individuals who underwent such therapy and those who did not use such services. Responses regarding competences and activities in the profession of an occupational therapist revealed differences in the opinions of the study participants. Conclusions: Taking into account only competences and activities of an occupational therapist, associations of the study participants reflected the knowledge of the model of therapy that existed before and was mainly devoted to occupational therapy workshops. The respondents would trust an occupational therapist both in adapting the house to their needs and in performing exercises connected with activities of daily living.

  6. Effects of Functional Analytic Psychotherapy Therapist Training on Therapist Factors Among Therapist Trainees in Singapore: A Randomized Controlled Trial.

    Science.gov (United States)

    Keng, Shian-Ling; Waddington, Emma; Lin, Xiangting Bernice; Tan, Michelle Su Qing; Henn-Haase, Clare; Kanter, Jonathan W

    2017-07-01

    Functional Analytic Psychotherapy (FAP) is a behavioral psychotherapy intervention that emphasizes the development of an intimate and intense therapeutic relationship as the vehicle of therapeutic change. Recently, research has provided preliminary support for a FAP therapist training (FAPTT) protocol in enhancing FAP competency. The present study aimed to expand on this research by examining the effects of FAPTT on FAP-specific skills and competencies and a set of broadly desirable therapist qualities (labelled awareness, courage and love in FAPTT) in a sample of therapist trainees in Singapore. The study also evaluated the feasibility and acceptability of FAP in the Singaporean context. Twenty-five students enrolled in a master's in clinical psychology program were recruited and randomly assigned to receive either eight weekly sessions of a FAPTT course or to a waitlist condition. All participants completed measures assessing empathy, compassionate love, trait mindfulness, authenticity and FAP-specific skills and competencies pre- and post-training, and at 2-month follow-up. A post-course evaluation was administered to obtain participants' qualitative feedback. Results indicated that compared with the waitlisted group, FAPTT participants reported significant increases in overall empathy, FAP skill and treatment acceptability from pre- to post-training. Improvements were observed on several outcome variables at 2-month follow-up. Participants reported finding the training to be both feasible and acceptable, although several raised issues related to the compatibility of the treatment with the local cultural context. Overall, the findings suggest that FAPTT is effective for improving specific FAP competencies and selected broadly desirable therapist qualities among therapist trainees. Copyright © 2016 John Wiley & Sons, Ltd. Functional Analytic Therapy (FAP) therapist training protocol was effective in improving empathy and FAP skills among Singaporean therapist

  7. Icelandic occupational therapists' attitudes towards educational issues.

    Science.gov (United States)

    Asmundsd ttir, ELIN EBBA; Kaplan, SUSAN

    2001-01-01

    The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.

  8. Children's Rights, Therapists' Responsibilities: Feminist Commentaries.

    Science.gov (United States)

    Anderson, Gail, Ed.; Hill, Marcia, Ed.

    One of the murkier areas of feminist therapy ethics involves decisions about children and adolescents within mental health settings. Some of those ethical dilemmas are covered in this text, which provides a feminist focus on the mental health rights and needs of children. The book addresses specific practices intended to help therapists organize…

  9. The Lawyer-Therapist Consultation Team.

    Science.gov (United States)

    Korelitz, Ann; Schulder, Diane

    1982-01-01

    Discusses a pilot study in which joint consultations with a family therapist and a matrimonial attorney were offered to 10 couples and one woman contemplating divorce. Videotaped sessions. Suggests joint consultations can be useful in helping couples understand the psychological and legal implications of conflicts expressed during separation.…

  10. Patient-Therapist Value Congruence and Ratings of Client Improvement

    Science.gov (United States)

    Martini, Janie L.

    1978-01-01

    It can be concluded from the results of the two studies described here that value similarity between client and therapist is related to therapists' ratings of client improvement. This phenomenon can be expected in therapies irrespective of theoretical orientation. (Author)

  11. New method to analyse internal disruptions with five-camera soft x-ray tomography on RTP

    Energy Technology Data Exchange (ETDEWEB)

    Tanzi, C.P. [FOM-Instituut voor Plasmafysica, Rijnhuizen (Netherlands); Blank, H.J. de [Max-Planck-Institut fuer Plasmaphysik, Garching (Germany)

    1994-12-31

    The five-camera soft x-ray diagnostic on the Rijnhuizen Tokamak Project (RTP) offers a wealth of information on sawteeth. Using four or five cameras, tomographic images with 7 poloidal harmonics have been obtained throughout sawtooth crashes and precursor oscillations. The purpose of this paper is to determine whether the precursors are ideal MHD modes or can be attributed to the resistive growth of a magnetic island. In practice, the detection of the topology of magnetic surfaces from the reconstructed tomographic images is complicated by the fact that (except during the final phase of the collapse) the time dependence is dominated by rotation of the m = 1 displacement. A novel method allows to define quantities, e.g. the plasma volume where the emissivity is within a certain range, whose change is only determined by cross-field transport or reconnection, and is not affected by m = 1 convection and by rotation. (author) 6 refs., 2 figs.

  12. New method to analyse internal disruptions with five-camera soft x-ray tomography on RTP

    International Nuclear Information System (INIS)

    Tanzi, C.P.; Blank, H.J. de

    1994-01-01

    The five-camera soft x-ray diagnostic on the Rijnhuizen Tokamak Project (RTP) offers a wealth of information on sawteeth. Using four or five cameras, tomographic images with 7 poloidal harmonics have been obtained throughout sawtooth crashes and precursor oscillations. The purpose of this paper is to determine whether the precursors are ideal MHD modes or can be attributed to the resistive growth of a magnetic island. In practice, the detection of the topology of magnetic surfaces from the reconstructed tomographic images is complicated by the fact that (except during the final phase of the collapse) the time dependence is dominated by rotation of the m = 1 displacement. A novel method allows to define quantities, e.g. the plasma volume where the emissivity is within a certain range, whose change is only determined by cross-field transport or reconnection, and is not affected by m = 1 convection and by rotation. (author) 6 refs., 2 figs

  13. Autonomous and controlled motivation for interpersonal therapy for depression: Between-therapists and within-therapist effects.

    Science.gov (United States)

    Zuroff, David C; McBride, Carolina; Ravitz, Paula; Koestner, Richard; Moskowitz, D S; Bagby, R Michael

    2017-10-01

    Differences between therapists in the average outcomes their patients achieve are well documented, and researchers have begun to try to explain such differences (Baldwin & Imel, 2013). Guided by Self-Determination Theory (Deci & Ryan, 2000), we examined the effects on outcome of differences between therapists in their patients' average levels of autonomous and controlled motivation for treatment, as well as the effects of differences among the patients within each therapist's caseload. Between and within-therapist differences in the SDT construct of perceived relational support were explored as predictors of patients' motivation. Nineteen therapists treated 63 patients in an outpatient clinic providing manualized interpersonal therapy (IPT) for depression. Patients completed the BDI-II at pretreatment, posttreatment, and each treatment session. The Impact Message Inventory was administered at the third session and scored for perceived therapist friendliness, a core element of relational support. We created between-therapists (therapist-level) scores by averaging over the patients in each therapist's caseload; within-therapist (patient-level) scores were computed by centering within each therapist's caseload. As expected, better outcome was predicted by higher levels of therapist-level and patient-level autonomous motivation and by lower levels of therapist-level and patient-level controlled motivation. In turn, autonomous motivation was predicted by therapist-level and patient-level relational support (friendliness). Controlled motivation was predicted solely by patient self-critical perfectionism. The results extend past work by demonstrating that both between-therapists and within-therapist differences in motivation predict outcome. As well, the results suggest that therapists should monitor their interpersonal impact so as to provide relational support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Diversity within African American, female therapists: variability in clients' expectations and assumptions about the therapist.

    Science.gov (United States)

    Kelly, Jennifer F; Greene, Beverly

    2010-06-01

    Despite the presence of some literature that has addressed the characteristics of the African American female therapist, most psychotherapy training proceeds with the assumption that therapists are members of dominant groups, and most of the psychological and psychotherapy literature has been written by therapists and psychologists who come from dominant cultural perspectives. Not as much has been written about psychological paradigms or the process of psychotherapy from the perspective of the therapist who is not a dominant group member. This article explores both the common and divergent experiences that we, the authors, share as African American female therapists and the different reactions we frequently elicit in clients. We also explore how individual differences in our physical appearances, personal backgrounds, and different characteristics of our respective practices elicit distinct responses from clients that we believe are based on differences between us, despite the fact that we are both African American women. We believe that many of the stereotypes that affect perceptions of African American female clients also exist for African American female therapists. We will address how the intersection of gender, race, and sexual orientation of the client highlights the complexity of culturally competent practice. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  15. An investigation of how university sports team athletic therapists and physical therapists experience ethical issues.

    Science.gov (United States)

    Riendeau, Catherine; Parent-Houle, Valérie; Lebel-Gabriel, Marie Eve; Gauvin, Patrick; Liu, Le Yu; Pearson, Isabelle; Hunt, Matthew R

    2015-03-01

    Qualitative study using interpretive description methodology. The purpose of this study was to better understand how ethical issues are experienced by university sports team athletic therapists and physical therapists. In clinical practice, sports teams are associated with a range of ethical issues. Issues commonly reported in the literature include confidentiality, return-to-play decisions, conflicts of interest, advertising, doping, and use of local anesthetic. To date, there has been limited examination of how athletic therapists and physical therapists involved with sports teams experience these ethical issues, and limited exploration of how these ethical issues, when encountered, are shaped by therapists' professional roles and responsibilities. Semi-structured interviews were conducted with 11 athletic or physical therapists working with sports teams in 5 Canadian provinces. The data were analyzed inductively, using a recursive approach and constant comparative techniques. Four key themes were developed relating to the participants' experiences of ethical issues: establishing and maintaining professional boundaries, striving for respectful and effective collaboration, seeking answers to ethical concerns, and living with the repercussions of challenging decisions. While many ethical issues reported by participants resemble those faced by sports medicine physicians, they are experienced in distinctive ways, due to differences in professional roles and identities. Issues concerning professional boundaries were also more prominent for the study participants than the literature has reported them to be for sports medicine physicians. Effective communication and enhanced collaboration appear to be key elements in managing these ethical challenges.

  16. Therapist Ethnicity and Treatment Orientation Differences in Multicultural Counseling Competencies

    Science.gov (United States)

    Berger, Lauren K.; Zane, Nolan; Hwang, Wei-Chin

    2014-01-01

    This study examined the relationship between therapist characteristics, therapeutic orientations, person-level and agency-level practices with cultural competency among 221 Los Angeles County community mental health clinicians. Results from an online survey indicated that compared to White therapists, ethnic minority therapists were more personally involved in communities of color, more likely to use a cultural framework in clinical practice, and perceived their agencies to be more culturally sensitive. Ethnic minority therapists also reported greater multicultural (MC) awareness and better MC counseling relationships with their clients than White therapists. Personal involvement in communities of color accounted for ethnic differences in MC awareness and MC counseling relationships. Compared to therapists with a strictly non-behavioral (psychodynamic or humanistic) orientation, therapists with an eclectic (or integrative) therapy orientation reported having a higher level of community knowledge. Therapists with an eclectic orientation reported greater MC awareness than therapists with a non-behavioral orientation, while both eclectic and behavioral (cognitive behavioral or behavior modification) therapists recounted better MC counseling relationships with their clients than therapists with a non-behavioral orientation. Community knowledge mediated eclectic vs. non-behavioral therapeutic orientation differences in MC awareness. Agency resources/linkages and outreach both moderated the relationship between therapeutic orientation and MC skills. Results suggest that if therapists become more personally involved with diverse populations, they will feel more culturally aware and feel like they have a better relationship with ethnic minority clients. PMID:25580187

  17. Differences between physical therapists in attention paid to patient education.

    NARCIS (Netherlands)

    Sluijs, E.M.; Zee, J. van der; Kok, G.J.

    1993-01-01

    This article describes differences between physical therapists in terms of the attention they pay to educating patients. The differences between therapists were identified from audiotaped treatment sessions of 1837 patients, recorded by physical therapists in non-institutional care in the

  18. What Does It Mean To Be a Feminist Family Therapist?

    Science.gov (United States)

    Whipple, Vicky

    This paper describes a qualitative study involving in-depth interviews with women who identify themselves as feminist family therapists. It includes a summary of the themes identified in these three questions: How did you become a feminist family therapist? How do you DO feminist family therapy? What does it mean to be a feminist family therapist?…

  19. Psychovisual masks and intelligent streaming RTP techniques for the MPEG-4 standard

    Science.gov (United States)

    Mecocci, Alessandro; Falconi, Francesco

    2003-06-01

    like: DivX, Xvid, and Cisco"s Mpeg-4IP, have been analyzed but, as for today, they do not support VO). The original code has been deeply modified to integrate the SLIC and to adapt it for real-time streaming. A personal RTP (Real Time Protocol) has been defined and a Client-Server application has been developed. The viewer can decode and demultiplex the stream in real-time, while adapting to the changing modalities adopted by the Server according to the current video content. The proposed codec works as follows: the image background is separated by means of a segmentation module and it is transmitted by means of a wavelet compression scheme similar to that used in the JPEG2000. The VO are coded separately and multiplexed with the background stream. At the receiver the stream is demultiplexed to obtain the background and the VO that are subsequently pasted together. The final quality depends on many factors, in particular: the quantization parameters, the Group Of Video Object (GOV) length, the GOV structure (i.e. the number of I-P-B VOP), the search area for motion compensation. These factors are strongly related to the following measurement parameters (that have been defined during the development): the Objects Apparent Size (OAS) in the scene, the Video Object Incidence factor (VOI), the temporal correlation (measured through the Normalized Mean SAD, NMSAD). The SLIC module analyzes the currently transmitted video and selects the most appropriate settings by choosing from a predefined set of transmission modalities. For example, in the case of a highly temporal correlated sequence, the number of B-VOP is increased to improve the compression ratio. The strategy for the selection of the number of B-VOP turns out to be very different from those reported in the literature for B-frames (adopted for MPEG-1 and MPEG-2), due to the different behaviour of the temporal correlation when limited only to moving objects. The SLIC module also decides how to transmit the background

  20. Exploring recruitment strategies to hire occupational therapists.

    Science.gov (United States)

    Mulholland, Susan; Derdall, Michele

    2005-02-01

    Recruitment issues in occupational therapy have been a long-standing concern for the profession. This descriptive study explored the strategies currently being used by employers to recruit occupational therapists for employment purposes. An 18-item survey was mailed to 251 sites where occupational therapists work in Alberta and Saskatchewan. There was a 64% response rate and data from 130 surveys were analyzed. The results indicate that employers continue to rely on a wide variety of strategies for advertising and recruiting, the most prevalent being word of mouth, postings at universities, and providing student fieldwork placements. In turn, the most effective recruitment strategies were listed as word of mouth, advertising in the general media, and providing student fieldwork placements. Various examples of financial incentives offered by employers were also listed. Many participants identified recent changes in recruitment strategies such as making a move towards web site job postings. PRACTICE IMPLICATIONS. The results suggest strategies for employers to target for recruiting occupational therapists and illustrate to both employers and students the importance of fieldwork in recruitment and hiring.

  1. A Female Therapist's Perspective on Growing Older.

    Science.gov (United States)

    Fodor, Iris

    2015-11-01

    As an older woman therapist, I find that my life experience grounds me in my work with people of all ages and backgrounds as they deal with life crises, aging issues, and loss. People with whom I work in therapy appreciate the fact that I am older and have had varied life experiences. Gender issues are still central to my work with clients whether I am working with a man or a woman. I am an integrative therapist, with a background in cognitive-behavioral therapy and gestalt therapy. Therapists need to help clients to identify less with their aging bodies and our culture's view of attractiveness, shifting instead to a paradigm that values life experience and the cultivation of wisdom. We need to find ways of embracing what we have learned about life instead of extolling youthful values. As I get older, I more fully appreciate a constructivism framework and life-cycle perspective, focusing on making sense of clients' life narratives. Storytelling and memoirs have both provided a framework for working with clients on coping with the many changes and challenges of life that bring them to therapy and added another layer to my integrative therapeutic work. © 2015 Wiley Periodicals, Inc.

  2. Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

    Science.gov (United States)

    Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

    2013-02-01

    Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high

  3. Utilization of thorium and U-ZrH1.6 fuels in various heterogeneous cores for TRIGA PUSPATI Reactor (RTP)

    Science.gov (United States)

    Damahuri, Abdul Hannan Bin; Mohamed, Hassan; Aziz Mohamed, Abdul; Idris, Faridah

    2018-01-01

    The use of thorium as nuclear fuel has been an appealing prospect for many years and will be great significance to nuclear power generation. There is an increasing need for more research on thorium as Malaysian government is currently active in the national Thorium Flagship Project, which was launched in 2014. The thorium project, which is still in phase 1, focuses on the research and development of the thorium extraction from mineral processing ore. Thus, the aim of the study is to investigate other alternative TRIGA PUSPATI Reactor (RTP) core designs that can fully utilize thorium. Currently, the RTP reactor has an average neutron flux of 2.797 x 1012 cm-2/s-1 and an effective multiplication factor, k eff, of 1.001. The RTP core has a circular array core configuration with six circular rings. Each ring consists of 6, 12, 18, 24, 30 or 36 U-ZrH1.6 fuel rods. There are three main type of uranium weight, namely 8.5, 12 and 20 wt.%. For this research, uranium zirconium hydride (U-ZrH1.6) fuel rods in the RTP core were replaced by thorium (ThO2) fuel rods. Seven core configurations with different thorium fuel rods placements were modelled in a 2D structure and simulated using Monte Carlo n-particle (MCNPX) code. Results show that the highest initial criticality obtained is around 1.35101. Additionally there is a significant discrepancy between results from previous study and the work because of the large estimated leakage probability of approximately 21.7% and 2D model simplification.

  4. An investigation into the feasibility of thorium fuels utilization in seed-blanket configurations for TRIGA PUSPATI Reactor (RTP)

    Science.gov (United States)

    Damahuri, Abdul Hannan Bin; Mohamed, Hassan; Aziz Mohamed, Abdul; Idris, Faridah

    2018-01-01

    Thorium is one of the elements that needs to be explored for nuclear fuel research and development. One of the popular core configurations of thorium fuel is seed-blanket configuration or also known as Radkowsky Thorium Fuel concept. The seed will act as a supplier of neutrons, which will be placed inside of the core. The blanket, on the other hand, is the consumer of neutrons that is located at outermost of the core. In this work, a neutronic analysis of seed-blanket configuration for the TRIGA PUSPATI Reactor (RTP) is carried out using Monte Carlo method. The reactor, which has been operated since 1982 use uranium zirconium hydride (U-ZrH1.6) as the fuel and have multiple uranium weight which are 8.5, 12 and 20 wt.%. The pool type reactor is one and only research reactor that located in Malaysia. The design of core included the Uranium Zirconium Hydride located at the centre of the core that will act as the seed to supply neutron. The thorium oxide that will act as blanket situated outside of seed region will receive neutron to transmute 232Th to 233U. The neutron multiplication factor or criticality of each configuration is estimated. Results show that the highest initial criticality achieved is 1.30153.

  5. Sequences of emotional distress expressed by clients and acknowledged by therapists: are they associated more with some therapists than others?

    Science.gov (United States)

    Viney, L L

    1994-11-01

    When clients come to psychotherapy they are distressed, this distress usually being expressed in the form of anxiety, hostility, depression and helplessness. This study explored the sequences of emotional distress expressed by clients and acknowledged by therapists, and examined their associations with other factors. The transcripts of five therapists (two single sessions each) were content-analysed: they used personal construct, client centered, rational-emotive, Gestalt and transactional analysis therapy. Log-linear analyses of appropriate contingency table cell frequencies were conducted to test associations between identified sequences and the two variables of therapist and timing of completion of the sequence. Therapist-client sequences of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to be associated more with the personal construct and client centred therapists than with the rational-emotive therapist. Client-therapist sequences of Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more often found with the client centred therapist than the other therapists. For most of these sequences timing had an effect, yet timing rarely interacted with the therapist variable. The findings are discussed in terms of their relevance to the theoretical positions represented, the shortcomings of the research and the value of this methodology in studies linking therapy process with outcome.

  6. Marriage consummated for 32 Iranian women using therapist-aided exposure therapy : a brief report

    NARCIS (Netherlands)

    Molaeinezhad, M.; Salehi, M.; Borg, C.; Yousefy, A.; Roudsari, R. Latifnejad; Salehi, P.; Shafiei, K.; Khoei, E. Merghati

    This brief report discusses the effectiveness of therapist-aided gradual exposure therapy for a sample of women suffering from lifelong vaginismus (LLV). Thirty two women who have never been able to have sexual intercourse, performed weekly exposure sessions of vaginal penetration exercises assisted

  7. On the therapist's yearning for intimacy.

    Science.gov (United States)

    Yerushalmi, Hanoch

    2013-07-01

    From the beginning of clinical psychoanalysis, analysts have been at risk of succumbing to yearnings for intimacy and contact that are stirred up by the heat of the analytic encounter. Recently, as theoretical developments have encouraged us to create moments of meeting (Stern et al. 1998) and have urged us to tolerate the feelings stimulated by enactments, these risks have increased. The author points out that foregoing the realization of this yearning within the analytic relationship and the resultant mourning for the loss of a fantasy or illusion carries a heavy personal price tag for the therapist. © 2013 The Psychoanalytic Quarterly, Inc.

  8. Asthma disease management and the respiratory therapist.

    Science.gov (United States)

    Kallstrom, Thomas J; Myers, Timothy R

    2008-06-01

    The role of the respiratory therapist (RT) is expanding with the growing acceptance and use of the disease-management paradigm for managing chronic diseases. RTs are key members of the asthma disease-management team, in acute-care settings, patients' homes, out-patient clinics, emergency departments, and in the community. Utilizing RTs as disease managers allows patients to be treated faster and more appropriately, discharged to home sooner, and decreases hospital admissions. RT are leaders in the emerging field of asthma disease management.

  9. Psychotherapy for massively traumatized refugees: the therapist variable.

    Science.gov (United States)

    Kinzie, J D

    2001-01-01

    In the treatment of severe posttraumatic stress disorder (PTSD), much emphasis is put on techniques, especially behavioral therapies. Such techniques negate the importance of the therapist as an individual in the treatment of complex PTSD as presented in severely traumatized refugees. The specific difficulties encountered by this population and the therapist responses are discussed: the need to tell the trauma story and the therapist's ability to listen; the patient's need for constancy and therapist's ability to stay; the patient's need to give and the therapist's ability to receive; the patient's problem with evil and the therapist's ability to believe. Case examples illustrate the approach and then discuss how generalizable this experience is to other populations. Research implications are suggested.

  10. Prevención en fonoaudiólogos de la Universidad del Valle en Cali, Colombia Prevention and performance role of speech-hearing therapist from University of Valley in Cali, Colombia

    Directory of Open Access Journals (Sweden)

    Gustavo A. Cabrera

    1998-04-01

    estudado não incorpora sistematicamente estratégias nem ações preventivas de desordens de comunicação da forma proposta no seu perfil de formação, nem tal como é socialmente esperado, apesar de reconhecer o role do currículo na sua fundamentação teórico-prática quanto à prevenção comunicativa. É sugerida a presença de determinantes laborais e da demanda de serviços que impedem práticas preventivas habituais.INTRODUCTION: Preventive activities in communication disorders treated by speech-hearing therapists of the Universidad del Valle in Cali Colombia, between January and April, 1995, are described. METHODOLOGY: Forty-five professionals to whom a self administered questionnaire with 13 questions was applied, were included in the study. RESULTS: For 67% the program of graduation is basic as source of their preventive knowledge. 47% used only one of nine strategic options and 29% report the use of only two of these preventive interventions. For all communication areas, on average nearly 60% of speech-hearing therapists never use preventive actions. CONCLUSION: The alumni of the Universidad del Valle do not exercise the practice of prevention in a sistematic way it has been claimed by the curriculum of the school. Some determinants of social context and demand of professional services are suspected to induce a great reduction in the proportion and frecuency of preventive practice in the professional role.

  11. Therapists perspectives on the effective elements of consultation following training.

    Science.gov (United States)

    Beidas, Rinad S; Edmunds, Julie M; Cannuscio, Carolyn C; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C

    2013-11-01

    Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered.

  12. Reported use of technology in stroke rehabilitation by physical and occupational therapists.

    Science.gov (United States)

    Langan, Jeanne; Subryan, Heamchand; Nwogu, Ifeoma; Cavuoto, Lora

    2017-08-16

    With the patient care experience being a healthcare priority, it is concerning that patients with stroke reported boredom and a desire for greater fostering of autonomy, when evaluating their rehabilitation experience. Technology has the potential to reduce these shortcomings by engaging patients through entertainment and objective feedback. Providing objective feedback has resulted in improved outcomes and may assist the patient in learning how to self-manage rehabilitation. Our goal was to examine the extent to which physical and occupational therapists use technology in clinical stroke rehabilitation home exercise programs. Surveys were sent via mail, email and online postings to over 500 therapists, 107 responded. Conventional equipment such as stopwatches are more frequently used compared to newer technology like Wii and Kinect games. Still, less than 25% of therapists' report using a stopwatch five or more times per week. Notably, feedback to patients is based upon objective data less than 50% of the time by most therapists. At the end of clinical rehabilitation, patients typically receive a written home exercise program and non-technological equipment, like theraband and/or theraputty to continue rehabilitation efforts independently. The use of technology is not pervasive in the continuum of stroke rehabilitation. Implications for Rehabilitation The patient care experience is a priority in healthcare, so when patients report feeling bored and desiring greater fostering of autonomy in stroke rehabilitation, it is troubling. Research examining the use of technology has shown positive results for improving motor performance and engaging patients through entertainment and use of objective feedback. Physical and occupational therapists do not widely use technology in stroke rehabilitation. Therapists should consider using technology in stroke rehabilitation to better meet the needs of the patient.

  13. Effects of therapist general self-disclosure and countertransference disclosure on ratings of the therapist and session.

    Science.gov (United States)

    Myers, David; Hayes, Jeffrey A

    2006-01-01

    Therapist decisions about self-disclosure depend theoretically upon both content and context, such as the quality of the therapeutic relationship. In this analogue study, 224 undergraduates viewed 1 of 3 videos for which the working alliance was described as positive or negative and in which a therapist made general self-disclosures, countertransference disclosures, or no disclosures. Interaction effects indicated that participants rated sessions as deeper and the therapist as more expert when the therapist made general disclosures compared to no disclosures, but only when the alliance was positive. When the alliance was negative, participants perceived sessions as shallower and the therapist as less expert when the therapist made either general or countertransference disclosures compared to no disclosures. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  14. Clients' and therapists' stories about psychotherapy.

    Science.gov (United States)

    Adler, Jonathan M

    2013-12-01

    This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

  15. Meeting the challenge of assessing clinical competence of occupational therapists within a program management environment.

    Science.gov (United States)

    Salvatori, Penny; Simonavicius, Nijole; Moore, Joan; Rimmer, Georgina; Patterson, Michele

    2008-02-01

    Program management models have raised concerns among occupational therapists about professional standards related to clinical competence, performance review procedures, and quality improvement initiatives. This paper describes how a chart-stimulated recall (CSR) peer-review process and interview tool was revised, implemented, and evaluated as a pilot project to assess the clinical competence of occupational therapy staff at a large urban health centre in southern Ontario. Fourteen pairs (n=28) of occupational therapists representing various practice areas participated in this project. Half served as peer assessors and half as interviewees. Peer assessors conducted an independent chart review followed by a one-hour personal interview with a peer partner to discuss clinical management issues related to the client cases. Each interviewer rated his or her partner's clinical competence in eight areas of performance using a 7-point Likert scale. Results indicated that the CSR tool could discriminate among occupational therapists in terms of overall levels of clinical competence and also identify specific areas of concern that could be targeted for professional development. Feedback from participants was positive. The CSR tool was found to be useful for assessing clinical competence of occupational therapists in this large health centre as a quality improvement initiative within that discipline group. Further research is needed to establish the reliability and validity of the CSR tool.

  16. Gross Motor Function Classification System Expanded & Revised (GMFCS E & R: reliability between therapists and parents in Brazil

    Directory of Open Access Journals (Sweden)

    Daniela B. R. Silva

    2013-10-01

    Full Text Available BACKGROUND: Several studies have demonstrated the importance of using the Gross Motor Function Classification System (GMFCS to classify gross motor function in children with cerebral palsy, but the reliability of the expanded and revised version has not been examined in Brazil (GMFCS E & R. OBJECTIVE:: To determine the intra- and inter-rater reliability of the Portuguese-Brazil version of the GMFCS E & R applied by therapists and compare to classification provided by parents of children with cerebral palsy. METHOD: Data were obtained from 90 children with cerebral palsy, aged 4 to 18 years old, attending the neurology or rehabilitation service of a Brazilian hospital. Therapists classified the children's motor function using the GMFCS E & R and parents used the Brazilian Portuguese version of the GMFCS Family Report Questionnaire. Intra- and inter-rater reliability was obtained through percentage agreement and Cohen's unweighted Kappa statistics (k. The Chi-square test was used to identify significant differences in the classification of parents and therapists. RESULTS: Almost perfect agreement was reached between the therapists [K=0.90 (95% confidence interval 0.83-0.97] and intra-raters (therapists with K=1.00 [95% confidence interval (1.00-1.00], p<0.001. Agreement between therapists and parents was substantial (k=0.716, confidence interval 0.596-0.836, though parents classify gross motor impairment more severely than therapists (p=0.04. CONCLUSIONS: The Portuguese version of the GMFCS E & R is reliable for use by parents and therapists. Parents tend to classify their children's limitations more severely, because they know their performance in different environments.

  17. Malpractice by physical therapists: descriptive analysis of reports in the National Practitioner Data Bank public use data file, 1991-2004.

    Science.gov (United States)

    Sandstrom, Robert

    2007-01-01

    As physical therapists increase autonomous practice, medical error becomes more important to public safety and public perceptions of the profession. The purpose of this study was to describe malpractice by physical therapists in the United States based on physical therapist malpractice reports in the National Practitioner Data Bank between January 1, 1991, and December 31, 2004. A frequency analysis of data related to physical therapist malpractice reports was performed. The relationship between size of malpractice payment and public policy related to access to physical therapist services and malpractice experience was explored. A total of 664 malpractice reports were found in the study period (mean, 47.73 events annually). California had 114 malpractice events, while Maine and Wyoming had none. The median payment amount for physical therapist malpractice was $10,000 to $15,000. "Treatment-related" events and events related to "improper technique" were the most common reasons for a malpractice report. Incidence of malpractice by physical therapists is low (estimated at 2.5 events/10,000 working therapists/year), and the average malpractice payment is small (public policy related to direct patient access to physical therapy services.

  18. CBT competence in novice therapists improves anxiety outcomes.

    Science.gov (United States)

    Brown, Lily A; Craske, Michelle G; Glenn, Daniel E; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy; Bystritsky, Alexander; Welch, Stacy S; Campbell-Sills, Laura; Lang, Ariel; Roy-Byrne, Peter; Rose, Raphael D

    2013-02-01

    This study explores the relationships between therapist variables (cognitive behavioral therapy [CBT] competence, and CBT adherence) and clinical outcomes of computer-assisted CBT for anxiety disorders delivered by novice therapists in a primary care setting. Participants were recruited for a randomized controlled trial of evidence-based treatment, including computer-assisted CBT, versus treatment as usual. Therapists (anxiety clinical specialists; ACSs) were nonexpert clinicians, many of whom had no prior experience in delivering psychotherapy (and in particular, very little experience with CBT). Trained raters reviewed randomly selected treatment sessions from 176 participants and rated therapists on measures of CBT competence and CBT adherence. Patients were assessed at baseline and at 6-, 12-, and 18-month follow-ups on measures of anxiety, depression, and functioning, and an average Reliable Change Index was calculated as a composite measure of outcome. CBT competence and CBT adherence were entered as predictors of outcome, after controlling for baseline covariates. Higher CBT competence was associated with better clinical outcomes whereas CBT adherence was not. Also, CBT competence was inversely correlated with years of clinical experience and trended (not significantly, though) down as the study progressed. CBT adherence was inversely correlated with therapist tenure in the study. Therapist competence was related to improved clinical outcomes when CBT for anxiety disorders was delivered by novice clinicians with technology assistance. The results highlight the value of the initial training for novice therapists as well as booster training to limit declines in therapist adherence. © 2012 Wiley Periodicals, Inc.

  19. Therapist reactions in self-experienced difficult situations: an exploration

    NARCIS (Netherlands)

    Smith, A.J.M.; Kleijn, W.C.; Hutschemaekers, G.J.M.

    2007-01-01

    This article describes a qualitative study of 63 difficult therapeutic situations described by 26 therapists. The study was part of research on specific reactions of therapists to traumatized clients. The research questions for the current analyses focused on the categorization of difficult

  20. The Therapist as Director of the Family Drama.

    Science.gov (United States)

    Andolfi, Maurizio; Angelo, Claudio

    1981-01-01

    Compares the therapist's function to that of a theatrical director who revises a play, the family drama, which the actors continue to recite according to an old script with a foregone conclusion. To achieve his goal, the therapist uses certain contextual elements to construct an alternative 'reading' of events. (Author)

  1. Feminist Therapy: A Comparative Study of Therapists and Clients.

    Science.gov (United States)

    Curtin, Catherine A.

    Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…

  2. The experiences of private somatology therapists on their self ...

    African Journals Online (AJOL)

    Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment ...

  3. Art Therapists' Emotional Reactions to the Demands of Technology

    Science.gov (United States)

    Asawa, Paige

    2009-01-01

    Art therapists increasingly are turning to educational and presentation technology to expand awareness of their field and to inform others in mental health care. This trend supports inquiry into how art therapists interact with and emotionally respond to the demands of technology. This paper presents a qualitative study that used 3 art-based focus…

  4. [Medical Devices Law for pain therapists].

    Science.gov (United States)

    Regner, M; Sabatowski, R

    2016-08-01

    Medical Devices Law is a relatively new legal system, which has replaced the Medical Devices Regulations still well-known in Germany. German Medical Devices Law is based on European directives, which are, in turn, incorporated into national law by the Medical Devices Act. The Medical Devices Act is a framework law and covers a number of regulations that address specific topics within Medical Devices Law. In turn, in individual regulations, reference is made to guidelines, recommendations, etc. from other sources that provide detailed technical information on specific topics. Medical Devices Law is a very complex legal system, which needs to be permanently observed due to constant updating and adjustment. In the current article, the design and the structure of the system will be described, but special emphasis will be laid on important problem areas that need to be considered when applying and operating medical products, in this case by pain therapists in particular.

  5. Structural strength analysis of lug component for RTP fuel transfer cask

    International Nuclear Information System (INIS)

    Ahmad Nabil Abdul Rahim; Tonny Lanyau; Mazleha Maskin

    2012-01-01

    A three decade aging PUSPATI TRIGA Reactor will soon require spent fuels to be replaced with fresh fuels. Initial procedure requires these spent fuels be cooled down due to high temperature and high radioactivity resulted from fission products activities and then transferred out of reactor tank into a spent fuel pool. Performing this task will need a fuel transfer cask (FTC) to provide sufficient radiation shielding for the workers during fuels transferring task. Currently the only economically viable route FTC to get into reactor tank is through the top of reactor tank using crane. The huge and high density lead filled FTC will be hanging throughout the task of transferring each fuel element thus FTC is subjected to tensile stress during its operation. Lug component is anticipated to be one of the main weaknesses of FTC design subjected under tensile load due to it diminutive in size but very large amount of stress to be introduced on it. Therefore lugs component requires an adequate stress analysis to prove the design reliability. This paper will discuss the structural strength using conventional engineering calculation based on best estimate approach. (author)

  6. Characterization of parameters and strategies used by physical therapists in difficult mechanical ventilation weaning

    Directory of Open Access Journals (Sweden)

    Fabíola Maria Sabino Meireles

    2013-03-01

    Full Text Available Objective: To characterize the main strategies and parameters used by physical therapists in difficult mechanical ventilation weaning. Methods: Cross-sectional study including all the physical therapists working in adult Intensive Care Units in three public hospitals in Fortaleza-CE. A questionnaire with closed questions related to difficult mechanical ventilation weaning was applied, with either one or multiple answers. The data was treated with descriptive and non-parametric analysis. Results: Among the parameters mostly used by the 56 interviewed physical therapists for the difficult weaning, were found: current volume reduction (26 - 46.4% and desaturation during aspiration (17 - 30.4%. It was observed that 38 (67.9% alternate T-tube and continuous positive airway pressure (CPAP as strategies for difficult weaning, and 28 (50% reported reducing the pressure support. There was no statistical difference between the strategies used in the studied hospitals, neither correlation between strategies and parameters. Conclusion: It was found that physical therapists have been performing similar strategies, which are also shown in the literature, but this is not the case with the parameters. The parameters used are not supported by the literature.

  7. Usage evaluation of the Physiotherapy Evidence Database (PEDro) among Brazilian physical therapists.

    Science.gov (United States)

    Elkins, Mark R; Moseley, Anne M; Pinto, Rafael Z

    2015-01-01

    It is unclear whether the Physiotherapy Evidence Database (PEDro) is widely and equally used by physical therapists in Brazil. As PEDro is considered a key resource to support evidence-based physical therapy, analyses of PEDro usage could reflect the extent of dissemination of evidence-based practice. To describe the usage of PEDro among the five regions of the World Confederation for Physical Therapy (WCPT) and, in more detail, in the South American region and Brazil over a 5-year period. PEDro home-page sessions and the number of searches performed were logged for a 5-year period (2010-2014). Absolute usage and relative usage were calculated for each region of the WCPT, each country in the South American region of WCPT, and each Regional Council (CREFITO) in Brazil. Europe had the highest absolute and relative usage among the five regions of the WCPT (971 searches per million-population per year), with the South American region ranked 4th in absolute terms and 3rd in relative terms (486). Within the South American region, Brazil accounted for nearly 60% of searches (755). Analysis at a national level revealed that usage per physical therapist in Brazil is very low across all CREFITOs. The highest usage occurred in CREFITO 6 with 1.3 searches per physical therapist per year. PEDro is not widely and equally used throughout Brazil. Strategies to promote PEDro and to make PEDro more accessible to physical therapists speaking Portuguese are needed.

  8. Job satisfaction and perceived future roles of Malaysian dental therapists: findings from a national survey.

    Science.gov (United States)

    Abu Bakar, A; Mohd Nor, N A; Ab-Murat, N; Jaafar, N

    2015-08-01

    To assess Malaysian dental therapists' perceptions of their job satisfaction and future roles. A nationwide postal survey involving all Malaysian dental therapists who met the inclusion criteria (n = 1726). The response rate was 76.8%. All respondents were females; mean age 35.4 years (SD = 8.4). Majority were married (85.5%) and more than one-half had a working experience of income (45.2%), allowances (45.2%) and non-commensurate between pay and performance (44.0%). Majority perceived their role as very important in routine clinical tasks such as examination and diagnosis, preventive treatment, extraction of deciduous teeth and oral health promotion. However, fewer than one-half consider complex treatment such as placement of preformed crowns on deciduous teeth (37.1%) and extraction of permanent teeth (37.2%) as very important tasks. Majority expressed high career satisfaction with most aspects of their employment but expressed low satisfaction in remuneration, lack of career advancement opportunities and administrative tasks. We conclude that most Malaysian dental therapists have positive perceptions of their current roles but do not favour wider expansion of their roles. These findings imply that there was a need to develop a more attractive career pathway for therapists to ensure sustainability of effective primary oral healthcare delivery system for Malaysia's children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. A comparison of work-related physical activity levels between inpatient and outpatient physical therapists: an observational cohort trial.

    Science.gov (United States)

    Brewer, Wayne; Ogbazi, Raluchukwu; Ohl, Devan; Daniels, Jeffry; Ortiz, Alexis

    2016-06-16

    Physical therapists (PTs) work in a variety of healthcare settings with varied levels of physical activity demands placed on them. The purpose of this study is to compare the physical activity (PA) levels between PTs in inpatient versus outpatient environments for one work week using a cross-sectional design. Sixty-one PTs (30 inpatient, 31 outpatient) wore a tri-axial accelerometer and inclinometer for one work-week. The number steps-per-day, PA intensities, energy expenditures and postural positions adopted during the work day were recorded. Significantly longer amounts of time spent sitting was found for inpatient PTs regardless of the significantly higher number of steps-per-day. Outpatient PTs had a higher number of breaks from sedentary activity with those breaks being longer than the inpatient PTs. The percentage of time spent performing moderate-vigorous PA approached significance implying more time was spent performing these types of activities for outpatient PTs. The energy expenditures between the two groups of PTs were not different. This study compared the differences in physical activity levels between physical therapists who worked at inpatient versus outpatient environment as little is known about their activity levels. Inpatient physical therapists took more steps per day than outpatient physical therapists but the outpatient physical therapists were less sedentary and took more frequent and longer breaks from sedentary activities. The energy expenditures were similar between both types of therapists and this may be reflective of the gender and bodyweight differences between the groups that equalizes the energy expenditures. The findings of this study suggests that there are differences in the physical activity demands between inpatient and outpatient physical therapists. The results of this study may serve dual purposes: (1) employers may be able to more accurately describe the expected physical activity demands to future employees; (2

  10. RTP Radiation Monitoring System

    International Nuclear Information System (INIS)

    Alfred, S.L.; Mohd Fairus Abdul Farid; Ahmad Nabil Abdul Rahim; Nurhayati Ramli

    2015-01-01

    Radiation Monitoring System aiming to limiting dose exposed to personnel to the lowest level referring to the concept of ALARA (As Low As Reasonably Achievable). Atomic Energy Licensing (Basic Safety Radiation Protection) Regulation 2010 (Act 304) is a baseline to control employee and public radiation protection program and guideline, as well as to meet the requirement of the Occupational Safety and Health 1994 (Act 514). (author)

  11. Patient personality and therapist response: an empirical investigation.

    Science.gov (United States)

    Colli, Antonello; Tanzilli, Annalisa; Dimaggio, Giancarlo; Lingiardi, Vittorio

    2014-01-01

    The aim of this study was to examine the relationship between therapists' emotional responses and patients' personality disorders and level of psychological functioning. A random national sample of psychiatrists and clinical psychologists (N=203) completed the Therapist Response Questionnaire to identify patterns of therapists' emotional response, and the Shedler-Westen Assessment Procedure-200 to assess personality disorders and level of psychological functioning in a randomly selected patient currently in their care and with whom they had worked for a minimum of eight sessions and a maximum of 6 months (one session per week). There were several significant relationships between therapists' responses and patients' personality pathology. Paranoid and antisocial personality disorders were associated with criticized/mistreated countertransference, and borderline personality disorder was related to helpless/inadequate, overwhelmed/disorganized, and special/overinvolved countertransference. Disengaged countertransference was associated with schizotypal and narcissistic personality disorders and negatively associated with dependent and histrionic personality disorders. Schizoid personality disorder was associated with helpless/inadequate responses. Positive countertransference was associated with avoidant personality disorder, which was also related to both parental/protective and special/overinvolved therapist responses. Obsessive-compulsive personality disorder was negatively associated with special/overinvolved therapist responses. In general, therapists' responses were characterized by stronger negative feelings when working with lower-functioning patients. Patients' specific personality pathologies are associated with consistent emotional responses, which suggests that clinicians can make diagnostic and therapeutic use of their responses to patients.

  12. Occupational therapists' perceptions of gender - a focus group study.

    Science.gov (United States)

    Liedberg, Gunilla M; Björk, Mathilda; Hensing, Gunnel

    2010-10-01

    Women and men are shaped over the courses of their lives by culture, society and human interaction according to the gender system. Cultural influences on individuals' social roles and environment are described in occupational therapy literature, but not specifically from a gender perspective. The purpose of this qualitative study was to explore how a sample of occupational therapists perceives the 'gender' concept. Four focus group interviews with 17 occupational therapists were conducted. The opening question was: 'How do you reflect on the encounter with a client depending on whether it is a man or a woman?' The transcribed interviews were analysed and two main themes emerged: 'the concept of gender is tacit in occupational therapy' and 'client encounters'. The occupational therapists expressed limited theoretical knowledge of 'gender'. Furthermore, the occupational therapists seemed to be 'doing gender' in their encounters with the clients. For example, in their assessment of the client, they focussed their questions on different spheres: with female clients, on the household and family; with male clients, on their paid work. This study demonstrated that occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. There is a need to increase occupational therapists' awareness of their own behaviour of 'doing gender'. Furthermore, there is a need to investigate whether gendered perceptions will shorten or lengthen a rehabilitation period and affect the chosen interventions, and in the end, the outcome for the clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  13. Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

    Science.gov (United States)

    Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J

    2018-03-01

    Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Therapist qualities preferred by sexual-minority individuals.

    Science.gov (United States)

    Burckell, Lisa A; Goldfried, Marvin R

    2006-01-01

    Psychotherapy research concerning lesbian, gay, and bisexual (LGB) individuals has focused on matching clients on gender and sexual orientation, yet has not considered how factors such as therapeutic skill, presenting problem, and cohort membership may influence preference for therapists. This study was designed to identify those therapist qualities that sexual-minority individuals prefer and to determine how the presenting problem influences therapist choice. Forty-two nonheterosexual adults between 18 and 29 years old ranked 63 therapist characteristics from "Extremely Uncharacteristic" to "Extremely Characteristic" when seeking treatment for a problem in which their sexual orientation was salient and one in which it was not. The analyses of both conditions yielded clusters of items reflecting therapist characteristics that participants considered unfavorable, neutral, beneficial, and essential. Participants valued therapists who had LGB-specific knowledge as well as general therapeutic skills, whereas they indicated that they would avoid therapists who held heterocentric views. Application of these findings to clinical practice and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  15. Going global in physical therapist education: International Service-Learning in US-based programmes.

    Science.gov (United States)

    Pechak, Celia; Thompson, Mary

    2011-12-01

     Internationalization is expanding its presence in higher education in the United States. Reflecting this trend that includes incorporating global perspectives in the curricula, physical therapist education programmes increasingly offer international opportunities such as International Service-Learning (ISL) to their students. Service-learning, a teaching strategy that integrates community service with structured learning activities, has gained broad acceptance in health professions education including physical therapy, and is therefore the focus of this paper. The specific purposes of this paper were to identify and analyse the commonalities that existed among established ISL programmes within physical therapist education programmes in terms of structures and processes, and to consider its broader implications for physical therapist education.   A descriptive, exploratory study was performed using grounded theory. Snowball and purposive, theoretical sampling yielded 14 faculty members with experience in international service, international learning or ISL in physical therapist education programmes. Faculty were interviewed by phone. Interview transcriptions and course documents were analysed applying grounded theory methodology. Data from eight programmes which met the operational definition of established ISL were used to address the purposes of this paper.   Five phases of establishing an ISL programme were identified: development, design, implementation, evaluation, and enhancement. Although no single model exists for ISL in physical therapist education; commonalities in structures and processes were identified in each phase. However, attention to service objectives and outcomes is lacking.   While analysis revealed that each programme shared commonalities and demonstrated differences in structures and processes compared with the other programmes, the study demonstrated a general lack of focus on formal community outcomes which raises ethical

  16. Community occupational therapists' clinical reasoning: identifying tacit knowledge.

    Science.gov (United States)

    Carrier, Annie; Levasseur, Mélanie; Bédard, Denis; Desrosiers, Johanne

    2010-12-01

      Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions.   To synthesise current knowledge about community occupational therapists' clinical reasoning.   A scoping study of the literature on community occupational therapists' clinical reasoning was undertaken.   Fifteen textbooks and 25 articles, including six focussing on community occupational therapists' clinical reasoning, were reviewed. Community occupational therapists' clinical reasoning is influenced by internal and external factors. Internal factors include past experiences, expertise and perceived complexity of a problem. One of the external factors, practice context (e.g. organisational or cultural imperatives, physical location of intervention), particularly shapes community occupational therapists' clinical reasoning, which is interactive, complex and multidimensional. However, the exact influence of many factors (personal context, organisational and legal aspects of health care, lack of resources and increased number of referrals) remains unclear.   Further studies are needed to understand better the influence of internal and external factors. The extent to which these factors mould the way community occupational therapists think and act could have a direct influence on the services they provide to their clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  17. The approach of occupational therapists in the Family Health Support Centers (NASF in the state of Alagoas, Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Alves dos Santos Silva

    2014-09-01

    Full Text Available Primary Health Care - ABS plays a key role among the public policies of the Brazilian Unified Health System - SUS, and it is guided by the Family Health Strategy - ESF. In this context, the Family Health Support Centers - NASF were created by the Health Ordinance No. 154 of 24 Jan. 2008, with the aim of expanding the action of ABS, and its importance was reaffirmed by the Health Ordinance No. 2, 488, dated 21 Oct. 2011, which revoked the first one but did not alter the assignments of the NASF professionals and consolidated teamwork as a priority for the reorganization of ABS in Brazil. In this context, the objective of this research was to understand the approach of Occupational Therapists in the Family Health Support Centers in Alagoas state. This is a qualitative study which uses a self-responsive questionnaire, structured by researchers, containing an open question where Occupational Therapists could describe their work in the NASF. All subjects agreed to participate. The responses were interpreted reflectively by researchers seeking contribution to the initial concepts of the working process of Occupational Therapists at the NASFs. In this study, the occupational therapist described the realization of preventive, promotion and education actions in health, as well as actions of rehabilitation, mental health and performance in Activities of Daily Living (ADL and Instrumental Activities of Daily Living (IADL. Thus, the NASF strategy places the Occupational Therapist in search for ways and strategies to perform a collective practice.

  18. The role of personal practice in therapist skill development: a model to guide therapists, educators, supervisors and researchers.

    Science.gov (United States)

    Bennett-Levy, James; Finlay-Jones, Amy

    2018-05-01

    Prior to 2000, personal practice (PP) for therapists mostly meant personal therapy. Recently a new landscape of PPs has emerged, with meditation-based programs and therapy self-practice/self-reflection (SP/SR) programs playing an increasing role in training and personal/professional development. The challenge now for practitioners and researchers is to refocus on the role of PPs in training and professional development. Are PPs of value - or not? Do they have a role in therapist development? How might PPs enhance therapist skilfulness? Do different PPs act in similar or different ways? Currently, the PP literature lacks a theoretical framework to guide practitioners in their choice of PPs or researchers in their choice of research questions and measures. The purpose of this article is to provide such a framework, the Personal Practice (PP) model. The PP model proposes primary impacts of PPs in four domains: personal development/wellbeing, self-awareness, interpersonal beliefs/attitudes/skills and reflective skills. The model also suggests a secondary impact on therapists' conceptual/technical skills when therapists use reflection to consider the implications of their PP for their "therapist self". We offer some suggestions to enhance the quality of future research, and conclude that PPs may play an important and perhaps unique role in therapist training.

  19. Occupational therapists in the interdisciplinary team setting.

    Science.gov (United States)

    Reed, S M

    1984-01-01

    The interdisciplinary team approach to patient care provides an answer to the fragmentation and confusion patients feel when dealing with our complex healthcare system. Even though the team approach has been in use for the past two decades, implementation of a successful team is very difficult and rarely sustained over a significant period of time. This is especially true in general hospitals and in physical rehabilitation programs that spring from general hospitals where the physician and the nurse are the traditional care group. Occupational therapists, as they establish roles on interdisciplinary teams as staff members and team leaders, will require a knowledge of what makes a team function effectively. They can use this knowledge to evaluate the status of their own team and contribute to changes that will insure its long-term success. Six key issues should be addressed during the planning stage of any new healthcare team to insure its continued viability. These issues are: program philosophy, client focus, role clarification, collaboration and information sharing, policies and procedures, and staff supportiveness.

  20. Biofeedback in Partial Weight Bearing: Usability of Two Different Devices from a Patient's and Physical Therapist's Perspective.

    Science.gov (United States)

    van Lieshout, Remko; Pisters, Martijn F; Vanwanseele, Benedicte; de Bie, Rob A; Wouters, Eveline J; Stukstette, Mirelle J

    2016-01-01

    Partial weight bearing is frequently instructed by physical therapists in patients after lower-limb trauma or surgery. The use of biofeedback devices seems promising to improve the patient's compliance with weight-bearing instructions. SmartStep and OpenGo-Science are biofeedback devices that provide real-time feedback. For a successful implementation, usability of the devices is a critical aspect and should be tested from a user's perspective. To describe the usability from the physical therapists' and a patients' perspective of Smartstep and OpenGo-Science to provide feedback on partial weight bearing during supervised rehabilitation of patients after lower-limb trauma or surgery. In a convergent mixed-methods design, qualitative and quantitative data were collected. Usability was subdivided into user performance, satisfaction and acceptability. Patients prescribed with partial weight bearing and their physical therapists were asked to use SmartStep and OpenGo-Science during supervised rehabilitation. Usability was qualitatively tested by a think-aloud method and a semi-structured interview and quantitatively tested by the System-Usability-Scale (SUS) and closed questions. For the qualitative data thematic content analyses were used. Nine pairs of physical therapists and their patients participated. The mean SUS scores for patients and physical therapists were for SmartStep 70 and 53, and for OpenGo-Science 79 and 81, respectively. Scores were interpreted with the Curved Grading Scale. The qualitative data showed that there were mixed views and perceptions from patients and physical therapists on satisfaction and acceptability. This study gives insight in the usability of two biofeedback devices from the patient's and physical therapist's perspective. The overall usability from both perspectives seemed to be acceptable for OpenGo-Science. For SmartStep, overall usability seemed only acceptable from the patient's perspective. The study findings could help

  1. Matching therapists' predicates: an in vivo test of effectiveness.

    Science.gov (United States)

    Dowd, E T; Hingst, A G

    1983-08-01

    The theory of neurolinguistic programming predicts that a therapist's matching of a client's primary representational system, as expressed in the client's predicates, should result in increased therapist's rapport and social influence. This hypothesis was tested in an actual interview situation. Six relatively inexperienced therapists, two each in predicate matching, predicate mismatching, and predicate no-matching conditions, conducted a 30-min. interview with nine undergraduate student volunteers each, for a total of 54 subjects. After the appropriate interview condition was completed, subjects rated ther therapists on the Counselor Rating Form and the Counseling Evaluation Inventory. No significant differences among the three conditions on any of the measures were found. Results are compared with those of previous research on assessment and primary representational matching in analogue situations.

  2. Inside Guillain-Barré Syndrome: An occupational therapist's perspective

    OpenAIRE

    Brooks, Shavaughn Ashley Nikita

    2014-01-01

    Occupational Therapists working with patients with Guillain-Barre Syndrome (GBS) are tasked with collaborating with the patient to achieve maximal functional recovery. Although much has been published about recovery after GBS from a scientific perspective; this article combines occupational therapy principles with the personal experiences of an occupational therapist who herself suffered from GBS. This commentary outlines important considerations for providing intervention to patients with GB...

  3. Attitudes About Cognitive Screening: A Survey of Home Care Physical Therapists.

    Science.gov (United States)

    Miles, Jean D; Staples, William H; Lee, Daniel J

    2018-02-14

    Home care physical therapists (PTs) are inconsistent regarding cognitive screening, possibly because screening tools were traditionally considered the domain of other home care disciplines, or because therapists perceive their dementia training to be inadequate. A cross sectional study was designed to survey home care therapists' attitudes and beliefs about the management of persons with dementia and to find out whether any specific cognitive tools or measures are currently used. A 5-point Likert-type survey was administered to home care PTs via an online survey. Three state home care associations and individual home care agencies agreed to share the survey link. The survey was also made available to American Physical Therapy Association members through the Home Health and Geriatric Section listservs. Two hundred fifty-one PTs opened the survey and 233 completed the survey. Respondents included 180 females and 53 males. Seventy-four had a bachelor's degree (BS), 53 held a master's degree (MS), 104 had achieved a doctor of physical therapy (DPT) or doctor of philosophy (PhD) degree, and 2 did not provide this information. Significant differences were found between those with the highest doctoral degrees and those with master's or bachelor's degrees (P = .01) regarding whether they were qualified to screen (strongly agree, agree) for cognitive deficits. Therapists with the highest degrees also attended continuing education for dementia training more than those with less formal education (P = .042.) Gender differences were found in 2 questions regarding positive outcomes (P = .010 and .42); for both questions, males were more likely to believe that dementia has a negative impact. Eighty-seven percent indicated that PTs are qualified (strongly agree, agree), but only 53% said that they possess the necessary skills (strongly agree, agree) to perform cognitive screens. Specialty certification revealed significant differences in several of the questions. No significance

  4. What Play Therapists Do within the Therapeutic Relationship of Humanistic/Non-Directive Play Therapy

    Science.gov (United States)

    Robinson, Sally

    2011-01-01

    Play therapists are increasingly being employed in schools, yet there is confusion among many health, education and social care practitioners about the role of play therapists. This paper explains how play therapists position themselves and what they do through an examination of the therapeutic relationship between the therapist and child. It…

  5. "Being a Therapist Doesn't Exclude You From Real Life": Family Therapists' Beliefs and Barriers to Political Action.

    Science.gov (United States)

    Jordan, Lorien S; Seponski, Desiree M

    2018-01-01

    A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients' lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists' (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists' engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs. © 2017 American Association for Marriage and Family Therapy.

  6. How does disclosing countertransference affect perceptions of the therapist and the session?

    Science.gov (United States)

    Yeh, Yun-Jy; Hayes, Jeffrey A

    2011-12-01

    Therapist self-disclosure has been theorized and found to have both positive and negative effects. These effects depend, in part, on the nature of the disclosure. This study sought to examine the differential effects of therapist disclosures of more and less resolved countertransference issues on perceptions of therapists and therapy sessions. Using an analogue method, undergraduate participants (N = 116) were randomly assigned to watch one of two videos in which a therapist disclosed personal issues that were relatively resolved or relatively unresolved. As hypothesized, therapist disclosure of issues that were more resolved caused the therapist to be rated as more attractive and trustworthy and instilled greater hope than therapist disclosure of less resolved issues. The type of therapist disclosure, however, did not affect ratings of the expertness of the therapist, the depth or smoothness of the session, or the perceived universality between client and therapist. Implications of the results for the judicious use of self-disclosure are discussed.

  7. Feminist Music Therapists in North America: Their Lives and Their Practices

    OpenAIRE

    Sandra L. Curtis

    2015-01-01

    This survey study investigated the lives and practices of those in North America who self-identify as feminist music therapists. Earlier reports from this survey studied: 1) the experiences of music therapists, with a comparison of men, women, and their 1990 counterparts (Curtis, 2013d); 2) the experiences of music therapists who self-identify as community music therapists (Curtis, 2015); and 3) the experiences of music therapists in Canada as they compare with their U.S. counterparts (Curtis...

  8. Conceptualizing the therapist's role in therapy in psychosis.

    Science.gov (United States)

    Dilks, Sarah; Tasker, Fiona; Wren, Bernadette

    2013-09-01

    This paper reports on a subset of findings from a wider ranging grounded theory analysis of therapy and recovery processes in psychosis. It describes therapist activities involved in maintaining an observational perspective during therapy and the links between these and other therapist activities. Grounded theory was used to examine the qualitative data collected. An initial sample of 19 taped therapy sessions and 23 interviews with psychologists and their clients was collected. This sample was extended through the collection of three further interviews with psychoanalytically aware psychologists. The data were analysed using grounded theory. A grounded theory model of therapy processes in psychosis was developed that conceptualized therapist actions as providing an observational scaffold to support the client's efforts in moving to new perspectives on their situation. Consistent with the understanding of the core therapy activity as a dialogical process, this set of therapist actions was understood as occurring alongside other therapist activities involved in managing emotion and building a relationship in therapy. The central activity of therapy in psychosis was understood as a dialogical process continuously negotiated between therapist and client in conversation and was conceptually summarized in the grounded theory as 'building bridges to observational perspectives'. However, the active and strategic efforts of psychologists to sustain the dialogue implied a particular assumption of responsibility for maintaining this process. In particular, therapists appeared to be 'working to maintain observational perspectives', 'managing emotion', and 'doing relationship' during the therapy conversation as part of the joint effort with clients to build bridges to new observational perspectives on distress and psychosis. © 2012 The British Psychological Society.

  9. THE ROLE OF THE SPORTS PHYSICAL THERAPIST-MARATHON EVENTS

    Science.gov (United States)

    Schuemann, Teresa; Hoogenboom, Barbara J.

    2013-01-01

    The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. In this role, the PT must be prepared to handle any type of emergency situation, which may occur from medical conditions to acute orthopedic/sports injuries, to medical conditions which may be found in the participants of the race or the spectators. Additional roles of the PT can be in pre-race education, pre-participation screening/physicals, and other concerns by the participant related to injury prevention. Regardless of the role assumed by the PT, prior planning is essential for the safety, security, and maximal performance of the participant and to make the race enjoyable and safe for everyone. Level of Evidence: 5 PMID:24175136

  10. The Role of Occupational Therapists and Physical Therapists in Elementary School System Early Intervening Services and Response to Intervention: A Case Report

    Science.gov (United States)

    Reeder, Deborah L.; Arnold, Sandra H.; Jeffries, Lynn M.; McEwen, Irene R.

    2011-01-01

    The Individuals with Disabilities Improvement Act and No Child Left Behind Act broadened the roles of occupational therapists (OTs) and physical therapists (PTs) to include therapist participation in early intervening services including response to intervention (RTI). This case report describes one school district's inclusion of OT and PT in the…

  11. [Therapist self-disclosure in cognitive-behavioral therapy].

    Science.gov (United States)

    Panagiotidou, K; Zervas, I

    2014-01-01

    Social changes and developments in medical science prompted mental health professionals to adopt new roles in relation to their self-disclosure practices. The physician-patient relationship has balanced on a different level, promoting the equity and the autonomy of the second. The contemporary patient is better informed, asks more questions and requires more answers. The boundaries between "professional" and "personal" are less strict and patients believe that they have a right to know whether the personal experiences (educational, clinical, research) of their therapists enable them to understand and help them. Although the latest version of the American Psychological Association's Ethics Code (APA, 2002) offers no explicit guidance on therapist self-disclosure, it incorporates an implicit message that therapists can no longer choose non-disclosure without having considered the issue carefully. Non-disclosure is no longer the easy answer, as it may affect adversely the therapeutic relationship and the therapeutic effect. These new circumstances prompted representatives of all psychotherapeutic orientations to reconsider traditional positions on therapist self-disclosure, to adapt to the diverse needs of the patients and the modern requirements of the therapeutic process and to define the framework within which its conduct is not only safe but also effective. This review attempts to describe the concept of therapist self-disclosure and its use and its functions in Cognitive-Behavioral Therapy, following a history of the term in other major therapeutic schools (psychoanalytic, client-centered and systemic). As the focus of any psychotherapy is the patient himself, we added reports of patients' experiences by their therapists' disclosures. Those descriptions reveal clearly not only the benefits of therapist self-disclosure but also the dangers posed by improper use. Finally, we attempt to set a framework in the form of proposals, as these result from existing

  12. A therapist version of the Alliance Negotiation Scale.

    Science.gov (United States)

    Doran, Jennifer M; Gómez-Penedo, Juan Martín; Safran, Jeremy D; Roussos, Andrés

    2018-05-02

    The aim of the current study was to design and evaluate a therapist version of the Alliance Negotiation Scale (ANS). The ANS was created in order to operationalize the construct of dyadic negotiation in psychotherapy and to augment existing conceptualizations of the working alliance. The ANS has existed only as a client self-report form since its inception and has demonstrated promise as a psychotherapy process measure. This research intended to develop a complementary therapist self-report version of the measure. The scale creation process is discussed in detail, and the results of a preliminary psychometric investigation are reported. The ANS-Therapist version (ANS-T) was developed using a sample of therapists (n = 114) through a principal components analysis procedure. The ANS-T contains 9 unidimensional items and was moderately correlated with therapist-reported working alliance (r = .468). The results of the study support the composition of the ANS-T and provide initial support for the reliability and validity of the measure. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Determinants of lesbian and gay affirmative practice among heterosexual therapists.

    Science.gov (United States)

    Alessi, Edward J; Dillon, Frank R; Kim, Hillary Mi-Sung

    2015-09-01

    The current study tested a conceptual model based on social-cognitive theory (Bandura, 1986), highlighting the influence of attitudes toward sexual minority individuals, training hours, affirmative counseling self-efficacy, and beliefs about affirmative practice on therapist engagement in lesbian and gay affirmative practice. We recruited via the Internet 443 heterosexual psychologists (n = 270), clinical social workers (n = 110), and marriage and family therapists (n = 63) residing in various parts of the United States. The majority of participants identified as female (70%) and White (88%). A path analysis indicated that beliefs and affirmative counseling self-efficacy mediated associations between attitudes and therapist engagement in affirmative practice. Furthermore, self-efficacy mediated the relation between training hours and engagement in affirmative practice. Results suggest that more affirmative attitudes are linked with higher levels of affirmative counseling self-efficacy and more positive beliefs, which in turn positively influences therapist engagement in affirmative practice. Additionally, more hours of training influence affirmative counseling self-efficacy, which in turn correlates with higher levels of therapist engagement in affirmative practice. The discussion includes implications for affirmative practice training. (c) 2015 APA, all rights reserved).

  14. Experiences of occupational therapists returning to work after maternity leave.

    Science.gov (United States)

    Parcsi, Lisa; Curtin, Michael

    2013-08-01

    Returning to work after maternity leave can be a challenging, anxious and fraught experience for women, and has been portrayed in the literature as a generally negative experience. Interestingly, although occupational therapists were predominantly women, no research was found focussing on their experiences of returning to work after maternity leave. The aim of this research was to gain an insight into occupational therapists' experiences of returning to work following maternity leave. Principles of interpretive phenomenological analysis were used to explore the individual experiences of six Australian occupational therapists returning to work after a period of maternity leave. Individual semi-structured interviews lasting up to 90 minutes were conducted. Interviews were audio-recorded, transcribed and then analysed. Two major themes emerged from the analysis of interviews: compromise and feeling valued. The experience of returning to work was a process of compromise in which women found strategies to cope with their changing roles and demands, to find a balance between home and work life. The women wanted to feel valued by their managers and co-workers, as this enabled them to feel comfortable and confident with some of the compromises they made. Occupational therapists returning to work after maternity leave will make compromises so that they can balance their home and work life. Occupational therapists value managers and co-workers who understand the compromises women make when returning to work following maternity leave and who create a supportive workplace that acknowledges and values their contribution. © 2013 Occupational Therapy Australia.

  15. The first year of practice: an investigation of the professional learning and development of promising novice physical therapists.

    Science.gov (United States)

    Black, Lisa L; Jensen, Gail M; Mostrom, Elizabeth; Perkins, Jan; Ritzline, Pamela D; Hayward, Lorna; Blackmer, Betsy

    2010-12-01

    The goal in studying expertise is not merely to describe ways in which experts excel but also to understand how experts develop in order to better facilitate the development of novices. The study of novice progression helps us to understand what successful versus unsuccessful learning looks like. This understanding is critical, as autonomous practice places increased demands for advanced clinical judgments and the ability to assume professional responsibilities. The purpose of this study was to explore the experiences, learning, and development of promising novice therapists throughout their first year of practice in the United States. A longitudinal, multiple-site qualitative case study method was used for within-case and across-case analysis. A purposive sample of 11 promising new graduates from 4 physical therapist education programs participated. Investigators followed the graduates throughout their first year of practice. Data sources included: (1) semistructured interviews conducted at baseline and every 3 months thereafter for 1 year, (2) reflective journals completed at regular intervals, and (3) review of academic and clinical education records and résumés. Four themes emerged: (1) the clinical environment influenced the novice physical therapists' performance, (2) participants learned through experience and social interaction and learning was primarily directed toward self, (3) growing confidence was directly related to developing communication skills, and (4) therapists were engaged in professional identity formation and role transitions. The findings suggest there are common experiences and themes that emerge as novice physical therapists develop. Although research has been conducted on expertise in physical therapy, few longitudinal investigations have explored the development of therapists across transitions from graduate to novice to expert practitioner. This study explored and described the learning and development of graduates during their first

  16. Psychological interventions for housebound people with psychosis: service user and therapist perspectives in South East London.

    Science.gov (United States)

    Iredale, Catherine; Fornells-Ambrojo, Miriam; Jolley, Suzanne

    2016-06-01

    People with psychosis often have difficulty leaving their homes to perform tasks of daily living, which also limits their access to clinic-based interventions to support recovery. Home-based psychological therapy may offer a solution. To examine service user and therapist perspectives on (i) houseboundness in psychosis and (ii) the value of home-based psychological interventions, as a first step towards a systematic evaluation. Semistructured interviews with 10 service users and 12 therapists from a large inner city mental health NHS Foundation Trust were thematically analysed. Houseboundness most commonly resulted from anxiety, paranoia and amotivation, indicating the potential usefulness of targeted psychological therapies. Home-based therapy was offered unsystematically, with variable goals. Although beneficial for engagement and assessment, little gain was reported from undertaking a full course of therapy at home. Home visits could be offered by psychological therapists to engage and assess housebound service users, but home-based therapy may be best offered on a short-term basis, targeting paranoia, anxiety and amotivation to increase access to other resources. Given the increased cost associated with home-based psychological interventions, a systematic evaluation of their impact is warranted.

  17. PHYSIOTHERAPISTS ATTIRE: DOES IT AFFECT PATIENTS COMFORT, CONFIDENCE AND OVERALL PATIENT-THERAPIST RELATIONSHIP

    Directory of Open Access Journals (Sweden)

    Adamu Ahmad Rufa'i

    2015-10-01

    Full Text Available Background: Attire is one of the major determinants of appearance and a key element of non-verbal communication that plays a critical role in the establishment and sustainability of therapeutic relationships. This study aimed to determine the patients’ preferred physiotherapists’ attire and the effect of physiotherapists’ attire on patients’ confidence, comfort and patient-therapists relationship. Methods: A questionnaire was used to collect data in this cross sectional study design. Patients (N=281 attending outpatients physiotherapy clinics in six selected tertiary health institutions in North-eastern Nigeria completed a questionnaire consisting of two sections. Section one solicited sociodemographic information while in section two patients rated their level of confidence and comfort with physiotherapists based on a photo pictures of a male and a female physiotherapists models in four different attires. Descriptive statistics were performed to characterize participants and the differences in patients’ confidence and comfort level by different types of attire were assessed using chi-square. The correlation between physiotherapists’ attire and patient-physiotherapist relationship was determined using spearman rank correlation. Results: Overwhelming majority of the participants were more comfortable (91.1% and more confident (89.0% with the physiotherapists dressed in white coat, while they were less comfortable and less confident when their therapists are dressed in suit, native or casual wear. Positive patient-therapist relationship was observed with white coat dressed physiotherapists; while the relationship with business, native and casual wears were inverse. Conclusion: The study supports for continuing recommendation of lab coat as a professional dressing for physiotherapists in Nigeria and affirms the importance of professional dressing in patient-therapists relationship.

  18. The diagnosis and treatment of chronic back pain by acupuncturists, chiropractors, and massage therapists.

    Science.gov (United States)

    Sherman, Karen J; Cherkin, Daniel C; Deyo, Richard A; Erro, Janet H; Hrbek, Andrea; Davis, Roger B; Eisenberg, David M

    2006-01-01

    To describe the diagnostic and therapeutic content of visits for chronic back pain to acupuncturists, chiropractors, and massage therapists. Randomly selected acupuncturists, chiropractors, and massage therapists in two states were surveyed, and then eligible providers collected data on consecutive patient visits. The authors analyzed information on diagnosis, treatment, and self-care recommendations for chronic back pain patients collected during consecutive patient visits to these complementary and alternative medicine (CAM) providers. Back pain was the most common reason for visits to each of these providers, with chronic back pain representing about 10% of visits to acupuncturists, 20% of visits to chiropractors, and 12% of visits to massage therapists. Diagnosis by acupuncturists included traditional questioning and inspecting the patient as well as pulse and tongue assessment and palpation of the acupuncture meridians. Treatments usually included acupuncture needling, heat of some sort, and other modalities, such as East Asian massage, herbs, and/or cupping (application of suction cups to the skin). Lifestyle recommendations were common, particularly exercise and dietary counseling. Visits to chiropractors usually included spinal and muscle/soft tissue examinations and spinal manipulation. Soft tissue techniques (eg, "active release"), stretch or strength training, and home exercise recommendations were much less common. Massage therapists usually performed a tissue assessment and commonly assessed range of motion. They emphasized Swedish, deep tissue, and trigger point massage techniques and usually made self-care recommendations, particularly increased water intake, hot/cold therapy, exercise, and body awareness. Information on the care patients routinely receive from CAM providers will help physicians better understand these increasingly popular forms of care.

  19. Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention.

    Science.gov (United States)

    Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

    2016-12-01

    Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.

  20. You Won't Get Me: Therapist Responses to Patient Impression Management Tactics.

    Science.gov (United States)

    Frühauf, Sarah; Figlioli, Patrick; Caspar, Franz

    2017-03-01

    In psychotherapy, therapist and patient influence each other constantly. We aimed to investigate how therapists respond to patient impression management and influence tactics. For 60 videotaped intake interviews, judges rated therapist responses to patient tactics as neutral, desired, or undesired from the patient perspective. Judges rated the therapist responses in 57% as neutral, in 40% as desired, and in 2% as undesired by the patients. The proportions of response outcomes varied across tactics. Therapist responses were unrelated to therapist and patient sex. Therapist experience was related to their responses to the tactic Supplication. Overall, some patient tactics seem to be more challenging for therapists than others. Awareness of such response tendencies can help therapists prepare their reactions to certain patient impression management and influence tactics. Implications for training and research are presented.

  1. Erotic feelings toward the therapist: a relational perspective.

    Science.gov (United States)

    Lotterman, Jenny H

    2014-02-01

    This article focuses on the relational treatment of a male patient presenting with sexual and erotic feelings toward the therapist. The use of relational psychotherapy allowed us to collaborate in viewing our therapeutic relationship as a microcosm of other relationships throughout the patient's life. In this way, the patient came to understand his fears of being close to women, his discomfort with his sexuality, and how these feelings impacted his ongoing romantic and sexual experiences. Use of the therapist's reactions to the patient, including conscious and unconscious feelings and behaviors, aided in the conceptualization of this case. Working under a relational model was especially helpful when ruptures occurred, allowing the patient and therapist to address these moments and move toward repair. The patient was successful in making use of his sexual feelings to understand his feelings and behaviors across contexts. © 2013 Wiley Periodicals, Inc.

  2. Negotiating behavioural change: therapists' proposal turns in Cognitive Behavioural Therapy.

    Science.gov (United States)

    Ekberg, Katie; Lecouteur, Amanda

    2012-01-01

    Cognitive behavioural therapy (CBT) is an internationally recognised method for treating depression. However, many of the techniques involved in CBT are accomplished within the therapy interaction in diverse ways, and with varying consequences for the trajectory of therapy session. This paper uses conversation analysis to examine some standard ways in which therapists propose suggestions for behavioural change to clients attending CBT sessions for depression in Australia. Therapists' proposal turns displayed their subordinate epistemic authority over the matter at hand, and emphasised a high degree of optionality on behalf of the client in accepting their suggestions. This practice was routinely accomplished via three standard proposal turns: (1) hedged recommendations; (2) interrogatives; and (3) information-giving. These proposal turns will be examined in relation to the negotiation of behavioural change, and the implications for CBT interactions between therapist and client will be discussed.

  3. Manual physical balance assistance of therapists during gait training of stroke survivors: characteristics and predicting the timing.

    Science.gov (United States)

    Haarman, Juliet A M; Maartens, Erik; van der Kooij, Herman; Buurke, Jaap H; Reenalda, Jasper; Rietman, Johan S

    2017-12-02

    During gait training, physical therapists continuously supervise stroke survivors and provide physical support to their pelvis when they judge that the patient is unable to keep his balance. This paper is the first in providing quantitative data about the corrective forces that therapists use during gait training. It is assumed that changes in the acceleration of a patient's COM are a good predictor for therapeutic balance assistance during the training sessions Therefore, this paper provides a method that predicts the timing of therapeutic balance assistance, based on acceleration data of the sacrum. Eight sub-acute stroke survivors and seven therapists were included in this study. Patients were asked to perform straight line walking as well as slalom walking in a conventional training setting. Acceleration of the sacrum was captured by an Inertial Magnetic Measurement Unit. Balance-assisting corrective forces applied by the therapist were collected from two force sensors positioned on both sides of the patient's hips. Measures to characterize the therapeutic balance assistance were the amount of force, duration, impulse and the anatomical plane in which the assistance took place. Based on the acceleration data of the sacrum, an algorithm was developed to predict therapeutic balance assistance. To validate the developed algorithm, the predicted events of balance assistance by the algorithm were compared with the actual provided therapeutic assistance. The algorithm was able to predict the actual therapeutic assistance with a Positive Predictive Value of 87% and a True Positive Rate of 81%. Assistance mainly took place over the medio-lateral axis and corrective forces of about 2% of the patient's body weight (15.9 N (11), median (IQR)) were provided by therapists in this plane. Median duration of balance assistance was 1.1 s (0.6) (median (IQR)) and median impulse was 9.4Ns (8.2) (median (IQR)). Although therapists were specifically instructed to aim for the

  4. Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy.

    Science.gov (United States)

    Hill, Clara E; Knox, Sarah; Crook-Lyon, Rachel E; Hess, Shirley A; Miles, Joe; Spangler, Patricia T; Pudasaini, Sakar

    2014-01-01

    Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.

  5. Therapist and supervisor competencies in cognitive behavioural therapy.

    Science.gov (United States)

    Prasko, Jan; Vyskocilová, Jana; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos

    2011-01-01

    For cognitive behavioural therapy, acquisition and maintenance of psychotherapeutic and supervisory competencies is crucial. The PubMed, Web of Science and Scopus databases were searched for articles containing the following keywords: cognitive-behavioural therapy, competencies, therapeutic relationship, intervention, technique, training, supervision, self-reflection, empirically supported, transference, countertransference, scheme of therapy, dialectical behaviour therapy. The search was performed by repeating the words in different combinations with no language or time limitations. The articles were sorted and key articles listed in reference lists were searched. In addition, original texts by A.T. Beck, J. Beck, C. Padesky, M. Linehan, R. Leahy, J. Young, W. Kuyken and others were used. The resources were confronted with our own psychotherapeutic and supervisory experiences and only most relevant information was included in the text. Thus, the article is a review with conclusions concerned with competencies in cognitive behavioural therapy. For cognitive behavioural therapy, four domains of competencies in psychotherapy are crucial - relationship, case assessment and conceptualization, self-reflection and intervention. These may be divided into foundational, specific and supervisory. The foundational competencies include recognition of empirical basis for a clinical approach, good interpersonal skills, ability to establish and maintain the therapeutic relationship, self-reflection, sensitivity to a difference and ethical behaviour. The specific competencies involve the skill of case conceptualization in terms of maladaptive beliefs and patterns of behaviour, ability to think scientifically and teach this to the patient, structure therapy and sessions, assign and check homework, etc. The supervisor's competencies include multiple responsibilities in supporting the supervisee, identification and processing of the therapist's problems with the patient, continuous

  6. Customer response to day-ahead market hourly pricing: Choices and performance

    International Nuclear Information System (INIS)

    Hopper, Nicole; Goldman, Charles; Bharvirkar, Ranjit; Neenan, Bernie

    2006-01-01

    Real-time pricing (RTP) has been advocated to address extreme price volatility and market power in electricity markets. This study of Niagara Mohawk Power Corporation's largest customers analyzes their choices and performance in response to day-ahead, default-service RTP. Overall price response is modest: 119 customers are estimated to reduce their peak demand by about 10% at high prices. Manufacturing customers are most responsive with a price elasticity of 0.16, followed by government/education customers (0.11), while commercial/retail, healthcare and public works customers are, at present, relatively unresponsive. Within market segments, individual customer response varies significantly. (author)

  7. Values in Conflict: Challenges to Family Therapists' Thinking.

    Science.gov (United States)

    Bograd, Michele

    1992-01-01

    Contends that familiar and comfortable family therapy theories were not designed to deal with violence and may help maintain collective avoidance of the issue of violence among family therapists. Explores limitations of therapeutic neutrality and dangers inherent in some interventions. Concludes that effective amelioration of family violence…

  8. Burnout in radiation therapists: the predictive value of selected stressors

    International Nuclear Information System (INIS)

    Akroyd, Duane; Caison, Amy; Adams, Robert D.

    2002-01-01

    Purpose: As cancer caregivers, radiation therapists experience a variety of stresses that may develop into burnout, which has been demonstrated to impact patient care, employee health, and organizational effectiveness. The purpose of the study was to assess the levels of radiation therapists' burnout at three stages. Additionally, the ability of selected workplace variables to predict each of the three stages of burnout was examined. Methods and Materials: We used descriptive and inferential statistical analyses on reliable and valid instruments, which measured stress, burnout, and social support. Results: Radiation therapists have high levels of the first two stages of burnout: emotional exhaustion and depersonalization. Although personal stress, organizational stress, guidance, reassurance of worth, and work load predicted 50% or more of the variance in emotional exhaustion and depersonalization, their predictive ability for personal accomplishment was low. Conclusion: Efforts to alleviate burnout among radiation therapists within an organization should have positive effects, including increased quality of patient care, improved quality of work life, higher levels of job satisfaction, and commitment and lower staff turnover

  9. Goal Development Practices of Physical Therapists Working in Educational Environments.

    Science.gov (United States)

    Wynarczuk, Kimberly D; Chiarello, Lisa A; Gohrband, Catherine L

    2017-11-01

    The aims of this study were to (1) describe the practices that school-based physical therapists use in developing student goals, and (2) identify facilitators and barriers to development of goals that are specific to participation in the context of the school setting. 46 school-based physical therapists who participated in a previous study on school-based physical therapy practice (PT COUNTS) completed a questionnaire on goal development. Frequencies and cross tabulations were generated for quantitative data. Open-ended questions were analyzed using an iterative qualitative analysis process. A majority of therapists reported that they frequently develop goals collaboratively with other educational team members. Input from teachers, related services personnel, and parents has the most influence on goal development. Qualitative analysis identified five themes that influence development of participation-based goals: (1) school-based philosophy and practice; (2) the educational environment, settings, and routines; (3) student strengths, needs, and personal characteristics; (4) support from and collaboration with members of the educational team; and (5) therapist practice and motivation. Goal development is a complex process that involves multiple members of the educational team and is influenced by many different aspects of practice, the school environment, and student characteristics.

  10. Clinical Perspective The parent-child-therapist alliance: A case ...

    African Journals Online (AJOL)

    Journal of Child and Adolescent Mental Health ... The parent-child-therapist alliance: A case study using a strategic approach. Thirusha Naidu, Sheethal Behari. Abstract. In this paper we present a single case study of a clinical approach that ...

  11. The meaning of caring in five experienced physical therapists.

    Science.gov (United States)

    Greenfield, Bruce H

    2006-09-01

    Caring has been identified as a desirable indicator of professional behavior in the physical therapy profession and as a necessary value for good patient care. Yet caring is an elusive concept with multiple meanings. The present aim was to describe the nature of caring in the clinical practice of five experienced physical therapists. Purposive sampling was used to recruit five experienced physical therapists. Each physical therapist underwent a series of in-depth, open-ended interviews that were transcribed and coded for themes based on similarities and differences. The analysis resulted in three themes: ethics of caring, risks and conflicts of caring, and learning to care. The data indicated for four of the five participants that caring constituted an ethics of practice or moral orientation. Their moral orientation influenced moral judgment that was integrated throughout their clinical and ethical decision-making practice. The findings stress the difficulty of caring in a managed care health care environment that results in conflicting demands for physical therapists to care for their patients in a system that increasingly values cost control and profit margin. However, the findings also describe the ultimate rewards associated with the practice of an ethics of caring in physical therapy practice.

  12. Managing 'Generation Y' occupational therapists: optimising their potential.

    Science.gov (United States)

    Hills, Caroline; Ryan, Susan; Warren-Forward, Helen; Smith, Derek R

    2013-08-01

    'Generation Y' is a descriptor of those therapists born between 1982 and 2000. According to generational theory, each generation have unique characteristics due to the social and historical factors they have experienced during their formative years. Occupational therapy educators have reported on 'Generation Y' characteristics observed in occupational therapy students. This study aimed to investigate if managers considered there was a 'Generation Y' therapist and their observed characteristics in practice, as well as successful management strategies used to maximise their potential in the workplace. A hard copy survey based on the 'Generation Y' literature was sent to all managers listed on an Australian University database. Almost all respondents considered there was a 'Generation Y' therapist. Overall, managers reported characteristics of this staff group as being hard working, confident with technology, needing positive feedback and demanding professional development opportunities. Managers also reported that this group may be a challenge to retain in work positions. Managers also viewed 'Generation Y' staff as a positive energy and considered that in the future they will be of benefit to the profession. While there may be generational differences between therapists in the workplace, inclusive management styles may be the most appropriate management approach. Career guidance, facilitating creativity, increasing work responsibility and integrating new technologies like social networking into practice may be appropriate strategies for this staff group, to facilitate both their professional development and to retain them in the profession. © 2013 Occupational Therapy Australia.

  13. Music Teachers and Music Therapists: Helping Children Together.

    Science.gov (United States)

    Patterson, Allyson

    2003-01-01

    Provides background information on music therapy. Discusses how music therapy works in the public school setting and offers advice to music teachers. Explores music therapy and the Individuals with Disabilities Education Act, addressing the benefits of having access to music therapists. (CMK)

  14. Therapist Warmth: Necessary or Sufficient Condition in Behavioral Desensitization?

    Science.gov (United States)

    Wolowitz, Howard Martin

    1975-01-01

    Discusses the Morris and Suckerman report on experimental studies testing the Rogerian hypothesis that phobic desensitization occurs as a function of therapist warmth versus the behavioral explanation that desensitization is a function of reciprocal inhibition. Morris and Suckerman respond to the critique. (Author/EJT)

  15. From learner to therapist: A story of transcendence and transformation

    African Journals Online (AJOL)

    Therapeutic interventions are guided as much by a therapist's philosophy as they are by an understanding of psychological and therapeutic principles. An individual gravitates toward ... The intention of the authors was to focus specifically on their lived experience with a view to observing how the different historically situated ...

  16. Occupational therapists' experience of workplace fatigue: Issues and action.

    Science.gov (United States)

    Brown, Cary A; Schell, Jennifer; Pashniak, Lisa M

    2017-01-01

    Occupational therapists (OTs) work in all areas of health and wellbeing. The work is physically and psychologically demanding, but OTs are often not diligent about recognizing and attending to the workplace health and safety issue of fatigue in their own work settings. The purpose of this paper is to determine current issues and the evidence-base as presented in the literature so as to develop awareness and best practice interventions for fatigue reduction and management in occupational therapists' workplace. A comprehensive search strategy was carried out by the medical librarian on the study team and themes were extracted from the relevant literature by the study team. The literature revealed little research directly addressing occupational therapy workplace fatigue and we expanded our review of the evidence-base across all healthcare workers to identify publications of particular relevance to occupational therapists. This background paper is an important first step to raising awareness among OTs, guide key stakeholders regarding contributing factors to, and consequences of, OTs' workplace fatigue, and set research direction. Knowing which factors influencing workplace fatigue are shared across healthcare professionals and which are unique to OTs can also help organizations develop more tailored workplace fatigue risk reduction programs. This review concludes with a list of existing guidelines and tools for developing workplace fatigue risk assessment and management programs relevant to occupational therapists.

  17. Attitude Similarity and Therapist Credibility as Predictors of Attitude Change and Improvement in Psychotherapy

    Science.gov (United States)

    Beutler, Larry E.; And Others

    1975-01-01

    This study attempts to (1) assess the effects of therapist credibility and patient-therapist similarity on interpersonal persuasion; and (2) to further assess the relationship between patient attitude change and psychotherapy outcome. (HMV)

  18. Therapist empathy, homework compliance, and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects.

    Science.gov (United States)

    Hara, Kimberley M; Aviram, Adi; Constantino, Michael J; Westra, Henny A; Antony, Martin M

    2017-09-01

    Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients' subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist-client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients' ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist's caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.

  19. Does the therapy manual or the therapist matter most in treatment of obsessive-compulsive disorder? A randomized controlled trial of exposure with response or ritual prevention in 118 patients.

    Science.gov (United States)

    van Oppen, Patricia; van Balkom, Anton J L M; Smit, Johannes H; Schuurmans, Josien; van Dyck, Richard; Emmelkamp, Paul M G

    2010-09-01

    The importance of the therapist's education and experience for the successful behavior treatment of obsessive-compulsive disorder (OCD) has not been investigated. Data on the relative effectiveness of self-controlled versus therapist-controlled in vivo exposure with response or ritual prevention (ERP) have yielded conflicting results. The present study compared the effectiveness of 4 different modes of delivery of ERP in a referred sample of OCD patients. Of the 146 eligible OCD outpatients, 118 patients enrolled in this randomized controlled trial and were randomly assigned to (1) therapist-controlled ERP performed by experienced behavior therapists; (2) therapist-controlled ERP performed by master's students of clinical psychology; (3) self-controlled ERP performed by experienced behavior therapists; and (4) self-controlled ERP performed by master's students of clinical psychology. This trial was performed from January 1999 to January 2005. Our analyses revealed no significant differences in clinical outcome between any of the different modes of delivery of ERP at posttreatment. The different ERP modes of delivery were associated with significant pretreatment to posttreatment improvement on all measurements, with large effect sizes on the primary outcome measure, the Yale-Brown Obsessive Compulsive Scale. Our results indicate that clinically inexperienced master's students with no postgraduate training can be as capable as experienced and certified behavior therapists in treating OCD patients, as long as therapists adhere to a standardized treatment manual and adequate training and supervision is provided. In contrast to other studies, we did not find a supposed benefit of therapist-controlled ERP versus self-controlled ERP in patients with OCD. www.trialregister.nl Identifier: NTR1444. © Copyright 2010 Physicians Postgraduate Press, Inc.

  20. Apps in therapy: occupational therapists' use and opinions.

    Science.gov (United States)

    Seifert, Anna M; Stotz, Nicole; Metz, Alexia E

    2017-11-01

    To gather information on occupational therapy practitioners' use and opinions of apps, an online survey was distributed to occupational therapy practitioners licensed in the state of Ohio. The survey sought information regarding clinical populations and skill areas for which apps are used, potential barriers to use of apps and preferred apps/app features. OTs working in medical and education-based settings and with clients of all ages responded to the survey. Over half (53%) reported not using apps in therapy, with "not having access to the technology at work" being the leading reason endorsed. Of practitioners who did report using apps, the majority used them with ≤25% of their case load and primarily used tablets to do so. Clinicians indicated that they use apps for a wide variety of reasons, including to promote skill building and to support the therapeutic process. Preferred features included the ability to grade difficulty up/down, multiple uses and accurate feedback. Recommendations from peers were the most commonly reported way respondents found new apps. The results suggest that occupational therapy practitioners employ clinical reasoning when implementing apps in therapy. Possible ways to improve access to apps for therapists who would like to implement them are discussed. Implications for Rehabilitation Many occupational therapy practitioners are using apps with at least a portion of their caseloads. Therapists select apps based on peer recommendations, most commonly selecting those which promote skill building and support the therapeutic process. More therapists might make use of apps if potential barriers were reduced or eliminated, including availability of technology in the clinical practice setting, therapist training and education, therapist input into app development and an enhanced evidence base.

  1. Shared trauma reality in war: Mental health therapists' experience.

    Science.gov (United States)

    Freedman, Sara A; Tuval Mashiach, Rivka

    2018-01-01

    Shared traumatic reality occurs when therapists are doubly exposed to a traumatic event, both through their clients' experience, along with their own direct exposure. Studies have shown that a shared traumatic reality can lead to both positive and negative outcomes for therapists. Most studies have examined these reactions sometime after the end of the traumatic event, and less is known about reactions that occur during a traumatic event. In addition, most studies have assumed, rather than examined, indirect exposure. In this study, we extend this literature by examining direct and indirect exposure of therapists during a war situation, and their psychological reactions. Over a period of two months in 2014, 70% of the Israeli population was exposed to rocket fire. Geographical areas differed in terms of amount of exposure, and its potential danger. 151 therapists living throughout Israel were assessed via an Internet based survey in the middle of the war, and were assessed for the effects on their professional and personal lives, degree of burnout, ways of coping and symptoms levels of PTSD and psychological distress. These indicate that significant differences in direct exposure occurred depending on place of residence. PTSD levels were related to higher direct exposure, as well as prior trauma exposure, but not to indirect exposure. Indirect exposure, as measured by increased workload, was related to increased distress and emotional exhaustion. These data shed light on the effects of direct and indirect exposure to a shared traumatic experience of war amongst therapists. The data support previous studies showing a greater effect of direct exposure on PTSD. Since indirect exposure appears to negatively impact burnout and psychological distress, rather than PTSD, this study shows that symptoms other than PTSD should be the result of in a shared traumatic reality.

  2. An Exploration of Feminist Family Therapists' Resistance to and Collusion with Oppression

    OpenAIRE

    Goodwin, Annabelle Michelle

    2011-01-01

    In this study, I explore the ways in which feminist family therapists encourage exploration of, resistance to, and collusion with, oppression. I explore qualitatively the critical dialogues, both inner, and with others, that feminist family therapists employ to address oppressive systems. My research questions are: a. How do family therapists who identify as feminist describe how their feminist identities and ideas about feminism have evolved over time? b. How do feminist family therapists re...

  3. Entry-Level Doctorate for Occupational Therapists: An Assessment of Attitudes of Occupational Therapists and Occupational Therapy Assistants

    Science.gov (United States)

    McCombie, Randy P.

    2016-01-01

    Purpose: The purpose of this study was to survey occupational therapists (OTs) and occupational therapy assistants (OTAs) on their attitudes toward a possible move to the entry-level doctorate as the mandated singular point of entry into the profession for OTs. Method: The study surveyed a random sample of 600 OTs and 600 OTAs from two…

  4. Burnout and work-related stress in Italian rehabilitation professionals: A comparison of physiotherapists, speech therapists and occupational therapists.

    Science.gov (United States)

    Bruschini, Marco; Carli, Antonella; Burla, Franco

    2018-01-01

    Healthcare workers are exposed to work related stresses that significantly increase their risk of burnout. To evaluate and compare burnout and work related stress levels in three categories of health professionals: physiotherapists, speech therapists and occupational therapists. A convenience sample of 391 health professionals participated, including 210 physiotherapists, 101 speech therapists and 80 occupational therapists. We collected general socio-demographic information and administered the standardized Italian version of the Maslach Burnout Inventory (MBI) and the Health and Safety Executive (HSE) Management Standards Indicator Tool. We found the proportion of professionals with high-risk scores in the three dimensions of the MBI to be as follows: Emotional Exhaustion 32%, Depersonalisation 13% and Personal Accomplishment 9%. Overall, 14% of participants were at high risk of burnout. No significant differences were found between the three professional categories. Five subscales of the HSE were associated with burnout: Control (p < 0.01), Management support (p < 0.01), Relationship (p < 0.05), Role (p < 0.01), and Change (p < 0.05). Like all health care workers, rehabilitation professionals are at a high risk of burnout. There are common mechanisms underlying burnout in the different professional groups investigated. Further research in occupational health in rehabilitation settings is needed to prevent burnout.

  5. Music's relevance for children with cancer: music therapists' qualitative clinical data-mining research.

    Science.gov (United States)

    O'Callaghan, Clare; Dun, Beth; Baron, Annette; Barry, Philippa

    2013-01-01

    Music is central in most children's lives. Understanding its relevance will advance efficacious pediatric supportive cancer care. Qualitative clinical data-mining uncovered four music therapists' perspectives about music and music therapy's relevance for pediatric oncology patients up to 14 years old. Inductive and comparative thematic analysis was performed on focus group transcripts and qualitative interrater reliability integrated. Music can offer children a safe haven for internalizing a healthy self-image alongside patient identity. Music therapy can calm, relieve distress, promote supportive relationships, enable self-care, and inspire playful creativity, associated with "normalcy" and hope. Preferred music and music therapy should be available in pediatric oncology.

  6. Ethnic Similarity, Therapist Adherence, and Long-Term Multisystemic Therapy Outcomes

    Science.gov (United States)

    Chapman, Jason E.; Schoenwald, Sonja K.

    2011-01-01

    The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were…

  7. Influence of physical therapists' kinesiophobic beliefs on lifting capacity in healthy adults

    NARCIS (Netherlands)

    Jorna-Lakke, Sandra; Soer, Remko; Krijnen, Wim; van der Schans, Cees; Reneman, Michiel; Geertzen, Jan

    2015-01-01

    BACKGROUND: Physical therapists' recommendations to patients to avoid daily physical activity can be influenced by the therapists' kinesiophobic beliefs. Little is known about the amount of influence of a physical therapist's kinesiophobic beliefs on a patient's actual lifting capacity during a

  8. Supervision and Increasing Self-Efficacy in the Therapist-Trainee.

    Science.gov (United States)

    Shanklin, Jennifer E.

    This work includes a discussion of the concept of self-efficacy, originally introduced by Albert Bandura, as it pertains to the therapist-trainee. Therapist self-efficacy has only recently gained attention theoretically as well as empirically. Measures used to assess the self-efficacy of the therapist are highlighted as well as factors…

  9. Verbal Therapeutic Behavior of Expert Psychoanalytically Oriented, Gestalt, and Behavior Therapists.

    Science.gov (United States)

    Brunink, Sharon A.; Schroeder, Harold E.

    1979-01-01

    Findings indicated that expert therapists were similar in their communication of empathy, the basis for their therapeutic relationships. Theoretical orientation, however, differentially influenced use of direct guidance and facilitative techniques, interview content, therapist self-disclosure, therapist initiative, and supportive therapy climate.…

  10. Assessment tools used by occupational therapists in children with obstetric brachial plexus palsy

    Directory of Open Access Journals (Sweden)

    Thaianny Taís Dantas de Brito

    2016-04-01

    Full Text Available Introduction: The Obstetric Brachial Plexus Palsy (OBPP is a result of brachial plexus injury at birth and may cause dysfunction of the affected upper limb, reflecting significantly in the child’s life. When evaluating a child with OBPP the occupational therapist can use evaluation tools, and has to have knowledge to choose and apply the most appropriate instrument. Objective: This review aimed to analyze the literature on the use of evaluation tools by occupational therapists in children with OBPP. Method: The search for articles was performed in the databases Scirus, Cinahl, Medline, Psycinfo, Scopus and Lilacs using the following selection criteria: studies with 0-12 years old children with OBPP in English, Portuguese and Spanish, published in the last 10 years, with the occupational therapist as one of the authors and/or reporting the application of the instrument by this professional. Results: There were 15 studies from six countries that reported 17 evaluation instruments, five of which, recently developed, were specific to this clientele. The study did not identify the need to modify the non-specific instruments to the application in children with OBPP, demonstrating that they can be used in its original format, facilitating the use in the clinical practice. Most instruments included aspects related to occupational performance inserted in the field of Activity and Participation of the International Classification of Functioning, indicating the concern of this professional in suiting the assessment process of the child with the OBPP to the current paradigm of health understanding and occupational therapy field.

  11. Immediate therapist self-disclosure bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial.

    Science.gov (United States)

    Ziv-Beiman, Sharon; Keinan, Giora; Livneh, Elad; Malone, Patrick S; Shahar, Golan

    2017-09-01

    We report a first randomized clinical trial examining the effect of immediate and non-immediate therapist self-disclosure in the context of a brief integrative psychotherapy for mild to moderate distress. A total of 86 patients with mild to moderate forms of distress were randomly divided into three 12-session integrative psychotherapy conditions based primarily on [Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). Washington, DC: American Psychological Association.] three-stage model. Therapists trained in this treatment modality were instructed to use either immediate self-disclosure (expressing feelings towards the patient/treatment/therapeutic relationship) or non-immediate self-disclosure (expressing personal or factual information regarding the therapist's life outside the treatment). In the comparison condition, the therapists were instructed to refrain from self-disclosure altogether. Immediate therapist self-disclosure reduced psychiatric symptoms among patients with elevated pretreatment symptoms (as assessed by the Brief Symptoms Inventory) and bolstered a favorable perception of the therapist. Therapists in both the immediate and non-immediate self-disclosure group evaluated themselves more favorably than their counterparts in the non-disclosure group. Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.

  12. Personal style of the therapist, attachment style and personality trait

    Directory of Open Access Journals (Sweden)

    Gabriel Genise

    2015-12-01

    Full Text Available The aim of this study is to analyze the relationship between the personal style of the therapist, attachment style and personality trait. It was used the personal style of the therapist questionnaire (PST – Q, the Argentinean attachment inventory and the big five inventory. The study sample consisted of 120 psychotherapists average age of 36.28 years (SD = 9.65, and the average years of experience was 7.90 years (SD = 8.04. The analysis of the results showed that there is a positive, significant and low intensity between the personality factor of openness to experience and personal style of involvement, a negative correlation, significant and of medium intensity between low extraversion factor correlation and mode not anxious romantic attachment and a significant positive relationship between the low–intensity factor neuroticism personality and how anxious romantic attachment. 

  13. Prevalence of work-related musculoskeletal disorders among physical therapists

    Directory of Open Access Journals (Sweden)

    Zaheen Iqbal

    2015-08-01

    Full Text Available Background: Health professions like dentistry, nursing and physical therapy have been reported at high risk for developing workrelated musculoskeletal disorders. Results of studies conducted in these occupational groups may help formulate prevention strategies. However, no such data among physical therapists has been reported in India. Material and Methods: We conducted an online survey among 100 physiotherapists in Delhi. Results: The response rate was 75%. The prevalence of work-related musculoskeletal disorders is found to be high since 92% of them reported to feel some pain after joining physical therapy which affects daily activities and even sometimes forces them to change their work. Physical therapists specialty, gender, furniture used in clinic and duration of patient contact are found to be related to the pain development (p < 0.05. Conclusions: We need to emphasize the role of ergonomics and techniques of patient handling in development of work-related pain symptoms. Med Pr 2015;66(4:459–469

  14. Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome.

    Science.gov (United States)

    Anderson, Timothy; Crowley, Mary Ellen J; Himawan, Lina; Holmberg, Jennifer K; Uhlin, Brian D

    2016-09-01

    Therapist effects, independent of the treatment provided, have emerged as a contributor to psychotherapy outcomes. However, past research largely has not identified which therapist factors might be contributing to these effects, though research on psychotherapy implicates relational characteristics. The present Randomized Clinical Trial tested the efficacy of therapists who were selected by their facilitative interpersonal skills (FIS) and training status. Sixty-five clients were selected from 2713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists met with 2 clients for 7 sessions and 20 participants served in a no-treatment control group. Outcome and alliance differences for Training Status were negligible. High FIS therapists had greater pre-post client outcome, and higher rates of change across sessions, than low FIS therapists. All clients treated by therapists improved more than the silent control, but effects were greater with high FIS than low FIS therapists. From the first session, high FIS therapists also had higher alliances than low FIS therapists as well as significant improvements on client-rated alliance. Results were consistent with the hypothesis that therapists' common relational skills are independent contributors to therapeutic alliance and outcome.

  15. Speech and language therapist views on building partnership with parents

    OpenAIRE

    Plohl, Kaja

    2016-01-01

    In my master’s degree thesis I focus on the opinions of a sample group of speech and language therapists working on partner cooperation with parents. In the theoretical part I describe various models of cooperation, which includes partnership model as well. I define the concept of partnership, on the basis of expert knowledge of various authors. I also define the difference between the concepts of partnership and cooperation. I list the elements of partnership mentioned by the authors. In ...

  16. Developing a Measure of Therapist Adherence to Contingency Management: An Application of the Many-Facet Rasch Model.

    Science.gov (United States)

    Chapman, Jason E; Sheidow, Ashli J; Henggeler, Scott W; Halliday-Boykins, Colleen; Cunningham, Phillippe B

    2008-06-01

    A unique application of the Many-Facet Rasch Model (MFRM) is introduced as the preferred method for evaluating the psychometric properties of a measure of therapist adherence to Contingency Management (CM) treatment of adolescent substance use. The utility of psychometric methods based in Classical Test Theory was limited by complexities of the data, including: (a) ratings provided by multiple informants (i.e., youth, caregivers, and therapists), (b) data from separate research studies, (c) repeated measurements, (d) multiple versions of the questionnaire, and (e) missing data. Two dimensions of CM adherence were supported: adherence to Cognitive Behavioral components and adherence to Monitoring components. The rating scale performed differently for items in these subscales, and of 11 items evaluated, eight were found to perform well. The MFRM is presented as a highly flexible approach that can be used to overcome the limitations of traditional methods in the development of adherence measures for evidence-based practices.

  17. Experiences of burnout and coping strategies utilized by occupational therapists.

    Science.gov (United States)

    Gupta, Sangeeta; Paterson, Margo L; Lysaght, Rosemary M; von Zweck, Claudia M

    2012-04-01

    Work-related stress and burnout have been found to lead to job dissatisfaction, low-organizational commitment, absenteeism, and high turnover. The purpose of this study was to examine the burnout experiences of occupational therapists practicing in Ontario and to describe the practice implications and coping strategies employed. Data for this mixed methods study were collected using the Maslach Burnout Inventory-General Survey, Areas of Worklife Survey, focus groups, and interviews in the hermeneutics tradition. High levels of emotional exhaustion were reported by 34.8% of participants, high levels of cynicism by 43.5%, and low professional efficacy by 24.6%. Practice issues included excessive demands on time, conflict, and lack of autonomy and respect. Coping strategies included spending time with family and maintaining professional/personal balance, control of work responsibilities, maintaining a sense of humor, and self-awareness/self-monitoring. This study contributes to understanding the practice challenges for occupational therapists, factors that contribute to therapist burnout, and strategies employed to maintain competent practice.

  18. Physical Therapists' Perceptions of School-Based Practices.

    Science.gov (United States)

    Holt, Sheryl L; Kuperstein, Janice; Effgen, Susan K

    2015-01-01

    Surveys have reported that most school-based physical therapists perceive ideal practices are not commonly implemented in their settings. Our aim was to obtain a more in-depth understanding of these perceptions through open-ended inquiry. Qualitative data were derived from voluntary open-ended responses provided upon completion of a survey regarding school-based physical therapy practice. Of the survey's 561 participants, 250 provided open-ended commentaries that were analyzed using interpretive phenomenology. Six qualitative themes emerged from the open-ended responses, including: In quest: Meeting students' school-based needs via physical therapy; Seeking relatedness: Finding working teams in the school system; Building understanding: Developing a voice/identity in the school context; Stretched beyond limits: Managing workloads; Networking: Coordinating services outside school to meet student needs; Defying definition: What does working in an educational model mean? School-based physical therapists seek to meet educationally relevant physical therapy needs of students, ages 3 to 21 years. Successes appear woven of a multitude of factors such as therapist expertise, team dynamics, and district supports.

  19. Attitudes of Turkish speech and language therapists toward stuttering.

    Science.gov (United States)

    Maviş, Ilknur; St Louis, Kenneth O; Özdemir, Sertan; Toğram, Bülent

    2013-06-01

    The study sought to identify clinical beliefs and attitudes of speech and language therapists (SLTs) in Turkey and to compare them to previous research on SLTs in the USA and UK. The Clinician Attitudes Toward Stuttering (CATS) inventory was administered by mail to nearly all-practicing SLTs in Turkey (n=61). Turkish SLTs, whose caseloads contained a substantial number of people who stutter, agreed with CATS items suggesting psychological causes and problems for those who stutter. They strongly believed therapy should focus on parent counseling for preschoolers who stutter as well as adolescents. They were not optimistic about carrying out stuttering therapy nor about the likelihood that children who stutter could be effectively treated. Attitudes toward stuttering by clinicians who treat them are important considerations in the conduct and outcomes of stuttering therapy. Additionally, SLTs working with stuttering clients should benefit from professional views and clinical experiences of their colleagues from surveys such as this one. The reader will be able to describe: (a) the components of the CATS, (b) common themes in Turkish speech and language therapists' attitudes toward stuttering, (c) differences between the attitudes of speech and language therapists from Turkey versus the United States and the United Kingdom. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. The meanings of craft to an occupational therapist.

    Science.gov (United States)

    Harris, Emma

    2008-06-01

    Craft was the first therapeutic occupation of occupational therapy. Since the early days of the profession, the value of craft in practice is a topic that has been discussed with fluctuating interest. Recent discussions by occupational therapists have reinforced that although craft is relevant to occupational therapy, there are uncertainties about its place in contemporary practice. Presently, scholars have identified that occupation is both the center of human experience and the core of our profession. Therefore, this study aimed to begin to clarify the meaning of craft to practice today by gaining a deep understanding of the meanings that one occupational therapist attributes to craft. Using narrative inquiry, data were gathered through a conversation held between the research participant and myself. A reflexive journal was also kept to support this data gathering process. Narrative analysis enabled intimate engagement with the data and the emergence of themes and sub-themes. The findings, in the form of an interpretive story, suggest first, that craft-making has therapeutic value; second, that reasoning about the therapeutic use of craft is similar to reasoning about other therapeutic activities; and third, that personal experience with craft-making can influence the selection of craft as therapeutic media. From this study, further research into the impact personal and professional experiences can have on choice of therapeutic media and an analysis of the sociopolitical context of the meanings that occupational therapists attribute to craft-making is suggested.

  1. Trainee Occupational Therapists Scoring the Barthel ADL.

    Science.gov (United States)

    Martin, Elizabeth; Nugent, Chris; Bond, Raymond; Martin, Suzanne

    2015-09-01

    Within medical applications there are two main types of information design; paper-based and digital information [1]. As technology is constantly changing, information within healthcare management and delivery is continually being transitioned from traditional paper documents to digital and online resources. Activity of Daily Living (ADL) charts are still predominantly paper based and are therefore prone to "human error" [2]. In light of this, an investigation has taken place into the design for reducing the amount of human error, between a paper based ADL, specifically the Barthel Index, and the same ADL created digitally. The digital ADL was developed as an online platform as this offers the best method of data capture for a large group of participants all together [3]. The aim of the study was to evaluate the usability of the Barthel Index ADL in paper format and then reproduce the same ADL digitally. This paper presents the findings of a study involving 26 participants who were familiar with ADL charts, and used three scenarios requiring them to complete both a paper ADL and a digital ADL. An evaluation was undertaken to ascertain if there were any 'human errors' in completing the paper ADL and also to find similarities/differences through using the digital ADL. The results from the study indicated that 22/26 participants agreed that the digital ADL was better, if not the same as a paper based ADL. Further results indicated that participants rate highly the added benefit of the digital ADL being easy to use and also that calculation of assessment scores were performed automatically. Statistically the digital BI offered a 100 % correction rate in the total calculation, in comparison to the paper based BI where it is more common for users to make mathematical calculation errors. Therefore in order to minimise handwriting and calculation errors, the digital BI proved superior than the traditional paper based method.

  2. Therapists' and patients' stress responses during graduated versus flooding in vivo exposure in the treatment of specific phobia: A preliminary observational study.

    Science.gov (United States)

    Schumacher, Sarah; Miller, Robert; Fehm, Lydia; Kirschbaum, Clemens; Fydrich, Thomas; Ströhle, Andreas

    2015-12-15

    Exposure therapy is considered an effective treatment strategy for phobic anxiety, however, it is rarely applied in clinical practice. The under-usage might be due to various factors of which heightened stress levels not only in patients but also in therapists are presumed to be of particular relevance. The present study aimed to investigate whether different forms of exposure might lead to varying physiological and psychological stress responses in therapists and phobic patients. 25 patients with specific phobia underwent individual cognitive behavioural therapy, performed by 25 psychotherapist trainees, applying exposure sessions in graduated form or the flooding technique. Patients and therapists provided subjective evaluations of stress and five saliva samples for analysis of salivary cortisol and alpha-amylase either during two graduated exposure sessions or during one flooding session, while a regular therapy session served as control condition. Therapists displayed heightened salivary alpha-amylase release during exposure of the flooding, but not the graduated, type. Patients showed elevated salivary cortisol during flooding exposure numerically, however, not on a statistically significant level. Therapists reported more pronounced subjective stress during flooding compared to graduated exposure. Elevated stress levels should be addressed in clinical training in order to improve application of exposure in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Rap and singing are used by music therapists to enhance emotional self-regulation of youth: Results of a survey of music therapists in the Netherlands.

    NARCIS (Netherlands)

    Uhlig, S.; Dimitriadis, Theo; Hackvoort, Laurien; Scherder, E.J.A.

    2016-01-01

    Music therapists use rap and singing for at-risk youth and young adults in different treatment settings. However, it is unclear how often and what kind of interventions they apply, and what kind of treatment goals are pursued. The purpose of this study was to examine approaches of music therapists

  4. Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center.

    Science.gov (United States)

    Johnson, Diana; Snedeker, Kristie; Swoboda, Michael; Zalieckas, Cheryl; Dorsey, Rachel; Nohe, Cassandra; Smith, Paige; Roche, Renuka

    The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

  5. Muslim Middle Eastern clients' reflections on their relationship with their occupational therapists in mental health care.

    Science.gov (United States)

    Pooremamali, Parvin; Eklund, Mona; Östman, Margareta; Persson, Dennis

    2012-07-01

    Persons with a Middle Eastern background represent a minority in Sweden which has significantly increased in size over recent years. The purpose of the present study was to explore the elements that shape the experiences and perceptions of clients with a Middle Eastern background living by Muslim norms who received occupational therapy in mental health care at the time of participating in the study. The study included interviews with 11 clients who received occupational therapy in mental health care. Data collection and analysis were carried out in accordance with the grounded theory approach. One core category, desiring a union, described the clients' desire for an alliance with the therapists that encompassed the realities and truths embedded in their values, preferences, world-views, and belief systems, as well as a wish to reconstruct their abilities to function and perform daily life tasks within their cultural contexts. The core category included sub-categories: desiring relationship, desiring affiliation, and desiring affirmation as well as some related components. The overall findings showed a tentative model in which the notion of mahram affinity was embedded. The results demonstrated that the clients' views regarding desiring a union had their support in collectivistic world-views that often clash with those of the therapists.

  6. What factors determine therapists' acceptance of new technologies for rehabilitation – a study using the Unified Theory of Acceptance and Use of Technology (UTAUT).

    Science.gov (United States)

    Liu, Lili; Miguel Cruz, Antonio; Rios Rincon, Adriana; Buttar, Vickie; Ranson, Quentin; Goertzen, Darrell

    2015-01-01

    The aim of this study was to examine what factors affect the acceptance behavior and use of new technologies for rehabilitation by therapists at a large rehabilitation hospital in Canada. A self-administrated paper-based survey was created by adapting scales with high levels of internal consistency in prior research using the Unified Theory of Acceptance and Use of Technology (UTAUT). Items were scored on a 7-point Likert scale, ranging from "strongly disagree (1)" to "strongly agree (7)". The target population was all occupational therapists (OT) and physical therapists (PT) involved with the provision of therapeutic interventions at the hospital. Our research model was tested using partial least squares (PLS) technique. Performance expectancy was the strongest salient construct for behavioral intention to use new technologies in rehabilitation, whereas neither effort expectancy nor social influence were salient constructs for behavioral intention to use new technologies; (4) facilitating condition and behavioral intention to use new technologies were salient constructs for current use of new technologies in rehabilitation, with facilitating condition the strongest salient for current use of new technologies in rehabilitation. In a large rehabilitation hospital where use of new technologies in rehabilitation is not mandatory, performance expectancy, or how the technology can help in therapists' work, was the most important factor in determining therapists' acceptance and use of technologies. However, effort expectancy and social influence constructs were not important, i.e. therapists were not influenced by the degree of difficulty or social pressures to use technologies. Behavioral intention and facilitating condition, or institutional support, are related to current use of new technologies in rehabilitation.

  7. Therapist adherence in individual cognitive-behavioral therapy for binge-eating disorder: assessment, course, and predictors.

    Science.gov (United States)

    Brauhardt, Anne; de Zwaan, Martina; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans-Christoph; Hilbert, Anja

    2014-10-01

    While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Occupational therapists' experiences of career progression following promotion.

    Science.gov (United States)

    Nelson, Helen; Giles, Susan; McInnes, Heather; Hitch, Danielle

    2015-12-01

    The recruitment and retention of a skilled occupational therapy workforce is highlighted as a key issue for the profession, and yet there have been relatively few studies into the career progression of occupational therapists. A qualitative, naturalistic approach was adopted to answer the research question, using semi-structured interviews to gather data. Eleven purposefully selected participants at an Australian health service were interviewed as part of this study. Categories representing the most common themes and topics supplied by participants within their individual interviews were identified and consolidated by the research team. The trustworthiness of this study was supported by strategies to maximise its credibility, dependability and confirmability. Four main themes were elicited from the data - (i) Readiness for progression, (ii) Tools and processes, (iii) Expectations and (iv) What I wish I had known first. Within these themes, related findings were also identified by both Grade 2 and Grade 3 staff. This study indicates that the readiness of occupational therapists to climb the career ladder is influenced by the tools and processes they can utilise, and the expectations they have around the realities of their new position. With hindsight, participants highlighted some things they wish they had known at the time of transition, which appeared to have been implicit. This study is the first to address the common issues for occupational therapy staff around progression between grade levels. It therefore provides a basis for further research in other practice settings and for the development of supports for therapists climbing the career ladder. © 2015 Occupational Therapy Australia.

  9. Palliative care in home care: perceptions of occupational therapists

    Directory of Open Access Journals (Sweden)

    Séfora Gomez Portela

    2015-03-01

    Full Text Available This research aimed at understanding and reflecting on the perceptions of occupational therapists regarding the implementation of palliative care in home care. This is an exploratory, qualitative study, through semi-structured interviews, conducted in the second semester of 2012 with eight occupational therapists with experience in palliative care in the city of São Paulo. Content analysis identified four themes: characterization and professional trajectory in the field, understanding the concepts of palliative care, home care and palliative care, and occupational therapy and palliative care in home care. The results suggest that the role of the occupational therapist in this field has taken place at different levels of health care, being addressed to people with varying needs. The use of the concept of palliative care by the interviewees exceeds the notion of end of life, following the changes in the epidemiological transition. They understand that professional services follow the trend of national palliative care services with focus on specialized levels, but manifest the importance of its implementation in primary and home care. Among the barriers to practice, they identified the complexity of “being at home “, peculiarities of palliative care with high cost demands, lack of infrastructure and implementation of the current policy. Professional training and scientific roduction in the area were viewed as inadequate, although they identified a call for change. The interviewees recognized palliative care in home care as a strong professional field, but one still requiring study and discussions regarding its limits and conditions of implementation, especially in the Unified Health System.

  10. Therapists' Perspectives on Suicide: A Conceptual Model of Connectedness.

    Science.gov (United States)

    Aherne, Cian; Coughlan, Barry; Surgenor, Paul

    2017-08-03

    A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists' ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. Psychotherapists (N = 12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of "psychotherapy" when trying to save someone's life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal. Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion

  11. Experience of Client-centered Practice amongst Danish Occupational Therapists

    DEFF Research Database (Denmark)

    Larsen, Anette Enemark

    A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...

  12. The role of supervision in the training of behavior therapists: Case study

    Directory of Open Access Journals (Sweden)

    Raquel Martins Sartori

    2014-08-01

    Full Text Available The therapeutic process therapist requires skills that go beyond the theoretical and technical knowledge, the therapeutic relationship is a prerequisite for the success of behavioral psychotherapy variable. Supervision of clinical care is a fundamental skill development of the future therapist educational resource as well as to increase the supply conditions of a more appropriate psychotherapeutic customer service. The article reports on supervisory experience in the first client of a therapist in training showed behavioral patterns of aggression. The default client produced in therapist behaviors and feelings that hindered progress and therapeutic success. Supervision thus occupied a role in analyzing and modeling the behavior therapist as a strategy to increase the chances of success of the case. As a result of the strategies adopted in supervision, there were changes in the pattern of interaction between therapist and client training with his progress in the case.

  13. Associations between therapists' occupational burnout and their patients' depression and anxiety treatment outcomes.

    Science.gov (United States)

    Delgadillo, Jaime; Saxon, David; Barkham, Michael

    2018-05-02

    Occupational burnout is common in mental health professionals, but its impact on patient outcomes is as yet uncertain. This study aimed to investigate associations between therapist-level burnout and patient-level treatment outcomes after psychological therapy. We used multilevel modeling using depression (PHQ-9) and anxiety (GAD-7) outcomes data from 2,223 patients nested within 49 therapists. Therapists completed a survey including the Oldenburg Burnout Inventory (OLBI) and a job satisfaction scale (JDSS). After controlling for case-mix, around 5% of variability in treatment outcomes was explained by therapist effects (TE). Higher therapist OLBI-disengagement and lower JDSS scores were significantly associated with poorer treatment outcomes, explaining between 31 and 39% of the TE estimate. Higher OLBI scores were also correlated with lower job satisfaction ratings. Therapist burnout has a negative impact on treatment outcomes and could be the target of future preventive and remedial action. © 2018 Wiley Periodicals, Inc.

  14. The role of the occupational therapist in the care of people living with lung cancer.

    Science.gov (United States)

    White, Kahren M

    2016-06-01

    This paper aims to explore the vital role occupational therapists play in enabling people living with lung cancer to continue to actively live. Core assessments and interventions employed by occupational therapists are described in a case study. It will demonstrate how people living with lung cancer can continue to participate in meaningful and chosen life roles, even in the face of functional decline. Skilled management by the occupational therapist of the refractory symptoms of advanced lung cancer supports this participation.

  15. Promoting Therapists? Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation

    OpenAIRE

    Levac, Danielle E.; Glegg, Stephanie M. N.; Sveistrup, Heidi; Colquhoun, Heather; Miller, Patricia; Finestone, Hillel; DePaul, Vincent; Harris, Jocelyn E.; Velikonja, Diana

    2016-01-01

    Purpose Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use. Method A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Sel...

  16. I will always be with you: traditional and complementary therapists' perspectives on patient-therapist-doctor communication regarding treatment of Arab patients with cancer in Israel.

    Science.gov (United States)

    Popper-Giveon, Ariela; Schiff, Elad; Ben-Arye, Eran

    2012-12-01

    In 2008, an Integrative Oncology Program was implemented at the Clalit Oncology Service in Haifa, Israel, to promote patients' well-being during chemotherapy and advanced stages of disease. We hypothesized that studying the perceptions of Arab complementary and alternative medicine (CAM) therapists would facilitate development of a cross-culturally integrative oncology approach. Semi-structured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran and various CAM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. Thematic analysis revealed that therapists act as go-betweens, mediating between patients and conventional physicians. Therapists translate diagnoses into Arabic and elucidate key concepts. They tend to perceive their role as gatekeepers accompanying patients through the conventional health system, referring them for further examinations, and providing CAM-based supportive care consultation. CAM therapists have an essential role in supportive care of Arab patients with cancer. Triangular patient-therapist-oncologist communication may have an impact on patients' experience and treatment quality. Recognition of CAM therapists as mediators between patients' health beliefs and conventional perceptions of care may improve doctor-patient dialogue and facilitate supportive care provision in a cross-cultural context. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Virtual Reality and Active Videogame-Based Practice, Learning Needs, and Preferences: A Cross-Canada Survey of Physical Therapists and Occupational Therapists.

    Science.gov (United States)

    Levac, Danielle; Glegg, Stephanie; Colquhoun, Heather; Miller, Patricia; Noubary, Farzad

    2017-08-01

    Describe the clinical use of virtual reality (VR)/active videogaming (AVG) by physical therapists (PTs) and occupational therapists (OTs) in Canada, identify usage barriers and facilitators, evaluate factors that predict intention to use VR/AVGs, and determine therapists' learning needs. Cross-sectional survey. Online survey of therapists in Canada who were members of 1 of 26 professional PT or OT colleges or associations using the Assessing Determinants Of Prospective Take-up of Virtual Reality (ADOPT-VR2) Instrument. We received 1071 (506 PTs, 562 OTs, 3 dual-trained) responses. Forty-six percent had clinical VR/AVG experience; only 12% reported current use, with the Wii being the most clinically accessible (41%) system. Therapists used VR/AVGs primarily in rehabilitation (32%) and hospital (29%) settings, preferentially targeting balance (39.3%) and physical activity (19.8%) outcomes. Stroke (25.8%), brain injury (15.3%), musculoskeletal (14.9%), and cerebral palsy (10.5%) populations were most frequently treated. Therapists with VR/AVG experience rated all ADOPT-VR2 constructs more highly than did those without experience (P < 0.001). Factors predictive of intention to use VR included the technology's perceived usefulness and therapist self-efficacy in VR/AVG use (P < 0.001). Highest-rated barriers to VR/AVG use were lack of funds, space, time, support staff, and appropriate clients, whereas facilitators included client motivation, therapist knowledge, and management support. Most (76%) respondents were interested in learning more. Understanding use, predictors of use, and learning needs is essential for developing knowledge translation initiatives to support clinical integration of VR/AVGs. Results of this first national survey will inform the creation of resources to support therapists in this field.

  18. Therapists' Metacognitive Monitoring of the Psychotherapeutic Process With Patients With Borderline Personality Disorder.

    Science.gov (United States)

    Bourke, Marianne E; Grenyer, Brin F S

    2017-07-01

    Therapy for borderline personality disorder (BPD) is challenging, in part, because of the impact of BPD on the therapeutic relationship. The therapist's metacognitive capacity within therapy may be perturbed due to the complexity of verbal and nonverbal affect and cognition in the therapeutic interchange; however, research on this issue is lacking. Therapists (N=20 clinical psychologists) were asked to discuss the treatment process when working with their patients with BPD (N=40) and their patients with major depressive disorder (N=40). Verbatim transcripts of the therapists' verbalizations were then scored using computerized linguistic content analysis. When discussing their patients with BPD, clinicians used significantly fewer words associated with cognitive processes (think, understand, realize) or words indicating causation (cause, because, effect), and more first-person singular pronouns, and adverbs. When describing their depressed patients, the therapists used more words associated with negative emotions, anxiety, anger, and sadness than positive words. The results did not seem to be influenced by the therapists' age, sex, or years of experience. Reflection on the psychotherapeutic process with patients with BPD induced in therapists a self-focused, emotionally intense linguistic style dominated by references to themselves and their experience of intense emotional states. These results suggest that, when describing their work with patients with BPD, therapists experience metacognitive challenges and mentalization processes that may parallel the challenges therapists face when thinking and working during the psychotherapy sessions themselves. The results underscore the important role of supervision in assisting therapists to organize their reflective processes when working with patients with BPD.

  19. Health promotion through employee assistance programs: a role for occupational therapists.

    Science.gov (United States)

    Maynard, M

    1986-11-01

    Health promotion is predicted to have a major impact on occupational therapy practice. Keeping people well and promoting a healthy life-style will be the focus for the future. Many companies and agencies are taking the lead by instituting employee assistance programs (EAPs). With the de-emphasis on long-term hospital care, many occupational therapists will be seeking employment with community health programs. This paper advocates a role for occupational therapists in health promotion and disease prevention in an EAP. A description of EAPs and the contributions that occupational therapists can make to these programs is offered. Practice and education considerations for occupational therapists' roles in EAPs are provided.

  20. Clinical reasoning in neurology: use of the repertory grid technique to investigate the reasoning of an experienced occupational therapist.

    Science.gov (United States)

    Kuipers, Kathy; Grice, James W

    2009-08-01

    The aim of this paper is to describe the use of a structured interview methodology, the repertory grid technique, for investigating the clinical reasoning of an experienced occupational therapist in the domain of upper limb hypertonia as a result of brain injury. Repertory grid interviews were completed before and after exposure to a protocol designed to guide clinical reasoning and decision-making in relation to upper limb neurological rehabilitation. Data were subjected to both qualitative and quantitative analyses. Qualitative analysis focussed on clinical reasoning content. Common themes across the pre- and post-exposure interviews were the use of theoretical frameworks and practice models, the significance of clinical expertise, and discrimination of 'broad' and 'specific' aspects, as well as differentiation between 'therapist and client-related' aspects of the clinical situation. Quantitative analysis indicated that for both pre- and post-exposure repertory grids, clinical reasoning was structured in terms of two main concepts. In the pre-exposure grid, these were related to the therapist's role, and to the 'scope' of practice tasks (either broad or specific). In the post-exposure grid the two main concepts were upper limb performance, and client-centred aspects of the therapy process. The repertory grid technique is proposed as an effective tool for exploring occupational therapy clinical reasoning, based on its capacity for accessing personal frames of reference, and elucidating both the meaning and the structure supporting clinical reasoning.

  1. Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil.

    Science.gov (United States)

    Costa, Larissa R; Costa, José L R; Oishi, Jorge; Driusso, Patricia

    2012-01-01

    The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.

  2. Telerehabilitation, virtual therapists, and acquired neurologic speech and language disorders.

    Science.gov (United States)

    Cherney, Leora R; van Vuuren, Sarel

    2012-08-01

    Telerehabilitation (telerehab) offers cost-effective services that potentially can improve access to care for those with acquired neurologic communication disorders. However, regulatory issues including licensure, reimbursement, and threats to privacy and confidentiality hinder the routine implementation of telerehab services into the clinical setting. Despite these barriers, rapid technological advances and a growing body of research regarding the use of telerehab applications support its use. This article reviews the evidence related to acquired neurologic speech and language disorders in adults, focusing on studies that have been published since 2000. Research studies have used telerehab systems to assess and treat disorders including dysarthria, apraxia of speech, aphasia, and mild Alzheimer disease. They show that telerehab is a valid and reliable vehicle for delivering speech and language services. The studies represent a progression of technological advances in computing, Internet, and mobile technologies. They range on a continuum from working synchronously (in real-time) with a speech-language pathologist to working asynchronously (offline) with a stand-in virtual therapist. One such system that uses a virtual therapist for the treatment of aphasia, the Web-ORLA™ (Rehabilitation Institute of Chicago, Chicago, IL) system, is described in detail. Future directions for the advancement of telerehab for clinical practice are discussed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. World Federation of Occupational Therapists' Position Statement on Telehealth

    Directory of Open Access Journals (Sweden)

    World Federation of Occupational Therapists

    2014-09-01

    Full Text Available The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served,and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed.

  4. Organisational support for evidence-based practice: occupational therapists perceptions.

    Science.gov (United States)

    Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

    2016-02-01

    Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

  5. Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions?

    Science.gov (United States)

    Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop

    2016-01-01

    To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.

  6. Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.

    Directory of Open Access Journals (Sweden)

    Danielle E Levac

    Full Text Available Therapists use motor learning strategies (MLSs to structure practice conditions within stroke rehabilitation. Virtual reality (VR-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use.A pre-post design evaluated a knowledge translation (KT intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Self-report and observer-rated outcome measures evaluated therapists' confidence, clinical reasoning and behaviour with respect to MLS use. A focus group captured therapists' perspectives on MLS use during VR-based therapy provision.The intervention improved self-reported confidence about MLS use as measured by confidence ratings (p <0.001. Chart-Stimulated Recall indicated a moderate level of competency in therapists' clinical reasoning about MLSs following the intervention, with no changes following additional opportunities to use VR (p = .944. On the Motor Learning Strategy Rating Instrument, no behaviour change with respect to MLS use was noted (p = 0.092. Therapists favoured the strategy of transferring skills from VR to real-life tasks over employing a more comprehensive MLS approach.The KT intervention improved therapists' confidence but did not have an effect on clinical reasoning or behaviour with regard to MLS use during VR-based therapy.

  7. The Incremental Validity of the MMPI-2: When Does Therapist Access Not Enhance Treatment Outcome?

    Science.gov (United States)

    Lima, Elizabeth N.; Stanley, Sheila; Kaboski, Beth; Reitzel, Lorraine R.; Richey, Anthony; Castro, Yezzennya; Williams, Foluso M.; Tannenbaum, Kendra R.; Stellrecht, Nadia E.; Jakobsons, Lara J.; Wingate, LaRicka R.; Joiner, Thomas E.

    2005-01-01

    The present study examined whether therapist access to the Minnesota Multiphasic Personality Inventory (MMPI-2) predicted favorable treatment outcome, above and beyond other assessment measures. A manipulated assessment design was used, in which patients were randomly assigned either to a group in which therapists had access to their MMPI-2 data…

  8. Therapist Self-Disclosure and the Therapeutic Relationship: A Phenomenological Study from the Client Perspective

    Science.gov (United States)

    Audet, Cristelle T.; Everall, Robin D.

    2010-01-01

    Therapist self-disclosure is gaining empirical attention amidst theoretical discourse and ethical debate, particularly with regards to its influence on the therapeutic relationship. This paper presents part of a larger qualitative study that explored client experiences of therapist self-disclosure and specifically focuses on the therapeutic…

  9. The values of occupational therapy: Perceptions of occupational therapists in Quebec.

    Science.gov (United States)

    Drolet, Marie-Josée; Désormeaux-Moreau, Marjorie

    2016-07-01

    Recently, there has been increasing interest in the values of occupational therapy and the values held by occupational therapists. A wide range of values has been reported in the literature. Furthermore, despite the fact that values are an important part of professional identity, empirical studies have demonstrated that several occupational therapists possess an ambiguous professional identity. This study was undertaken to explore the values of Canadian occupational therapists, specifically French-speaking occupational therapists in Quebec. Semi-structured interviews were conducted with 26 occupational therapists. Their narratives were subject to hermeneutic analysis, a method of textual analysis common in philosophical research. A total of 16 values were identified in the discourses of the occupational therapists interviewed: autonomy; human dignity; occupational participation; social justice and equity; professionalism; holism; partnership, environment, or ecological approach; quality of life; solicitude; honesty; integrity; health; creativity; professional autonomy; effectiveness; and spirituality. The results of this study are, in general, consistent with those reported in the few other empirical studies that have documented the values perceptions of occupational therapists. Finally, the explanation of the values of occupational therapists may reinforce their professional identity and favour best, or at least desirable, professional practices related to ethics and culture.

  10. Therapeutic Change in Colombian Families Dealing with Violence: Therapists, Clients, and Referring Systems in Conversation

    Science.gov (United States)

    Ripoll-Nunez, Karen; Villar-Guhl, Carlos Felipe; Villar-Concha, Eduardo

    2012-01-01

    There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of…

  11. Relationship between Therapists' Knowledge about Divorce Effects and Marital Therapy Intervention Preferences.

    Science.gov (United States)

    Levengood, Jan; And Others

    The effects of divorce on children have been greatly disputed among therapists. Since the perceived harmfulness of divorce may affect how marital counseling is done, this study examined how therapists' beliefs about divorce consequences are related to their intervention preferences. A two-part questionnaire was devised to be administered to…

  12. The effect of congruence in patient and therapist alliance on patient's symptomatic levels.

    Science.gov (United States)

    Zilcha-Mano, Sigal; Snyder, John; Silberschatz, George

    2017-05-01

    The ability of alliance to predict outcome has been widely demonstrated, but less is known about the effect of the level of congruence between patient and therapist alliance ratings on outcome. In the current study we examined whether the degree of congruence between patient and therapist alliance ratings can predict symptomatic levels 1 month later in treatment. The sample consisted of 127 patient-therapist dyads. Patients and therapists reported on their alliance levels, and patients reported their symptomatic levels 1 month later. Polynomial regression and response surface analysis were used to examine congruence. Findings suggest that when the congruence level of patient and therapist alliance ratings was not taken into account, only the therapist's alliance served as a significant predictor of symptomatic levels. But when the degree of congruence between patient and therapist alliance ratings was considered, the degree of congruence was a significant predictor of symptomatic levels 1 month later in treatment. Findings support the importance of the level of congruence between patient and therapist alliance ratings in predicting patient's symptomatic levels.

  13. University Vocal Training and Vocal Health of Music Educators and Music Therapists

    Science.gov (United States)

    Baker, Vicki D.; Cohen, Nicki

    2017-01-01

    The purpose of this study was to describe the university vocal training and vocal health of music educators and music therapists. The participants (N = 426), music educators (n = 351) and music therapists (n = 75), completed a survey addressing demographics, vocal training, voice usage, and vocal health. Both groups reported singing at least 50%…

  14. Research for the radiation therapist from question to culture

    CERN Document Server

    Gillan, Cailtin; Harnett, Nicole; Holden, Lori

    2014-01-01

    This book addresses a wide range of topics, from the principles of evidence-based practice to the process and dissemination of research to unique considerations such as clinical trials, patenting, and health services research. The case for evidence-based practice and a collaborative research culture is made first, followed by a series of chapters walking the reader through the research process by way of the scientific method. One of the more unique aspects of the scope of this book is the inclusion of chapters relating to the dissemination of knowledge, manuscript publication, and how to build an academic research program. Each chapter focuses on introducing the reader to foundational principles, methodology, and terminology, and highlight case studies of radiation therapist research or experience that is relevant to provide contextual examples and inspiration to the reader.

  15. Hurricane Sandy: Shared Trauma and Therapist Self-Disclosure.

    Science.gov (United States)

    Rao, Nyapati; Mehra, Ashwin

    2015-01-01

    Hurricane Sandy was one of the most devastating storms to hit the United States in history. The impact of the hurricane included power outages, flooding in the New York City subway system and East River tunnels, disrupted communications, acute shortages of gasoline and food, and a death toll of 113 people. In addition, thousands of residences and businesses in New Jersey and New York were destroyed. This article chronicles the first author's personal and professional experiences as a survivor of the hurricane, more specifically in the dual roles of provider and trauma victim, involving informed self-disclosure with a patient who was also a victim of the hurricane. The general analytic framework of therapy is evaluated in the context of the shared trauma faced by patient and provider alike in the face of the hurricane, leading to important implications for future work on resilience and recovery for both the therapist and patient.

  16. Burnout syndrome in physical therapists – Demographic and organizational factors

    Directory of Open Access Journals (Sweden)

    Urszula Pustułka-Piwnik

    2014-08-01

    Full Text Available Background: Professional burnout results from prolonged exposure to chronic, job-related stressors. According to Christina Maslach, professional burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. Literature includes a number of reports on burnout syndrome within health service, but hardly ever do they make any references to physiotherapists. The purpose of this study is assessment of the level of professional burnout in a group of physiotherapists and investigating relationships between the indices of burnout syndrome and selected demographic as well as organizational variables. Material and Methods: The study group consisted of 151 physiotherapists with at least 3 years of experience, employed in various health service outposts in Krakow, Poland. The Maslach Burnout Inventory (MBI was used to measure emotional exhaustion, depersonalization and personal accomplishment. A questionnaire for the description of socio-demographic and work characteristics was used as well. Results: Job burnout among the physiotherapists was manifested by an increased emotional exhaustion and decreased sense of personal achievement. Emotional exhaustion was significantly higher among physical therapists working with adults and employed in hospitals, depersonalization was higher among men, hospital workers and employees with seniority from 15 to 19 years, personal accomplishment was decreased among men and less-educated therapists. Conclusions: The study confirmed that indicators of burnout in physiotherapists are significantly associated with selected demographic and organizational variables. It is necessary to undertake a more exhaustive study of burnout in this group of employees, and implement elements of prevention. Med Pr 2014;65(4:453–462

  17. Facilitating a teleconference-delivered fatigue management program: perspectives of occupational therapists.

    Science.gov (United States)

    Dunleavy, Leah; Preissner, Katharine L; Finlayson, Marcia L

    2013-12-01

    Telehealth refers to the provision of health information and services across a geographical distance. Little is known about the experiences of occupational therapists using this method of service delivery. The study explored the process of facilitating a telehealth intervention from the perspective of occupational therapists. Occupational therapists completed SOAP (Subjective, Objective, Assessment, and Plan) notes after facilitating group-based, teleconference-delivered fatigue management groups to people with multiple sclerosis. Notes were also documented after therapist team meetings. All SOAP notes and field notes were subjected to thematic analysis. Five major themes were identified. "Managing time" was the central theme and was facilitated by professional foundation and challenged by logistics. Managing time contributed to challenging work, which led to the realization that it can work! Based on study findings, the theory and research on clinical reasoning, professional development, and adult learning are relevant to developing curricula that prepare occupational therapists for using telehealth approaches in practice.

  18. The relationships between adult attachment, theoretical orientation, and therapist-reported alliance quality among licensed psychologists.

    Science.gov (United States)

    Fleischman, Sari; Shorey, Hal S

    2016-01-01

    Attachment anxiety has been depicted as an undesirable therapist characteristic based on findings that preoccupied therapists, relative to those with other attachment styles, report more ruptures in the therapeutic alliance. What has not been considered, however, is the extent to which attachment dynamics are related to theoretical orientations and how attachment styles and theoretical orientations combine to predict therapists' perceptions of the quality of their alliances. The present surveyed 290 licensed psychologists nationally. Results revealed that even within a sample of primarily secure psychologists, higher 15 levels of attachment anxiety correlated positively with the endorsement of psychodynamic orientations, and negatively with the endorsement of cognitive-behavioral orientations and self-reported alliance quality. Endorsement of cognitive-behavioral orientations, in turn, correlated positively with therapist-reported alliance quality. The results are discussed in terms of the extent to which attachment dimensions should be considered in therapists' understandings of their therapeutic alliances.

  19. Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy.

    Science.gov (United States)

    D'Arrigo-Patrick, Justine; Hoff, Chris; Knudson-Martin, Carmen; Tuttle, Amy

    2017-09-01

    The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach. © 2016 Family Process Institute.

  20. Social constructionism and supervision: experiences of AAMFT supervisors and supervised therapists.

    Science.gov (United States)

    Hair, Heather J; Fine, Marshall

    2012-10-01

    A phenomenological research process was used to investigate the supervision experience for supervisors and therapists when supervisors use a social constructionist perspective. Participants of the one-to-one interviews were six AAMFT Approved Supervisors and six therapists providing counseling to individuals, couples and families. The findings suggest supervisors were committed to their self-identified supervision philosophy and intentionally sought out congruence between epistemology and practice. The shared experience of therapists indicates they associated desirable supervision experiences with their supervisors' social constructionist perspective. Our findings also indicated that supervisors' and therapists' understanding of social constructionism included the more controversial concepts of agency and extra-discursiveness. This research has taken an empirical step in the direction of understanding what the social constructionist supervision experience is like for supervisors and therapists. Our findings suggest a linkage between epistemology and supervision practice and a satisfaction with the supervision process. © 2012 American Association for Marriage and Family Therapy.

  1. Therapist's interpersonal style and therapy benefit as the determinants of personality self-reports in clients.

    Science.gov (United States)

    Hadziahmetović, Nina; Alispahić, Sabina; Tuce, Đenita; Hasanbegović-Anić, Enedina

    2016-02-01

    BACKGROUND/AIM. In (counter)transference relationship therapist's interpersonal style, implying the perceived relation of therapist to a client (patient) in terms of control, autonomy, care and positive feedback, has been shown to be important. The aim of our study was to assess the relationship between therapist's interpersonal style and clients' personality self-reports. Within therapist's interpersonal style, preliminary validation of the Therapist's Interpersonal Style Scale has been conducted, which included double translation method, exploratory factor analysis, confirmatory factor analysis, as well as the reliability tests of the derived components. This research was conducted on a group of 206 clients, attending one of the four psychotherapy modalities: psychoanalysis, gestalt therapy, cognitive-behavioral and systemic family therapy. Beside Therapist's Interpersonal Style Scale, Big Five Questionnaire and Therapy Benefit Scale were administered, showing good internal consistency. Principal component analysis of therapist's interpersonal style singled out two components Supportive Autonomy and Ignoring Control, explaining 42% of variance. Two-factor model of the therapist's styles was better fitted in confirmatory factor analysis than the original 4-factor model. Structural model showing indirect and direct effects of therapist's interpersonal styles on self-reports in clients indicates good fitness (χ²(12) = 8.932, p = 0.709; goodness-of-fit index = 0.989), with Ignoring Control having direct effect on Stability, Supportive Autonomy on Therapy Benefit, and Therapy Benefit on Plasticity. The results of this study indicate the importance of further research on therapist's interpersonal style, as well as further validation of the instrument that measures this construct. Besides, a client's perception that the therapy is being helpful could instigate more explorative and approach-oriented behavior, what indirectly might contribute to a client's stability.

  2. Emotional congruence between clients and therapists and its effect on treatment outcome.

    Science.gov (United States)

    Atzil-Slonim, Dana; Bar-Kalifa, Eran; Fisher, Hadar; Peri, Tuvia; Lutz, Wolfgang; Rubel, Julian; Rafaeli, Eshkol

    2018-01-01

    The present study aimed to (a) explore 2 indices of emotional congruence-temporal similarity and directional discrepancy-between clients' and therapists' ratings of their emotions as they cofluctuate session-by-session; and (b) examine whether client/therapist emotional congruence predicts clients' symptom relief and improved functioning. The sample comprised 109 clients treated by 62 therapists in a university setting. Clients and therapists self-reported their negative (NE) and positive emotions (PE) after each session. Symptom severity and functioning level were assessed at the beginning of each session using the clients' self-reports. To assess emotional congruence, an adaptation of West and Kenny's (2011) Truth and Bias model was applied. To examine the consequences of emotional congruence, polynomial regression, and response surface analyses were conducted (Edwards & Parry, 1993). Clients and therapists were temporally similar in both PE and NE. Therapists experienced less intense PE on average, but did not experience more or less intense NE than their clients. Those therapists who experienced more intense NE than their clients were more temporally similar in their emotions to their clients. Therapist/client incongruence in both PE and NE predicted poorer next-session symptomatology; incongruence in PE was also associated with lower client next-session functioning. Session-level symptoms were better when therapists experienced more intense emotions (both PE and NE) than their clients. The findings highlight the importance of recognizing the dynamic nature of emotions in client-therapist interactions and the contribution of session-by-session emotional dynamics to outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  3. Increasing knowledge of best practices for occupational therapists treating post-stroke unilateral spatial neglect: results of a knowledge-translation intervention study.

    Science.gov (United States)

    Petzold, Anita; Korner-Bitensky, Nicol; Salbach, Nancy M; Ahmed, Sara; Menon, Anita; Ogourtsova, Tatiana

    2012-02-01

    The aim of this study was to investigate: (i) the feasibility of delivering a multi-modal knowledge translation intervention specific to the management of acute post-stroke unilateral spatial neglect; and (ii) the impact of the knowledge translation intervention on occupational therapists' knowledge of evidence-based unilateral spatial neglect problem identification, assessment and treatment, and self-efficacy related to evidence-based practice implementation. A 3-period (pre-post) repeated measures design. Acute care occupational therapists treating patients with post-stroke unilateral spatial neglect were recruited from two major Canadian cities. Participants completed two pre-intervention assessments, took part in a day-long interactive multi-modal knowledge translation intervention and a subsequent 8-week follow-up, and completed a post-intervention assessment. Knowledge of evidence-based problem identification, assessment and treatment of unilateral spatial neglect, and self-efficacy to perform evidence-based practice activities were measured using standard scales. The intervention was tested on 20 occupational therapists. Results indicate a significant improvement in knowledge of best practice unilateral spatial neglect management (p knowledge translation intervention is feasible and can significantly improve occupational therapists' knowledge of unilateral spatial neglect best practices and self-efficacy. The findings should help advance best practices specific to the management of post-stroke unilateral spatial neglect as well as informing knowledge translation studies in other areas of practice.

  4. Does Therapists' Disengaged Feelings Influence the Effect of Transference Work? A Study on Countertransference.

    Science.gov (United States)

    Dahl, Hanne-Sofie Johnsen; Høglend, Per; Ulberg, Randi; Amlo, Svein; Gabbard, Glen O; Perry, John Christopher; Christoph, Paul Crits

    2017-03-01

    Exploration of the patient-therapist relationship (transference work) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances these interventions are beneficial. This study investigates long-term effects of transference work in the context of patients' quality of object relations (QOR) and therapists' self-reported disengaged feelings. Therapists' disengaged feelings may negatively influence the therapeutic process, especially while working explicitly with the transference since discussing feelings that are present in the session is an essential aspect of transference work. One hundred outpatients seeking psychotherapy for depression, anxiety and personality disorders were randomly assigned to one year of dynamic psychotherapy with transference work or to the same type and duration of treatment, but without transference work. Patients' QOR-lifelong pattern was evaluated before treatment and therapists' feelings were assessed using the Feeling Word Checklist-58 after each session. Outcome was measured with self-reports and interviews at pre-treatment, mid-treatment, post-treatment, one year and three years after treatment termination. A significant interaction of treatment group (transference work versus no transference work) by QOR by disengaged therapist feelings was present, indicating that disengaged feelings, even small amounts, were associated with negative long-term effects of transference work, depending on QOR Scale scores. The strengths of the negative association increased significantly with lower levels of QOR. The negative association between even a small increase in disengaged therapist feelings and long-term effects of transference interpretation was substantial for patients with poor QOR, but small among patients with good QOR. Copyright © 2016 John Wiley & Sons, Ltd. Therapists' emotional reactions to their patients (countertransference) seem to have a

  5. Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain.

    Science.gov (United States)

    Calley, Darren Q; Jackson, Steven; Collins, Heather; George, Steven Z

    2010-12-01

    Cross-sectional. To evaluate the accuracy with which physical therapists identify fear-avoidance beliefs in patients with low back pain by comparing therapist ratings of perceived patient fear-avoidance to the Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale of Kinesiophobia 11-item (TSK-11), and Pain Catastrophizing Scale (PCS). To compare the concurrent validity of therapist ratings of perceived patient fear-avoidance and a 2-item questionnaire on fear of physical activity and harm, with clinical measures of fear-avoidance (FABQ, TSK-11, PCS), pain intensity as assessed with a numeric pain rating scale (NPRS), and disability as assessed with the Oswestry Disability Questionnaire (ODQ). The need to consider psychosocial factors for identifying patients at risk for disability and chronic low back pain has been well documented. Yet the ability of physical therapists to identify fear-avoidance beliefs using direct observation has not been studied. Eight physical therapists and 80 patients with low back pain from 3 physical therapy clinics participated in the study. Patients completed the FABQ, TSK-11, PCS, ODQ, NPRS, and a dichotomous 2-item fear-avoidance screening questionnaire. Following the initial evaluation, physical therapists rated perceived patient fear-avoidance on a 0-to-10 scale and recorded 2 influences on their ratings. Spearman correlation and independent t tests determined the level of association of therapist 0-to-10 ratings and 2-item screening with fear-avoidance and clinical measures. Therapist ratings of perceived patient fear-avoidance had fair to moderate interrater reliability (ICC2,1 = 0.663). Therapist ratings did not strongly correlate with FABQ or TSK-11 scores. Instead, they unexpectedly had stronger associations with ODQ and PCS scores. Both 2-item screening questions were associated with FABQ-physical activity scores, while the fear of physical activity question was also associated with FABQ-work, TSK-11, PCS, and ODQ scores

  6. The revised APTA code of ethics for the physical therapist and standards of ethical conduct for the physical therapist assistant: theory, purpose, process, and significance.

    Science.gov (United States)

    Swisher, Laura Lee; Hiller, Peggy

    2010-05-01

    In June 2009, the House of Delegates (HOD) of the American Physical Therapy Association (APTA) passed a major revision of the APTA Code of Ethics for physical therapists and the Standards of Ethical Conduct for the Physical Therapist Assistant. The revised documents will be effective July 1, 2010. The purposes of this article are: (1) to provide a historical, professional, and theoretical context for this important revision; (2) to describe the 4-year revision process; (3) to examine major features of the documents; and (4) to discuss the significance of the revisions from the perspective of the maturation of physical therapy as a doctoring profession. PROCESS OF REVISION: The process for revision is delineated within the context of history and the Bylaws of APTA. FORMAT, STRUCTURE, AND CONTENT OF REVISED CORE ETHICS DOCUMENTS: The revised documents represent a significant change in format, level of detail, and scope of application. Previous APTA Codes of Ethics and Standards of Ethical Conduct for the Physical Therapist Assistant have delineated very broad general principles, with specific obligations spelled out in the Ethics and Judicial Committee's Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. In contrast to the current documents, the revised documents address all 5 roles of the physical therapist, delineate ethical obligations in organizational and business contexts, and align with the tenets of Vision 2020. The significance of this revision is discussed within historical parameters, the implications for physical therapists and physical therapist assistants, the maturation of the profession, societal accountability and moral community, potential regulatory implications, and the inclusive and deliberative process of moral dialogue by which changes were developed, revised, and approved.

  7. Cultural context in the effort to improve oral health among Alaska Native people: the dental health aide therapist model.

    Science.gov (United States)

    Wetterhall, Scott; Burrus, Barri; Shugars, Daniel; Bader, James

    2011-10-01

    The Alaska Native people in rural Alaska face serious challenges in obtaining dental care. Itinerant care models have failed to meet their needs for more than 50 years. The dental health aide therapist (DHAT) model, which entails training midlevel care providers to perform limited restorative, surgical, and preventive procedures, was adopted to address some of the limitations of the itinerant model. We used quantitative and qualitative methods to assess residents' satisfaction with the model and the role of DHATs in the cultural context in which they operate. Our findings suggest that the DHAT model can provide much-needed access to urgent care and is beneficial from a comprehensive cultural perspective.

  8. Secondary Traumatic Stress and Adjustment in Therapists Who Work with Sexual Violence Survivors: The Moderating Role of Posttraumatic Growth

    Science.gov (United States)

    Samios, Christina; Rodzik, Amber K.; Abel, Lisa M.

    2012-01-01

    Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who…

  9. The lack of cross-national equivalence of a therapist adherence measure (TAM-R) in multisystemic therapy (MST)

    NARCIS (Netherlands)

    Lange, A.M.C.; Scholte, R.H.J.; Geffen, W. van; Timman, R.; Busschbach, J.J.V. van; Rijken, R.E.A. van der

    2016-01-01

    This two-study report investigates the equivalence of the Dutch Therapist Adherence Measure Revised (TAM-R) to the US original. The TAM-R is a questionnaire measuring therapist adherence to the treatment model of Multisystemic Therapy (MST). Monitoring of therapist adherence is essential for

  10. The impact of selected organizational variables and managerial leadership on radiation therapists' organizational commitment

    International Nuclear Information System (INIS)

    Akroyd, Duane; Legg, Jeff; Jackowski, Melissa B.; Adams, Robert D.

    2009-01-01

    The purpose of this study was to examine the impact of selected organizational factors and the leadership behavior of supervisors on radiation therapists' commitment to their organizations. The population for this study consists of all full time clinical radiation therapists registered by the American Registry of Radiologic Technologists (ARRT) in the United States. A random sample of 800 radiation therapists was obtained from the ARRT for this study. Questionnaires were mailed to all participants and measured organizational variables; managerial leadership variable and three components of organizational commitment (affective, continuance and normative). It was determined that organizational support, and leadership behavior of supervisors each had a significant and positive affect on normative and affective commitment of radiation therapists and each of the models predicted over 40% of the variance in radiation therapists organizational commitment. This study examined radiation therapists' commitment to their organizations and found that affective (emotional attachment to the organization) and normative (feelings of obligation to the organization) commitments were more important than continuance commitment (awareness of the costs of leaving the organization). This study can help radiation oncology administrators and physicians to understand the values their radiation therapy employees hold that are predictive of their commitment to the organization. A crucial result of the study is the importance of the perceived support of the organization and the leadership skills of managers/supervisors on radiation therapists' commitment to the organization.

  11. The impact of selected organizational variables and managerial leadership on radiation therapists' organizational commitment

    Energy Technology Data Exchange (ETDEWEB)

    Akroyd, Duane [Department of Adult and Community College Education, College of Education, Campus Box 7801, North Carolina State University, Raleigh, NC 27695 (United States)], E-mail: duane_akroyd@ncsu.edu; Legg, Jeff [Department of Radiologic Sciences, Virginia Commonwealth University, Richmond, VA 23284 (United States); Jackowski, Melissa B. [Division of Radiologic Sciences, University of North Carolina School of Medicine 27599 (United States); Adams, Robert D. [Department of Radiation Oncology, University of North Carolina School of Medicine 27599 (United States)

    2009-05-15

    The purpose of this study was to examine the impact of selected organizational factors and the leadership behavior of supervisors on radiation therapists' commitment to their organizations. The population for this study consists of all full time clinical radiation therapists registered by the American Registry of Radiologic Technologists (ARRT) in the United States. A random sample of 800 radiation therapists was obtained from the ARRT for this study. Questionnaires were mailed to all participants and measured organizational variables; managerial leadership variable and three components of organizational commitment (affective, continuance and normative). It was determined that organizational support, and leadership behavior of supervisors each had a significant and positive affect on normative and affective commitment of radiation therapists and each of the models predicted over 40% of the variance in radiation therapists organizational commitment. This study examined radiation therapists' commitment to their organizations and found that affective (emotional attachment to the organization) and normative (feelings of obligation to the organization) commitments were more important than continuance commitment (awareness of the costs of leaving the organization). This study can help radiation oncology administrators and physicians to understand the values their radiation therapy employees hold that are predictive of their commitment to the organization. A crucial result of the study is the importance of the perceived support of the organization and the leadership skills of managers/supervisors on radiation therapists' commitment to the organization.

  12. Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists.

    Science.gov (United States)

    Nugent, Alexandra; Hancock, Nicola; Honey, Anne

    2017-01-01

    Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists' experiences of developing and sustaining recovery-orientation in mental health practice. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists' workplace environment influenced this process. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

  13. Can a Community of Practice Improve Physical Therapists' Self-Perceived Practice in Developmental Coordination Disorder?

    Science.gov (United States)

    Camden, Chantal; Rivard, Lisa M; Hurtubise, Karen; Héguy, Léa; Berbari, Jade

    2017-07-01

    Communities of practice (CoPs) are useful knowledge translation (KT) strategies, but little is known about their impact on physical therapists' self-perceived practice. The impact of a CoP on physical therapists' self-perceived practice was evaluated, and factors influencing changes in self-perceived knowledge, skills, and practice related to developmental coordination disorder (DCD) were explored. An explanatory sequential mixed-methods design was used, guided by the Theory of Reasoned Action and Theory of Planned Behavior. Physical therapists participated in a DCD physical therapist CoP, which included 2 full-day, face-to-face workshops, with access to a 5-month online forum between the workshops, and completed questionnaires at 3 time-points: before the first workshop, before accessing the online forum, and following the second workshop. Measures completed before and after the CoP included closed-ended questions providing global scores on therapists' self-perceived knowledge, skills, and practice. Physical therapists' sociodemographic characteristics, information-seeking style, use of the online forum, and behavioral change goals were also collected. Paired t-tests, ANCOVAs, and linear regression models were used to analyze the data. Forty-one physical therapists completed all questionnaires. Their self-perceived knowledge, skills, and practice change scores were significantly higher (+0.47, +1.23, and +2.61, respectively; P behavioral changes influence patient outcomes. © 2017 American Physical Therapy Association

  14. Patient affect experiencing following therapist interventions in short-term dynamic psychotherapy.

    Science.gov (United States)

    Town, Joel M; Hardy, Gillian E; McCullough, Leigh; Stride, Chris

    2012-01-01

    The aim of this research was to examine the relationship between therapist interventions and patient affect responses in Short-Term Dynamic Psychotherapy (STDP). The Affect Experiencing subscale from the Achievement of Therapeutic Objectives Scale (ATOS) was adapted to measure individual immediate affect experiencing (I-AES) responses in relation to therapist interventions coded within the preceding speaking turn, using the Psychotherapy Interaction Coding (PIC) system. A hierarchical linear modelling procedure was used to assess the change in affect experiencing and the relationship between affect experiencing and therapist interventions within and across segments of therapy. Process data was taken from six STDP cases; in total 24 hours of video-taped sessions were examined. Therapist interventions were found to account for a statistically significant amount of variance in immediate affect experiencing. Higher levels of immediate affect experiencing followed the therapist's use of Confrontation, Clarification and Support compared to Questions, Self-disclosure and Information interventions. Therapist Confrontation interventions that attempted to direct pressure towards either the visceral experience of affect or a patient's defences against feelings led to the highest levels of immediate affect experiencing. The type of therapist intervention accounts for a small but significant amount of the variation observed in a patient's immediate emotional arousal. Empirical findings support clinical theory in STDP that suggests strategic verbal responses promote the achievement of this specific therapeutic objective.

  15. Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.

    Science.gov (United States)

    Levac, Danielle E; Glegg, Stephanie M N; Sveistrup, Heidi; Colquhoun, Heather; Miller, Patricia; Finestone, Hillel; DePaul, Vincent; Harris, Jocelyn E; Velikonja, Diana

    2016-01-01

    Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use. A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Self-report and observer-rated outcome measures evaluated therapists' confidence, clinical reasoning and behaviour with respect to MLS use. A focus group captured therapists' perspectives on MLS use during VR-based therapy provision. The intervention improved self-reported confidence about MLS use as measured by confidence ratings (p behaviour change with respect to MLS use was noted (p = 0.092). Therapists favoured the strategy of transferring skills from VR to real-life tasks over employing a more comprehensive MLS approach. The KT intervention improved therapists' confidence but did not have an effect on clinical reasoning or behaviour with regard to MLS use during VR-based therapy.

  16. Professional and organizational commitment in paediatric occupational therapists: the influence of practice setting.

    Science.gov (United States)

    Seruya, Francine M; Hinojosa, Jim

    2010-09-01

    The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web-based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty-seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school-based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web-based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale. Copyright 2010 John Wiley & Sons, Ltd.

  17. Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors.

    Science.gov (United States)

    Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula

    2017-12-01

    This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

  18. Attitudes of speech and language therapists towards stammering: 1985 and 2000.

    Science.gov (United States)

    Crichton-Smith, Isobel; Wright, Jannet; Stackhouse, Joy

    2003-01-01

    Past research has indicated that speech and language therapists hold some negative attitudes towards people who stammer, their parents and the treatment of stammering. However, studies on attitudes towards stammering have predominantly focussed on therapists in the USA. Recent trends towards earlier intervention suggest that more therapists in the UK will be involved in working with stammering. This study aimed to gather current attitudes of therapists in the UK and to compare them with attitudes measured 15 years previously. It also considered the impact of postgraduate training on attitudes and examined the attitudes of therapists trained in the Lidcombe Programme. The attitudes of 261 speech and language therapists were measured in a postal survey using the Clinician Attitudes Toward Stuttering (CATS) Inventory. The survey revealed an increase in positive attitudes towards early intervention and a reduction in negative attitudes towards people who stammer since the CATS inventory was carried out in 1985. An analysis of generalist and specialist attitudes revealed that generalists were unsure about appropriate treatments to use with people who stammer. Therapists trained in the Lidcombe Programme held some different attitudes about early intervention, people who stammer and the treatment of stammering; however, they continued to view parental counselling as a critical factor in the treatment of the preschool child. The survey indicated that although therapists were more positive about some aspects of stammering, the treatment of stammering remains a complex issue. All therapists working with clients who stammer would therefore benefit from undertaking ongoing professional development in this area such as additional training, liaison with colleagues and joining a special interest group.

  19. The insecure psychotherapy base: Using client and therapist attachment styles to understand the early alliance.

    Science.gov (United States)

    Marmarosh, Cheri L; Kivlighan, Dennis M; Bieri, Kathryn; LaFauci Schutt, Jean M; Barone, Carrie; Choi, Jaehwa

    2014-09-01

    The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Manual Ability Classification System (MACS: reliability between therapists and parents in Brazil

    Directory of Open Access Journals (Sweden)

    Daniela B. R. Silva

    2015-02-01

    Full Text Available BACKGROUND: The Manual Ability Classification System (MACS has been widely used to describe the manual ability of children with cerebral palsy (CP; however its reliability has not been verified in Brazil. OBJECTIVE: To establish the inter- and intra-rater reliability of the Portuguese-Brazil version of the MACS by comparing the classifications given by therapists and parents of children with CP. METHOD: Data were obtained from 90 children with CP between the ages of 4 and 18 years, who were treated at the neurology and rehabilitation clinics of a Brazilian hospital. Therapists (an occupational therapist and a student classified manual ability (MACS through direct observation and information provided by parents. Therapists and parents used the Portuguese-Brazil version of the MACS. Intra- and inter-rater reliability was obtained using unweighted Kappa coefficient (k and intra-class correlation coefficient (ICC. The Chi-square test was used to identify the predominance of disagreements in the classification of parents and therapists. RESULTS: An almost perfect agreement resulted among therapists [K=0.90 (95% CI 0.83-0.97; ICC=0.97 (95%CI 0.96-0.98], as well as with intra-rater (therapists, with Kappa ranging between 0.83 and 0.95 and ICC between 0.96 and 0.99 for the evaluator with more and less experience in rehabilitation, respectively. The agreement between therapists and parents was fair [K=0.36 (95% CI 0.22-0.50; ICC=0.79 (95% CI 0.70-0.86]. CONCLUSIONS: The Portuguese version of the MACS is a reliable instrument to be used jointly by parents and therapists.

  1. Informal Leadership in the Clinical Setting: Occupational Therapist Perspectives

    Directory of Open Access Journals (Sweden)

    Clark Patrick Heard

    2018-04-01

    Full Text Available Background: Leadership is vital to clinical, organizational, and professional success. This has compelled a high volume of research primarily related to formal leadership concepts. However, as organizations flatten, eliminate departmental structures, or decentralize leadership structures the relevance of informal leaders has markedly enhanced. Methods: Using a qualitative phenomenological methodology consistent with interpretative phenomenological analysis, this study examines the impact of informal leadership in the clinical setting for occupational therapists. Data was collected through the completion of semi-structured interviews with 10 peer-identified informal occupational therapy leaders in Ontario, Canada. Collected data was transcribed verbatim and coded for themes by multiple coders. Several methods were employed to support trustworthiness. Results: The results identify that informal leaders are collaborative, accessible, and considered the “go to” staff. They demonstrate professional competence knowledge, experience, and accountability and are inspirational and creative. Practically, informal leaders organically shape the practice environment while building strength and capacity among their peers. Conclusion: Recommendations for supporting informal leaders include acknowledgement of the role and its centrality, enabling informal leaders time to undertake the role, and supporting consideration of informal leadership concepts at the curriculum and professional level.

  2. CLINICAL APPLICATIONS OF CRYOTHERAPY AMONG SPORTS PHYSICAL THERAPISTS.

    Science.gov (United States)

    Hawkins, Shawn W; Hawkins, Jeremy R

    2016-02-01

    Therapeutic modalities (TM) are used by sports physical therapists (SPT) but how they are used is unknown. To identify the current clinical use patterns for cryotherapy among SPT. Cross-sectional survey. All members (7283) of the Sports Physical Therapy Section of the APTA were recruited. A scenario-based survey using pre-participation management of an acute or sub-acute ankle sprain was developed. A Select Survey link was distributed via email to participants. Respondents selected a treatment approach based upon options provided. Follow-up questions were asked. The survey was available for two weeks with a follow-up email sent after one week. Question answers were the main outcome measures. Reliability: Cronbach's alpha=>0.9. The SPT response rate = 6.9% (503); responses came from 48 states. Survey results indicated great variability in respondents' approaches to the treatment of an acute and sub-acute ankle sprain. SPT applied cryotherapy with great variability and not always in accordance to the limited research on the TM. Continuing education, application of current research, and additional outcomes based research needs to remain a focus for clinicians. 3.

  3. Ethical dilemmas experienced by clinical psychology trainee therapists.

    Science.gov (United States)

    Bhola, Poornima; Sinha, Ananya; Sonkar, Suruchi; Raguram, Ahalya

    2015-01-01

    Ethical dilemmas are inevitable during psychotherapeutic interactions, and these complexities and challenges may be magnified during the training phase. The experience of ethical dilemmas in the arena of therapy and the methods of resolving these dilemmas were examined among 35 clinical psychologists in training, through an anonymous and confidential online survey. The trainees' responses to four open-ended questions on any one ethical dilemma encountered during therapy were analysed, using thematic content analysis. The results highlighted that the salient ethical dilemmas related to confidentiality and boundary issues. The trainees also raised ethical questions regarding therapist competence, the beneficence and non-maleficence of therapeutic actions, and client autonomy. Fifty-seven per cent of the trainees reported that the dilemmas were resolved adequately, the prominent methods of resolution being supervision or consultation and guidance from professional ethical guidelines. The trainees felt that the professional codes had certain limitations as far as the effective resolution of ethical dilemmas was concerned. The findings indicate the need to strengthen training and supervision methodologies and professional ethics codes for psychotherapists and counsellors in India.

  4. Interobserver variability of radiation therapists aligning to fiducial markers for prostate radiation therapy.

    Science.gov (United States)

    Deegan, Timothy; Owen, Rebecca; Holt, Tanya; Roberts, Lisa; Biggs, Jennifer; McCarthy, Alicia; Parfitt, Matthew; Fielding, Andrew

    2013-08-01

    As the use of fiducial markers (FMs) for the localisation of the prostate during external beam radiation therapy (EBRT) has become part of routine practice, radiation therapists (RTs) have become increasingly responsible for online image interpretation. The aim of this investigation was to quantify the limits of agreement (LoA) between RTs when localising to FMs with orthogonal kilovoltage (kV) imaging. Six patients receiving prostate EBRT utilising FMs were included in this study. Treatment localisation was performed using kV imaging prior to each fraction. Online stereoscopic assessment of FMs, performed by the treating RTs, was compared with the offline assessment by three RTs. Observer agreement was determined by pairwise Bland-Altman analysis. Stereoscopic analysis of 225 image pairs was performed online at the time of treatment, and offline by three RT observers. Eighteen pairwise Bland-Altman analyses were completed to assess the level of agreement between observers. Localisation by RTs was found to be within clinically acceptable 95% LoAs. Small differences between RTs, in both the online and offline setting, were found to be within clinically acceptable limits. RTs were able to make consistent and reliable judgements when matching FMs on planar kV imaging. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  5. Interobserver variability of radiation therapists aligning to fiducial markers for prostate radiation therapy

    International Nuclear Information System (INIS)

    Deegan, Timothy; Owen, Rebecca; Holt, Tanya; Roberts, Lisa; Biggs, Jennifer; McCarthy, Alicia; Parfitt, Matthew; Fielding, Andrew

    2013-01-01

    As the use of fiducial markers (FMs) for the localisation of the prostate during external beam radiation therapy (EBRT) has become part of routine practice, radiation therapists (RTs) have become increasingly responsible for online image interpretation. The aim of this investigation was to quantify the limits of agreement (LoA) between RTs when localising to FMs with orthogonal kilovoltage (kV) imaging. Six patients receiving prostate EBRT utilising FMs were included in this study. Treatment localisation was performed using kV imaging prior to each fraction. Online stereoscopic assessment of FMs, performed by the treating RTs, was compared with the offline assessment by three RTs. Observer agreement was determined by pairwise Bland-Altman analysis. Stereoscopic analysis of 225 image pairs was performed online at the time of treatment, and offline by three RT observers. Eighteen pairwise Bland-Altman analyses were completed to assess the level of agreement between observers. Localisation by RTs was found to be within clinically acceptable 95% LoAs. Small differences between RTs, in both the online and offline setting, were found to be within clinically acceptable limits. RTs were able to make consistent and reliable judgements when matching FMs on planar kV imaging.

  6. Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education.

    Science.gov (United States)

    Christensen, Nicole; Black, Lisa; Furze, Jennifer; Huhn, Karen; Vendrely, Ann; Wainwright, Susan

    2017-02-01

    Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. A descriptive, cross-sectional survey was administered to physical therapist program representatives. An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or

  7. Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy.

    Science.gov (United States)

    Ter Kuile, Moniek M; Melles, Reinhilde; de Groot, H Ellen; Tuijnman-Raasveld, Charlotte C; van Lankveld, Jacques J D M

    2013-12-01

    Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other "objects" (e.g., tampons, fingers, speculum). Lifelong vaginismus is diagnosed when a woman has never been able to have intercourse. The aim of this study was to investigate the efficacy of therapist-aided exposure for lifelong vaginismus. Seventy women and their partners were randomly allocated to exposure or a waiting-list control period of 3 months. The main outcome measure (intercourse ability) was assessed daily during 12 weeks. Secondary outcome measures were complaints about vaginismus, coital pain, coital fear, sexual distress, and sexual functioning. The exposure treatment consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. Each participant performed vaginal penetration exercises herself, in the presence of her partner and a female therapist. Two follow-up sessions were scheduled over a 5-week period. Thirty-one out of 35 (89%; 95% CI [72%, 96%]) participants reported having had sexual intercourse at posttreatment compared with 4 out of 35 (11%; 95% CI [4%, 28%]) participants in the control condition. In most of the successfully treated women (90%), intercourse was possible within the first 2 weeks of treatment. Moreover, treatment resulted in clinical improvement regarding other symptoms related to vaginismus, coital fear, coital pain, and sexual distress. No treatment effects were found regarding other aspects of sexual functioning in women or their partners. This study provides evidence of the efficacy of therapist-aided exposure therapy for women with lifelong vaginismus.

  8. Therapist Multicultural Competence, Asian American Participants' Cultural Values, and Counseling Process.

    Science.gov (United States)

    Wang, Shihwe; Kim, Bryan S K

    2010-10-01

    Asian Americans drop out of mental health treatment at a high rate. This problem could be addressed by enhancing therapists' multicultural competence and by examining clients' cultural attitudes that may affect the counseling process. In the present study, we used a video analogue design with a sample of 113 Asian American college students to examine these possibilities. The result from a t test showed that the session containing therapist multicultural competencies received higher ratings than the session without therapist multicultural competence. In addition, correlational analyses showed that participant values acculturation was positively associated with participant ratings of counseling process, while the value of emotional self-control was negatively correlated. The results of a hierarchical multiple regression analysis did not support any interaction effects among the independent variables on counseling process. All of these findings could contribute to the field of multicultural competence research and have implications for therapist practices and training.

  9. How to Choose a Therapist for Post-Traumatic Stress and Dissociative Conditions

    Science.gov (United States)

    ... therapy include individual (or one-on-one) therapy, couples’ therapy, family therapy, and group therapy. Some therapists ... Poor Don’t forget (or avoid) talking about money. You need to know before you start how ...

  10. Therapist self-disclosure and the therapeutic alliance in the treatment of eating problems.

    Science.gov (United States)

    Simonds, Laura M; Spokes, Naomi

    2017-01-01

    Evidence is mixed regarding the potential utility of therapist self-disclosure. The current study modelled relationships between perceived helpfulness of therapist self-disclosures, therapeutic alliance, patient non-disclosure, and shame in participants (n = 120; 95% women) with a history of eating problems. Serial multiple mediator analyses provided support for a putative model connecting the perceived helpfulness of therapist self-disclosures with current eating disorder symptom severity through therapeutic alliance, patient self-disclosure, and shame. The analyses presented provide support for the contention that therapist self-disclosure, if perceived as helpful, might strengthen the therapeutic alliance. A strong therapeutic alliance, in turn, has the potential to promote patient disclosure and reduce shame and eating problems.

  11. Strategies Used by Foreign-Born Family Therapists to Connect Across Cultural Differences: A Thematic Analysis.

    Science.gov (United States)

    Niño, Alba; Kissil, Karni; Davey, Maureen P

    2016-01-01

    With the growing diversity in the United States among both clinicians and clients, many therapeutic encounters are cross-cultural, requiring providers to connect across cultural differences. Foreign-born therapists have many areas of differences to work through. Thus, exploring how foreign-born family therapists in the United States connect to their clients can uncover helpful strategies that all therapists can use to establish stronger cross-cultural therapeutic connections. A thematic analysis was conducted to understand strategies 13 foreign-born therapists used during therapeutic encounters. Four themes were identified: making therapy a human-to-human connection, dealing with stereotypes, what really matters, and flexibility. Findings suggest that developing a deep therapeutic connection using emotional attunement and human-to-human engagement is crucial for successful cross-cultural therapy. Clinical and training implications are provided. © 2015 American Association for Marriage and Family Therapy.

  12. Association among Work-Related Musculoskeletal Disorders, Job Stress, and Job Attitude of Occupational Therapists.

    Science.gov (United States)

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2017-01-01

    This study was conducted to investigate the associations among work-related musculoskeletal disorders (WMSDs), job stress, and job attitude of occupational therapists in South Korea. Self-reporting questionnaires were distributed to 150 occupational therapists. Of the 128 occupational therapists who responded, 110 (85.9%) reported WMSDs affecting at least one body site. The most affected WMSDs site was the low back (26.8%), and the most reported number of body site affected by WMSDs was one (53.9%). As a result, there were significant differences in job stress and job attitude depending on the age, work experience, working hour, presence or absence of WMSDs, and number of site of pain. Factors influencing job attitude included job stress, the presence or absence of WMSDs and duration of pain. The results showed that the occurrence of WMSDs in occupational therapists was associated with increased job stress and negative job attitude.

  13. Actions of occupational therapists in the care of people with problems related to use of alcohol and other drugs

    Directory of Open Access Journals (Sweden)

    Adriana Maria Nogueira

    2014-09-01

    Full Text Available This exploratory descriptive study aimed to characterize the interventions of occupational therapists in substance abuse treatment centers, identifying the form and frequency of sessions and mapping the major activities and their objectives. The study subjects were obtained through the Snowball Sampling technique, eleven participating occupational therapists working in seven states. Data collection occurred from October to December 2011 through self-explanatory and self-administered structured questionnaires developed by the authors, which inquired the professionals interviewed about their training (undergraduate and graduate courses; time working in the field of chemical dependency and professional performance (form and frequency of sessions, criteria governing the choice of form and frequency of sessions, activities most frequently used in the sessions, and key objectives to be achieved with the development of such activities. It was possible to verify that individual and group sessions are performed of twice a week or more often. The most developed activities are self-expressive and manual activities and those related to health education, self-care, and reorganization of everyday life. The goals most frequently reported were recovery of personal and social values; reframing the activities of everyday life; expansion of the co-responsibility of families in the treatments; expression of feelings and internal conflicts; and enjoyment of relaxation and leisure moments. We conclude that varied behavior occurs among the professionals with respect to their practice, indicating the different philosophical and methodological conceptions involved in this process.

  14. A Descriptive Study of the Practice Patterns of Massage New Zealand Massage Therapists

    Science.gov (United States)

    Smith, Joanna M.; Sullivan, S. John; Baxter, G. David

    2011-01-01

    Background: Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices. Purpose and Setting: The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to therapist characteristics; practice modes and settings, and therapy characteristics; referral patterns; and massage therapy as an occupation. Research Design and Participants: A survey questionnaire was mailed to 66 trained massage therapist members of Massage New Zealand who were recruiting massage clients for a concurrent study of massage therapy culture. Results: Most massage therapists were women (83%), NZ European (76%), and holders of a massage diploma qualification (89%). Massage therapy was both a full- (58%) and part-time (42%) occupation, with the practice of massage therapy being the only source of employment for 70% of therapists. Nearly all therapists (94%) practiced massage for more than 40 weeks in the year, providing a median of 16 – 20 hours of direct client care per week. Most massage therapists worked in a “solo practice” (58%) and used a wide and active referral network. Almost all therapists treated musculoskeletal symptoms: the most common client issues or conditions treated were back pain/problem (99%), neck/shoulder pain/problem (99%), headache or migraine (99%), relaxation and stress reduction (96%), and regular recovery or maintenance massage (89%). The most frequent client fee per treatment was NZ$60 per hour in a clinic and NZ$1 per minute at a sports event or in the workplace. Therapeutic massage, relaxation massage, sports massage, and trigger-point therapy were the most common styles of massage therapy offered. Nearly all massage therapists (99%) undertook client assessment; 95% typically provided self-care recommendations; and 32% combined other complementary and alternative medicine therapies with their

  15. A descriptive study of the practice patterns of massage new zealand massage therapists.

    Science.gov (United States)

    Smith, Joanna M; Sullivan, S John; Baxter, G David

    2011-03-30

    Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices. The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to therapist characteristics; practice modes and settings, and therapy characteristics; referral patterns; and massage therapy as an occupation. A survey questionnaire was mailed to 66 trained massage therapist members of Massage New Zealand who were recruiting massage clients for a concurrent study of massage therapy culture. Most massage therapists were women (83%), NZ European (76%), and holders of a massage diploma qualification (89%). Massage therapy was both a full- (58%) and part-time (42%) occupation, with the practice of massage therapy being the only source of employment for 70% of therapists. Nearly all therapists (94%) practiced massage for more than 40 weeks in the year, providing a median of 16 - 20 hours of direct client care per week. Most massage therapists worked in a "solo practice" (58%) and used a wide and active referral network. Almost all therapists treated musculoskeletal symptoms: the most common client issues or conditions treated were back pain/problem (99%), neck/shoulder pain/problem (99%), headache or migraine (99%), relaxation and stress reduction (96%), and regular recovery or maintenance massage (89%). The most frequent client fee per treatment was NZ$60 per hour in a clinic and NZ$1 per minute at a sports event or in the workplace. Therapeutic massage, relaxation massage, sports massage, and trigger-point therapy were the most common styles of massage therapy offered. Nearly all massage therapists (99%) undertook client assessment; 95% typically provided self-care recommendations; and 32% combined other complementary and alternative medicine therapies with their massage consultations. This study provides new information about the practice of

  16. Treating internet addiction with cognitive-behavioral therapy: a thematic analysis of the experiences of therapists.

    OpenAIRE

    Rooij, A.J. van; Zinn, M.F.; Schoenmakers, T.M.; Mheen, D. van de

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program (‘Lifestyle Training’) to treat internet addiction. The current study evaluates this pilot treatment program by providing a qualitative analysis of the experiences of the therapists with the treatment of 12 selfproclaimed internet addicts. Therapists report that the program, whi...

  17. From dictatorship to a reluctant democracy: stroke therapists talking about self-management.

    Science.gov (United States)

    Norris, Meriel; Kilbride, Cherry

    2014-01-01

    Self-management is being increasingly promoted within chronic conditions including stroke. Concerns have been raised regarding professional ownership of some programmes, yet little is known of the professional's experience. This paper aims to present the views of trained therapists about the utility of a specific self-management approach in stroke rehabilitation. Eleven stroke therapists trained in the self-management approach participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Two overriding themes emerged. The first was the sense that in normal practice therapists act as "benign dictators", committed to help their patients, but most comfortable when they, the professional, are in control. Following the adoption of the self-management approach therapists challenged themselves to empower stroke survivors to take control of their own recovery. However, therapists had to confront many internal and external challenges in this transition of power resulting in the promotion of a somewhat "reluctant democracy". This study illustrates that stroke therapists desire a more participatory approach to rehabilitation. However, obstacles challenged the successful delivery of this goal. If self-management is an appropriate model to develop in post stroke pathways, then serious consideration must be given to how and if these obstacles can be overcome. Stroke therapists perceive that self-management is appropriate for encouraging ownership of rehabilitation post stroke. Numerous obstacles were identified as challenging the implementation of self-management post stroke. These included: professional models, practices and expectations; institutional demands and perceived wishes of stroke survivors. For self-management to be effectively implemented by stroke therapists, these obstacles must be considered and overcome. This should be as part of an integrated therapy service, rather than as an add-on.

  18. Uncharted 'tearitory': mapping Australian therapist experiences, attitudes, and understandings of their in-session tears

    OpenAIRE

    Brownlie, Megan Ruth

    2017-01-01

    This study explored psychotherapist experiences of and attitudes to in-session crying. Historically, therapists were encouraged to hide their emotions from clients. Subsequently, self-disclosure and empathy theory and research developed with a focus on verbal modes of self-disclosure and empathic communication, to the neglect of the non-verbal dimension of these interventions. The current study attempted to locate therapist tearfulness within the theoretical discourses on self-disclosure and ...

  19. Do treatment manuals undermine youth–therapist alliance in community clinical practice?

    OpenAIRE

    Langer, David A.; McLeod, Bryce D.; Weisz, John R

    2011-01-01

    Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client–therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8–15 years, 34% Caucasian) were randomly assigned to receive nonmanualized usual care or manual-guided treatment to address anxiety or depressive disorders. Treatment was provided in community c...

  20. More than reflections: Empathy in motivational interviewing includes language style synchrony between therapist and client

    Science.gov (United States)

    Lord, Sarah Peregrine; Sheng, Elisa; Imel, Zac E.; Baer, John; Atkins, David C.

    2016-01-01

    Empathy is a basic psychological process that involves the development of synchrony in dyads. It is also a foundational ingredient in specific, evidence-based behavioral treatments like motivational interviewing (MI). Ratings of therapist empathy typically rely on a gestalt, “felt sense” of therapist understanding and the presence of specific verbal behaviors like reflective listening. These ratings do not provide a direct test of psychological processes like behavioral synchrony that are theorized to be an important component of empathy in psychotherapy. To explore a new objective indicator of empathy, we hypothesized that synchrony in language style (i.e., matching how statements are phrased) between client and therapists would predict gestalt ratings of empathy over and above the contribution of reflections. We analyzed 122 MI transcripts with high and low empathy ratings based on the Motivational Interviewing Treatment Integrity (MITI) global rating scale. Linguistic inquiry and word count was used to estimate language style synchrony (LSS) of adjacent client and therapist talk turns. High empathy sessions showed greater LSS across 11 language style categories compared to low empathy sessions (p empathy vs. low empathy sessions (d = 0.62). Regression analyses showed that LSS was predictive of empathy ratings over and above reflection counts; a 1 SD increase in LSS is associated with 2.4 times increase in the odds of a high empathy rating, controlling for therapist reflections (odds ratio = 2.4, 95% CI: 1.36, 4.24, p empathy ratings are related to synchrony in language style, over and above synchrony of content as measured by therapist reflections. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists. PMID:25892166

  1. Assessment tools used by occupational therapists in children with obstetric brachial plexus palsy

    OpenAIRE

    Thaianny Taís Dantas de Brito; Carolinne Linhares Pinheiro

    2016-01-01

    Introduction: The Obstetric Brachial Plexus Palsy (OBPP) is a result of brachial plexus injury at birth and may cause dysfunction of the affected upper limb, reflecting significantly in the child’s life. When evaluating a child with OBPP the occupational therapist can use evaluation tools, and has to have knowledge to choose and apply the most appropriate instrument. Objective: This review aimed to analyze the literature on the use of evaluation tools by occupational therapists in...

  2. Schizophrenic Patients’ Attitudes to Therapists Using Behavioral and Holistic-Humanistic Techniques

    OpenAIRE

    STARK, F. MICHAEL; LIBERMAN, ROBERT PAUL; CORRIGAN, PATRICK W.

    1992-01-01

    In a preliminary study of patients‘ perceptions of therapists’ styles, 18 subjects with diagnoses of schizophrenia were randomly assigned either to social skills training or holistic health therapy. Four therapists conducted each treatment session in pairs, rotating between treatment conditions daily. At the end of 10 weeks of treatment, patients were able to discriminate among therapists on three interactional styles—"understanding," "independence-encouraging," and "and "criti...

  3. A Child’s Perspective on the Role of Therapists in Custody Battles

    OpenAIRE

    Roy Lubit

    2016-01-01

    Children’s therapists often avoid involvement in court at all cost, utilizing twists of logic and applying false dictums. Avoiding involvement not only violates the therapist’s fiduciary responsibility to the child and fundamental moral principles, but almost inevitably leads to the collapse of the therapeutic relationship and any benefit coming from the therapy. Assertions that the therapist is avoiding involvement to protect the therapy are little more than rationalizations. Sin...

  4. Therapist adherence in individual cognitive-behavioral therapy for binge-eating disorder

    OpenAIRE

    Brauhardt, Anne; de Zwaan, Martina; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans-Christoph; Hilbert, Anja

    2017-01-01

    While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study...

  5. Differences and similarities in therapeutic mode use between occupational therapists and occupational therapy students in Norway.

    Science.gov (United States)

    Carstensen, Tove; Bonsaksen, Tore

    2017-11-01

    The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or 'mode' use, but to date no group comparisons have been reported. To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use. The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n = 109) and of second-year occupational therapy students (n = 96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests. The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did. There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.

  6. Occupational therapists intervention methodologies in schools with children with Special Educational Needs in Portugal

    Directory of Open Access Journals (Sweden)

    Andreia Sofia Nabiço Maia

    2016-10-01

    Full Text Available Introduction: students with special educational needs should be inserted in regular classes, receiving all appropriate educational services allowing the development of skills and capabilities. The success of the school inclusion depends on the partnership between the various professionals in the school context. The insertion and occupational therapist’s contribution in the area of education is the subject of many studies. The importance of a professional team in school context is already recognized and valued by the community. Objectives: the aim is to identify the intervention methodologies used by occupational therapists in school with children with special educational needs. In order to determine the most common methodologies as well as relevant aspects of the therapeutic process. Method: this is a non-experimental research with descriptive and cross-sectional basis. A semi-structured questionnaire was prepared initially, quantitative in nature that was taught to occupational therapists that work or have worked for less than 3 years in school context. Results: the sample is composed of 40 occupational therapists, 37 are female and 3 are male. The majority of individuals (77.5% currently works in school context. The occupational therapists involved mainly with children, aged between 6 and 18 years. Conclusion: the methodologies used by the occupational therapists are playful activity/play therapy and the training activities of daily living. Riding for therapeutic purposes and the hippotherapy represent less widely used methodologies in school context, in that each was selected by 10% of therapists.

  7. Implementing the work disability prevention paradigm among therapists in Hong Kong: facilitators and barriers.

    Science.gov (United States)

    Szeto, Grace P Y; Cheng, Andy S K; Lee, Edwin W C; Schonstein, Eva; Gross, Douglas P

    2011-03-01

    This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.

  8. Occupational therapists' perceptions about the clinical utility of the 3D interior design software.

    Science.gov (United States)

    Atwa, Anita; Money, Arthur G; Spiliotopoulou, Georgia; Mcintyre, Anne

    2013-07-01

    The 3D interior design software (3DIDS) is a technology, which primarily allows users to simulate their homes and visualize any changes prior to implementing them. This feasibility study aimed to examine occupational therapists' perceptions about the clinical utility of the 3DIDS. A secondary aim was to explore the attitudes of occupational therapists towards technology in general. Three focus groups were conducted with 25 occupational therapists working with older people in the UK. The qualitative data were analysed using inductive thematic analysis. The three main themes that were identified were usage and attitudes of technology, opportunities for realistic application of the 3DIDS and related threats and benefits for the occupational therapy profession. Occupational therapists had a positive attitude towards technology. They suggested that the 3DIDS could be used in discharge planning and in rehabilitation. They viewed it as a tool that could enhance their status within the health care profession and improve communication, but not as a tool that should replace the role of the occupational therapist. This research offers new and important findings about the utilization of the 3DIDS by occupational therapists and provides information as to where this technology should be trialled.

  9. Occupational therapists' job satisfaction in a changing hospital organisation--a time-geography-based study.

    Science.gov (United States)

    Bendixen, Hans Jørgen; Ellegård, Kajsa

    2014-01-01

    To investigate occupational therapists' job satisfaction under a changing regime by using a time-geographic approach focusing on the therapists' everyday working lives. Nine occupational therapists at the Copenhagen University Hospital, Gentofte, Denmark. A mixed-method design was employed. Occupational therapists kept time-geographic diaries, and the results from them were grounded for individual, semi-structured in-depth interviews. Individual reflections on everyday working life were recorded. Transcribed statements from the interviews were analysed to determine factors influencing job satisfaction. The nine therapists kept diaries for one day a month for a total of 70 preselected days over a period of nine months; six participated in individual interviews. Four factors constraining OT job satisfaction were revealed. Economic concerns, new professional paradigms and methods in combination with a new organisational structure for the occupational therapy service caused uncertainty. In addition, decreasing possibilities for supervision by colleagues influenced job satisfaction. Opportunities for experiencing autonomy in everyday working life were described as facilitators for job satisfaction. The time-geographic and interview methods were useful in focusing on the job satisfaction of occupational therapists, who provided individual interpretations of the balance between autonomy and three types of constraints in everyday working life. The constraints related to organisation, power relations and - not least - how the organisational project of the department fitted in with OTs' individual projects. Matching of organisational and individual projects is of crucial importance, not only for OTs but for most workplaces where individuals are employed to serve patients in the healthcare sector.

  10. Therapist effects on dropout from a college counseling center practice research network.

    Science.gov (United States)

    Xiao, Henry; Castonguay, Louis G; Janis, Rebecca A; Youn, Soo Jeong; Hayes, Jeffrey A; Locke, Benjamin D

    2017-07-01

    Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent findings regarding therapist effects on dropout. The final model resulted in a dropout rate of 15.9% and a therapist effect of 9.51% on dropout variance. Therapist demographic variables were investigated, though none were found to be significant. Variables found to be predictive of increased likelihood of dropping out included higher levels of general presenting concerns, alcohol-related distress, and current financial stress. Ultimately, this study showed that therapists may play an important role in the likelihood of client dropout, and that additional research should be conducted to identify additional predictors, particularly at the therapist and center level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Songs composed for use in music therapy: a survey of original songwriting practices of music therapists.

    Science.gov (United States)

    Jones, Jennifer D

    2006-01-01

    While researchers have documented the efficacy of clinical songwriting in music therapy, limited research has been conducted on songs composed by music therapists that address clinical goals. The purpose of this research was to examine the original songwriting practices of music therapists. Professional music therapists (N = 1,364) received a 14-question survey via email asking each to identify client populations and clinical goals addressed by original songs, their length of time in clinical practice, and specifics about their acquisition of songwriting skills. The data collected from 302 completed surveys revealed that respondents who used original songs were most likely to work with children and adolescents in schools or the developmental disability field and wrote songs in order to individualize treatment. Music therapists working with persons over 65 years of age in long term care or assisted living programs were the least likely to use original songs in clinical practice, opting for interventions utilizing the client's familiar music. Most music therapists found songwriting generally easy, but only 37% indicated that they acquired this skill during their undergraduate degree. Additional research on the clinical efficacy of original songs and therapist's compositional processes is needed to identify best practices models for strategic songwriting.

  12. Singing and Vocal Interventions in Palliative and Cancer Care: Music Therapists' Perceptions of Usage.

    Science.gov (United States)

    Clements-Cortés, Amy

    2017-11-01

    Music therapists in palliative and cancer care settings often use singing and vocal interventions. Although benefits for these interventions are emerging, more information is needed on what type of singing interventions are being used by credentialed music therapists, and what goal areas are being addressed. To assess music therapists' perceptions on how they use singing and vocal interventions in palliative and cancer care environments. Eighty credentialed music therapists from Canada and the United States participated in this two-part convergent mixed-methods study that began with an online survey, followed by individual interviews with 50% (n = 40) of the survey participants. In both palliative and cancer care, singing client-preferred music and singing for relaxation were the most frequently used interventions. In palliative care, the most commonly addressed goals were to increase self-expression, improve mood, and create a feeling of togetherness between individuals receiving palliative care and their family. In cancer care, the most commonly addressed goals were to support breathing, improve mood, and support reminiscence. Seven themes emerged from therapist interviews: containing the space, connection, soothing, identity, freeing the voice within, letting go, and honoring. Music therapists use singing to address the physical, emotional, social, and spiritual goals of patients, and described singing interventions as accessible and effective. Further research is recommended to examine intervention efficacy and identify factors responsible that contribute to clinical benefit. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. Therapists' perspectives on optimal treatment for pathological narcissism.

    Science.gov (United States)

    Kealy, David; Goodman, Geoff; Rasmussen, Brian; Weideman, Rene; Ogrodniczuk, John S

    2017-01-01

    This study used Q methodology to explore clinicians' perspectives regarding optimal psychotherapy process in the treatment of pathological narcissism, a syndrome of impaired self-regulation. Participants were 34 psychotherapists of various disciplines and theoretical orientations who reviewed 3 clinical vignettes portraying hypothetical cases of grandiose narcissism, vulnerable narcissism, and panic disorder without pathological narcissism. Participants then used the Psychotherapy Process Q set, a 100-item Q-sort instrument, to indicate their views regarding optimal therapy process for each hypothetical case. By-person principal components analysis with varimax rotation was conducted on all 102 Q-sorts, revealing 4 components representing clinicians' perspectives on ideal therapy processes for narcissistic and non-narcissistic patients. These perspectives were then analyzed regarding their relationship to established therapy models. The first component represented an introspective, relationally oriented therapy process and was strongly correlated with established psychodynamic treatments. The second component, most frequently endorsed for the panic disorder vignette, consisted of a cognitive and alliance-building approach that correlated strongly with expert-rated cognitive-behavioral therapy. The third and fourth components involved therapy processes focused on the challenging interpersonal behaviors associated with narcissistic vulnerability and grandiosity, respectively. The perspectives on therapy processes that emerged in this study reflect different points of emphasis in the treatment of pathological narcissism, and may serve as prototypes of therapist-generated approaches to patients suffering from this issue. The findings suggest several areas for further empirical inquiry regarding psychotherapy with this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Occupational therapy practice in emergency care: Occupational therapists' perspectives.

    Science.gov (United States)

    Spang, Lisa; Holmqvist, Kajsa

    2015-01-01

    Emergency care takes place in a complex work environment that is characterized by critically ill patients, short hospital stays, and a wide variety of different healthcare professionals. Studies of occupational therapists' (OTs) experiences of working within emergency care have shown that they often experience difficulties in explaining the essence of occupational therapy and have to justify their approaches. Much effort has been made in Sweden to help OTs dispel the notion that occupational therapy is difficult to explain, and the aim of this study was to describe how Swedish OTs perceive their work in emergency care. A qualitative descriptive approach was taken, and 14 interviews were conducted with OTs working in emergency care. Qualitative content analysis was used to analyse the data. The overall theme that emerged was "Feeling established through deliberate occupation-based work". The underlying categories showed different strategies used by the OTs to provide occupational therapy in an emergency care context. Deliberate strategies were used to demonstrate the effectiveness of occupational therapy and its approaches to patients and other health care professionals, and this resulted in the OTs feeling both established and needed. Unlike the OTs in previous studies, the Swedish OTs experienced no difficulties in explaining occupational therapy and could make convincing arguments for their interventions. Parallel to their clinical work, the OTs worked with on-going development to find ways to improve their approaches. In summary, these Swedish OTs seem to have been provided with a professional language and the knowledge required to establish themselves in an emergency care setting.

  15. Models of practice organisation using dental therapists: English case studies.

    Science.gov (United States)

    Sun, N; Harris, R V

    2011-08-12

    A new dental remuneration system based on bands of activity has changed the reward system operating in dental practices and influenced practitioner behaviour in relation to the delegation of tasks to English dental therapists (DTs). Since dental practitioners operate as independent contractors they are free to innovate. A variety of models incorporating DTs in general practice teams exist, some of which may overcome the apparent delegation constraints embedded within this system of remuneration. To describe the way different practices are organised to take account of DTs in their teams and identify whether any of these models address delegation disincentives arising from the system of remuneration. A purposive sample of six dental practices was identified, comprising two small, two medium and two large dental practices, including a variety of models of practice organisation. Semi-structured interviews were carried out with principal dentists, associate dentists, DTs, practice managers and dental hygienists (35 participants in total). A thematic analysis was applied to interview transcripts. The six dental practices demonstrated six different models of practice organisation which could be grouped into 'practice payment' and 'dentist payment' models according to whether the salary costs of the DT were met by a central practice fund or from the income of individual dentists in the team. In both of the large practices only some of the dentists in the team referred work to the DT because of reimbursement issues. In two practices the system was perceived to be satisfactory to all parties, one of these being a single-handed practice with two DTs. Although the remuneration system contained some potential disincentives to DT delegation, some practices innovated in their organisations to overcome these issues.

  16. Interpersonal Factors Are Associated with Lower Therapist Adherence in Cognitive-Behavioural Therapy for Panic Disorder.

    Science.gov (United States)

    Zickgraf, Hana F; Chambless, Dianne L; McCarthy, Kevin S; Gallop, Robert; Sharpless, Brian A; Milrod, Barbara L; Barber, Jacques P

    2016-05-01

    The contributions of disorder severity, comorbidity and interpersonal variables to therapists' adherence to a cognitive-behavioural treatment (CBT) manual were tested. Thirty-eight patients received panic control therapy (PCT) for panic disorder. Trained observers watching videotapes of the sixth session of a 24-session protocol rated therapists' adherence to PCT and their use of interventions from outside the CBT model. Different observers rated patients' behavioural resistance to therapy in the same session using the client resistance code. Interview measures obtained before treatment included the Panic Disorder Severity Scale, the anxiety disorders interview schedule for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and the structured clinical interview for DSM-IV, Axis II. Questionnaire measures were the anxiety sensitivity index at intake, and, at session 2, the therapist and client versions of the working alliance inventory-short form. The higher the patients' resistance and the more Axis II traits a patient had, the less adherent the therapist. Moreover, the more resistant the client, the more therapists resorted to interventions from outside the CBT model. Stronger therapist and patient alliance was also generally related to better adherence, but these results were somewhat inconsistent across therapists. Pretreatment disorder severity and comorbidity were not related to adherence. Interpersonal variables, particularly behavioural resistance to therapy, are related to therapists' ability to adhere to a treatment manual and to their use of interventions from outside of the CBT model. Copyright © 2015 John Wiley & Sons, Ltd. Patients' behavioural resistance to therapy may make it more difficult for cognitive-behavioural clinicians to adhere to a structured treatment protocol and more likely for them to borrow interventions from outside the CBT model. Patients' Axis II traits may make adherence to treatment CBT protocol more difficult

  17. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

    Science.gov (United States)

    Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

    2012-01-01

    The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to

  18. Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals.

    Science.gov (United States)

    Gyer, Giles; Michael, Jimmy; Inklebarger, James

    2018-03-01

    Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

  19. Effectiveness of Home-Based Exercises Without Supervision by Physical Therapists for Patients With Early-Stage Amyotrophic Lateral Sclerosis: A Pilot Study.

    Science.gov (United States)

    Kitano, Kosuke; Asakawa, Takashi; Kamide, Naoto; Yorimoto, Keisuke; Yoneda, Masaki; Kikuchi, Yutaka; Sawada, Makoto; Komori, Tetsuo

    2018-03-31

    To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). A historical controlled study that is part of a multicenter collaborative study. Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Patients (N=21) with ALS were enrolled and designated as the home-based exercise (Home-EX) group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features. The Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months. The primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, with a higher score indicating better function. In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively). Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Learning management by self-employed occupational therapists in private practice.

    Science.gov (United States)

    Millsteed, Jeannine; Redmond, Janice; Walker, Elizabeth

    2017-04-01

    This study explored how occupational therapists in private practice developed the business skills needed to operate a successful private practice. The literature shows that many small-business owner-managers have poorly developed business skills, and some experience high rates of failure. This indicates that to be successful in private practice, occupational therapists need to gain mastery of management competencies in addition to their professional clinical competencies. A qualitative study, using in-depth interviews, collected data from twenty-six self-employed occupational therapists on their experiences of becoming a small-business owner-manager. A narrative analysis built an understanding about how these therapists developed their business competencies. Analysis revealed the factors affecting the development of business competencies were interactions between the initial motivations for start-up, growth aspirations and engagement with external business environments. Business competencies developed through a combination of formal learning prior to starting their businesses, and informal learning once their businesses were in operation. Lower level learning occurred in the routine and operational processes, with higher level learning through discontinuous events resulting in a transformation in the therapists' understanding about themselves as business owner-managers. Findings led to a proposition that occupational therapists make the transition to becoming successful small-business owner-manager through management learning that includes elements of self-reflection, identifying environmental opportunities and risks, developing capabilities, and strategic planning for growth and development. It provides insights on what occupational therapists need to consider to become successful small-business owner-managers. © 2016 Occupational Therapy Australia.

  1. Factors associated with physical therapists' implementation of physical activity interventions in The Netherlands.

    Science.gov (United States)

    Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R

    2015-04-01

    Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to

  2. The role of physical therapists in the context of family health support centers

    Directory of Open Access Journals (Sweden)

    Cássia Cristina Braghini

    Full Text Available Abstract Introduction: Since 2008, with the establishment of Family Health Support Centers (NASF, physiotherapists have been listed among professionals to be included in the team. Physical therapists have many assignments in the NASF, which are conducted through group sessions, in the households, with complementary and integrative practices, lectures and referrals to reference services. Objective: To analyze role and obstacles to the realization of the work of the physiotherapists in NASF. Methods: This is a qualitative research, guided by the case study method. The population was composed by eight physiotherapists active in NASF. Participant observation and semi-structured interviews with physiotherapists were used for data collection. Results: The actions performed by physiotherapists consist of group assistance, home visits, ear therapy and oxygen therapy and activities of health education and disease prevention. As for the barriers, these included lack of training to work at NASF; structural and organizational impediments; insufficient workload and fragility of professional training to work with public health. Conclusion: The role of physiotherapists is in line, in part, with the guidelines recommended by NASF, but principles as matrix support and collective pacts need to be strengthened.

  3. Physical therapist management of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Van Alstyne, Linda S; Harrington, Kendra L; Haskvitz, Esther M

    2010-12-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) negatively affects quality of life and sexual function in men of all ages. Typical treatment with antibiotic and antimicrobial drugs often is not successful. The purpose of this case report is to describe a multimodal physical therapy intervention that included manual therapy techniques applied to the pelvic floor in 2 patients who were unsuccessfully treated with the biomedical model of prescription drug therapies. Two men, aged 45 years and 53 years and diagnosed with chronic prostatitis, were referred for physical therapy following unsuccessful pharmacological treatment. The patients were treated with manual therapy techniques applied to the pelvic floor and instructed in progressive muscle relaxation, flexibility exercises, and aerobic exercises. Changes in the patients' National Institutes of Health Chronic Prostatitis Symptom Index revealed differences between preintervention and postintervention scores reflecting decreased pain and improved quality of life. One patient improved from a score of 25 (total possible score = 43) before treatment to a score of 0 after treatment, and the other patient improved from a score of 29 to a score of 21. Manual therapy techniques applied to the pelvic floor and performed by a physical therapist specially trained in these techniques, along with progressive muscle relaxation, flexibility exercises, and aerobic exercises, appeared to be beneficial to both patients in reducing pain and improving sexual function.

  4. Ability of radiation therapists to assess radiation-induced skin toxicity

    International Nuclear Information System (INIS)

    Acharya, Urvi; Cox, Jennifer; Rinks, Marianne; Gaur, Pankaj; Back, Michael

    2013-01-01

    Radiation therapy has seen enhancement of the radiation therapist (RT) role, with RTs and nurses performing duties that were traditionally in the radiation oncologist's (RO) domain. This study aimed to assess whether RTs can consistently grade radiation-induced skin toxicity and their concordance with the gradings given by ROs. Digital photographs of skin reactions were taken at weeks 1, 3 and 6 of radiotherapy on nine patients with breast cancer. The randomly ordered photographs were reviewed once by eight ROs and four RO registrars and on two occasions separated by 6 weeks by 17 RTs. All graded the skin toxicities using the revised Radiation Therapy Oncology Group system. No significant difference was seen between the median scores of the RTs at the first scoring session and the RO/Registrar group. The RTs at both measurement times showed greater inter-rater reliability than the RO/Registrars (W=0.6866, time 1 and 0.6981 time 2, vs. 0.6517), with the experienced RTs the most consistent (W=0.7078). The RTs also showed high intra-rater reliability (rho=0.8461, P<0.0010). These results from RTs with no specific preparation indicate that experienced RTs could assess breast cancer skin toxicity as part of their role.

  5. A Novel and Cost-Effective Method for Evaluating Cardiopulmonary Auscultation Skills in Student Physical Therapists.

    Science.gov (United States)

    Sword, David O; Thomas, K Jackson; Wise, Holly H; Brown, Deborah D

    2017-01-01

    Sophisticated high-fidelity human simulation (HFHS) manikins allow for practice of both evaluation and treatment techniques in a controlled environment in which real patients are not put at risk. However, due to high demand, access to HFHS by students has been very competitive and limited. In the present study, a basic CPR manikin with a speaker implanted in the chest cavity and internet access to a variety of heart and breath sounds was used. Students were evaluated on their ability to locate and identify auscultation sites and heart/breath sounds. A five-point Likert scale survey was administered to gain insight into student perceptions on the use of this simulation method. Our results demonstrated that 95% of students successfully identified the heart and breath sounds. Furthermore, survey results indicated that 75% of students agreed or strongly agreed that this manner of evaluation was an effective way to assess their auscultation skills. Based on performance and perception, we conclude that a simulation method as described in this paper is a viable and cost-effective means of evaluating auscultation competency in not only student physical therapists but across other health professions as well.

  6. Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): a randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists

    NARCIS (Netherlands)

    Rutten, Juliette M. T. M.; Vlieger, Arine M.; Frankenhuis, Carla; George, Elvira K.; Groeneweg, Michael; Norbruis, Obbe F.; Tjon A ten, Walther; van Wering, Herbert; Dijkgraaf, Marcel G. W.; Merkus, Maruschka P.; Benninga, Marc A.

    2014-01-01

    Irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)) are common pediatric disorders, characterized by chronic or recurrent abdominal pain. Treatment is challenging, especially in children with persisting symptoms. Gut-directed hypnotherapy (HT) performed by a therapist

  7. Commentary on Dinger et al.: Therapist's attachment, interpersonal problems and alliance development over time in inpatient psychotherapy.

    Science.gov (United States)

    Holmes, Jeremy

    2009-09-01

    This short article is a commentary on a research study investigating therapist and client attachment styles and their relationship to alliance development in a 12-week psychodynamic psychotherapy program for nonpsychotic inpatients. The relationship is complex; unsurprisingly, securely attached therapists with less distressed clients formed the strongest alliances. A significant proportion of therapists were insecure, almost entirely in the preoccupied or hyperactivating mode. It is argued that collusive relationships between such therapists and similarly overaroused clients may be common. Therapists need both to accommodate to their client's attachment style and to confound it if positive change is to result. Therapist self-scrutiny is likely to be a precondition for such positive outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  8. Communication skills training for radiation therapists: preparing patients for radiation therapy.

    Science.gov (United States)

    Halkett, Georgia; O'Connor, Moira; Aranda, Sanchia; Jefford, Michael; Merchant, Susan; York, Debra; Miller, Lisa; Schofield, Penelope

    2016-12-01

    Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing

  9. Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective

    OpenAIRE

    Beidas, Rinad S.; Kendall, Philip C.

    2010-01-01

    Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowled...

  10. A qualitative study of barriers to the implementation of a rheumatoid arthritis guideline among generalist and specialist physical therapists.

    Science.gov (United States)

    van Bodegom-Vos, Leti; Verhoef, John; Dickmann, Margot; Kleijn, Marjon; van Vliet, Ingrid; Hurkmans, Emalie; van der Wees, Philip; Vliet Vlieland, Thea

    2012-10-01

    Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied. Objectives The objective of this study was to identify the similarities and differences in barriers to the implementation of a Dutch rheumatoid arthritis (RA) guideline by generalist and specialist physical therapists. Design This observational study consisted of 4 focus group interviews in which 24 physical therapists (13 generalist and 11 specialist physical therapists) participated. Physical therapists were asked to discuss barriers to the implementation of the RA guideline. Data were analyzed qualitatively using a directed approach to content analysis. Both the interviews and the interview analysis were informed by a previously developed conceptual framework. Besides a number of similarities (eg, lack of time), the present study showed important, although subtle, differences in barriers to the implementation of the RA guideline between generalist physical therapists and specialist physical therapists. Generalist physical therapists more frequently reported difficulties in interpreting the guideline (cognitive barriers) and had less favorable opinions about the guideline (affective barriers) than specialist physical therapists. Specialist physical therapists were hampered by external barriers that are outside the scope of generalist physical therapists, such as a lack of agreement about the roles and responsibilities of medical professionals involved in the care of the same patient. The identified differences in barriers to the implementation of the RA guideline indicated that the effectiveness of implementation strategies could be improved by tailoring them to the level of specialization of physical therapists. However, it is expected that tailoring implementation strategies to barriers that hamper both generalist

  11. Non-therapist identification of falling hazards in older adult homes using digital photography

    Directory of Open Access Journals (Sweden)

    Katherine C. Ritchey

    2015-01-01

    Full Text Available Evaluation and removal of home hazards is an invaluable method for preventing in-home falls and preserving independent living. Current processes for conducting home hazard assessments are impractical from a whole population standpoint given the substantial resources required for implementation. Digital photography offers an opportunity to remotely evaluate an environment for falling hazards. However, reliability of this method has only been tested under the direction of skilled therapists. Ten community dwelling adults over the age of 65 were recruited from local primary care practices between July, 2009 and February, 2010. In-home (IH assessments were completed immediately after a photographer, blinded to the assessment form, took digital photographs (DP of the participant home. A different non-therapist assessor then reviewed the photographs and completed a second assessment of the home. Kappa statistic was used to analyze the reliability between the two independent assessments. Home assessments completed by a non-therapist using digital photographs had a substantial agreement (Kappa = 0.61, p < 0.001 with in-home assessments completed by another non-therapist. Additionally, the DP assessments agreed with the IH assessments on the presence or absence of items 96.8% of the time. This study showed that non-therapists can reliably conduct home hazard evaluations using digital photographs.

  12. Physical therapists' perceptions of sexual boundaries in clinical practice in the United States.

    Science.gov (United States)

    Roush, Susan E; Cox, Kenneth; Garlick, John; Kane, Molly; Marchand, Lauren

    2015-07-01

    Physical therapists' perceptions of sexual boundaries in clinic settings in the United States have not been studied. Given the magnitude of potential consequences of sexual boundary violations, examination of this topic is imperative. The purpose of this study was to describe the perceptions of sexual boundaries among licensed physical therapists in the United States. Licensed physical therapists from Arkansas, Kansas, Maine, Ohio, and Oregon were contacted by email and asked to complete a sexual boundaries questionnaire via Survey Monkey™; 967 surveys (7.3%) were returned. While most physical therapists practice within the profession's Code of Ethics, there are practitioners who date current and former patients, and condone patients' sexual banter in the clinic. Almost half (42%) of the participants acknowledged feeling sexually attracted to a patient. While gender differences were seen throughout the analyses, generally, the demographic and professional variables did not account for meaningful variance. Results were similar to previous research on physiotherapists in other countries. Sexuality is part of the physical therapy practice environment and physical therapists' understanding of sexual boundaries is ambiguous. These data can inform professional conversation on sexual boundaries in physical therapy practice leading to greater understanding and decreased potential for violations.

  13. The knowledge of family health team on the action of physical therapist in primary care

    Directory of Open Access Journals (Sweden)

    Greicimar de Oliveira

    2011-12-01

    Full Text Available Objective: To evaluate the knowledge of health team from Basic Health Units in the city of Coari-AM, Brazil, on the action of physical therapist in primary care. Methods: A quantitative,exploratory and descriptive study, like a field survey conducted in 11 primary care units in Coari, Amazonas state. The data were collected through a questionnaire comprising closed questions regarding the action of physical therapist in primary care. 76 professionals joinedin the survey by category: (05 physicians, (10 nurses, (08 nursing technicians and (53 community health workers. Results: 61.64% (n = 45 of the professionals working in the family health team reported knowing the action of physical therapist in primary care; 79.45%(n = 58 referred it in secondary level and 69.86% (n = 51 at the tertiary level of health care. Conclusion: This work showed some knowledge of professionals on the professional action of physical therapists in primary care; however, the knowledge for this level presents itself disadvantaged in relation to other levels of health care. We demonstrated that a share of professionals presented difficulties to consider the possibility of physiotherapeuticintervention in diseases mostly worked in primary care, but the reference to the viability of action of physical therapist for different publics was satisfactory. This conclusion does notexhaust the possibility of discussing the proposed theme.

  14. Exploring the therapist's use of self: enactments, improvisation and affect in psychodynamic psychotherapy.

    Science.gov (United States)

    Pagano, Christopher J

    2012-01-01

    Psychoanalytic psychotherapists, drawing upon intersubjective and attachment theories, recognize that mutual influence impacts the treatment process. Mutual influence generates enactments--emotionally intense joint creations stemming from the unconscious of both therapist and patient--which often leave both patient and therapist feeling confused and stuck. The author presents a case in which the therapist's use of improvisational role play was a critical therapeutic response to an enactment. The therapist's self-expression through the displacement of the role play 1) modeled a safe, affectively genuine engagement in relationship, 2) provided the patient with an unexpected and powerful window into the therapist's emotional world, 3) shifted the patient's fundamental belief that fathers and men are cold and unfeeling, and 4) led the patient to uncover "new" early memories and to become aware of his role as an agent of vitality and intimacy. The author concludes that using improvisation as a flexible response to rigid patterns of enactment may provide a catalyst for therapeutic change.

  15. The working practices and career satisfaction of dental therapists in New Zealand.

    Science.gov (United States)

    Ayers, K M S; Meldrum, A; Thomson, W M; Newton, J T

    2007-12-01

    To describe the working practices and level of career satisfaction of dental therapists in New Zealand. Postal survey of dental therapists identified from the New Zealand Dental Council's dental therapy database. One mailing with one follow-up. Questionnaires were sent to 683 registered dental therapists. Replies were received from 566 (82.9%). Current working practice, career breaks, continuing education, career satisfaction. Respondents had a high career satisfaction, but were much less satisfied with their remuneration. After controlling for age and income satisfaction, therapists who felt that they were valued members of the dental community had over four times the odds of having higher overall job satisfaction. There were no differences in the mean career satisfaction scale score by age, but respondents aged 45 and over had a lower mean income satisfaction scale score than their younger counterparts (pmanagement/coordination (ppractice than their older colleagues (pproductivity of this workforce. Remuneration and career progression are key issues; therapists need to feel that they are valued members of the dental profession.

  16. Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists

    Directory of Open Access Journals (Sweden)

    Alexandra Nugent

    2017-01-01

    Full Text Available Background/Aim. Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists’ experiences of developing and sustaining recovery-orientation in mental health practice. Methods. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Results. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists’ workplace environment influenced this process. Conclusions. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

  17. Exploring arising moments and mindfulness in occupational therapists working in diverse clinical practice areas.

    Science.gov (United States)

    Reid, Denise; Naseer, Zahid

    2012-10-01

    An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

  18. The relative importance of relational and scientific characteristics of psychotherapy: Perceptions of community members vs. therapists.

    Science.gov (United States)

    Farrell, Nicholas R; Deacon, Brett J

    2016-03-01

    Although client preferences are an integral component of evidence-based practice in psychology (American Psychological Association, 2006), relatively little research has examined what potential mental health consumers value in the psychotherapy they may receive. The present study was conducted to examine community members' preferences for the scientific and relational aspects of psychotherapy for different types of presenting problems, and how accurately therapists perceive these preferences. Community members (n = 200) were surveyed about the importance of scientific (e.g., demonstrated efficacy in clinical trials) and relational (e.g., therapist empathy) characteristics of psychotherapy both for anxiety disorders (e.g., obsessive-compulsive disorder) and disorder-nonspecific issues (e.g., relationship difficulties). Therapists (n = 199) completed the same survey and responded how they expected the average mental health consumer would. Results showed that although community members valued relational characteristics significantly more than scientific characteristics, the gap between these two was large for disorder-nonspecific issues (d = 1.24) but small for anxiety disorders (d = .27). Community members rated scientific credibility as important across problem types. Therapists significantly underestimated the importance of scientific characteristics to community members, particularly in the treatment of disorder-nonspecific issues (d = .74). Therapists who valued research less in their own practice were more likely to underestimate the importance of scientific credibility to community members. The implications of the present findings for understanding the nature of client preferences in evidence-based psychological practice are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Which Individual Therapist Behaviors Elicit Client Change Talk and Sustain Talk in Motivational Interviewing?

    Science.gov (United States)

    Apodaca, Timothy R; Jackson, Kristina M; Borsari, Brian; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

    2016-02-01

    To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (pmotivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. National Study of Excellence and Innovation in Physical Therapist Education: Part 2-A Call to Reform.

    Science.gov (United States)

    Jensen, Gail M; Hack, Laurita M; Nordstrom, Terrence; Gwyer, Janet; Mostrom, Elizabeth

    2017-09-01

    This perspective shares recommendations that draw from (1) the National Study of Excellence and Innovation in Physical Therapist Education research findings and a conceptual model of excellence in physical therapist education, (2) the Carnegie Foundation's Preparation for the Professions Program (PPP), and (3) research in the learning sciences. The 30 recommendations are linked to the dimensions described in the conceptual model for excellence in physical therapist education: Culture of Excellence, Praxis of Learning, and Organizational Structures and Resources. This perspective proposes a transformative call for reform framed across 3 core categories: (1) creating a culture of excellence, leadership, and partnership, (2) advancing the learning sciences and understanding and enacting the social contract, and (3) implementing organizational imperatives. Similar to the Carnegie studies, this perspective identifies action items (9) that should be initiated immediately in a strategic and systematic way by the major organizational stakeholders in physical therapist education. These recommendations and action items provide a transformative agenda for physical therapist education, and thus the profession, in meeting the changing needs of society through higher levels of excellence. © 2017 American Physical Therapy Association.

  1. Experienced Practitioners' Beliefs Utilized to Create a Successful Massage Therapist Conceptual Model: a Qualitative Investigation.

    Science.gov (United States)

    Kennedy, Anne B; Munk, Niki

    2017-06-01

    The massage therapy profession in the United States has grown exponentially, with 35% of the profession's practitioners in practice for three years or less. Investigating personal and social factors with regard to the massage therapy profession could help to identify constructs needed to be successful in the field. This data-gathering exercise explores massage therapists' perceptions on what makes a successful massage therapist that will provide guidance for future research. Success is defined as supporting oneself and practice solely through massage therapy and related, revenue-generating field activity. Ten successful massage therapy practitioners from around the United States who have a minimum of five years of experience. Semistructured qualitative interviews were used in an analytic induction framework; index cards with preidentified concepts printed on them were utilized to enhance conversation. An iterative process of interview coding and analysis was used to determine themes and subthemes. Based on the participants input, the categories in which therapists needed to be successful were organized into four main themes: effectively establish therapeutic relationships, develop massage therapy business acumen, seek valuable learning environments and opportunities, and cultivate strong social ties and networks. The four themes operate within specific contexts (e.g., regulation and licensing requirements in the therapists' state), which may also influence the success of the massage therapist. The model needs to be tested to explore which constructs explain variability in success and attrition rate. Limitations and future research implications are discussed.

  2. Relating Therapist Characteristics to Client Engagement and the Therapeutic Alliance in an Adolescent Custodial Group Substance Misuse Treatment Program.

    Science.gov (United States)

    Daniels, Rachael Anne; Holdsworth, Emma; Tramontano, Carlo

    2017-07-29

    Client engagement in substance misuse treatment programs is directly associated with positive treatment outcomes. The nature of these programs means there are often difficulties engaging and retaining clients, but authors have consistently found a strong therapeutic alliance is associated with client engagement. While research has focused on the association between the alliance and engagement, the factors that influence the therapeutic alliance have received less attention. To examine therapists' characteristics, namely therapists' stress and empathy levels, as potential predictors of client engagement and the therapeutic alliance, within an adolescent substance misuse group treatment program. The sample included 84 adolescent clients and 14 therapists from a Secure Training Centre in England. Client engagement in the treatment program was observed, while self-reporting measures assessed the therapeutic alliance (client and therapist-rated), and therapists' stress and empathy levels. Multiple regression analysis revealed that therapists' stress levels negatively influenced the therapeutic alliance and had a curvilinear relationship with client engagement, indicating that stress is not exclusively negatively related to engagement. Although stress was found to negatively impact both cognitive and affective empathy, neither cognitive nor affective empathy were significantly related to client engagement or the therapeutic alliance. This study demonstrates the importance of therapist characteristics on client engagement and the therapeutic alliance. Within practice stress can have a positive impact on clients' engagement. Nevertheless, therapists may need additional support to deal with stress effectively. Therapists' empathy may too be fundamental to client engagement, but only it if is perceived by clients.

  3. Descriptive analysis of the verbal behavior of a therapist: a known-group validity analysis of the putative behavioral functions involved in clinical interaction.

    Science.gov (United States)

    Virues-Ortega, Javier; Montaño-Fidalgo, Montserrat; Froján-Parga, María Xesús; Calero-Elvira, Ana

    2011-12-01

    This study analyzes the interobserver agreement and hypothesis-based known-group validity of the Therapist's Verbal Behavior Category System (SISC-INTER). The SISC-INTER is a behavioral observation protocol comprised of a set of verbal categories representing putative behavioral functions of the in-session verbal behavior of a therapist (e.g., discriminative, reinforcing, punishing, and motivational operations). The complete therapeutic process of a clinical case of an individual with marital problems was recorded (10 sessions, 8 hours), and data were arranged in a temporal sequence using 10-min periods. Hypotheses based on the expected performance of the putative behavioral functions portrayed by the SISC-INTER codes across prevalent clinical activities (i.e., assessing, explaining, Socratic method, providing clinical guidance) were tested using autoregressive integrated moving average (ARIMA) models. Known-group validity analyses provided support to all hypotheses. The SISC-INTER may be a useful tool to describe therapist-client interaction in operant terms. The utility of reliable and valid protocols for the descriptive analysis of clinical practice in terms of verbal behavior is discussed. Copyright © 2011. Published by Elsevier Ltd.

  4. Spatial-attention and emotional evocation: line bisection performance and visual art emotional evocation.

    Science.gov (United States)

    Drago, Valeria; Finney, Glen R; Foster, Paul S; Amengual, Alejandra; Jeong, Yong; Mizuno, Tomoiuki; Crucian, Gregory P; Heilman, Kenneth M

    2008-03-01

    Lesion studies demonstrate that the right temporal-parietal region (RTP) is important for mediating spatial attention. The RTP is also involved in emotional experiences that can be evoked by art. Normal people vary in their ability to allocate spatial attention, thus, people who can better allocate attention might also be more influenced by the emotional messages of the paintings (evocative impact). Seventeen healthy participants bisected an unlabeled 100mm line and their performance on this task was used to create two groups, individuals who were more (mALB) and less accurate (lALB). These participants also judged 10 paintings on five qualities, Evocative Impact, Aesthetics, Novelty, Technique, and Closure by marking a 100mm line from 1 (low degree) to 10 (high degree). An ANOVA indicated differences in accuracy on the line bisection (LB) between the two groups. Additional ANOVAs, using the quality ratings as the dependent measure, revealed that the mALB group scored the Evocative Impact greater than the lALB group. These results suggest that the differences in attentional bias between the two groups, as indicated by their LB performance, might influence their evocative impact or reactions and also be a 'barometer' of other RTP functions, including emotional processing.

  5. Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

    Science.gov (United States)

    Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

    2018-01-01

    The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

  6. Respiratory therapists and critical-thinking behaviors: a self-assessment.

    Science.gov (United States)

    Goodfellow, L T

    2001-01-01

    The purpose of this study was to assess critical-thinking behaviors of respiratory therapists through self-report. Using a quantitative survey research method, respiratory therapists rated themselves on seven critical thinking skills. The effects of personal variables on the self-assessments were also investigated. The respiratory therapists self-assessed their critical-thinking behaviors highest in the categories of prioritizing, troubleshooting, and communicating. Anticipating was self-assessed as the lowest-ranked critical-thinking behavior. Age and educational level were found to have no effect on the self-assessed behaviors, while years of experience in respiratory care and gender were found to affect self-assessed troubleshooting, decision making, and anticipating. The results of this study suggest that educators and clinicians should consider learning strategies that incorporate the use of experience when targeting novice practitioners.

  7. Transitioning From Occupational Therapy Student To Practicing Occupational Therapist: First Year of Employment.

    Science.gov (United States)

    McCombie, Randy P; Antanavage, Meredith E

    2017-04-01

    This research examined the transition from occupational therapy student to practicing occupational therapist over the course of one's first year of professional employment, as recalled by a sample of occupational therapists. Surveys were mailed to 500 occupational therapists randomly selected from membership in the American Occupational Therapy Association resulting in 202 returned surveys. Median year of graduation was 1998, ranging from 1967 to 2014. In general, respondents indicated the transition was positive. Having a mentor was related to high job satisfaction and good clinical fit, while supervising an occupational therapy assistant and low self-confidence were viewed as negative impact factors. Recent graduates presented with lower ratings of a positive transition and higher ratings of likelihood of experiencing burnout and initial job stress than earlier graduates. Recommendations for improving the transition experience are presented.

  8. From Child-Robot Interaction to Child-Robot-Therapist Interaction: A Case Study in Autism

    Directory of Open Access Journals (Sweden)

    I. Giannopulu

    2012-01-01

    Full Text Available Troubles in social communication as well as deficits in the cognitive treatment of emotions are supposed to be a fundamental part of autism. We present a case study based on multimodal interaction between a mobile robot and a child with autism in spontaneous, free game play. This case study tells us that the robot mediates the interaction between the autistic child and therapist once the robot-child interaction has been established. In addition, the child uses the robot as a mediator to express positive emotion playing with the therapist. It is thought that the three-pronged interaction i.e., child-robot-therapist could better facilitate the transfer of social and emotional abilities to real life settings. Robot therapy has a high potential to improve the condition of brain activity in autistic children.

  9. What Did They Learn? Effects of a Brief Cognitive Behavioral Therapy Workshop on Community Therapists' Knowledge.

    Science.gov (United States)

    Scott, Kelli; Klech, David; Lewis, Cara C; Simons, Anne D

    2016-11-01

    Knowledge gain has been identified as necessary but not sufficient for therapist behavior change. Declarative knowledge, or factual knowledge, is thought to serve as a prerequisite for procedural knowledge, the how to knowledge system, and reflective knowledge, the skill refinement system. The study aimed to examine how a 1-day workshop affected therapist cognitive behavioral therapy declarative knowledge. Participating community therapists completed a test before and after training that assessed cognitive behavioral therapy knowledge. Results suggest that the workshop significantly increased declarative knowledge. However, post-training total scores remained moderately low, with several questions answered incorrectly despite content coverage in the workshop. These findings may have important implications for structuring effective cognitive behavioral therapy training efforts and for the successful implementation of cognitive behavioral therapy in community settings.

  10. A Marxist therapist treats a Trump-supporting client: A tale of politics and psychotherapy.

    Science.gov (United States)

    Yourman, David B

    2018-05-01

    When there are politically polarizing events taking place in the world, can it be useful for a therapist to disclose his or her political views within the context of a psychotherapeutic dyad? This paper examines this question through the example of a Marxist therapist working with a politically conservative patient in the polarized political atmosphere following Donald Trump's election to the Presidency of the United States. Also explored are the patient's dynamics that might have made it particularly salient for the therapist to eschew a more neutral stance. The theoretical and technical bases for this disclosure are examined via the Affect Theory of Silvan S. Tomkins as well as the Person-Centered Therapy of Carl Rogers. The family history of the patient is examined to further understand the context in which the political/therapeutic interactions take place. © 2018 Wiley Periodicals, Inc.

  11. Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Borg, Tove; Hounsgaard, Lise

    2012-01-01

    , and six focus-group interviews. RESULTS: New knowledge concerning the substantial influence of professional values in the occupational therapists' local cultures was indicated. It was of importance that the therapists as a group are given the opportunity to explicit and critically appraise values...... and knowledge use in order to develop their practice knowledge and new skills. Moreover personal values and clinical experiences influenced clinical reasoning. Current knowledge of the importance of local cultures and leadership was reinforced. CONCLUSION: The influence of professional values...... in the occupational therapists' local cultures was a substantial factor in the implementation processes. In addition personal values and clinical experiences influenced professional decision-making. Furthermore, the study reinforced current knowledge of the importance of culture and leadership in implementation...

  12. Therapists' perceptions of social media and video game technologies in upper limb rehabilitation.

    Science.gov (United States)

    Tatla, Sandy K; Shirzad, Navid; Lohse, Keith R; Virji-Babul, Naznin; Hoens, Alison M; Holsti, Liisa; Li, Linda C; Miller, Kimberly J; Lam, Melanie Y; Van der Loos, H F Machiel

    2015-03-10

    The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians' perspectives regarding technology adoption by their clients. The objective of our study was to explore therapists' perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation. We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes. Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media. This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies.

  13. Parallel Journeys: How a Music Therapist Can Travel with his Client

    Directory of Open Access Journals (Sweden)

    Henry Dunn

    2009-01-01

    Full Text Available This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the client’s experience was related to my own mental health history. I examine how this affected the way I worked and the way our therapeutic relationship developed. I ask the question of whether it is helpful for the therapist to be personally involved in the therapeutic process and how this can either aid or interfere with the work.Through reference to the work of Carl Jung in particular, I conclude that it is not only helpful, but essential for the therapist to be prepared to be part of the therapeutic process. By examining the nature of the wounded healer archetype and its relevance for the client-therapist relationship, it becomes clear that the therapist cannot help but be personally involved in some way, and that being conscious of this can be a very helpful part of our work. This is especially the case in music therapy, where the therapist usually participates in the co-creation of music, and therefore cannot stand totally outside it. It is this balance of being both outside and inside the process that is crucial to our work.

  14. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients

    Directory of Open Access Journals (Sweden)

    Ekundayo A. Sodeke-Gregson

    2013-12-01

    Full Text Available Background: Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. Objectives: This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253 working with adult trauma clients. Method: An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5 to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Results: Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. Conclusions: UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion

  15. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients.

    Science.gov (United States)

    Sodeke-Gregson, Ekundayo A; Holttum, Sue; Billings, Jo

    2013-01-01

    Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253) working with adult trauma clients. An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5) to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion satisfaction.

  16. Knowledge of congenital cytomegalovirus (cCMV) among physical and occupational therapists in the United States.

    Science.gov (United States)

    Muldoon, Kathleen M; Armstrong-Heimsoth, Amy; Thomas, Jodi

    2017-01-01

    Congenital cytomegalovirus (cCMV) infections cause more children to have permanent disabilities than Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and pediatric HIV/AIDS combined. The risk of infection during pregnancy can be significantly decreased using universal precautions, such as thorough handwashing and cleansing of surfaces and objects that have come into contact with infected body fluids. Children under 3 years of age are commonly asymptomatic excretors of CMV, with the highest viral loads present in saliva. Pediatric therapists have regular close contact with young children, and are thus likely at elevated occupational risk of acquiring CMV. Our objective was to evaluate therapist knowledge of cCMV and its transmission. We recruited American Occupational Therapy Association (AOTA) and American Physical Therapy Association (APTA) members via electronic newsletters and printed flyers from April to September 2015. Participants completed an online, anonymous 24-question survey using Survey Monkey. We compared responses between groups and previously published CMV awareness data using binomial tests of difference of proportions and multiple logistic regression. Our study identified both a low level of therapist awareness and poor demonstrated understanding of cCMV. Self-reported cCMV awareness amongst therapists was greater than awareness in the general population, and equivalent to awareness amongst health care professionals. Whereas 52% of participants self-reported awareness of cCMV, only 18% demonstrated understanding of the behavioral modes of CMV transmission. Fewer therapists reported awareness of cCMV than other, less prevalent conditions. Higher levels of health risk knowledge were associated with greater contact with children. Most participants reported learning about cCMV from the workplace. The knowledge gaps between self-reported awareness of cCMV and demonstrated understanding of modes of transmission described by our results emphasize the

  17. A system of networks and continuing education for physical therapists in rheumatology: a feasibility study

    Directory of Open Access Journals (Sweden)

    J. Verhoef

    2004-07-01

    Full Text Available Purpose: To evaluate the feasibility of regional physical therapy networks including continuing education in rheumatology. The aim of these networks was to improve care provided by primary care physical therapists by improving specific knowledge, technical and communicative skills and the collaboration with rheumatologists. Methods: In two regions in The Netherlands continuing education (CE programmes, consisting of a 5-day postgraduate training course followed by bimonthly workshops and teaching practices, were organised simultaneously. Network activities included consultations, newsletters and the development of a communication guideline. Endpoint measures included the participation rate, compliance, quality of the CE programme, teaching practices, knowledge, network activities, communication, number of patients treated and patient satisfaction. Results: Sixty-three physical therapists out of 193 practices (33% participated in the project. They all completed the education programmes and were formally registered. All evaluations of the education programmes showed positive scores. Knowledge scores increased significantly directly after the training course and at 18 months. A draft guideline on communication between physical therapists and rheumatologists was developed, and 4 newsletters were distributed. A substantial proportion of physical therapists and rheumatologists reported improved communication at 18 months. The mean number of patients treated by physical therapists participating in the networks increased significantly. Patients' satisfaction scores within the networks were significantly higher than those from outside the networks at 18 months. Conclusions: Setting up a system of networks for continuing education for physical therapists regarding the treatment of patients with rheumatic diseases is feasible. Further research will focus on the effectiveness of the system and its implementation on a larger scale.

  18. Erognomic education on housework for women with upper limb repetitive strain injury (RSI): a conceptual representation of therapists' clinical reasoning.

    Science.gov (United States)

    Cheung, Therma W C; Clemson, Lindy; O' Loughlin, Kate; Shuttleworth, Russell

    2017-09-18

    Ergonomic education in housework that aims to facilitate behavior change is important for women with upper limb repetitive strain injury. Therapists usually conduct such programs based on implicit reasoning. Making this reasoning explicit is important in contributing to the profession's knowledge. To construct a conceptual representation of how occupational therapists make clinical decisions for such program. Based on a constructivist-grounded theory methodology, data were collected through in-depth interviewing with 14 occupational therapists from a major hospital in Singapore. Interviews were audiotaped and transcribed. Data was analyzed with line by line, focused and axial coding with constant data comparison throughout data collection. Therapists made clinical decisions based on their perceptions of their clients' behavior change in three stages: (i) listen; (ii) try; and (iii) persevere, bearing significant similarities to the transtheoretical theory of change. The study also showed that therapists may not have considered the full range of meanings that their clients attach to housework when interacting with them, a gap that needs to be addressed. The present study indicates the importance of therapists' understanding of the meanings that their clients attach to housework. Further research needs to address how to achieve this in a time-pressured clinical environment. Implications for Rehabilitation This study used qualitative research to demonstrate the process of translating therapists' tacit knowledge into an explicit form. It elucidates the following major implications for practice when therapists conduct ergonomic education to facilitate behavior change in housework for female homemakers with upper limb RSI:The conceptual framework of clinical reasoning constructed from the results can be used to increase therapists' awareness of how they make clinical decisions during an intervention. This framework can also be used for training new therapists. It is

  19. Therapist adherence is associated with outcome in cognitive–behavioral therapy for bulimia nervosa

    DEFF Research Database (Denmark)

    Folke, Sofie; Daniel, Sarah Ingrid Franksdatter; Gondan, Matthias

    2017-01-01

    Studies of therapist adherence in relation to treatment outcome have produced mixed results. The aim of the present study was to investigate change in therapist adherence to cognitive–behavioral therapy (CBT) for bulimia nervosa over time, and to investigate the relationship between adherence...... and client outcome in early, middle, and late phases of treatment. Thirty-six clients received the focused form of “enhanced” CBT (CBT-E) for bulimia nervosa. Trained observers rated audiotapes of 92 full-length therapy sessions from early (Session 3), middle (Session 11), and late phases (Session 20...

  20. Acceptance of Serious Games in Psychotherapy: An Inquiry into the Stance of Therapists and Patients.

    Science.gov (United States)

    Eichenberg, Christiane; Grabmayer, Gloria; Green, Nikos

    2016-11-01

    Serious games are computer or video games that contain elements that are specifically designed for the purpose of education or training. Serious games are increasingly being used within healthcare, but their introduction into and application in psychotherapeutic settings as an e-mental health treatment modality raises questions for both patients and therapists. Current research demonstrates the potential role and effectiveness of serious games within a psychotherapeutic context. However, a limited understanding of patients' and therapists' existing knowledge and experience of serious games, as well as of their readiness to utilize and apply them for the treatment of psychological conditions, requires further investigation. Acceptance, experience, and requirements for the utilization of serious games in therapeutic contexts were assessed through online surveys with German-speaking patients (n = 260) and psychotherapists (n = 234). Respondents' answers were analyzed by a combination of descriptive and inferential statistics by using SPSS. Current knowledge regarding serious games was very limited, with only 10.4% of patients and 11.5% of therapists reporting existing knowledge. However, a general openness toward the concept was observed: 88% of patients and 90% of therapists could envisage a therapeutic use. Patients (rs = 0.169, p = 0.006) who self-rated their level of computer and video game expertise as high were more likely to consider use within psychotherapy, compared with patients who self-rated their expertise as low. Therapists who currently play computer and video games perceive fewer disadvantages of serious game application in a psychotherapeutic context (p = 0.097). Consideration of serious game use was differentiated by the therapeutic approach (p = 0.003), specific mental disorders (highest rated relevant cases: anxiety disorders, affective disorders, disorders regarding impulse control, and adjustment disorders), and patient

  1. Occupational therapists as dog handlers: the collective experience with animal-assisted therapy in Iraq.

    Science.gov (United States)

    Fike, Lorie; Najera, Cecilia; Dougherty, David

    2012-01-01

    The first pair of US Army animal-assisted therapy (AAT) dogs deployed to Iraq in December 2007 with the 85th Medical Detachment Combat and Operational Stress Control unit. As of this writing, 6 dogs have deployed to Iraq and Afghanistan, offering Soldiers a small reminder of home. Army occupational therapists led the way in this endeavor as primary handlers; the path has been rocky but ultimately rewarding. This article depicts how occupational therapists used AAT and animal-assisted activities to help Soldiers cope with the stressors of living in a deployed environment. Challenges and lessons-learned, including anecdotal examples, are discussed.

  2. A Dental Hygienist's and Therapist's Guide to the Management of Tooth Erosion.

    Science.gov (United States)

    Ariyanayagam, Yana

    2016-08-01

    Dental care professionals can support patients to prevent and manage tooth erosion. The role of the dentist is to restore the structure and function of teeth damaged by acid erosion, while the role of the dental hygienist therapist is to work alongside the dentist to help manage and reduce the risk of tooth erosion. This article will highlight how the dental hygienist or therapist can identify tooth erosion. It will describe the features of tooth erosion and outline the causes. This article will discuss preventative care options for patients who are at risk of tooth erosion, including specific oral hygiene instructions, fluoride advice and use of other dental products.

  3. Handwriting and Common Core State Standards: Teacher, Occupational Therapist, and Administrator Perceptions From New York State Public Schools.

    Science.gov (United States)

    Collette, Debra; Anson, Kylie; Halabi, Nora; Schlierman, April; Suriner, Allison

    Handwriting is the cornerstone of written performance and communication for school-age children. This mixed-methods study explored the impact of Common Core State Standards on handwriting instruction and its effects on perceptions regarding children's written responses in elementary school. Using surveys and interviews of elementary teachers, occupational therapists, and administrators in New York State public schools, we sought to understand current trends in handwriting instruction, changes in time spent on handwriting instruction in the classroom, supports offered to students who did not meet expectations for handwriting, and the impact of Common Core on children's written expression. Themes emerged revealing decreased handwriting instruction time and inconsistent use of handwriting instructional programs in the classroom after implementation of Common Core. Handwriting should be considered as a greater component in the foundational standards in Common Core. Occupational therapy services can support handwriting instruction implementation. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  4. Home discharge of technology-dependent children: evaluation of a respiratory-therapist driven family education program.

    Science.gov (United States)

    Tearl, Donna K; Hertzog, James H

    2007-02-01

    Initial hospital discharge to home of technology-dependent children requires extensive training and education of the family caregivers. Education of adult family members should promote positive interactions in a nonthreatening manner while facilitating the development of the knowledge and skills to competently and independently provide all aspects of the medical care. We utilize a training program for adult family members of children who have undergone tracheostomy to facilitate long-term mechanical ventilatory support and who are being prepared for their initial discharge from the hospital to home. A dedicated respiratory therapist family educator directs this program. Multiple teaching tools, activities, and training sessions, based on adult learning theory, are utilized to develop appropriate clinical skills to manage children with tracheostomies and the associated technological supports. We evaluated the effectiveness of our program by administering a written test to caregivers, at the start and the conclusion of their training. We also surveyed the caregivers about their satisfaction with the educational program and the respiratory therapist family educator's performance. We also surveyed employees of the durable medical equipment companies used by the families, regarding the caregivers' knowledge and competency in the home one month following discharge. Our program was associated with a statistically significant improvement in caregiver test performance, and the caregivers expressed a high degree of satisfaction with the program. The employees of the durable medical equipment companies perceived a high degree of knowledge and competence on the part of the home caregivers. Our training program appears to have a positive impact on the educational preparation of caregivers.

  5. Recovered eating disorder therapists using their experiential knowledge in therapy : A qualitative examination of the therapists’ and the patients’ view

    NARCIS (Netherlands)

    De Vos, Jan Alexander; Netten, Carmen; Noordenbos, Greta

    2016-01-01

    In the eating disorder (ED) field there is a lack of guidelines regarding the utilization of recovered therapists and the experiential knowledge they can bring to therapy. In this study, a qualitative design was used to examine recovered eating disorder therapists using their experiential knowledge

  6. Therapist and Patient Perceptions of Alliance and Progress in Psychological Therapy for Women Diagnosed with Gynecological Cancers

    Science.gov (United States)

    Manne, Sharon L.; Kashy, Deborah A.; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2012-01-01

    Objective: The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also…

  7. Gender-role stereotypes and interpersonal behavior: How addicted patients view their ideal male and female therapist

    NARCIS (Netherlands)

    Jonker, J.; Jong, C.A.J. de; Weert-van Oene, G.H. de; Gijs, L.A.C.L.

    2000-01-01

    This study focuses on the influences of self-perceived interpersonal behavior of addicted inpatients (n = 107) on the stereotypes of their ideal male and female therapist. Based on the interpersonal model of personality patients were asked to describe their ideal male and female therapist.

  8. Long-Term Youth Criminal Outcomes in MST Transport: The Impact of Therapist Adherence and Organizational Climate and Structure

    Science.gov (United States)

    Schoenwald, Sonja K.; Chapman, Jason E.; Sheidow, Ashli J.; Carter, Rickey E.

    2009-01-01

    This study investigated relations among therapist adherence to an evidence-based treatment for youth with serious antisocial behavior (i.e., Multisystemic Therapy), organizational climate and structure, and youth criminal charges on average 4 years posttreatment. Participants were 1,979 youth and families treated by 429 therapists across 45…

  9. Mixed messages? A comparison between the perceptions of radiation therapy patients and radiation therapists regarding patients' educational needs

    International Nuclear Information System (INIS)

    Bolderston, Amanda

    2008-01-01

    Objectives: The purpose of this study was to discover and compare radiation therapy patients' and radiation therapists' perceptions of patients' educational topics of interest and methods of information delivery during a course of radiation therapy. Methods: Using Likert-type 4-point rating scales, 42 therapists and 183 radiation therapy patients were surveyed to rate the degree of importance of 15 informational items (for example, 'What it feels like to have treatment'). In addition, therapists and patients ranked 11 methods of informational delivery (for example, 'Watching video tapes') in order of preference. Results: Results indicated several differences in therapists' and patients' perceptions of both the educational topics of interest and methods of information delivery. Among other things, patients assigned high importance to after treatment issues ('What happens after radiation therapy is finished') and how radiation therapy works, these areas were not seen as important by the studied therapists. Patients expressed a strong preference for receiving information about radiation therapy from their family doctor (ranked third), therapists ranked this source of information as the least important. Conclusion: It is vital to tailor educational interventions according to the patient's preference to optimize both understanding and compliance. This study demonstrated noteworthy differences in several areas between therapists' and patients' perceptions. Recommendations therefore include raising therapist's awareness of topics that are important to patients and meaningful informational delivery methods

  10. A Respiratory Therapist Disease Management Program for Subjects Hospitalized With COPD.

    Science.gov (United States)

    Silver, Patty C; Kollef, Marin H; Clinkscale, Darnetta; Watts, Peggy; Kidder, Robin; Eads, Brittany; Bennett, Debbie; Lora, Carolyn; Quartaro, Michael

    2017-01-01

    Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed. We enrolled 428 subjects (214 intervention, 214 control). The primary outcome (combined non-hospitalized emergency department visits and hospital readmissions for a COPD exacerbation during the 6-month follow-up) was similar for the study groups (91 vs 159, P = .08). When the 2 components of the primary end point were analyzed individually, the percentage of subjects with non-hospitalized emergency department visits for COPD exacerbations was similar between groups (15.0% vs 15.9%, P = .79). Readmission for a COPD exacerbation was significantly lower in the intervention group (20.1% vs 28.5%, P = .042). The median (interquartile range) duration of hospitalization for a COPD exacerbation was less for the intervention group (5 [3-11] d vs 8 [4-18.5] d, P = .045). In-patient hospital days (306 d vs 523 d, P = .02) and ICU days (17 d vs 53 d, P = .02) due to COPD exacerbations were significantly less for the intervention group. Mortality was similar for both groups (1.4% vs 0.9%, P > .99). Our RT disease management program was associated with less readmission, fewer ICU days, and shorter hospital stays due to COPD exacerbations. Further studies are needed to determine the optimal utilization of RT disease management teams for patients with COPD to optimize outcomes and prevent return hospital visits. (ClinicalTrials.gov registration NCT01543217.). Copyright © 2017 by Daedalus Enterprises.

  11. Rehabilitation Practice Patterns Following Anterior Cruciate Ligament Reconstruction: A Survey of Physical Therapists.

    Science.gov (United States)

    Greenberg, Elliot M; Greenberg, Eric T; Albaugh, Jeffrey; Storey, Eileen; Ganley, Theodore J

    2018-05-22

    Study Design Cross-sectional survey. Background Recovery from anterior cruciate ligament reconstruction (ACLR) requires an intensive course of post-operative rehabilitation. Although guidelines outlining evidence-based rehabilitation recommendations have been published, the actual practice patterns of physical therapists are unknown. Objectives To analyze the current landscape of clinical practice as it pertains to rehabilitation progression and the use of time and objective criteria following ACLR. Methods An online survey was distributed to members of the orthopaedics, sports and private practice sections of the American Physical Therapy Association (APTA) between January and March 2017. Results 1074 responses were analyzed. Supervised physical therapy was reported to last ≤5 months by 56% of the sample. The most frequent time frame for activity progression was: 3-4 months (58%) for jogging, 4-5 months (51%) for modified sports activity and 9-12 months (40%) for unrestricted sports participation. Greater than 80% of the sample reported using strength and functional measures during rehabilitation. Of those that assessed strength, 56% used manual muscle testing as their only means of strength testing. Single limb hop testing (89%) was the most frequently reported measure utilized to begin modified sports activity. Performance criteria for strength and functional tests varied significantly across all phases of rehabilitation. Of the 45% that reported utilizing patient reported outcome measures, only a small proportion of those concerned fear or athletic confidence scales (10%). Conclusions Considerable variation exists amongst APTA members with regards to rehabilitation following ACLR. This variability in practice may contribute to suboptimal outcomes and confusion among practitioners and patients. J Orthop Sports Phys Ther, Epub 22 May 2018. doi:10.2519/jospt.2018.8264.

  12. Therapists' thoughts on therapy: clinicians' perceptions of the therapy processes that distinguish schema, cognitive behavioural and psychodynamic approaches.

    Science.gov (United States)

    Boterhoven De Haan, Katrina L; Lee, Christopher W

    2014-01-01

    Debates continue over shared factors in therapy processes between different theoretical orientations. By seeking the opinions of practicing clinicians, this study aimed to elucidate the similarities and differences between cognitive-behavioural (CBT), psychodynamic (PDT), and schema therapy (ST) approaches. Forty-eight practitioners aligning with one of the three approaches were asked to identify crucial processes in their therapy using a modified online version of the Psychotherapy Process Q-set. Distinct differences between each theoretical orientation with few shared common factors were found. A comparison with ratings from previous studies indicated that CBT therapists have not changed over the last 20 years, whereas PDT therapists have changed and the differences appeared consistent with modern PDT theory. The differences between the therapy approaches were consistent with theories underlying each model. PDT therapists valued a neutral relationship, CBT therapists emphasized a didactic interaction, and therapists form a ST orientation placed a greater emphasis on emotional involvement.

  13. Correction to: The hidden therapist: evidence for a central role of music in psychedelic therapy.

    Science.gov (United States)

    Kaelen, Mendel; Giribaldi, Bruna; Raine, Jordan; Evans, Lisa; Timmermann, Christopher; Rodriguez, Natalie; Roseman, Leor; Feilding, Amanda; Nutt, David; Carhart-Harris, Robin

    2018-05-01

    The article The hidden therapist: evidence for a central role of music in psychedelic therapy, written by Mendel Kaelen, Bruna Giribaldi, Jordan Raine, Lisa Evans, Christopher Timmerman, Natalie Rodriguez, Leor Roseman, Amanda Feilding, David Nutt, Robin Carhart-Harris, was originally published electronically on the publisher's internet portal.

  14. Therapist-Designed Adaptive Riding in Children With Cerebral Palsy : Results of a Feasibility Study

    NARCIS (Netherlands)

    Angsupaisal, Mattana; Visser, Baudina; Alkema, Anne; Meinsma-van der Tuin, Marja; Maathuis, Carel G. B.; Reinders-Messelink, Heleen; Hadders-Algra, Mijna

    Background. It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development. Objective. The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed

  15. Viewpoints of working sandwich generation women and occupational therapists on role balance strategies.

    Science.gov (United States)

    Evans, Kiah L; Girdler, Sonya J; Falkmer, Torbjorn; Richmond, Janet E; Wagman, Petra; Millsteed, Jeannine; Falkmer, Marita

    2017-09-01

    Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.

  16. The contribution of the therapist's competence in the treatment of adolescents with generalized social phobia.

    Science.gov (United States)

    Olivares, José; Olivares-Olivares, Pablo J; Rosa-Alcázar, Ana I; Montesinos, Luis; Macià, Diego

    2014-01-01

    The purpose of this study was to explore which of the outcomes attained by the application of the psychological program Intervención en Adolescentes con Fobia Social (Intervention in Adolescents with Social Phobia) can be attributed to the therapist's competence. The experimental study consists of three conditions: Waiting list control, Group treated by expert psychologists, and Group treated by inexperienced psychologists, with a sample of 110 Spanish adolescents whose mean age was 15.42 years (SD = 0.97, range: 14-18). All participants met the criteria for diagnosis of Generalized Social Phobia) and most of them were female (65.45%). (i) The effect size attributable to the therapist was low compared to the effect size associated with the manual-based treatment program in the dependent variables measured, and (ii) Expert therapists attained a much greater remission of the criteria for the diagnosis of Generalized Social Phobia among participants than did the inexperienced therapists. The IAFS Program was responsible for most of the change measured in participants.

  17. United States Physical Therapists' Knowledge About Joint Hypermobility Syndrome Compared with Fibromyalgia and Rheumatoid Arthritis.

    Science.gov (United States)

    Russek, Leslie N; LaShomb, Emily A; Ware, Amy M; Wesner, Sarah M; Westcott, Vanessa

    2016-03-01

    Joint hypermobility syndrome (JHS) is one of the most common inherited connective tissue disorders. It causes significant pain and disability for all age groups, ranging from developmental delay among children to widespread chronic pain in adults. Experts in JHS assert that the condition is under-recognized and poorly managed. The aim of this study was to assess US physical therapists' knowledge about JHS compared with other causes of widespread pain and activity limitations: fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis. Cross-sectional, Internet-based survey of randomly selected members of the American Physical Therapy Association and descriptive statistics were used to explore physical therapists' knowledge about JHS, fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis, and chi square was used to compare knowledge about the different conditions. The response rate was 15.5% (496). Although 36% recognized the Beighton Scale for assessing joint hypermobility, only 26.8% of respondents were familiar with the Brighton Criteria for diagnosing JHS. Few respondents (11-19%) realized that JHS has extra-articular features such as anxiety disorder, fatigue, headache, delayed motor development, easy bruising and sleep disturbance. Physical therapists working in environments most likely to see patients with JHS underestimated the likely prevalence in their patient population. The results suggest that many physical therapists in the United States are not familiar with the diagnostic criteria, prevalence or common clinical presentation of JHS. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

    Science.gov (United States)

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-01-01

    Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

  19. Helping Children with Attentional Challenges in a Montessori Classroom: The Role of the Occupational Therapist

    Science.gov (United States)

    Luborsky, Barbara

    2017-01-01

    Barbabra Luborsky links the medical field and Montessori pedagogy to address atypical attention in children through the lens of the occupational therapist. She provides an overview of attention and sensory processing disorders and then informs about particular diagnoses, particularly ADHD and its comorbidity with other diagnoses. Her specific…

  20. Exploring what works in art therapy with children with autism : Tacit knowledge of art therapists

    NARCIS (Netherlands)

    Schweizer, Celine; Spreen, Marinus; Knorth, Erik J.

    2017-01-01

    Children with Autism Spectrum Disorders (ASD) are often referred to art therapy. To investigate what works in art therapy with these children 'tacit knowledge' of eight well experienced art therapists was explored. Promising components were arranged into the Context and Outcomes of Art Therapy

  1. The Role of the Occupational Therapist in the Treatment of Children with Eating Disorders

    Science.gov (United States)

    Bradford, Robert; Holliday, Megan; Schultz, Amy; Moser, Christy

    2015-01-01

    The prevalence of childhood eating disorders is increasing in pediatric practice across the country. It is therefore important for occupational therapists to be familiar with current research, resources, and intervention strategies related to a variety of eating diagnoses. In this column we highlight basic definitions of a variety of eating…

  2. Famine at the Feast: A Therapist's Guide to Working with the Eating Disordered.

    Science.gov (United States)

    Doane, H. Mitzi

    This guide, written for therapists and counselors working with eating disordered individuals, focuses on both bulimia and anorexia. A brief historical perspective and comments on epidemiology and etiology are provided. Definitions and clinical characteristics of both disorders are presented as well as psychodevelopmental profiles of male and…

  3. Factors Related to Play Therapists' Social Justice Advocacy Attitudes

    Science.gov (United States)

    Parikh, Sejal B.; Ceballos, Peggy; Post, Phyllis

    2013-01-01

    The authors used a correlational research design to examine how belief in a just world, political ideology, socioeconomic status of family of origin, and percentage of racial minority clients were related to social justice advocacy attitudes among play therapists. A multiple regression was used to analyze the data. Results indicated that belief in…

  4. Online Gaming Issues in Offline Couple Relationships: A Primer for Marriage and Family Therapists (MFTs)

    Science.gov (United States)

    Hertlein, Katherine M.; Hawkins, Blendine P.

    2012-01-01

    Although the challenges around participation in online gaming grow, gamers and their partners who experience online relationship issues related to gaming, present a new set of treatment challenges for therapists. In this article, we report on the findings of a hermeneutic research study aimed at evaluating the scholarly literature related to…

  5. Know History, Know Self: Art Therapists' Responsibility to Dismantle White Supremacy

    Science.gov (United States)

    Hamrick, Cassie; Byma, Christine

    2017-01-01

    In this article, we call on white art therapists to assume responsibility for dismantling white supremacy in the field of art therapy, in personal as well as political-structural arenas. We respond to calls from scholars and writers of color for white people to assume increased responsibility for dismantling white supremacy in white communities…

  6. Therapist adherence is associated with outcome in cognitive-behavioral therapy for bulimia nervosa.

    Science.gov (United States)

    Folke, Sofie; Daniel, Sarah I F; Gondan, Matthias; Lunn, Susanne; Tækker, Louise; Poulsen, Stig

    2017-06-01

    Studies of therapist adherence in relation to treatment outcome have produced mixed results. The aim of the present study was to investigate change in therapist adherence to cognitive-behavioral therapy (CBT) for bulimia nervosa over time, and to investigate the relationship between adherence and client outcome in early, middle, and late phases of treatment. Thirty-six clients received the focused form of "enhanced" CBT (CBT-E) for bulimia nervosa. Trained observers rated audiotapes of 92 full-length therapy sessions from early (Session 3), middle (Session 11), and late phases (Session 20) of treatment using the Cognitive-Behavioral Therapy Treatment Protocol Adherence Scale. Change in adherence across the 3 treatment phases was examined using multilevel analysis. The relationship between early, middle, and late adherence levels and end-of-treatment binging frequency was examined using multilevel Poisson regression analysis. Adherence decreased significantly over the course of treatment. Higher levels of therapist adherence in early and middle phases of treatment were associated with reduced binging frequency, whereas higher levels of adherence measured late in treatment was not. Results indicate that therapists' adherence to the CBT-E treatment protocol decreases over time and that high levels of protocol adherence in early and middle phases of treatment are more important for positive client outcomes than high levels of adherence in the end of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    Science.gov (United States)

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  8. The entry-level physical therapist: a case for COMFORT communication training.

    Science.gov (United States)

    Goldsmith, Joy; Wittenberg-Lyles, Elaine; Frisby, Brandi N; Platt, Christine Small

    2015-01-01

    Entry-level physical therapists provide clinical care for patients with functional mobility limitations. Their care spans the continuum of settings, disease processes, and diagnoses. Although effective communication skills are required to conduct physical therapy work, there is limited instruction provided in physical therapy education and students receive little exposure to seriously or chronically ill patients. The goal of this study was to assess the effects of communication training for the entry-level physical therapist facing palliative and end-of-life communication with patients/families. A pre-post survey design and narrative writing were used to assess the effect of the COMFORT communication training curriculum provided to doctorally trained, graduating physical therapists. The study demonstrated decreased student apprehension about communicating with dying patients and their families, and a comparison of mean scores reflecting the students' communication knowledge, confidence, and behaviors increased in a positive direction. As students became more willing to communicate, they were also more adept at integrating task and relational messages, as well as assimilating emotional support messages for patients and families. This study shows promise for the feasibility and utilization of the COMFORT curriculum for entry-level physical therapists. Further research should address the integration of COMFORT earlier into physical therapy education, as well as assess evidence of COMFORT communication skills in the clinical context.

  9. Embodied wordings of change:How do dance movement therapists describe their interventions?

    NARCIS (Netherlands)

    Samaritter, Rosemarie; Cantell, Marja Helena

    2016-01-01

    The politics of health care urge arts therapists to deliver evidence for the effectiveness of their interventions. XXX professional association has started to focus on the arts therapists’ specific contribution to clinical guidelines and effectiveness research. On one hand, the question is how to

  10. European American Therapist Self-Disclosure in Cross-Cultural Counseling

    Science.gov (United States)

    Burkard, Alan W.; Knox, Sarah; Groen, Michael; Perez, Maria; Hess, Shirley A.

    2006-01-01

    Eleven European American psychotherapists' use of self-disclosure in cross-cultural counseling was studied using consensual qualitative research. As reasons for self-disclosing, therapists reported the intent to enhance the counseling relationship, acknowledge the role of racism/oppression in clients' lives, and acknowledge their own…

  11. Hidden in Plain Sight: A Music Therapist and Music Educator in A Public School District

    Science.gov (United States)

    Smith, Jacqueline C.

    2018-01-01

    The purpose of this intrinsic case study was to clarify the roles of a music educator and music therapist in a North American public school district. This case was unique because some of the students with special needs received both music instruction and music therapy services, yet there was little collaboration between the two disciplines. In an…

  12. The Hope and Promise of Career Life-Span Counselor and Therapist Development.

    Science.gov (United States)

    Skovholt, Thomas M.; Ronnestad, Michael H.

    2003-01-01

    Reformulation of the findings of a cross-sectional longitudinal study of 100 counselors and therapists resulted in 14 themes and a 6-phase model: lay helper, beginning student, advanced student, novice professional, experienced professional, and senior professional. Results show that experiences in personal and professional domains are significant…

  13. Outcome and process differences between professional and nonprofessional therapists in time-limited group psychotherapy.

    Science.gov (United States)

    Burlingame, G M; Barlow, S H

    1996-10-01

    The outcome of clients who saw one of four "expert" professional group therapists selected by peer nomination or four "natural helper" nonprofessional nominated by students is contrasted in a 15-session psychotherapy group. Process measures tapping specific group and "common factors" were drawn from sessions 3, 8, and 14; outcome was assessed at pre, mid, posttreatment, and a 6-month follow-up. Results were examined by leader condition (professional vs. nonprofessional therapists) and time (group development). Virtually no reliable differences were found on measures of outcome primarily because of a floor effect on several measures. Therapist differences on the process measures tapping the "common factors" of therapeutic alliance, client expectancy, and perception of therapists were either nonsignificant or disappeared by the end of treatment. A complex picture of differences on one therapeutic factor (insight), common factor measures and subtle variation in the outcome data suggests a distinct pattern of change, however. Methodological limitations are also addressed including problems inherent in large-scale clinical-trial studies, ethical concerns raised by using nonprofessional leaders, and problems with generalizability, given the absence of significant psychopathology in group members.

  14. Working with Families Living with Autism: Potential Contributions of Marriage and Family Therapists

    Science.gov (United States)

    Neely, Jason; Amatea, Ellen S.; Echevarria-Doan, Silvia; Tannen, Tina

    2012-01-01

    This article introduces marriage and family therapists (MFT) to some of the common issues faced by families that have a child with autism spectrum disorder (ASD). First, autism is defined and common myths surrounding it are discussed. Next, relational challenges are presented that families report experiencing during early childhood through the…

  15. Attachment Patterns in the Psychotherapy Relationship: Development of the Client Attachment to Therapist Scale.

    Science.gov (United States)

    Mallinckrodt, Brent; And Others

    1995-01-01

    Describes development of an instrument, the Client Attachment to Therapist Scale (CATS). CATS factors correlated in expected directions with survey measures of object relations, client-rated working alliance, social self-efficacy, and adult attachment. Cluster analysis revealed four types of client attachment. Discusses implications of attachment…

  16. Therapist-Aided Exposure for Women with Lifelong Vaginismus: A Replicated Single-Case Design

    Science.gov (United States)

    ter Kuile, Moniek M.; Bulte, Isis; Weijenborg, Philomeen T. M.; Beekman, Aart; Melles, Reinhilde; Onghena, Patrick

    2009-01-01

    Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able to have intercourse. A replicated single-case A-B-phase design was used to investigate the effectiveness of therapist-aided exposure for lifelong vaginismus. A baseline period…

  17. Exploring Undergraduate Gender Differences in Anxiety about Meeting Their Assigned Therapist

    Science.gov (United States)

    Blau, Gary; DiMino, John; DeMaria, Peter A., Jr.; Beverly, Clyde; Chessler, Marcy

    2016-01-01

    An online survey sample of 166 non-urgent undergraduates, N = 47 (male) and N = 119 (female) waiting to begin counseling after triage found that females had significantly higher anxiety about meeting their assigned (intake) therapist than males. This gender difference of females being higher in counselor meeting anxiety could not be accounted for…

  18. Physical Therapy for Metabolic Syndrome Prevention in Workers: Novel Role of Physical Therapist.

    Science.gov (United States)

    Satoh, Tomonori; Nemoto, Yuki; Utumi, Takako; Munakata, Masanori

    2016-01-01

    In Japan, physical therapists have usually been involved in physical therapy for patients with functional disorders associated with cerebrovascular or orthopedic diseases in hospitals. With the aging of Japanese society, the number of diseased people will progressively increase; thus, it is important to pay much more attention to disease prevention. In this regard, physical therapists are expected to play a new role in the field of preventive medicine. Metabolic syndrome or central obesity with multiple cardiometabolic risks is associated with a high risk of type 2 diabetes or cardiovascular diseases and is now a central target for early detection and intervention for disease prevention. The incidence of metabolic syndrome increases with age, and men showed a higher incidence of metabolic syndrome than women in all generations. We have been involved in the guidance of workers with metabolic syndrome for a long time, and we conducted a multicenter study to establish effective guidance for these worker. In this paper, we will use our evidence to discuss the role of physical therapists in providing guidance for preventing metabolic syndrome. We are now conducting worksite supporting exercise intervention for workers who were resistant to conventional lifestyle guidance. In addition, the unique role of physical therapists in this new trial will be introduced.

  19. Effect of Physical Attractiveness on Therapists' Initial Judgments of a Person's Self-concept

    Science.gov (United States)

    Hobfoll, Stevan E.; Penner, Louis A.

    1978-01-01

    Investigated effect of a person's physical attractiveness on a therapist's initial judgment of that person's self-concept. Videotapes and audiotapes were made of interviews with attractive and unattractive males and females. Physically attractive persons of both sexes were rated as having better self-concepts than unattractive persons. (Author)

  20. Therapist Factors in Internet-Delivered Cognitive Behavioural Therapy for Major Depressive Disorder

    NARCIS (Netherlands)

    Almlov, J.; Carlbring, P.; Berger, T.; Cuijpers, P.; Andersson, G.

    2009-01-01

    Internet-delivered cognitive behavioural therapy (CBT) can be an effective method for treating major depression, but it often works best when therapist support is provided in the form of e-mail support or telephone calls. The authors investigated whether there were any intraclass correlations within

  1. Educating Students to Become Culturally Competent Physical Therapists: Issues of Teaching and Assessment

    Science.gov (United States)

    Barnes, Lisa Jayroe

    2013-01-01

    With the growing multicultural population within the United States, healthcare providers need to be prepared to care for and educate adult clients from various cultural backgrounds. The purpose of the study was to examine the teaching and assessment methods being used by faculty in the education of future physical therapists in teaching the…

  2. 75 FR 51958 - California Association of Marriage and Family Therapists; Notice of Receipt of Petition for...

    Science.gov (United States)

    2010-08-24

    ... NUCLEAR REGULATORY COMMISSION 10 CFR Part 26 [Docket No. PRM-26-4; NRC-2010-0269] California Association of Marriage and Family Therapists; Notice of Receipt of Petition for Rulemaking AGENCY: Nuclear Regulatory Commission. ACTION: Petition for rulemaking; notice of receipt. SUMMARY: The Nuclear Regulatory...

  3. 76 FR 46651 - Petition for Rulemaking Submitted by the California Association of Marriage and Family Therapists

    Science.gov (United States)

    2011-08-03

    ... NUCLEAR REGULATORY COMMISSION 10 CFR Part 26 [Docket No. PRM-26-4; NRC-2010-0269] Petition for Rulemaking Submitted by the California Association of Marriage and Family Therapists AGENCY: Nuclear... U.S. Nuclear Regulatory Commission (NRC) has decided to consider in a rulemaking the issues raised...

  4. Factors influencing job satisfaction among Jordanian occupational therapists: a qualitative study.

    Science.gov (United States)

    Abu Tariah, Hashem Salman; Hamed, Razan T; AlHeresh, Rawan A; Abu-Dahab, Sana M N; AL-Oraibi, Saleh

    2011-12-01

    The main purpose of this study was to explore factors influencing job satisfaction and dissatisfaction among Jordanian occupational therapists. Ours was an explorative qualitative study involving the use of structured open-ended written questions. Participants were asked to answer in narrative their perception about the factors behind their job satisfaction and dissatisfaction. In addition, they were asked to express their suggestions, ideas, or solutions for increasing job satisfaction. Ninety-three occupational therapists responded to the survey. For job satisfaction questions, four themes emerged: a humanistic profession; professional issues; work benefits; and work environment. Participant's comments at the end of the survey revealed one general theme for improving job satisfaction, 'a call for improvement'. This qualitative study revealed that the humanistic nature of occupational therapist was counterbalanced by several dissatisfying factors for occupational therapy practitioners in Jordan. The need for better supported working conditions in terms of financial rewards, recognition, awareness and resources as well as public and professional recognition of occupational therapists are needed to enhance the occupational therapy profile in Jordan. A comprehensive collaboration is highly needed between the individual practitioners, representatives of the profession, government and hospital administrators. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

  5. What is a health worker? How spa therapists in a Norwegian health hotel understand their work.

    Science.gov (United States)

    Anderssen, Jorid

    2016-01-01

    In Norway, as in many other wealthy countries, the number of health-related services that are being offered outside of the health sector is increasing. The present paper is based on qualitative interviews that were conducted with providers of health-related services at a commercial health hotel in Norway. The hotel is marketed as a health hotel - that is, a place for people with health problems and for those who need relaxation and an escape from their stressful everyday lives. The paper discusses whether the providers of this kind of service consider it a health service or if they distinguish and distance themselves from the health system. The interviews showed that they consider themselves health workers and refer to themselves as therapists. Even though they use therapy in the health sector as a model, they distinguish themselves from therapists in the health sector. They do not want to treat what they call sick people. Most of their therapy is directed toward cultivating or improving people's bodies and souls. These service providers think that they contribute to improving their guests' health by teaching them how to take care of themselves; enjoying oneself (for instance, by receiving skin treatment or a massage) is an important aspect of good health. According to the therapists, modern-day women, in particular, are often worn-out, and they deserve, and are entitled, to enjoy themselves. In these ways, the therapists use health to legitimize their services, and they challenge the current understanding of health.

  6. Male Cross-Dressers in Therapy: A Solution-Focused Perspective for Marriage and Family Therapists.

    Science.gov (United States)

    Dzelme, Kristina; Jones, Rene A.

    2001-01-01

    Offers techniques on how to work with male cross-dressers using solution focused therapy. Solution focused therapy is discussed as a way to work with male cross dressers and their partners. A case study of a male cross dresser and his wife is presented and possible directions are suggested for marriage and family therapists. (BF)

  7. Workplace assessments and functional capacity evaluations: current beliefs of therapists in Australia.

    Science.gov (United States)

    Innes, Ev; Straker, Leon

    2003-01-01

    The purpose of this study was to understand the current beliefs of therapists in Australia, and the strategies they use to address the issues of credibility, reliability, consistency, trustworthiness, validity, generalisability and quality in conducting work-related assessments. In-depth semi-structured interviews were conducted with 26 occupational therapists and physiotherapists from around Australia. Participants expressed the belief that the therapist was the assessment instrument and was central to the credibility of an assessment. Conflict was reported when participants modified standardised assessments in an attempt to focus on context relevant activities and tasks. Participants were aware of the issues of reliability and validity but believed it was not practical to establish these aspects formally in most work-related assessments. The strategies used to achieve credibility, reliability, consistency, trustworthiness, validity, generalisability and quality were similar to those recommended for use in qualitative research. The strategies identified in this study can provide the basis for therapists to examine how they conduct work-related assessments and consider whether they currently use these strategies or have the opportunity to implement others.

  8. Exploring What Works in Art Therapy with Children with Autism: Tacit Knowledge of Art Therapists

    Science.gov (United States)

    Schweizer, Celine; Spreen, Marinus; Knorth, Erik J.

    2017-01-01

    Children with autism spectrum disorders (ASD) are often referred to art therapy. To investigate what works in art therapy with children with ASD, the tacit knowledge of 8 experienced art therapists was explored through interviews. Promising components were arranged into the Context and Outcomes of Art Therapy (COAT) model. According to the…

  9. Coping as a Predictor of Burnout and General Health in Therapists Working in ABA Schools

    Science.gov (United States)

    Griffith, G. M.; Barbakou, A.; Hastings, R. P.

    2014-01-01

    Background: Little is known about the work-related well-being of applied behaviour analysis (ABA) therapists who work in school-based contexts and deliver ABA interventions to children with autism. Methods: A questionnaire on work-related stress (burnout), general distress, perceived supervisor support and coping was completed by 45 ABA therapists…

  10. Therapist Adherence and Competence with Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology

    Science.gov (United States)

    Frueh, B. Christopher; Monnier, Jeannine; Grubaugh, Anouk L.; Elhai, Jon D.; Yim, Eunsil; Knapp, Rebecca

    2007-01-01

    Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioral therapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited…

  11. The Clinical Practice of Speech and Language Therapists with Children with Phonologically Based Speech Sound Disorders

    Science.gov (United States)

    Oliveira, Carla; Lousada, Marisa; Jesus, Luis M. T.

    2015-01-01

    Children with speech sound disorders (SSD) represent a large number of speech and language therapists' caseloads. The intervention with children who have SSD can involve different therapy approaches, and these may be articulatory or phonologically based. Some international studies reveal a widespread application of articulatory based approaches in…

  12. Clinical reasoning of Filipino physical therapists: Experiences in a developing nation.

    Science.gov (United States)

    Rotor, Esmerita R; Capio, Catherine M

    2018-03-01

    Clinical reasoning is essential for physical therapists to engage in the process of client care, and has been known to contribute to professional development. The literature on clinical reasoning and experiences have been based on studies from Western and developed nations, from which multiple influencing factors have been found. A developing nation, the Philippines, has distinct social, economic, political, and cultural circumstances. Using a phenomenological approach, this study explored experiences of Filipino physical therapists on clinical reasoning. Ten therapists working in three settings: 1) hospital; 2) outpatient clinic; and 3) home health were interviewed. Major findings were: a prescription-based referral system limited clinical reasoning; procedural reasoning was a commonly experienced strategy while diagnostic and predictive reasoning were limited; factors that influenced clinical reasoning included practice setting and the professional relationship with the referring physician. Physical therapists' responses suggested a lack of autonomy in practice that appeared to stifle clinical reasoning. Based on our findings, we recommend that the current regulations governing PT practice in the Philippines may be updated, and encourage educators to strengthen teaching approaches and strategies that support clinical reasoning. These recommendations are consistent with the global trend toward autonomous practice.

  13. Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

    Science.gov (United States)

    Zalewski, Kathryn; Alt, Carlynn; Arvinen-Barrow, Monna

    2014-06-01

    Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, Pbarriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

  14. Management of sternal precautions following median sternotomy by physical therapists in Australia: a web-based survey.

    Science.gov (United States)

    Tuyl, Lara J; Mackney, Jennifer H; Johnston, Catherine L

    2012-01-01

    Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included "workplace practices/protocols" (n=27) and "clinical experience" (n=22). Limitations The study may be limited by response bias. Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay.

  15. Factors that influence the professional resilience of occupational therapists in mental health practice.

    Science.gov (United States)

    Ashby, Samantha E; Ryan, Susan; Gray, Mel; James, Carole

    2013-04-01

    Mental health practice can create challenging environments for occupational therapists. This study explores the dynamic processes involved in the development and maintenance of professional resilience of experienced mental health occupational therapy practitioners. It presents the PRIOrity model that summarises the dynamic relationship between professional resilience, professional identity and occupation-based practice. A narrative inquiry methodology with two phases of interviews was used to collect the data from nine experienced mental health practitioners. Narrative thematic analysis was used to interpret the data. Professional resilience was linked to: (i) professional identity which tended to be negatively influenced in contexts dominated by biomedical models and psychological theories; (ii) expectations on occupational therapists to work outside their professional domains and use generic knowledge; and (iii) lack of validation of occupation-focussed practice. Professional resilience was sustained by strategies that maintained participants' professional identity. These strategies included seeking 'good' supervision, establishing support networks and finding a job that allowed a match between valued knowledge and opportunities to use it in practice. For occupational therapists professional resilience is sustained and enhanced by a strong professional identity and valuing an occupational perspective of health. Strategies that encourage reflection on the theoretical knowledge underpinning practice can sustain resilience. These include supervision, in-service meetings and informal socialisation. Further research is required into the role discipline-specific theories play in sustaining professional values and identity. The development of strategies to enhance occupational therapists' professional resilience may assist in the retention of occupational therapists in the mental health workforce. © 2012 The Authors Australian Occupational Therapy Journal © 2012

  16. Patient SWAP-200 personality dimensions and FFM traits: Do they predict therapist responses?

    Science.gov (United States)

    Tanzilli, Annalisa; Lingiardi, Vittorio; Hilsenroth, Mark

    2018-05-01

    The main aim of this study was to examine the relationship between therapists' emotional responses and patients' personality evaluated by 3 dimensional diagnostic approaches empirically derived from the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b): Two of these rely on the 5-factor model (FFM) domains, that were assessed with different SWAP-200 FFM versions developed by Shedler and Westen (SW-FFM scales; 2004) and McCrae, Löckenhoff, and Costa (MLC-FFM scales; 2005); the third approach is based on a multifaceted model of personality syndromes (SWAP personality dimension scales; see Shedler & Westen, 2004). A national sample of psychiatrists and psychologists (N = 166) of various theoretical orientations completed the Therapist Response Questionnaire (TRQ; Zittel Conklin & Westen, 2003) to identify patterns of therapist response, and the SWAP-200 to assess personality regarding a patient currently in their care. The findings showed good levels of construct validity between the SW-FFM and MLC-FFM scales, with the exception of the Openness trait. Moreover, specific SW-FFM and MLC-FFM scales were significantly associated with distinct SWAP personality dimension scales according in a conceptually meaningful nomological network. Although there were significant, theoretically coherent, and systematic relationships between therapists' responses and patients' personality features, overall the contribution of the SW-FFM and MLC-FFM traits in predicting therapists' responses was less sizable than the SWAP personality dimensions. These results seem to confirm the diagnostic and therapeutic value of countertransference as an essential tool in understanding psychological traits/dimensions that underlie the patients' psychopathology, both from within and outside of the FFM. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. How mental health occupational therapists address issues of diet with their clients: a qualitative study.

    Science.gov (United States)

    Mahony, Georgia; Haracz, Kirsti; Williams, Lauren T

    2012-08-01

    Poor diet is a contributing factor to the high rates of obesity and related comorbidities in people with severe mental illness, and dietary change is a key treatment strategy. Providing healthy lifestyle interventions is a recognised role for occupational therapists. However, the existing literature fails to elucidate boundaries of this role. To begin to address this gap in the literature, this study explored the attitudes, actions and beliefs of mental health occupational therapists about providing diet-related interventions. Semi-structured interviews were conducted with mental health occupational therapists working in one Area Health Service in New South Wales. Purposive sampling was used. Data were analysed using Constructivist Grounded Theory methods, where meaning is co-constructed by, and the theory ultimately grounded in the experiences of, the participant and researcher. The participants felt confident providing clients with interventions to promote diet-related skill development and providing general healthy eating education to support this development. However, they were not comfortable providing clients with specific dietary advice. Participants identified a need for further training and support to enhance their effectiveness in providing healthy eating education and highlighted the need for more dietitians in mental health services. The occupational therapists in this study identified clear boundaries of their role in providing diet-related interventions for people with severe mental illness. Suggestions for improvement in this area included further training for occupational therapists as well as increased access to dietitians for those services that lie outside the occupational therapy role. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

  18. A therapist-focused knowledge translation intervention for improving patient adherence in musculoskeletal physiotherapy practice.

    Science.gov (United States)

    Babatunde, Folarin Omoniyi; MacDermid, Joy Christine; MacIntyre, Norma

    2017-01-01

    Nonadherence to treatment remains high among patients with musculoskeletal conditions with negative impact on the treatment outcomes, use of personal and cost of care. An active knowledge translation (KT) strategy may be an effective strategy to support practice change. The purpose of this study was to deliver a brief, interactive, multifaceted and targeted KT program to improve physiotherapist knowledge and confidence in performing adherence enhancing activities related to risk, barriers, assessment and interventions. We utilised a 2-phase approach in this KT project. Phase 1 involved the development of an adherence tool kit following a synthesis of the literature and an iterative process involving 47 end-users. Clinicians treating patients with musculoskeletal conditions were recruited from two Physiotherapy and Occupational therapy national conferences in Canada. The intervention, based on the acronym SIMPLE TIPS was tested on 51 physiotherapists in phase 2. A pre- and post-repeated measures design was used in Phase 2. Graham's knowledge-to-action cycle was used as the conceptual framework. Participants completed a pre-intervention assessment, took part in a 1-h educational session and completed a post-intervention assessment. A questionnaire was used to measure knowledge of evidence-based treatment adherence barriers, interventions and measures and confidence to perform evidence-based adherence practice activities. Data was analysed using descriptive statistics (frequency and percentage), Fisher's exact test and Wilcoxon Sign-Ranked tests. Barriers and facilitators of adherence were identified under three domains (therapist, patient, health system) in phase 1. Seventy percent of the participants completed the questionnaire. Results indicated that 46.8% of respondents explored barriers including the use of behaviour change strategies and 45.7% reported that they measured adherence but none reported the use of validated outcomes. A significant improvement in

  19. Physical Therapists Forward Deployed on Aircraft Carriers: A Retrospective Look at a Decade of Service.

    Science.gov (United States)

    Rosenthal, Michael D; Ziemke, Gregg W; Bush, Matthew L; Halfpap, Joshua

    2018-04-25

    Navy physical therapists (PTs) have been a part of ship's company aboard Aircraft Carriers since 2002 due to musculoskeletal injuries being the number one cause of lost duty time and disability. This article describes a decade of physical therapy services provided aboard aircraft carriers. A retrospective survey was conducted to evaluate the types of services provided, volume of workload, value of services provided, and impact of PTs on operational readiness for personnel aboard Naval aircraft carriers. Thirty-four reports documenting workload from PTs stationed onboard aircraft carriers were collected during the first decade of permanent PT assignment to aircraft carriers. This report quantifies a 10-yr period of physical therapy services (PT and PT Technician) in providing musculoskeletal care within the carrier strike group and adds to existing literature demonstrating a high demand for musculoskeletal care in operational platforms. A collective total of 144,211 encounters were reported during the 10-yr period. The number of initial evaluations performed by the PT averaged 1,448 per assigned tour. The average number of follow-up appointments performed by the PT per tour was 1,440. The average number of treatment appointments per tour provided by the PT and PT technician combined was 1,888. The average number of visits per patient, including the initial evaluation, was 3.3. Sixty-five percent (65%) of the workload occurred while deployed or out to sea during training periods. It was estimated that 213 medical evacuations were averted over the 10-yr period. There were no reports of adverse events or quality of care reviews related to the care provided by the PT and/or PT technician. Access to early PT intervention aboard aircraft carriers was associated with a better utilization ratio (lower average number of visits per condition) than has been reported in prior studies and suggests an effective utilization of medical personnel resources. The impact of Navy PTs

  20. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults.

    Science.gov (United States)

    Olthuis, Janine V; Watt, Margo C; Bailey, Kristen; Hayden, Jill A; Stewart, Sherry H

    2016-03-12

    Cognitive behavioural therapy (CBT) is an evidence-based treatment for anxiety disorders. Many people have difficulty accessing treatment, due to a variety of obstacles. Researchers have therefore explored the possibility of using the Internet to deliver CBT; it is important to ensure the decision to promote such treatment is grounded in high quality evidence. To assess the effects of therapist-supported Internet CBT (ICBT) on remission of anxiety disorder diagnosis and reduction of anxiety symptoms in adults as compared to waiting list control, unguided CBT, or face-to-face CBT. Effects of treatment on quality of life and patient satisfaction with the intervention were also assessed. We searched the Cochrane Depression, Anxiety and Neurosis Review Group Specialised Register (CCDANCTR) to 16 March 2015. The CCDANCTR includes relevant randomised controlled trials from MEDLINE, EMBASE, PsycINFO and CENTRAL. We also searched online clinical trial registries and reference lists of included studies. We contacted authors to locate additional trials. Each identified study was independently assessed for inclusion by two authors. To be included, studies had to be randomised controlled trials of therapist-supported ICBT compared to a waiting list, attention, information, or online discussion group; unguided CBT (that is, self-help); or face-to-face CBT. We included studies that treated adults with an anxiety disorder (panic disorder, agoraphobia, social phobia, post-traumatic stress disorder, acute stress disorder, generalized anxiety disorder, obsessive compulsive disorder, and specific phobia) defined according to the Diagnostic and Statistical Manual of Mental Disorders III, III-R, IV, IV-TR or the International Classification of Disesases 9 or 10. Two authors independently assessed the risk of bias of included studies and judged overall study quality. We used data from intention-to-treat analyses wherever possible. We assessed treatment effect for the dichotomous outcome

  1. Applying the Collaborative Study Psychotherapy Rating Scale to Rate Therapist Adherence in Cognitive-Behavior Therapy, Interpersonal Therapy, and Clinical Management.

    Science.gov (United States)

    Hill, Clara E.; And Others

    1992-01-01

    Studied adherence of therapists to behaviors specified in cognitive-behavior therapy, interpersonal therapy, and clinical management manuals. Rated therapist adherence in each of 4 sessions from 180 patients in treatment phase of National Institute of Mental Health Treatment of Depression Collaborative Research Program. Therapists exhibited more…

  2. Child-Focused and Context-Focused Behaviors of Physical and Occupational Therapists during Treatment of Young Children with Cerebral Palsy

    NARCIS (Netherlands)

    Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J.

    2016-01-01

    Aims: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. Method: Videos of 49 therapy sessions

  3. Child-Focused and Context-Focused Behaviors of Physical and Occupational Therapists during Treatment of Young Children with Cerebral Palsy

    NARCIS (Netherlands)

    Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J

    2016-01-01

    AIMS: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. METHOD: Videos of 49 therapy sessions

  4. The lived experience of being a speech-language therapist in the Western Cape public health service.

    Science.gov (United States)

    Warden, Jocelyn A; Mayers, Patricia; Kathard, Harsha

    2008-01-01

    This study explores the lived experience of being a Speech-Language Therapist (S-L Therapist) in the South African Western Cape public health service. The lived experience of seven S-L Therapists with varied clinical experience was illuminated using a qualitative phenomenological research design. S-L Therapists, working in the three Western Cape tertiary hospitals, provided an in-depth account of their experiences as S-L Therapists. The audio recorded interviews were transcribed verbatim and analysed using an adaptation of Colaizzi's (1978) method of analysis. The rigour and trustworthiness of the research process was informed by consideration of issues of credibility, applicability, confirmability and dependability as they relate to phenomenological design. Five main themes emerged from data analysis: expectations of practice and practice realities; being part of the "underdog" profession: role definition and status; being connected; the holistic nature of the S-L Therapist's practice; and erosion or promotion.The implications for training and support of S-L Therapists by managers and policymakers and peers are highlighted.

  5. Successful Therapist-Parent Coaching: How In Vivo Feedback Relates to Parent Engagement in Parent-Child Interaction Therapy.

    Science.gov (United States)

    Barnett, Miya L; Niec, Larissa N; Peer, Samuel O; Jent, Jason F; Weinstein, Allison; Gisbert, Patricia; Simpson, Gregory

    2017-01-01

    Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. This study investigated how different techniques of therapist in vivo feedback (i.e., coaching) influenced parent attrition and skill acquisition in parent-child interaction therapy (PCIT). Participants included 51 parent-child dyads who participated in PCIT. Children (age: M = 5.03, SD = 1.65) were predominately minorities (63% White Hispanic, 16% African American or Black). Eight families discontinued treatment prematurely. Therapist coaching techniques during the first session of treatment were coded using the Therapist-Parent Interaction Coding System, and parent behaviors were coded with the Dyadic Parent-Child Interaction Coding System, Third Edition. Parents who received more responsive coaching acquired child-centered parenting skills more quickly. Therapists used fewer responsive techniques and more drills with families who dropped out of treatment. A composite of therapist behaviors accurately predicted treatment completion for 86% of families. Although group membership was correctly classified for the treatment completers, only 1 dropout was accurately predicted. Findings suggest that therapist in vivo feedback techniques may impact parents' success in PCIT and that responsive coaching may be particularly relevant.

  6. Definition and structure of body-relatedness from the perspective of patients with severe somatoform disorder and their therapists.

    Directory of Open Access Journals (Sweden)

    Hanneke Kalisvaart

    Full Text Available BACKGROUND: How a patient is connected with one's body is core to rehabilitation of somatoform disorder but a common model to describe body-relatedness is missing. The aim of our study was to investigate the components and hierarchical structure of body-relatedness as perceived by patients with severe somatoform disorder and their therapists. METHODS: Interviews with patients and therapists yielded statements about components of body-relatedness. Patients and therapists individually sorted these statements according to similarity. Hierarchical cluster analysis was applied to these sortings. Analysis of variance was used to compare the perceived importance of the statements between patients and therapists. RESULTS: The hierarchical structure included 71 characteristics of body-relatedness. It consisted of three levels with eight clusters at the lowest level: 1 understanding, 2 acceptance, 3 adjustment, 4 respect for the body, 5 regulation, 6 confidence, 7 self-esteem, and 8 autonomy. The cluster 'understanding' was considered most important by patients and therapists. Patients valued 'regulating the body' more than therapists. CONCLUSION: According to patients with somatoform disorders and their therapists, body-relatedness includes awareness of the body and self by understanding, accepting and adjusting to bodily signals, by respecting and regulating the body, by confiding and esteeming oneself and by being autonomous. This definition and structure of body-relatedness may help professionals to improve interdisciplinary communication, assessment, and treatment, and it may help patients to better understand their symptoms and treatment. (German language abstract, Abstract S1; Spanish language abstract, Abstract S2.

  7. Definition and structure of body-relatedness from the perspective of patients with severe somatoform disorder and their therapists.

    Science.gov (United States)

    Kalisvaart, Hanneke; van Broeckhuysen, Saskia; Bühring, Martina; Kool, Marianne B; van Dulmen, Sandra; Geenen, Rinie

    2012-01-01

    How a patient is connected with one's body is core to rehabilitation of somatoform disorder but a common model to describe body-relatedness is missing. The aim of our study was to investigate the components and hierarchical structure of body-relatedness as perceived by patients with severe somatoform disorder and their therapists. Interviews with patients and therapists yielded statements about components of body-relatedness. Patients and therapists individually sorted these statements according to similarity. Hierarchical cluster analysis was applied to these sortings. Analysis of variance was used to compare the perceived importance of the statements between patients and therapists. The hierarchical structure included 71 characteristics of body-relatedness. It consisted of three levels with eight clusters at the lowest level: 1) understanding, 2) acceptance, 3) adjustment, 4) respect for the body, 5) regulation, 6) confidence, 7) self-esteem, and 8) autonomy. The cluster 'understanding' was considered most important by patients and therapists. Patients valued 'regulating the body' more than therapists. According to patients with somatoform disorders and their therapists, body-relatedness includes awareness of the body and self by understanding, accepting and adjusting to bodily signals, by respecting and regulating the body, by confiding and esteeming oneself and by being autonomous. This definition and structure of body-relatedness may help professionals to improve interdisciplinary communication, assessment, and treatment, and it may help patients to better understand their symptoms and treatment. (German language abstract, Abstract S1; Spanish language abstract, Abstract S2).

  8. Therapist Perspectives: Wii Active Videogames Use in Inpatient Settings with People Who Have Had a Brain Injury.

    Science.gov (United States)

    Putnam, Cynthia; Cheng, Jinghui; Seymour, Gregory

    2014-12-01

    Brain injuries (BIs) are a major public health issue. Clinical experience and literature have identified that it is often challenging to motivate people who have had a BI to engage in repetitive exercises commonly prescribed for rehabilitation. As a result, some therapists include commercial active videogames (AVGs) in their therapy sessions to help make repetitive actions fun and engaging. In this project, we explored how the therapists used commercial AVGs to better understand the major barriers and enablers of use. We interviewed 17 therapists from two rehabilitation hospitals who work with people who have had a BI. After the interviews were transcribed, we identified salient themes. At the time of the interviews, therapists were using only the Nintendo(®) (Kyoto, Japan) Wii™ console. Common therapeutic goals included balance and weight shifting. Several patient factors, such as cognitive and physical abilities, age, and previous gaming experience, were considered important considerations when deciding to use games. Therapists also indicated many desired changes to games, including better control/interface, better feedback, and the ability to adjust timing, challenge, and stimulation levels. When considering therapy-centered game design, the needs of both therapists and patients should be considered. There is a necessary balance to consider in game design: They need to (a) be perceived as fun, (b) meet therapy goals, and (c) address therapists' needs (e.g., adjustability to address a range of patient abilities). Additionally, there is a need for a wide variety of available games to address novelty and personal preferences.

  9. Linguistic analysis of communication in therapist-assisted internet-delivered cognitive behavior therapy for generalized anxiety disorder.

    Science.gov (United States)

    Dirkse, Dale; Hadjistavropoulos, Heather D; Hesser, Hugo; Barak, Azy

    2015-01-01

    Therapist-assisted Internet-delivered cognitive behavior therapy (ICBT) involves elements of expressive writing through secure messaging with a therapist. Expressive writing has been associated with psychological and physical health benefits in past research; furthermore, certain linguistic dimensions in expressive writing have been identified as particularly beneficial to health, such as less frequent use of negative emotion words and greater use of positive emotion words. No research, to date, has analyzed linguistic dimensions in client communication over the course of therapist-assisted ICBT for individuals with symptoms of generalized anxiety. This naturalistic study examined messages sent to therapists during the course of ICBT using linguistic analysis, and explored covariation of word use with symptom improvement. Data were obtained from patients with symptoms of generalized anxiety (N = 59) who completed 12 modules of therapist-assisted ICBT and rated symptoms of anxiety, depression, and panic at the beginning of each module. Linguistic analysis categorized text submitted to therapists into different word categories. Results found that patients' use of negative emotion, anxiety, causation, and insight words reduced over the course of treatment, while past tense words increased. Furthermore, negative emotion words significantly covaried with symptom ratings over the course of treatment. While causal statements cannot be made, findings improve our understanding of patient communication in ICBT and suggest that the further study of linguistic dimensions as psychological indicators and the potential utility of expressive writing strategies in therapist-assisted ICBT may be worthwhile.

  10. The current impact of entry-level associate and baccalaureate degree education on the diversity of respiratory therapists.

    Science.gov (United States)

    Becker, Ellen A; Nguyen, Xuan T

    2014-12-01

    Transitioning from an associate degree to a baccalaureate degree for respiratory therapists has been suggested as a new entry-level educational standard. One potential risk for this change is that it may limit the diversity of potential applicants for entry-level education. A diverse workforce is important to achieve the goal of reducing healthcare disparities. This study evaluated characteristics of therapists who completed associate and baccalaureate degree entry-level education. A secondary analysis of data collected from the 2009 AARC Respiratory Therapist Human Resource Survey explored relationships between the choice of entry-level associate or baccalaureate education and variables of gender, race, salary, career advancement, and job satisfaction. There were no differences between therapists with entry-level associate and baccalaureate degrees in gender, race, number of additional healthcare credentials, numbers of life support credentials, wages, delivering respiratory care by protocol, and job satisfaction. There were significantly higher percentages of advanced academic degrees, desire to pursue a higher academic degree, registered respiratory therapist credentials, total National Board for Respiratory Care credentials, and leadership roles for therapists with baccalaureate entry-level degrees. Current entry-level associate and baccalaureate degree graduates have similar gender and race proportions. This finding challenges concerns that an entry-level baccalaureate degree would decrease the diversity of the respiratory therapist workforce. Copyright © 2014 by Daedalus Enterprises.

  11. Physical Therapists, Telephone Coaches, and Patients With Knee Osteoarthritis: Qualitative Study About Working Together to Promote Exercise Adherence.

    Science.gov (United States)

    Hinman, Rana S; Delany, Clare M; Campbell, Penelope K; Gale, Janette; Bennell, Kim L

    2016-04-01

    Integrated models of care are recommended for people with knee osteoarthritis (OA). Exercise is integral to management, yet exercise adherence is problematic. Telephone-based health coaching is an attractive adjunct to physical therapist-prescribed exercise that may improve adherence. Little is known about the perceptions and interpretations of physical therapists, telephone coaches, and patients engaged in this model of care. The purpose of this study was to explore how stakeholders (physical therapists, telephone coaches, and patients) experienced, and made sense of, being involved in an integrated program of physical therapist-supervised exercise and telephone coaching for people with knee OA. A cross-sectional qualitative design drawing from symbolic interactionism was used. Semistructured interviews with 10 physical therapists, 4 telephone coaches, and 6 patients with painful knee OA. Interviews were audiorecorded, transcribed, and analyzed using thematic analysis informed by grounded theory. Four themes emerged: (1) genuine interest and collaboration, (2) information and accountability, (3) program structure, and (4) roles and communication in teamwork. Patients reported they appreciated personalized, genuine interest from therapists and coaches and were aware of their complementary roles. A collaborative approach, with defined roles and communication strategies, was identified as important for effectiveness. All participants highlighted the importance of sharing information, monitoring, and being accountable to others. Coaches found the lack of face-to-face contact with patients hampered relationship building. Therapists and coaches referred to the importance of teamwork in delivering the intervention. The small number of physical therapists and telephone coaches who delivered the intervention may have been biased toward favorable experiences with the intervention and may not be representative of their respective professions. Integrated physical therapy and

  12. Prevalence and Risk of Inappropriate Sexual Behavior of Patients Toward Physical Therapist Clinicians and Students in the United States.

    Science.gov (United States)

    Boissonnault, Jill S; Cambier, Ziádee; Hetzel, Scott J; Plack, Margaret M

    2017-11-01

    For health care providers in the United States, the risk for nonfatal violence in the workplace is 16 times greater than that for other workers. Inappropriate patient sexual behavior (IPSB) is directed at clinicians, staff, or other patients and may include leering, sexual remarks, deliberate touching, indecent exposure, and sexual assault. Inappropriate patient sexual behavior may adversely affect clinicians, the organization, or patients themselves. Few IPSB risk factors for physical therapists have been confirmed. The US prevalence was last assessed in the 1990s. The objectives of this study were to determine career and 12-month exposure to IPSB among US physical therapists, physical therapist assistants, physical therapist students, and physical therapist assistant students and to identify IPSB risk factors. This was a retrospective and observational study. An electronic survey was developed; content validity and test-retest reliability were established. Participants were recruited through physical therapist and physical therapist assistant academic programs and sections of the American Physical Therapy Association. Inappropriate patient sexual behavior risk models were constructed individually for any, mild, moderate, and severe IPSB events reported over the past 12 months. Open-ended comments were analyzed using qualitative methods. Eight hundred ninety-two physical therapist professionals and students completed the survey. The career prevalence among respondents was 84%, and the 12-month prevalence was 47%. Statistical risk modeling for any IPSB over the past 12 months indicated the following risks: having fewer years of direct patient care, routinely working with patients with cognitive impairments, being a female practitioner, and treating male patients. Qualitative analysis of 187 open-ended comments revealed patient-related characteristics, provider-related characteristics, and abusive actions. Self-report, clinician memory, and convenience sampling are

  13. Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 2: a national cross-sectional survey of orthodontic therapists.

    Science.gov (United States)

    Ahmed, Farooq; Dugdale, Charlotte; Malik, Ovais; Waring, David

    2018-03-01

    Orthodontic therapists (OTs) are the most recent addition to the orthodontic clinical team. The General Dental Council (GDC) and the British Orthodontic Society have formulated guidance and guidelines relating to their scope of practice and level of supervision, however there has been no contemporary UK-based research investigating practice and supervision of OTs. The aim of this study was to investigate the scope of practice and level of supervision of OTs working in the UK. Ethical approval was received from the University of Manchester Research Ethics Committee. An anonymous postal questionnaire was dispatched using postal details acquired through the British Orthodontic Societies mailing list. Three mailings of the questionnaire were conducted. A 74% response rate was achieved. OTs routinely conducted 16 of the 20 procedures from their scope of practice. Uncommon procedures included fitting headgear (24%), lingual appliances (27%), inserting or removing temporary anchorage devices (20%), and taking facebow record (18%). A total of 62% of OTs took patient consent for treatment. 59% were supervised through a written prescription with no direct supervision. OTs were directly supervised for only a quarter of their clinical practice. Orthodontists viewing frequency for OTs varied significantly, and was found to be the following: every 2-4 visits (36%), every other visit (35%), and every visit (26%). OTs mostly carried out the scope of practice as permitted by the GDC. Procedures uncommon to routine orthodontic practice were also uncommon to Orthodontic therapist clinical practice. OTs work mostly through written prescription with no direct supervision.

  14. Exploring a fourth dimension: spirituality as a resource for the couple therapist.

    Science.gov (United States)

    Anderson, D A; Worthen, D

    1997-01-01

    This article explores ways in which the therapist's own spirituality can serve as a resource in couple therapy. Spirituality is defined as subjective engagement with a fourth, transcendent dimension of human experience. This engagement enhances human life and evokes corresponding behavior. Spiritually based therapy may be influenced by three assumptions: that God or a Divine Being exists, that human-kind yearns innately for connection with this Being, and that this Being is interested in humans and acts upon and within their relationships to promote beneficial change. In therapy these assumptions affect how the therapist listens and responds throughout sessions. The authors incorporate a case example illustrating the application of this fourth dimension in couple therapy.

  15. The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

    Science.gov (United States)

    Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

    2018-01-01

    People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

  16. The relations between personality characteristics, work environment, and the professional well-being of music therapists.

    Science.gov (United States)

    Fowler, Kelly L

    2006-01-01

    The purpose of this correlational study was to investigate the relations between professional well-being (as characterized by positive attitudes toward work and longevity as a practicing music therapist) and the following factors: age, level of education, income, attitudes regarding the workplace (e.g., perceived control, feeling valued, as well as the amount of perceived comfort and input into administrative policies), attitudes toward work as measured by the Maslach Burnout Inventory (Maslach & Jackson, 1986a), and measures of stress and stress management as measured by the Stress Profile (Nowack, 1999a). Participants included 49 music therapists who had between one to 36 years of work experience. Correlations indicated that those respondents with greatest professional longevity tended to have higher ratings on items regarding cognitive coping strategies (e.g., positive appraisal and threat minimization) and greater perception of personal achievement. These correlational results are related to psychological theories regarding occupational burnout and cognitive hardiness.

  17. Navigating career pathways--dental therapists in the workforce: a report of the career path subcommittee.

    Science.gov (United States)

    Yoder, Karen; DePaola, Dominick

    2011-01-01

    Creating career pathways to facilitate current dental and other healthcare providers becoming dental therapists can be an efficient means to expand the dental workforce and reduce barriers to access to oral health services. Career pathways are proposed to facilitate dental providers building on previously learned skills to broaden their scope of practice and become even more versatile and productive providers of oral health services. Creation of a unified and integrated curriculum will enable research to document the effectiveness of this new dental provider who will work as part of dental teams and with supervision by dentists. The goal of augmenting the current dental team and reducing barriers to access to dental services for underserved populations can be enhanced by offering alternative pathways to achieve the competencies required of dental therapists.

  18. Uniqueness of family therapists as family business systems consultants: a cross-disciplinary investigation.

    Science.gov (United States)

    Lee, Jinhee; Danes, Sharon M

    2012-06-01

    The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team. © 2012 American Association for Marriage and Family Therapy.

  19. Lessons offered, lessons learned: reflections on how doing family therapy can affect therapists.

    Science.gov (United States)

    Heatherington, Laurie; Friedlander, Myrna L; Diamond, Gary M

    2014-08-01

    Only in working conjointly with couples and families do therapists literally witness clients struggling to improve their most intimate relationships. In writing this article, we realized that, in true systemic fashion, not only have many of our clients benefited from working with us, but also we have learned some invaluable lessons from them. Indeed, practicing couple and family therapy gives therapists many opportunities to learn about themselves, especially when it is done thoughtfully. In this article, we reflect on myriad ways in which couples and family therapy has affected each of us personally-as individuals, as partners, as parents, as adult children in our families of origin, and as educators. © 2014 Wiley Periodicals, Inc.

  20. Comparison of therapist implemented and iPad-assisted interventions for children with autism.

    Science.gov (United States)

    Lee, Allyson; Lang, Russell; Davenport, Katy; Moore, Melissa; Rispoli, Mandy; van der Meer, Larah; Carnett, Amarie; Raulston, Tracy; Tostanoski, Amy; Chung, Clare

    2015-04-01

    This study compares intervention delivered by a therapist to intervention delivered using an iPad for two children with autism. Further, this study evaluates the influence of choice between the conditions. Time on-task, challenging behaviour, session duration and correct responses were compared across conditions in an alternating treatment design. The effect of choice was evaluated in an ABAB design. The iPad was associated with shorter intervention sessions, more time on-task and less challenging behaviour for one participant. There was no difference between conditions for the second participant. Both participants selected the iPad when given the choice and, although the effect of choice was modest, choosing was associated with more time on-task and less challenging behaviour. These data suggest that iPad-assisted intervention can be as effective as therapist-implemented intervention. Further, even for children for whom no differences between the interventions exist, offering a choice may be beneficial.

  1. Exploring the Role of the Speech-language Therapist in City Centre Preschools

    Directory of Open Access Journals (Sweden)

    Sandra du Plessis

    2012-12-01

    Full Text Available This study investigates the perception of the strengths and challenges that face city centre preschool teachers and preschool learners in the acquisition of English as medium of instruction and to use the results to explore the role of speech-language therapists in this context. A descriptive survey, incorporating a quantitative data collection method, was selected as the research design and a questionnaire was developed as a survey instrument. The findings identified the strengths as including the creative communication strategies employed by the pre-schoolers and the innovative techniques of the teachers. Perceived challenges include a cultural and linguistic mismatch between teachers and learners and communication barriers that cause emotional and behavioural problems in classrooms. The study suggests that speech-language therapists need to consider and employ service delivery models instead of traditional models with the preschool teachers.

  2. Authority, Psychotherapy and the Authority of the Therapist in the Religious Haredi Community.

    Science.gov (United States)

    Hess, Esther

    2018-06-01

    This article considers the meaning and significance of authority, and its relevance to the transference process, within the framework of psychotherapy in the orthodox Jewish (Haredi) community in Israel. In this community, deeply-rooted habits of obedience to the commandments of the Torah and the authority of the Rabbi are integral to maintaining an orthodox way of life. Clinical vignettes with Haredi patients are presented to illustrate the complexities that arise when both patient and therapist belong to the orthodox community, and highlight the authority-related issues that are central to the therapy. This combination of factors requires a sensitive and finely-tuned approach which will enable the therapist to maintain the treatment framework while still accommodating the orthodox way of life.

  3. The relevance of psychodynamic psychotherapy to understanding therapist-patient sexual abuse and treatment of survivors.

    Science.gov (United States)

    Yahav, Rivka; Oz, Sheri

    2006-01-01

    Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.

  4. Attitudes to professional boundaries among therapists with and without substance abuse history

    Directory of Open Access Journals (Sweden)

    Pietkiewicz Igor

    2017-09-01

    Full Text Available There is no empirical research exploring how substance abuse therapists perceive and manage their professional role or privacy boundaries. This study explores their attitudes associated with self-disclosure and dual relationships. Ten therapists, five who had recovered (neophytes and five who had never been substance dependent, shared their work experiences during semi-structured, in-depth interviews, which have been subjected to interpretative phenomenological analysis. While nonneophytes were generally reluctant to share personal information or establish alternative forms of relationship with current or former clients, neophytes were more open to using self-disclosure and admitted changing professional relationships into friendships. These findings are discussed in relation to ethical codes, training and supervision in substance abuse treatment.

  5. HOSPITALITY ENGLISH FOR SPA THERAPISTS IN BANYAN TREE HOTELS AND RESORTS

    Directory of Open Access Journals (Sweden)

    Ratnasari Nugraheni

    2018-04-01

    Full Text Available This study is a preliminary study of research and design for hospitality English for SPA therapist in Banyan Tree Hotels and Resorts at Bintan Island. The purpose of this study is to help the English teacher to provide a successful English training since a good English proficiency used in the hospitality industry is obliged, especially for an-international-five-star-hotel-brand. The nature of the study is qualitative using R&D approach. Since this is only a preliminary study, need analysis becomes the primary focus. The data were collected through interview and observation. The participants were people who are working in SPA department in Banyan Tree Bintan, such as SPA trainer, SPA therapist, and SPA manager.

  6. RELATIONAL NEEDS OF THE THERAPIST: COUNTERTRANSFERENCE, CLINICAL WORK AND SUPERVISION. BENEFITS AND DISRUPTIONS IN PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Lindsay Stewart

    2010-02-01

    Full Text Available Relational needs are the emotional needs which underlie our social connectedness and help sustain and nurture our attachments to others. In doing psychotherapy, therapists must be attuned not only to the needs of the client, but also to their own relational needs. Through self awareness and knowledge of healthy and appropriate boundaries, therapists can ensure the best interest of the client is kept foremost. In this article, the influence of the therapist’s own relational needs in the psychotherapy process is examined in terms of the possible benefits and disruptions to the client’s emotional growth. This is discussed in the context of the Integrative Psychotherapy model based on the core concepts of inquiry, involvement and attunement. Clinical supervision is seen as an important part of working through counter-transference.

  7. Outcomes of systemic/strategic team consultation: III. The importance of therapist warmth and active structuring.

    Science.gov (United States)

    Green, R J; Herget, M

    1991-09-01

    This is the third in a series of reports on a small-sample study of systemic/strategic team consultations. It sheds new light on aspects of the therapeutic alliance in Milan-informed therapy. Ratings of the end-of-session interventions and ratings of the therapist's relationship skills (warmth, active structuring) significantly predicted client improvement at 1-month and 3-year followups. These results dispute the Milan team's idea that an intervention's effects are unpredictable. Also, our findings challenge the way some teams have adopted an impersonal, emotionally unresponsive style under the guise of "neutrality." In view of this and other recent studies, we conclude that systemic/strategic therapists should devote more attention to collaborative and affective qualities of the therapeutic alliance.

  8. Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

    Science.gov (United States)

    Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

    2011-01-01

    Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

  9. Job satisfaction, burnout and turnover intention in occupational therapists working in mental health.

    Science.gov (United States)

    Scanlan, Justin Newton; Still, Megan

    2013-10-01

    Employee wellbeing is an important issue for mental health services. Poor employee wellbeing (i.e., high levels of burnout or low job satisfaction) is associated with poorer consumer outcomes and higher staff turnover. This study set out to examine factors related to job satisfaction, turnover intention and burnout in a group of occupational therapists in mental health. Thirty-four occupational therapists (response rate approximately 60%) in a metropolitan public mental health service participated in a whole-of-service workforce survey. The survey included measures of job satisfaction, turnover intention, burnout, job hindrances, job challenges and job resources and questions about positive and negative aspects of positions and factors that attracted employees to their current position. Burnout was associated with lower job satisfaction and higher turnover intention. Higher job satisfaction was associated with rewards (remuneration and recognition) as well as cognitively challenging work. The variables most significantly associated with poorer wellbeing (higher turnover intention and burnout) were recipient contact demands (perception that contact with service users or families was demanding), and feelings of stress or fatigue. This study provides a detailed analysis of factors associated with job satisfaction, turnover intention and burnout in a group of occupational therapists working in mental health. To promote workforce wellbeing and enhanced retention, interventions to minimise burnout should be implemented and evaluated. These strategies should focus on enhancing job resources such as supervisor support, feedback and participation in decision making as well as building the personal resilience of occupational therapists working in mental health. © 2013 Occupational Therapy Australia.

  10. Occupational burnout among radiation therapists in Australia: Findings from a mixed methods study

    International Nuclear Information System (INIS)

    Singh, N.; Wright, C.; Knight, K.; Baird, M.; Akroyd, D.; Adams, R.D.; Schneider, M.E.

    2017-01-01

    Introduction: Evidence demonstrates that health care professionals in the palliative care context are more burned out than other health professionals. The aims of this study were to examine: (1) occupational burnout levels among radiation therapists in Australia, (2) association between demographic factors on burnout and (3) radiation therapists' perceptions of burnout. Methods: A cross-sectional online survey including the Maslach Burnout Inventory was administered to Radiation Therapists in Australia. Data were analysed using SPSS Ver 20 and open ended comments were analysed thematically using Nvivo 10. Results: A total of 200 radiation therapists participated in the survey. RTs had a high mean (±SD) burnout score for emotional exhaustion (38.5 ± 8.2), depersonalisation (17.5 ± 4.7) and personal achievement (30.5.3 ± 4.3) compared to RTs and health workers in other studies. High levels of emotional exhaustion, depersonalisation and low levels of personal achievement were present in 93% (186/200), 87% (174/200) and 61% (122/200) of participants respectively. RTs identified high workload and staff shortages, interpersonal conflict and technology as key sources of stress in the RT work environment. Conclusion: Australian RTs' level of burnout on all three stages of burnout exceed previously reported burnout levels for similar cohorts both locally and internationally. It is important that future interventions aimed at minimising or preventing stressors are identified and implemented in the radiation therapy work environment. - Highlights: • The burnout rate is higher among Australian RTs compared to studies in other countries. • Dealing with patients and their emotions were not a contributing factor to RTs' stress. • Challenging interpersonal relationships between staff was identified as one of the key stressors. • It is important that future interventions aimed at minimising or preventing stressors are recognised.

  11. Therapists? Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation

    OpenAIRE

    Tatla, Sandy K; Shirzad, Navid; Lohse, Keith R; Virji-Babul, Naznin; Hoens, Alison M; Holsti, Liisa; Li, Linda C; Miller, Kimberly J; Lam, Melanie Y; Van der Loos, HF Machiel

    2015-01-01

    Background The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians? perspectives regarding technology adoption by their clients. Objective The objective of our study was to explore therapists? perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these...

  12. Currency and Competence of Occupational Therapists and Consumers with Rapidly Changing Technology

    OpenAIRE

    Steel, Emily J.; Buchanan, Ricky; Layton, Natasha; Wilson, Erin

    2017-01-01

    Assistive technology was once a specialised field of practice, involving products designed for populations with specific impairments or functional goals. In Australia, occupational therapists have, at times, functioned as gatekeepers to public funding, prescribing products from a predefined list. An expanding range of accessible mainstream products available via international and online markets has changed the meaning and application of assistive technology for many people with disability. In...

  13. [The speech therapist in geriatrics: caregiver, technician-researcher, or both?].

    Science.gov (United States)

    Orellana, Blandine

    2015-01-01

    Geriatric care mostly consists not in curingthe patient, but supportingthem to the end of their life, giving meaning to care procedures and actions through speech, touch or look and maintaining a connection.The helping relationship is omnipresent and the role of the speech therapist is therefore essential in helping to maintain or re-establish elderly patients' abilityto communicate. However, todaythis role is struggling to define itself between that of the technician-researcher and that of caregiver.

  14. Tenth national congress of the South African Society of Radiation Therapists

    International Nuclear Information System (INIS)

    1986-01-01

    The proceedings of the tenth national congress of the South African Society of Radiation Therapists are presented. Papers on the following topics were presented: gynaecological malignancies and oncology; pain and symptom control; radiobiology; radiotherapy of the head and neck; combined modality therapy, and lymphoma. Separate abstracts were prepared for thirty five of the papers presented. The remaining papers were considered outside the subject scope of INIS

  15. UK survey of occupational therapist's and physiotherapist's experiences and attitudes towards hip replacement precautions and equipment.

    Science.gov (United States)

    Smith, T O; Sackley, C M

    2016-05-25

    Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR. A 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents). The survey included questions regarding the current practices in the provision of equipment and hip precautions for THR patients, and physiotherapist's and occupational therapist's attitudes towards these practices. The survey was disseminated through print and web-based/social media channels. 170 health professionals (87 physiotherapists and 83 occupational therapists), responded to the survey. Commonly prescribed equipment in respondent's health trusts were raised toilet seats (95 %), toilet frames and rails (88 %), furniture raises (79 %), helping hands/grabbers (77 %), perching stools (75 %) and long-handled shoe horns (75 %). Hip precautions were routinely prescribed by 97 % of respondents. Hip precautions were most frequently taught in a pre-operative group (52 % of respondents). Similarly equipment was most frequently provided pre-operatively (61 % respondents), and most commonly by occupational therapists (74 % respondents). There was variability in the advice provided on the duration of hip precautions and equipment from up to 6 weeks post-operatively to life-time usage. Current practice on hip precautions and provision of equipment is not full representative of clinician's perceptions of best care after THR. Future research is warranted to determine whether and to whom hip precautions and equipment

  16. Occupational burnout among radiation therapists in Australia: Findings from a mixed methods study.

    Science.gov (United States)

    Singh, N; Wright, C; Knight, K; Baird, M; Akroyd, D; Adams, R D; Schneider, M E

    2017-08-01

    Evidence demonstrates that health care professionals in the palliative care context are more burned out than other health professionals. The aims of this study were to examine: (1) occupational burnout levels among radiation therapists in Australia, (2) association between demographic factors on burnout and (3) radiation therapists' perceptions of burnout. A cross-sectional online survey including the Maslach Burnout Inventory was administered to Radiation Therapists in Australia. Data were analysed using SPSS Ver 20 and open ended comments were analysed thematically using Nvivo 10. A total of 200 radiation therapists participated in the survey. RTs had a high mean (±SD) burnout score for emotional exhaustion (38.5 ± 8.2), depersonalisation (17.5 ± 4.7) and personal achievement (30.5.3 ± 4.3) compared to RTs and health workers in other studies. High levels of emotional exhaustion, depersonalisation and low levels of personal achievement were present in 93% (186/200), 87% (174/200) and 61% (122/200) of participants respectively. RTs identified high workload and staff shortages, interpersonal conflict and technology as key sources of stress in the RT work environment. Australian RTs' level of burnout on all three stages of burnout exceed previously reported burnout levels for similar cohorts both locally and internationally. It is important that future interventions aimed at minimising or preventing stressors are identified and implemented in the radiation therapy work environment. Copyright © 2017 The College of Radiographers. All rights reserved.

  17. Primary therapist model for patients referred for rheumatoid arthritis rehabilitation: a cost-effectiveness analysis.

    Science.gov (United States)

    Li, Linda C; Maetzel, Andreas; Davis, Aileen M; Lineker, Sydney C; Bombardier, Claire; Coyte, Peter C

    2006-06-15

    To estimate the incremental cost-effectiveness (ICE) of services from a primary therapist compared with traditional physical therapists and/or occupational therapists for managing rheumatoid arthritis (RA), from the societal perspective. Patients with RA were randomly assigned to the primary therapist model (PTM) or traditional treatment model (TTM) for approximately 6 weeks of rehabilitation treatment. Health outcomes were expressed in terms of quality-adjusted life years (QALYs), measured with the EuroQol instrument at baseline, 6 weeks, and 6 months. Direct and indirect costs, including visits to health professionals, use of investigative tests, hospital visits, use of medications, purchases of adaptive aids, and productivity losses incurred by patients and their caregivers, were collected monthly. Of 144 consenting patients, 111 remained in the study after the baseline assessment: 63 PTM (87.3% women, mean age 54.2 years, disease duration 10.6 years) and 48 TTM (79.2% women, mean age 56.8 years, disease duration 13.2 years). From a societal perspective, PTM generated higher QALYs (mean +/- SD 0.068 +/- 0.22) and resulted in a higher mean cost ($6,848 Canadian, interquartile range [IQR] $1,984-$9,320) compared with TTM (mean +/- SD QALY -0.017 +/- 0.24; mean costs $6,266, IQR $1,938-$10,194) in 6 months, although differences were not statistically significant. The estimated ICE ratio was $13,700 per QALY gained (95% nonparametric confidence interval -$73,500, $230,000). The PTM has potential to be an alternative to traditional physical/occupational therapy, although it is premature to recommend widespread use of this model in other regions. Further research should focus on strategies to reduce costs of the model and assess the long-term economic consequences in managing RA and other rheumatologic conditions.

  18. National Study of Excellence and Innovation in Physical Therapist Education: Part 1-Design, Method, and Results.

    Science.gov (United States)

    Jensen, Gail M; Nordstrom, Terrence; Mostrom, Elizabeth; Hack, Laurita M; Gwyer, Janet

    2017-09-01

    The Carnegie Foundation for the Advancement of Teaching commissioned the Preparation for the Professions Program, a qualitative study of professional education in 5 professions: medicine, nursing, law, engineering, and clergy. These studies identified curricular structures, instructional practices, assessment approaches, and environmental characteristics that support the preparation of professionals and led to educational reforms. The physical therapy profession has not had any in-depth, national investigation of physical therapist education since the Catherine Worthingham studies conducted more than 50 years ago. This research was a Carnegie-type study, investigating elements of excellence and innovation in academic and clinical physical therapist education in the United States. Five physical therapist education researchers from across the United States used a qualitative multiple-case study design. Six academic and 5 clinical programs were selected for the study. The academic institutions and clinical agencies studied were diverse in size, institutional setting, geography, and role in residency education. Qualitative case studies were generated from review of artifacts, field observations, and interviews (individual and focus group), and they provided the data for the study. A conceptual framework grounded in 3 major dimensions was generated, with 8 supporting elements: (1) culture of excellence (shared beliefs and values, leadership and vision, drive for excellence, and partnerships), (2) praxis of learning (signature pedagogy, practice-based learning, creating adaptive learners, and professional formation), and (3) organizational structures and resources. Building on the work of the Carnegie Foundation's Preparation for the Professions Program, a conceptual model was developed, representing the dimensions and elements of excellence in physical therapist education that is centered on the foundational importance of a nexus of linked and highly valued aims of

  19. Assertiveness training: Effects of treatment, maintenance of change and therapists' contribution in therapy outcome

    Directory of Open Access Journals (Sweden)

    Tovilović Snežana

    2005-01-01

    Full Text Available In this research is shown part of results concerning evaluation study of group assertiveness training. Treatment, which has been organized as structured program of assertiveness training, has been applied on 18 groups of subjects during 9 group sessions. This treatment has been adjusted to non-psychiatric clients from our country. Groups were lead by two therapists. During 20 months of our research 215 voluntary participants of full age have joined training groups. Final sample consisted of 158 subjects who had finished treatment and who had fulfilled criteria for taking repeated measurement. Subjects had taken battery of questionnaires before the treatment and eight weeks after they had completed treatment. Subsample, which included 35 subjects from one therapist’s groups, took retest after twice longer time period. Results of conducted research have confirmed the hypothesis concerning the potentiality of assertiveness training to produce expected and significant improvements of treated subjects. Therapy effect is found on symptomatic level through reduction of symptoms of non-assertive behaviors, which were target of the treatment. Contrary to expectation interactive effect of treatment and therapist to reduction of symptoms of non-assertive behavior has been found, which implies need for further investigation of variables that are related to therapists. Through the medium of treatment therapeutic changes in structural level, in domain of general assertiveness, social anxiety and treated subjects' self-concept are produced. The effect of therapy we might consider stabled and maintained after 16 weeks of finishing the treatment.

  20. Experienced Practitioners’ Beliefs Utilized to Create a Successful Massage Therapist Conceptual Model: a Qualitative Investigation

    Science.gov (United States)

    Kennedy, Anne B.; Munk, Niki

    2017-01-01

    Background The massage therapy profession in the United States has grown exponentially, with 35% of the profession’s practitioners in practice for three years or less. Investigating personal and social factors with regard to the massage therapy profession could help to identify constructs needed to be successful in the field. Purpose This data-gathering exercise explores massage therapists’ perceptions on what makes a successful massage therapist that will provide guidance for future research. Success is defined as supporting oneself and practice solely through massage therapy and related, revenue-generating field activity. Participants and Setting Ten successful massage therapy practitioners from around the United States who have a minimum of five years of experience. Research Design Semistructured qualitative interviews were used in an analytic induction framework; index cards with preidentified concepts printed on them were utilized to enhance conversation. An iterative process of interview coding and analysis was used to determine themes and subthemes. Results Based on the participants input, the categories in which therapists needed to be successful were organized into four main themes: effectively establish therapeutic relationships, develop massage therapy business acumen, seek valuable learning environments and opportunities, and cultivate strong social ties and networks. The four themes operate within specific contexts (e.g., regulation and licensing requirements in the therapists’ state), which may also influence the success of the massage therapist. Conclusions The model needs to be tested to explore which constructs explain variability in success and attrition rate. Limitations and future research implications are discussed. PMID:28690704

  1. Cultural order and participatory local development: structure for the occupational therapist practice

    Directory of Open Access Journals (Sweden)

    Ricardo Lopes Correia

    2016-01-01

    Full Text Available The Cultural Order is understood as the expression of a game of interdependencies determinations between local and global social groups, pairs identified by productions, values and behavior that consciously guide the life projects and the expansion of a collective freedom. Based on a Social Science research and with theoretical mark of Nobert Elias and Amartya Sen, this article aims to present a theoretical-practice structure of the approach in participatory local development- PLD to the occupational therapist surround by the construction of collective life projects, in order to operationalize in the practice of the community question, understood as the strengths that singularize the participation. We discuss the use of the PLD approach to the occupational therapist in a flexible structure, aiming to guarantee its domain, the Human Occupation, and the set of interventions, technologies, sustained in the management of the activities of daily living. The approach in participatory local development presents itself as an important structural outline to the community actions, and it is the occupational therapist role to be an articulator of the Local Cultural Order dimensions, to deal with the target population their work processes of continuity in collective life projects and expansion of freedom.

  2. (What) do you believe?: Therapist spiritual/religious/non-religious self-disclosure.

    Science.gov (United States)

    Magaldi, Danielle; Trub, Leora

    2018-05-01

    Spiritual/religious/non-religious (S/R/N) identity development is often neglected in psychotherapy training and represents an area where psychotherapists feel they lack competence. Such feelings can become even more pronounced when it comes to S/R/N self-disclosure. This study explores the decisions therapists make regarding self-disclosure, which impacts the psychotherapy process. This grounded theory study explores psychotherapists' S/R/N self-disclosure based on qualitative interviews with 21 psychotherapists representing varied theoretical orientations and spiritual, religious, atheist, and agnostic backgrounds. Findings reveal that while some self-disclosure happens on an explicit level, more often psychotherapists find implicit ways to share S/R/N aspects of the self for purposes of enhancing the therapeutic alliance and to convey openness. Psychotherapists also attempt to avoid the topic altogether, either to protect the therapeutic relationship or because of unresolved S/R/N identity in the therapist. Developing skills related to S/R/N self-disclosure represents an important aspect of multicultural competence, which can impact clients' feelings of safety and comfort discussing their own S/R/N identity. This capacity is strongly influenced by the therapist's self-awareness regarding S/R/N identity. Suggestions for engaging S/R/N identity and disclosure in supervisory experiences and academic preparation are discussed.

  3. Focusing on the Environment to Improve Youth Participation: Experiences and Perspectives of Occupational Therapists.

    Science.gov (United States)

    Anaby, Dana; Law, Mary; Teplicky, Rachel; Turner, Laura

    2015-10-23

    The environment plays a key role in supporting children's participation and can serve as a focus of intervention. This study aimed to elicit the perceptions and experiences of occupational therapists who had applied the PREP approach--Pathways and Resources for Engagement and Participation. PREP is a novel 12-week intervention for youth with physical disabilities, aimed at improving participation in leisure community-based activities by modifying aspects of the environment. Using a qualitative post-intervention only design, 12 therapists took part in individual semi-structured interviews, in which the therapists reflected on their experience using PREP to enable participation. A thematic analysis was conducted. Four themes emerged from the data; two of which were informative in nature, describing elements of the PREP intervention that target multi-layered composition of the environment and use strategies that involve leveraging resources and problem solving. The two remaining themes were reflective in nature, illustrating a new take on the Occupational Therapy role and re-positioning the concept of participation in therapy practices. Results emphasize aspects of the environment that can serve as effective targets of intervention, guided by the PREP approach. Findings can broaden the scope and focus of occupational therapy practice by redefining views on participation and the environment.

  4. INTRODUCTION TO THE MOVEMENT SYSTEM AS THE FOUNDATION FOR PHYSICAL THERAPIST PRACTICE EDUCATION AND RESEARCH.

    Science.gov (United States)

    Saladin, Lisa; Voight, Michael

    2017-11-01

    In 2013, the American Physical Therapy Association (APTA) adopted an inspiring new vision, "Transforming society by optimizing movement to improve the human experience." This new vision for our profession calls us to action as physical therapists to transform society by using our skills, knowledge, and expertise related to the movement system in order to optimize movement, promote health and wellness, mitigate the progression of impairments, and prevent the development of (additional) disability. The guiding principle of the new vision is "identity," which can be summarized as "The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society." Recognition and validation of the movement system is essential to understand the structure, function, and potential of the human body. As currently defined, the "movement system" represents the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts. By better characterizing physical therapists as movement system experts, we seek to solidify our professional identity within the medical community and society. The physical therapist will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations, and participation restrictions; and provide interventions targeted at preventing or ameliorating activity limitations and participation restrictions. 5.

  5. Attitudes of mental health occupational therapists toward evidence-based practice.

    Science.gov (United States)

    Hitch, Danielle P

    2016-02-01

    Evidence-based practice is an important driver in modern health care and has become a priority in mental health occupational therapy in recent years. The aim of this study was to measure the attitudes of a cohort of mental health occupational therapists toward evidence-based practice. Forty-one mental health occupational therapists were surveyed using the Evidence-Based Practice Attitude Scale (EBPAS). Mann-Whitney U tests and Spearman's rho were used to analyze the data. The occupational therapy respondents had generally positive attitudes toward evidence-based practices comparable to established norms. Respondents with further qualifications beyond their professional degree were significantly more likely to try new interventions (p = .31). Significant negative correlations were found also for the subscales of Appeal and Openness in relation to years of occupational therapy practice (rho = -.354, p = .023; rho = -.344, p = 0.28) and mental health experience (rho = -.390, p = 0.12; rho = -.386, p = .013). Therapist factors can significantly impact attitudes toward evidence-based practice. © CAOT 2015.

  6. New graduate occupational therapists' perceptions of near-misses and mistakes in the workplace.

    Science.gov (United States)

    Clark, Michele; Gray, Marion; Mooney, Jane

    2013-01-01

    The purpose of this paper is to explore the perceptions of near-misses and mistakes among new graduate occupational therapists from Australia and Aotearoa/New Zealand (NZ), and their knowledge of current incident reporting systems. New graduate occupational therapists in Australia and Aotearoa/NZ in their first year of practice (n = 228) participated in an online electronic survey that examined five areas of work preparedness. Near-misses and mistakes was one focus area. The occurrence and disclosure of practice errors among new graduate occupational therapists are similar between Australian and Aotearoa/NZ participants. Rural location, structured supervision and registration status significantly influenced the perceptions and reporting of practice errors. Structured supervision significantly impacted on reporting procedure knowledge. Current registration status was strongly correlated with perceptions that the workplace encouraged event reporting. Areas for further investigation include investigating the perceptions and knowledge of practice errors within a broader profession and the need to explore definitional aspects and contextual factors of adverse events that occur in allied health settings. Selection bias may be a factor in this study. Findings have implications for university and workplace structures, such as clinical management, supervision, training about practice errors and reporting mechanisms in allied health. Findings may enable the development of better strategies for detecting, managing and preventing practice errors in the allied health professions.

  7. [Occupational exposure of physical therapists to electric and magnetic fields and the efficacy of Faraday cages].

    Science.gov (United States)

    Messias, Iracimara de Anchieta; Okuno, Emico; Colacioppo, Sérgio

    2011-10-01

    Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation Protection (ICNIRP). Observe the efficacy of Faraday cages as a means of protecting physical therapists from exposure to oscillating electric and magnetic fields. Electric and magnetic field measurements were taken at four points during actual physical therapy sessions: in proximity to the operator's pelvis and head, the devices' electrical cables, and the electrodes. The measuring equipment was a Wandel & Goltermann EMR-200. The values obtained in proximity to the electrodes and cables were 10 to 30 times higher than ICNIRP's recommended occupational reference levels. In the shortwave diathermy treatment rooms with Faraday cages, the fields were even higher than in treatment rooms not so equipped-principally the magnetic field, where the values were more than 100 times higher than the ICNIRP exposure limit. The electric and magnetic field intensities obtained in this study are generally above the exposure levels recommend in ICNIRP standards. It was also observed that the Faraday cage offers physical therapists no protection, and instead, increases their level of exposure.

  8. A technology prototype system for rating therapist empathy from audio recordings in addiction counseling.

    Science.gov (United States)

    Xiao, Bo; Huang, Chewei; Imel, Zac E; Atkins, David C; Georgiou, Panayiotis; Narayanan, Shrikanth S

    2016-04-01

    Scaling up psychotherapy services such as for addiction counseling is a critical societal need. One challenge is ensuring quality of therapy, due to the heavy cost of manual observational assessment. This work proposes a speech technology-based system to automate the assessment of therapist empathy-a key therapy quality index-from audio recordings of the psychotherapy interactions. We designed a speech processing system that includes voice activity detection and diarization modules, and an automatic speech recognizer plus a speaker role matching module to extract the therapist's language cues. We employed Maximum Entropy models, Maximum Likelihood language models, and a Lattice Rescoring method to characterize high vs. low empathic language. We estimated therapy-session level empathy codes using utterance level evidence obtained from these models. Our experiments showed that the fully automated system achieved a correlation of 0.643 between expert annotated empathy codes and machine-derived estimations, and an accuracy of 81% in classifying high vs. low empathy, in comparison to a 0.721 correlation and 86% accuracy in the oracle setting using manual transcripts. The results show that the system provides useful information that can contribute to automatic quality insurance and therapist training.

  9. Psychotherapy Termination Practices with Older Adults: Impact of Patient and Therapist Characteristics.

    Science.gov (United States)

    Sullivan, Daniel J; Zeff, Patricia; Zweig, Richard A

    2018-02-06

    The aims of this study were to survey clinicians' opinions regarding psychotherapy practices in mutual termination with a specified population (depressed older adult outpatients) and to examine the patient and therapist characteristics that may influence such practices. We surveyed psychologists' (N = 96) psychotherapy termination practices, using a hypothetical depressed older adult as a referent, to assess consensus on the appropriateness of various guidelines to termination and to examine whether these differ as a function of patient and therapist characteristics. Several practices were generally agreed to be "extremely appropriate" when terminating psychotherapy with older adults, including collaborating to determine the end date of treatment and discussing patient growth. Data also indicate that patient factors, such as personality pathology, and therapist factors, such as having an Integrative theoretical orientation were associated with differential endorsement of termination practices. Identification as a geropsychologist or working regularly with older adults were associated with a more cautious approach to termination. There is substantial consensus regarding many approaches to termination, but modifications might be appropriate depending on patient characteristics. Clinicians agree on a set of fundamental termination practices when working with older adults, but modify these based on orientation and diagnosis.

  10. Factors influencing job satisfaction among Swedish occupational therapists in psychiatric care.

    Science.gov (United States)

    Eklund, M; Hallberg, I R

    2000-01-01

    This study examined job satisfaction among occupational therapists in Swedish psychiatric care, and investigated how clinical supervision, organizational aspects and demographic characteristics contributed to job satisfaction. We received 332 returned questionnaires, corresponding to a response rate of 66.9%. Job satisfaction factors that emerged were: general satisfaction with work, communication and co-operation among team members, managerial feedback, the patients' influence on care and the relatives' influence on care. The respondents rated their general satisfaction, co-operation and communication as high. They were least satisfied with the relatives' influence on care. We found few relationships between other factors and job satisfaction, but, for example, satisfaction with the patients' influence on care was higher among occupational therapists working in outpatient care than among those working in hospital wards. Furthermore, having supervision was positively associated with co-operation and communication. This study revealed a fairly satisfactory situation, possibly thanks to social support, advantageous care-planning strategies and supervision. However, managerial staff must be aware that measures need to be taken continuously to counteract detrimental forces. The study pointed to a need for further research that relates occupational therapists' job satisfaction with issues such as support, control and individual need for growth.

  11. Attitudes and beliefs of occupational therapists participating in a cultural competency workshop.

    Science.gov (United States)

    Steed, Robin

    2010-09-01

    The purpose of this study was to increase understanding of the subjective experience of 13 white, female occupational therapists in Louisiana as they participated in a 6-hour workshop on cultural competency. The study employed a mixed method design using qualitative data, obtained from structured reflection questions, and quantitative data, obtained from two objective outcome measures. Three themes emerged from the qualitative data regarding the participants' conflicting attitudes towards African American clients. Therapists believed that: (1) healthcare disparities are not due to racial discrimination; (2) therapists should listen to and educate African American clients; and (3) racial bias and stress contribute to health issues in African American clients. Results from the two outcome measures, the Racial Argument Scale and the Racial Attitude Implicit Association Test, indicate that overall, the study participants held significantly negative attitudes towards African Americans which was not ameliorated by the intervention. The small convenience sample in this study precludes generalization to a broader population, and further investigation into the attitudes of healthcare professionals in Louisiana is needed. Future instructional interventions should take into account the participants' developmental stage of cultural competence. Copyright 2010 John Wiley & Sons, Ltd.

  12. Global Mental Health: A Call for Increased Awareness and Action for Family Therapists.

    Science.gov (United States)

    Patterson, Jo Ellen; Edwards, Todd M; Vakili, Susanna

    2018-03-01

    Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community. © 2017 Family Process Institute.

  13. Motor Skill Assessment of Children: Is There an Association between Performance-Based, Child-Report, and Parent-Report Measures of Children's Motor Skills?

    Science.gov (United States)

    Kennedy, Johanna; Brown, Ted; Chien, Chi-Wen

    2012-01-01

    Client-centered practice requires therapists to actively seek the perspectives of children and families. Several assessment tools are available to facilitate this process. However, when evaluating motor skill performance, therapists typically concentrate on performance-based assessment. To improve understanding of the information provided by the…

  14. Occupational Therapists With Oncology Exposure: Perceived Needs on Adults and Older Adults With Cancer-Related Cognitive Impairments.

    Science.gov (United States)

    Ulfers, Sara S; Berg, Christine

    2017-07-01

    Cancer-related cognitive impairments (CRCI) can limit participation in meaningful activities before, during, and after cancer treatment. This study explored occupational therapists' perceived knowledge gaps and needs regarding CRCI in adults and older adults. An online survey was sent to a convenience sample of 60 practitioners at facilities throughout the continuum of care and 176 directors and faculty in accredited occupational therapy programs. Using a snowball sampling approach, recipients were asked to forward the survey to other occupational therapists. One hundred seven occupational therapists participated. The majority (92%) responded that it would be beneficial to attend a face-to-face continuing education program; preferences for the content and design of a continuing competency seminar are described. These findings support the development and delivery of continuing competence programs tailored toward occupational therapists' CRCI knowledge needs.

  15. Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing.

    Science.gov (United States)

    Morland, Leslie A; Greene, Carolyn J; Grubbs, Kathleen; Kloezeman, Karen; Mackintosh, Margaret-Anne; Rosen, Craig; Frueh, B Christopher

    2011-06-01

    Therapist adherence to a manualized cognitive-behavioral anger management group treatment (AMT) was compared between therapy delivered via videoconference (VC) and the traditional in-person modality, using data from a large, randomized controlled trial comparing the effectiveness of AMT for veterans with combat-related posttraumatic stress disorder. Therapist adherence was rated for the presence or absence of process and content treatment elements. Secondary analyses were conducted using a repeated measures ANOVA. Overall adherence to the protocol was excellent (M = 96%, SD = 1%). Findings indicate that therapist adherence to AMT is similar across delivery modalities and VC is a viable service delivery strategy that does not compromise a therapist's ability to effectively structure sessions and manage patient care. © 2011 Wiley Periodicals, Inc.

  16. Long-term youth criminal outcomes in MST transport: the impact of therapist adherence and organizational climate and structure.

    Science.gov (United States)

    Schoenwald, Sonja K; Chapman, Jason E; Sheidow, Ashli J; Carter, Rickey E

    2009-01-01

    This study investigated relations among therapist adherence to an evidence-based treatment for youth with serious antisocial behavior (i.e., Multisystemic Therapy), organizational climate and structure, and youth criminal charges on average 4 years posttreatment. Participants were 1,979 youth and families treated by 429 therapists across 45 provider organizations. Results showed therapist adherence predicted significantly lower rates of youth criminal charges independently and in the presence of organizational variables. Therapist perceptions of job satisfaction and opportunities for growth and advancement relative to the organizational average predicted youth criminal charges, as did organizational average levels of participation in decision making. These associations washed out in the presence of adherence, despite the fact that job satisfaction and growth and advancement were associated with adherence.

  17. Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports.

    Science.gov (United States)

    Mai, Harry T; Chun, Danielle S; Schneider, Andrew D; Erickson, Brandon J; Freshman, Ryan D; Kester, Benjamin; Verma, Nikhil N; Hsu, Wellington K

    2017-08-01

    Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Cohort study; Level of evidence, 3. National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

  18. Clients' narratives in psychotherapy and therapist's theoretical orientation : an exploratory analysis of Gloria's narratives with Rogers, Ellis and Perls

    OpenAIRE

    Moreira, Paulo; Gonçalves, Óscar F.; Matias, Carla

    2011-01-01

    The therapist’s theoretical orientation has been shown to impact the psychotherapy process. However, less is known about the extent to which the therapist’s orientation may impact clients’ narratives. This exploratory study analysed clients’ narrative production in psychoptherapy, when interacting with different therapists. The data consisted of transcripts of Shostrom’s videotaped therapy sessions between the client Gloria and the therapists Carl Rogers, Fritz Perls and Alb...

  19. Workforce Projections 2010-2020: Annual Supply and Demand Forecasting Models for Physical Therapists Across the United States.

    Science.gov (United States)

    Landry, Michel D; Hack, Laurita M; Coulson, Elizabeth; Freburger, Janet; Johnson, Michael P; Katz, Richard; Kerwin, Joanne; Smith, Megan H; Wessman, Henry C Bud; Venskus, Diana G; Sinnott, Patricia L; Goldstein, Marc

    2016-01-01

    Health human resources continue to emerge as a critical health policy issue across the United States. The purpose of this study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the United States into 2020. A traditional stock-and-flow methodology or model was developed and populated with publicly available data to produce estimates of supply and demand for physical therapists by 2020. Supply was determined by adding the estimated number of physical therapists and the approximation of new graduates to the number of physical therapists who immigrated, minus US graduates who never passed the licensure examination, and an estimated attrition rate in any given year. Demand was determined by using projected US population with health care insurance multiplied by a demand ratio in any given year. The difference between projected supply and demand represented a shortage or surplus of physical therapists. Three separate projection models were developed based on best available data in the years 2011, 2012, and 2013, respectively. Based on these projections, demand for physical therapists in the United States outstrips supply under most assumptions. Workforce projection methodology research is based on assumptions using imperfect data; therefore, the results must be interpreted in terms of overall trends rather than as precise actuarial data-generated absolute numbers from specified forecasting. Outcomes of this projection study provide a foundation for discussion and debate regarding the most effective and efficient ways to influence supply-side variables so as to position physical therapists to meet current and future population demand. Attrition rates or permanent exits out of the profession can have important supply-side effects and appear to have an effect on predicting future shortage or surplus of physical therapists. © 2016 American Physical Therapy

  20. A Descriptive Analysis of the Educational Perceptions, Professional Identity, and Professional Practices of Dual-Trained Music Therapists as Counselors.

    Science.gov (United States)

    Sevcik, Emily E; Jones, Jennifer D; Myers, Charles E

    2017-11-01

    Given the rise in music therapy master's programs that offer dual degrees in music therapy and counseling or programs that satisfy state mental health counseling licensure laws, the professional counseling field is playing an increased role in the advanced education and professional practices of music therapists. To identify factors that lead music therapists to pursue advanced education with an emphasis in professional counseling, perceptions about benefits and drawbacks for three advanced degree options (i.e., music therapy, counseling, and music therapy/counseling dual degree), and describe the professional practices and identity of dual-trained music therapists as counselors. A convenience sample of music therapists (n = 123) who held board certification, and held a master's degree or higher that emphasized professional counseling, completed an online survey. We used descriptive statistics to analyze categorical and numeric survey data. Eligibility for licensure as a professional counselor was the most important decisional factor in selecting a specific master's degree program. Respondents also reported favorable perceptions of the dual degree in music therapy and counseling. With regard to professional practice and identity, respondents reported high use of verbal processing techniques alongside music therapy interventions, and dual-trained music therapists retained their professional identity as a music therapist. The reported view of licensure in a related field as beneficial and frequent use of verbal processing techniques warrants future study into the role of counseling in the advanced training of music therapists. Given contradictory findings across studies, we recommend investigators also explore how a degree in a related field affects career longevity of music therapists. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. Constrained physical therapist practice: an ethical case analysis of recommending discharge placement from the acute care setting.

    Science.gov (United States)

    Nalette, Ernest

    2010-06-01

    Constrained practice is routinely encountered by physical therapists and may limit the physical therapist's primary moral responsibility-which is to help the patient to become well again. Ethical practice under such conditions requires a certain moral character of the practitioner. The purposes of this article are: (1) to provide an ethical analysis of a typical patient case of constrained clinical practice, (2) to discuss the moral implications of constrained clinical practice, and (3) to identify key moral principles and virtues fostering ethical physical therapist practice. The case represents a common scenario of discharge planning in acute care health facilities in the northeastern United States. An applied ethics approach was used for case analysis. The decision following analysis of the dilemma was to provide the needed care to the patient as required by compassion, professional ethical standards, and organizational mission. Constrained clinical practice creates a moral dilemma for physical therapists. Being responsive to the patient's needs moves the physical therapist's practice toward the professional ideal of helping vulnerable patients become well again. Meeting the patient's needs is a professional requirement of the physical therapist as moral agent. Acting otherwise requires an alternative position be ethically justified based on systematic analysis of a particular case. Skepticism of status quo practices is required to modify conventional individual, organizational, and societal practices toward meeting the patient's best interest.

  2. Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

    Directory of Open Access Journals (Sweden)

    David P. G. van den Berg

    2016-09-01

    Full Text Available Background: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective: This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method: Therapist-rated (n=16 credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results: Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD in patients with psychotic disorders (n=79, pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions: These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment.

  3. Telemedicine Versus Face-to-Face Evaluations by Respiratory Therapists of Mechanically Ventilated Neonates and Children: A Pilot Study.

    Science.gov (United States)

    Bell, Rebecca C; Yager, Phoebe H; Clark, Maureen E; Roumiantsev, Serguei; Venancio, Heather L; Chipman, Daniel W; Kacmarek, Robert M; Noviski, Natan N

    2016-02-01

    Mechanical ventilation is one of the most important therapeutic interventions in neonatal and pediatric ICUs. Telemedicine has been shown to reliably extend pediatric intensivist expertise to facilities where expertise is limited. If reliable, telemedicine may extend the reach of pediatric respiratory therapists (RTs) to facilities where expertise does not exist or free up existing RT resources for important face-to-face activities in facilities where expertise is limited. The aim of this study was to determine how well respiratory assessments for ventilated neonates and children correlated when performed simultaneously by 2 RTs face-to-face and via telemedicine. We conducted a pilot study including 40 assessments by 16 RTs on 11 subjects (5 neonatal ICU; 6 pediatric ICU). Anonymously completed intake forms by 2 different RTs concurrently assessing 14 ventilator-derived and patient-based respiratory variables were used to determine correlations. Forty paired assessments were performed. Median telemedicine assessment time was 8 min. The Pearson correlation coefficient (r) was used to determine agreement between continuous data, and the Cohen kappa statistics were used for binary variables. Pressure control, PEEP, breathing frequency, and FIO2 perfectly correlated (r = 1, all P Telemedicine technology was acceptable to RTs. Telemedicine evaluations highly correlated with face-to-face for 10 of 14 aspects of standard bedside respiratory assessment. Poor correlation was noted for more complex, patient-generated parameters, highlighting the importance of further investigation incorporating a virtual stethoscope. Copyright © 2016 by Daedalus Enterprises.

  4. Professional Athletes' Return to Play and Performance After Operative Repair of an Achilles Tendon Rupture.

    Science.gov (United States)

    Trofa, David P; Miller, J Chance; Jang, Eugene S; Woode, Denzel R; Greisberg, Justin K; Vosseller, J Turner

    2017-10-01

    Most Achilles tendon ruptures are sports related. However, few studies have examined and compared the effect of surgical repair for complete ruptures on return to play (RTP), play time, and performance across multiple sports. To examine RTP and performance among professional athletes after Achilles tendon repair and compare pre- versus postoperative functional outcomes of professional athletes from different major leagues in the United States. Cohort study; Level of evidence, 3. National Basketball Association (NBA), National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who sustained a primary complete Achilles tendon rupture treated surgically between 1989 and 2013 were identified via public injury reports and press releases. Demographic information and performance-related statistics were recorded for 2 seasons before and after surgery and compared with matched controls. Statistical analyses were used to assess differences in recorded metrics. Of 86 athletes screened, 62 met inclusion criteria including 25 NBA, 32 NFL, and 5 MLB players. Nineteen (30.6%) professional athletes with an isolated Achilles tendon rupture treated surgically were unable to return to play. Among athletes who successfully returned to play, game participation averaged 75.4% ( P .05). When individual sports were compared, NBA players were most significantly affected, experiencing significant decreases in games played, play time, and performance. An Achilles tendon rupture is a devastating injury that prevents RTP for 30.6% of professional players. Athletes who do return play in fewer games, have less play time, and perform at a lower level than their preinjury status. However, these functional deficits are seen only at 1 year after surgery compared with matched controls, such that players who return to play can expect to perform at a level commensurate with uninjured controls 2 years postoperatively.

  5. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

    Science.gov (United States)

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

    2017-09-10

    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  6. Music therapists' research activity and utilization barriers: a survey of the membership.

    Science.gov (United States)

    Waldon, Eric G

    2015-01-01

    Music therapists have access to a rapidly expanding body of research supporting the use of music-based interventions. What is not known is the extent to which music therapists access these resources and what factors may prevent them from incorporating research findings into clinical work. After constructing the Music Therapists' Research Activity and Utilization Barrier (MTRAUB) database, the purposes of this study involved: assessing the extent to which American Music Therapy Association (AMTA) members engage in certain research-related activities; and identifying respondents' perceived barriers to integrating research into clinical practice. This study employed a quantitative, non-experimental approach using an online survey. Respondents included professional, associate, student/graduate student, retired, inactive, and honorary life members of AMTA. Instrumentation involved a researcher-designed Background Questionnaire as well as the Barriers to Research Utilization Scale (BARRIERS; Funk, Champagne, Wiese, & Tornquist, 1991), a tool designed to assess perceived barriers to incorporating research into practice. Of the 3,194 survey invitations distributed, 974 AMTA members replied (a response rate of 30%). Regarding research-related activities, descriptive findings indicate that journal reading is the most frequently reported research-related activity while conducting research is the least frequently reported activity. Results from the BARRIERS Scale indicated that Organizational and Communication factors are perceived as interfering most prominently with the ability to utilize research in clinical practice. Findings suggest that research-related activity and perceived barriers vary as a function of educational attainment, work setting, and occupational role. The author discusses these differential findings in detail, suggests supportive mechanisms to encourage increased research activity and utilization, and offers recommendations for further analysis of the

  7. Investigating the Relationship between Sensory Processing and Job Satisfaction in Occupational Therapists Working in Shiraz Cit

    Directory of Open Access Journals (Sweden)

    Sahar Ghanbari

    2015-09-01

    Full Text Available Background: job satisfaction is referred to a set of individual’s positive and negative attitudes toward his/her job. Personality traits of individuals are among the factors contributing to job satisfaction. According to Dunn model, people receive information based on their self-regulatory strategies and sensory thresholds. Then behave accordingly and in response to the environment. This paper examines the relationship between sensory processing and job satisfaction especially in occupational therapist employing in Shiraz (2014. Methods: This study is descriptive-analytic. The sample consisted of all 33 occupational therapists working in Shiraz City who work in private and public sectors, part-time and full-time of both genders. After obtaining written consent, the demographic characteristics questionnaire, adult sensory profile and Minnesota Job Satisfaction Test were obtained. The results were analyzed by SPSS 21 software as well as Spearman’s and Pearson chi square tests. Results: No statistical correlation was found between job satisfaction and all four quadrants including the first quadrant (P=0.441 and second (P=0.943 and third (P=0.650 and fourth (P=0.338. In addition, statistically, there was no relationship between job satisfaction and various variables such as participants’ ages (P=0.51, gender (P=0.401, marital status (P=0.114, educational level (P=0.073, job experience (P=0.403, average of daily work hours (P=0.617 and at end the type of contract (P=0.079. Conclusion: The sensory processing cannot directly determine people’s satisfaction with their jobs. Job satisfaction is a complex issue that is influenced by different internal and external factors, and cannot be considered as an element for determining job satisfaction of therapists.

  8. Development and pilot of an international survey: 'Radiation Therapists and Psychosocial Support'.

    Science.gov (United States)

    Elsner, Kelly L; Naehrig, Diana; Halkett, Georgia K B; Dhillon, Haryana M

    2018-06-07

    Up to one third of radiation therapy patients are reported to have unmet psychosocial needs. Radiation therapists (RTs) have daily contact with patients and can provide daily psychosocial support to reduce patient anxiety, fear and loneliness. However, RTs vary in their values, skills, training, knowledge and involvement in providing psychosocial support. The aims of this study were to: (1) develop an online survey instrument to explore RT values, skills, training and knowledge regarding patient anxiety and psychosocial support, and (2) pilot the instrument with RT professionals to assess content validity, functionality and length. An online cross-sectional survey, titled 'Radiation therapists and psychosocial support' was developed. Items included patient vignettes, embedded items from RT research, and the Professional Quality of Life Scale (ProQOL5). Four radiation oncology departments volunteered to pilot the survey; each nominated four RT staff to participate. Survey data were analysed descriptively and qualitative feedback grouped and coded to determine whether the survey needed to be refined. Thirteen of sixteen RTs completed the pilot survey and feedback form. Median time to completion was 35 mins, with 54% of respondents stating this was too long. Respondents reported content, questions and response options were relevant and appropriate. Feedback was used to: refine the survey instrument, minimise responder burden and drop out and improve functionality and quality of data collection. This pilot of the 'Radiation therapists and psychosocial support' survey instrument demonstrated content validity and usability. The main survey will be circulated to a representative sample of RTs for completion. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  9. Therapist competencies necessary for the delivery of compassion-focused therapy: A Delphi study.

    Science.gov (United States)

    Liddell, Alice E; Allan, Steven; Goss, Ken

    2017-06-01

    Compassion-focused therapy (CFT) has shown promising results for a range of clinical presentations. This study explored the therapeutic competencies required to deliver CFT and organized these into a coherent framework. The Delphi method was used to explore and refine competencies for delivering CFT in three rounds of data collection. The first round involved interviews with 12 experts in CFT. Data were analysed using template analysis to generate a draft competency framework. The main competencies were used to create a survey for rounds two and three involving CFT experts and practitioners. Data collected from the surveys were used to refine the competencies. The CFT competency framework (CFT-CF) that was produced comprised 25 main competencies within six key areas of competence. The areas were as follows: competencies in creating safeness, meta-skills, non-phase-specific skills, phase-specific skills, knowledge and understanding and use of supervision. The main competencies included several subcompetencies specifying knowledge, skills and attributes needed to demonstrate the main competence. Overall, there was consensus on 14 competencies and 20 competencies exceeded an 80% agreement level. Some of the CFT competencies overlapped with existing therapies, whilst others were specific to CFT. The CFT-CF provides useful guidance for clinicians, supervisors and training programmes. Further research could develop the CFT-CF into a therapist rating scale in order to measure the outcome of training and to assess treatment fidelity in clinical trials. The compassion-focused therapy competency framework (CFT-CF) identifies therapeutic competencies that overlap with existing treatments as well as those specific to compassion-focused therapy (CFT). The CFT-CF builds guidance for the competencies required to deliver CFT in a range of clinical settings. The CFT-CF provides guidance for those training CFT therapists. The CFT-CF could be used as a basis to develop a therapist

  10. Use of standardized outcome measures in physical therapist practice: perceptions and applications.

    Science.gov (United States)

    Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

    2009-02-01

    Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

  11. Parallel Journeys: How a Music Therapist Can Travel with his Client

    OpenAIRE

    Henry Dunn

    2009-01-01

    This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the clien...

  12. The association between patient-therapist MATRIX congruence and treatment outcome.

    Science.gov (United States)

    Mendlovic, Shlomo; Saad, Amit; Roll, Uri; Ben Yehuda, Ariel; Tuval-Mashiah, Rivka; Atzil-Slonim, Dana

    2018-03-14

    The present study aimed to examine the association between patient-therapist micro-level congruence/incongruence ratio and psychotherapeutic outcome. Nine good- and nine poor-outcome psychodynamic treatments (segregated by comparing pre- and post-treatment BDI-II) were analyzed (N = 18) moment by moment using the MATRIX (total number of MATRIX codes analyzed = 11,125). MATRIX congruence was defined as similar adjacent MATRIX codes. the congruence/incongruence ratio tended to increase as the treatment progressed only in good-outcome treatments. Progression of MATRIX codes' congruence/incongruence ratio is associated with good outcome of psychotherapy.

  13. PERFORMANCE

    Directory of Open Access Journals (Sweden)

    M Cilli

    2014-10-01

    Full Text Available This study aimed to investigate the kinematic and kinetic changes when resistance is applied in horizontal and vertical directions, produced by using different percentages of body weight, caused by jumping movements during a dynamic warm-up. The group of subjects consisted of 35 voluntary male athletes (19 basketball and 16 volleyball players; age: 23.4 ± 1.4 years, training experience: 9.6 ± 2.7 years; height: 177.2 ± 5.7 cm, body weight: 69.9 ± 6.9 kg studying Physical Education, who had a jump training background and who were training for 2 hours, on 4 days in a week. A dynamic warm-up protocol containing seven specific resistance movements with specific resistance corresponding to different percentages of body weight (2%, 4%, 6%, 8%, 10% was applied randomly on non consecutive days. Effects of different warm-up protocols were assessed by pre-/post- exercise changes in jump height in the countermovement jump (CMJ and the squat jump (SJ measured using a force platform and changes in hip and knee joint angles at the end of the eccentric phase measured using a video camera. A significant increase in jump height was observed in the dynamic resistance warm-up conducted with different percentages of body weight (p 0.05. In jump movements before and after the warm-up, while no significant difference between the vertical ground reaction forces applied by athletes was observed (p>0.05, in some cases of resistance, a significant reduction was observed in hip and knee joint angles (p<0.05. The dynamic resistance warm-up method was found to cause changes in the kinematics of jumping movements, as well as an increase in jump height values. As a result, dynamic warm-up exercises could be applicable in cases of resistance corresponding to 6-10% of body weight applied in horizontal and vertical directions in order to increase the jump performance acutely.

  14. The Embodied Attunement of Therapists and a Couple within Dialogical Psychotherapy: An Introduction to the Relational Mind Research Project.

    Science.gov (United States)

    Seikkula, Jaakko; Karvonen, Anu; Kykyri, Virpi-Liisa; Kaartinen, Jukka; Penttonen, Markku

    2015-12-01

    In dialogical practice, therapists seek to respond to the utterances of clients by including in their own response what the client said. No research so far exists on how, in dialogs, therapists and clients attune themselves to each other with their entire bodies. The research program The Relational Mind is the first to look at dialog in terms of both the outer and the inner dialogs of participants (clients and therapists), observed in parallel with autonomic nervous system (ANS) measurements. In the ANS, the response occurs immediately, even before conscious thought, making it possible to follow how participants in a multiactor dialog synchronize their reactions and attune themselves to each other. The couple therapy case presented in this article demonstrates how attunement is often not a simple "all at the same time" phenomenon, but rather a complex, dyadic or triadic phenomenon which changes over time. In the case presented, there was strong synchrony between one therapist and one client in terms of their arousal level throughout the therapy session. It was also observed that high stress could occur when someone else was talking about something related to the participant, or if that person mirrored the participant's words. Overall, it seems that in evaluating the rhythmic attunement between therapists and clients it is not enough to look at single variables; instead, integrated information from several channels is needed when one is seeking to make sense of the embodiment. © 2015 Family Process Institute.

  15. Investigating the impact of alliance-focused training on interpersonal process and therapists' capacity for experiential reflection.

    Science.gov (United States)

    Safran, Jeremy; Muran, J Christopher; Demaria, Anthony; Boutwell, Catherine; Eubanks-Carter, Catherine; Winston, Arnold

    2014-01-01

    In this article we present preliminary findings from a research program designed to investigate the value of alliance-focused training (AFT), a supervision approach designed to enhance therapists' ability to work constructively with negative therapeutic process. In the context of a multiple baseline design, all therapists began treating their patients using cognitive therapy and then joined AFT supervision groups at either session 8 or 16 of a 30 session protocol. Study I investigated the impact of AFT on patient and therapist interpersonal process as assessed through the Structural Analysis of Social Behavior (SASB). Study 2 investigated the impact of AFT on therapists' tendency to reflect on their relationships with their patients in an experientially grounded fashion, as assessed via the Experiencing Scale (EXP). Since one of the goals of AFT is to train therapists to use their own emerging feelings as important clues regarding what may be taking place in the therapeutic relationship, we hypothesized that they would show increased levels of EXP after undergoing AFT. The results of both studies 1 and 2 were for the most part consistent with hypotheses. Implications and future research directions are discussed.

  16. Child involvement, alliance, and therapist flexibility: process variables in cognitive-behavioural therapy for anxiety disorders in childhood.

    Science.gov (United States)

    Hudson, Jennifer L; Kendall, Philip C; Chu, Brian C; Gosch, Elizabeth; Martin, Erin; Taylor, Alan; Knight, Ashleigh

    2014-01-01

    This study examined the relations between treatment process variables and child anxiety outcomes. Independent raters watched/listened to taped therapy sessions of 151 anxiety-disordered (6-14 yr-old; M = 10.71) children (43% boys) and assessed process variables (child alliance, therapist alliance, child involvement, therapist flexibility and therapist functionality) within a manual-based cognitive-behavioural treatment. Latent growth modelling examined three latent variables (intercept, slope, and quadratic) for each process variable. Child age, gender, family income and ethnicity were examined as potential antecedents. Outcome was analyzed using factorially derived clinician, mother, father, child and teacher scores from questionnaire and structured diagnostic interviews at pretreatment, posttreatment and 12-month follow-up. Latent growth models demonstrated a concave quadratic curve for child involvement and therapist flexibility over time. A predominantly linear, downward slope was observed for alliance, and functional flexibility remained consistent over time. Increased alliance, child involvement and therapist flexibility showed some albeit inconsistent, associations with positive treatment outcome. Findings support the notion that maintaining the initial high level of alliance or involvement is important for clinical improvement. There is some support that progressively increasing alliance/involvement also positively impacts on treatment outcome. These findings were not consistent across outcome measurement points or reporters. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. The effects of feedback self-consistency, therapist status, and attitude toward therapy on reaction to personality feedback.

    Science.gov (United States)

    Collins, David R; Stukas, Arthur A

    2006-08-01

    Individuals' reactions to interpersonal feedback may depend on characteristics of the feedback and the feedback source. The present authors examined the effects of experimentally manipulated personality feedback that they--in the guise of therapists--e-mailed to participants on the degree of their acceptance of the feedback. Consistent with Self-Verification Theory (W. B. Swann Jr., 1987), participants accepted feedback that was consistent with their self-views more readily than they did feedback that was inconsistent with their self-views. Furthermore, the authors found main effects for therapist's status and participant's attitude toward therapy. Significant interactions showed effects in which high-status therapists and positive client attitudes increased acceptance of self-inconsistent feedback, effects that were only partially mediated by clients' perceptions of therapist competence. The present results indicate the possibility that participants may be susceptible to self-concept change or to self-fulfilling prophecy effects in therapy when they have a positive attitude toward therapy or are working with a high-status therapist.

  18. UK-based physical therapists' attitudes and beliefs regarding exercise and knee osteoarthritis: findings from a mixed-methods study.

    Science.gov (United States)

    Holden, Melanie A; Nicholls, Elaine E; Young, Julie; Hay, Elaine M; Foster, Nadine E

    2009-11-15

    Within the UK, differences exist between physical therapists' use of exercise for patients with knee osteoarthritis (OA) and recent exercise recommendations. This may be explained by their underlying attitudes and beliefs. We aimed to describe UK physical therapists' attitudes and beliefs regarding exercise and knee OA, and understand and explain them. A survey was mailed to 2,000 UK-based chartered physical therapists that included 23 attitude statements derived from recently published recommendations. Semistructured telephone interviews were conducted with a purposeful sample of questionnaire respondents (n = 24), and were recorded and analyzed thematically. The questionnaire response rate was 58% (n = 1,152); 538 respondents reported treating a patient with knee OA in the last 6 months. The survey highlighted uncertainty about potential benefits of exercise for knee OA: only 56% largely/totally agreed that knee problems are improved by local exercise. Although exercise adherence was deemed important, it was seen as the patient's, not the therapist's, responsibility. Interviews revealed an underlying biomedical model of care of knee pain, with knee OA viewed as a progressive degenerative condition. A paternalistic treatment approach was evident. Health care systems presented a number of barriers to best practice, including limited opportunity to provide followup. Although the attitudes and beliefs of physical therapists may help to explain differences between current practice and recent exercise recommendations, the wider health care system also plays a part. Further research is needed to support meaningful shifts in physical therapy care in line with the best practice recommendations.

  19. Enhancing retention of occupational therapists working in mental health: relationships between wellbeing at work and turnover intention.

    Science.gov (United States)

    Scanlan, Justin Newton; Meredith, Pamela; Poulsen, Anne A

    2013-12-01

    Occupational therapists working in mental health who experience burnout, low work engagement or poor job satisfaction are at risk of poor wellbeing at work and may be more likely to leave their jobs. The aim of this project was to explore factors associated with wellbeing at work and turnover intention in a sample of occupational therapists working in mental health. One hundred and three occupational therapists working in mental health in Queensland completed a survey exploring work/life balance, effort invested in work, rewards received from work, wellbeing at work (job satisfaction, burnout and work engagement) and turnover intention. Analyses were conducted to explore relationships between work/life balance, effort, reward, wellbeing at work and turnover intention. All measures of wellbeing at work were significantly associated with turnover intention. A large proportion (33%) of the variance in turnover intention was predicted by job satisfaction. Perceptions of both work/life balance and effort invested in work, as well as perceived rewards in terms of recognition, prestige and personal satisfaction were significantly associated with work-related wellbeing scores. Results from this study deepen the understanding of factors associated with wellbeing at work and turnover intention for occupational therapists in mental health. This knowledge will support the development of interventions aimed at reducing turnover intention and enhancing retention of occupational therapists in the mental health workforce. © 2013 Occupational Therapy Australia.

  20. The therapeutic alliance and therapist adherence as predictors of dropout from cognitive therapy for depression when combined with antidepressant medication.

    Science.gov (United States)

    Cooper, Andrew A; Strunk, Daniel R; Ryan, Elizabeth T; DeRubeis, Robert J; Hollon, Steven D; Gallop, Robert

    2016-03-01

    Previous psychotherapy research has examined the therapeutic alliance and therapist adherence as correlates or predictors of symptom change. While some initial evidence suggests the alliance is associated with risk of dropout in cognitive behavioral treatment for depression, evidence of such relations has been limited to date. We examined the relation of these psychotherapy process variables and dropout in the context of cognitive therapy for depression when provided in combination with pharmacotherapy. Patients were randomized to the CT plus pharmacotherapy condition of a clinical trial for chronic or recurrent depression. Consistent with the spirit of personalized medicine, patients were treated until they met remission and recovery criteria (or reached the maximum allowable time in the study). In a sample of 176 patients, we examined observer-rated alliance and therapist adherence in the first three CT sessions as potential predictors of treatment dropout. The therapeutic alliance and one facet of therapist adherence (i.e., Behavioral Methods/Homework) predicted reduced odds of dropout. Therapist use of Negotiating/Structuring predicted greater likelihood of dropout, but only when other variables were included in the model. Process ratings were not available for concurrent pharmacotherapy sessions. A minority of patients did not have session recordings available. Results are consistent with the possibility that the therapeutic alliance and therapists' focus on homework and behavioral methods promote treatment retention in combined treatment for depression. Copyright © 2015 Elsevier Ltd. All rights reserved.