Basic Counseling Skills: Working With People With Aphasia and Their Families

2021 ◽  
pp. 1-12
Author(s):  
Rebecca Hunting Pompon
Keyword(s):  
Brain Injury ◽  
Therapeutic Alliance ◽  
Chronic Stress ◽  
Counseling Skills ◽  
High Quality ◽  
Client Engagement ◽  
Communication Impairment ◽  
Loss And Grief ◽  
Limited Period ◽  
Basic Counseling Skills

Purpose People with aphasia (PWA) and their families experience dramatic changes to many facets of life following stroke or other brain injury. With these changes comes complex loss and grief that can lead to chronic stress and depression, and impact recovery and rehabilitation. Clinicians working with PWA are often unsure how to best address these experiences and reactions. This tutorial introduces an approach to building the therapeutic alliance and navigating challenging conversations with clients and families using basic counseling skills that can be adapted to varying situations and clinical contexts. In addition to demonstrating each skill using example scenarios (Part 1), these skills are applied to the evolving stages of crisis and recovery experienced by many clients with communication impairment and their families—from injury onset to adjustment to chronic aphasia (Part 2). Conclusions Clinicians can adapt a set of basic counseling skills to promote effective therapeutic relationships and change in the lives of their clients across the contexts of recovery and rehabilitation. Although the clinician and client may work together for a relatively limited period of time, these flexible skills can help galvanize client engagement and participation in clinical activities, yield high-quality client information for treatment planning, and motivate clients as they navigate life with aphasia.

scholarly journals Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses

2021 ◽  
Vol 10 (7) ◽  
pp. 1478
Author(s):  
Alexandra Voinescu ◽  
Jie Sui ◽  
Danaë Stanton Fraser
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Brain Injury ◽  
Upper Limb ◽  
Umbrella Review ◽  
High Quality ◽  
Quality Of Evidence ◽  
Upper Limb Function ◽  
Meta Analyses

Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.

It takes two to tango: The therapeutic alliance in community brain injury rehabilitation

2021 ◽  
pp. 1-18
Author(s):  
Liz M. Williams ◽  
Jacinta M. Douglas
Keyword(s):  
Brain Injury ◽  
Pilot Study ◽  
Therapeutic Alliance ◽  
Qualitative Methodology ◽  
Rehabilitation Programme ◽  
Injury Rehabilitation ◽  
Community Rehabilitation ◽  
Purposeful Sampling ◽  
Study Results ◽  
Working Together

Abstract Objective: A positive therapeutic (or working) alliance has been associated with better outcomes for clients in the psychotherapeutic and traumatic brain injury (TBI) rehabilitation literature. The aim of this pilot study was to gain an understanding of the therapeutic alliance in community rehabilitation from the perspectives of adults with TBI and their close others who have completed a community rehabilitation programme. Method: This study used a constructivist, qualitative methodology which applied grounded theory analysis techniques. Using purposeful sampling, three pairs of participants (adults with TBI and close others) who had finished a community rehabilitation programme completed separate in-depth interviews which were transcribed verbatim and progressively analysed using a process of constant comparison. Results: A preliminary framework illustrating participants’ experience of a therapeutic alliance was generated, comprising three interconnected themes: being recognised as an individual, working together and feeling personally connected. All participants viewed being able to work together as important in their experience of community rehabilitation and described features that helped and hindered the alliance. Conclusion: These pilot study results demonstrate the importance of the therapeutic alliance to the rehabilitation experience of individuals with TBI and those close to them.

scholarly journals The Secondary Impact of Traumatic Brain Injury

2018 ◽  
Vol 26 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Jane Townshend ◽  
Alyson Norman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Members ◽  
Information Provision ◽  
Phenomenological Approach ◽  
Loss And Grief ◽  
Interpretative Phenomenological Approach ◽  
Long Term Impact ◽  
And Coping ◽  
The Impact

This study seeks to contribute to our understanding of the lived experiences of family members and friends of individuals with traumatic brain injury (TBI). The study employed an interpretative phenomenological approach, enabling family members and friends to identify and reflect upon the factors they themselves considered most significant about the impact of TBI on someone close to them, and how this experience has affected their own lives and their relationship with the TBI survivor. Eleven participants, two males and nine females aged 22–79, were from the United Kingdom. Several strong and interconnected themes emerged from the interviews, clustering into four superordinate themes: “continuity and discontinuity”; “damage, loss, and grief”; “roles and responsibility”; and “coping and not coping.” The study findings identify the importance of support and information provision for family members and friends of those with TBI to help them manage the long-term impact of TBI.

Helping Beliefs Inventory: Brief Screening Measure for Training Volunteer Applicants in Counseling

1985 ◽  
Vol 56 (3) ◽  
pp. 843-846 ◽  
Author(s):  
James P. McLennan
Keyword(s):  
Training Programs ◽  
Counseling Skills ◽  
Psychological Mindedness ◽  
Counseling Trainees ◽  
Retest Reliability ◽  
Screening Measure ◽  
Test Retest Reliability ◽  
Brief Screening ◽  
Basic Counseling Skills

A 10-item Helping Beliefs Inventory was constructed for use as a brief screening measure for applicants for nonprofessional training programs in basic counseling skills. Scores correlated significantly with measures of Authoritarianism, Flexibility, and Psychological Mindedness. Test-retest reliability of .74 was adequate ( n = 43). The inventory discriminated between 30 experienced counselors and 230 noncounselors and between counseling trainees of high and low skill.

scholarly journals Court-Mandated Patients’ Perspectives on the Psychotherapist’s Dual Loyalty Conflict – Between Ally and Enemy

2021 ◽  
Vol 11 ◽  
Author(s):  
Helene Merkt ◽  
Tenzin Wangmo ◽  
Félix Pageau ◽  
Michael Liebrenz ◽  
Corinne Devaud Cornaz ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Mental Health Professionals ◽  
Qualitative Interview ◽  
Interview Study ◽  
Dual Role ◽  
Therapist Characteristics ◽  
High Quality ◽  
Dual Loyalty ◽  
Qualitative Interview Study ◽  
Court Mandated

BackgroundMental health professionals working in correctional contexts engage a double role to care and control. This dual loyalty conflict has repeatedly been criticized to impede the development of a high-quality alliance. As therapeutic alliance is a robust predictor of outcome measures of psychotherapy, it is essential to investigate the effects of this ethical dilemma.MethodsThis qualitative interview study investigates patients’ perceptions of their therapists’ dual role conflict in court-mandated treatment settings. We interviewed 41 older incarcerated persons using a semi-structured interview guide, the interviews were subsequently analyzed following thematic analysis.ResultsWe first present the patients’ perceptions of their treating psychotherapist’s dual loyalty conflict, which was linked to their overall treatment experience. In a second step, we outline the study participants’ reasons for this judgment, which were most commonly linked to feelings of trust or betrayal. More specifically, they named certain therapist characteristics and activities that enabled them to develop a trustful therapeutic alliance, which we grouped into four topics: (1) respecting the patient’s pace and perceived coercion; (2) patient health needs to be first priority; (3) clarity in roles and responsibilities; and (4) the art of communication – between transparency and unchecked information sharing.DiscussionDeveloping a high quality alliance in mandatory offender treatment is central due to its relationship with recovery and desistance. Our findings show that some therapists’ characteristics and activities attenuate the negative impact of their double role on the development and maintenance of the alliance. To increase the effectiveness of court-mandated treatments, we need to support clinicians in dealing with their dual role to allow the formation of a high quality therapeutic alliance. Our qualitative interview study contributed to this much-needed empirical research on therapist’ characteristics promoting a trustful relationship in correctional settings.

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