An investigation of the measurement properties of the physiotherapy therapeutic relationship measure in patients with musculoskeletal conditions

Background Speech-language pathologists make clinical decisions informed by evidence-based theory and “beliefs, values and emotional experiences” ( Hinckley, 2005 , p. 265). These subjective processes, while not extensively studied, underlie the workings of the therapeutic relationship and contribute to treatment outcomes. While speech-language pathologists do not routinely pay attention to subjective experiences of the therapeutic encounter, social workers do. Thus, the field of social work makes an invaluable contribution to the knowledge and skills of speech-language pathologists. Purpose This clinical focus article focuses on the clinician's contribution to the therapeutic relationship by surfacing elements of the underlying subjective processes. Method Vignettes were gathered from clinicians in two community aphasia programs informed by the principles of the Life Participation Approach to Aphasia. Results and Discussion By reflecting on and sharing aspects of clinical encounters, clinicians reveal subjective processing occurring beneath the surface. The vignettes shed light on the following clinical behaviors: listening to the client's “whole self,” having considerations around self-disclosure, dealing with biases, recognizing and surfacing clients' identities, and fostering hope. Speech-language pathologists are given little instruction on the importance of the therapeutic relationship, how to conceptualize this relationship, and how to balance this relationship with professionalism. Interprofessional collaboration with social workers provides a rich opportunity to learn ways to form and utilize the benefits of a strong therapeutic relationship while maintaining high standards of ethical behavior. Conclusion This clinical focus article provides speech-language pathologists with the “nuts and bolts” for considering elements of the therapeutic relationship. This is an area that is gaining traction in the field of speech-language pathology and warrants further investigation.

Download Full-text

Employing Latino Value Orientations to Facilitate Success in Stuttering Treatment

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd18.3.111 ◽

2008 ◽

Vol 18 (3) ◽

pp. 111-118

Author(s):

Lourdes Ramos-Heinrichs ◽

Lynn Hansberry Mayo ◽

Sandra Garzon

Keyword(s):

Foreign Language ◽

Therapeutic Relationship ◽

Service Provider ◽

Speech Therapy ◽

Cross Cultural ◽

Value Orientations ◽

Collaborative Partnership ◽

The Family ◽

Therapy Services ◽

Cultural Connections

Abstract Providing adequate speech therapy services to Latinos who stutter can present challenges that are not obvious to the practicing clinician. This article addresses cultural, religious, and foreign language concerns to the therapeutic relationship between the Latino client and the clinician. Suggestions are made for building cross-cultural connections with clients and incorporating the family into a collaborative partnership with the service provider.

Download Full-text

The Effect of Alternative Scoring Procedures on the Measurement Properties of a Self-Administered Depression Scale

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000371 ◽

2019 ◽

Vol 35 (1) ◽

pp. 55-62 ◽

Cited By ~ 1

Author(s):

Noboru Iwata ◽

Akizumi Tsutsumi ◽

Takafumi Wakita ◽

Ryuichi Kumagai ◽

Hiroyuki Noguchi ◽

...

Keyword(s):

Classical Test Theory ◽

Depression Scale ◽

Psychometric Testing ◽

Epidemiologic Studies ◽

Test Theory ◽

Measurement Properties ◽

Irt Model ◽

Response Alternatives ◽

Polytomous Item Response ◽

Θ Point

Abstract. To investigate the effect of response alternatives/scoring procedures on the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D) which has the four response alternatives, a polytomous item response theory (IRT) model was applied to the responses of 2,061 workers and university students (1,640 males, 421 females). Test information functions derived from the polytomous IRT analyses on the CES-D data with various scoring procedures indicated that: (1) the CES-D with its standard (0-1-2-3) scoring procedure should be useful for screening to detect subjects with “at high-risk” of depression if the θ point showing the highest information corresponds to the cut-off point, because of its extremely higher information; (2) the CES-D with the 0-1-1-2 scoring procedure could cover wider range of depressive severity, suggesting that this scoring procedure might be useful in cases where more exhaustive discrimination in symptomatology is of interest; and (3) the revised version of CES-D with replacing original positive items into negatively revised items outperformed the original version. These findings have never been demonstrated by the classical test theory analyses, and thus the utility of this kind of psychometric testing should be warranted to further investigation for the standard measures of psychological assessment.

Download Full-text

Expressed Emotion in the Client-Professional Dyad

European Journal of Psychological Assessment ◽

10.1027/1015-5759.20.4.237 ◽

2004 ◽

Vol 20 (4) ◽

pp. 237-246 ◽

Cited By ~ 7

Author(s):

G. Van Humbeeck ◽

Ch. Van Audenhove ◽

G. Storms ◽

M. De Hert ◽

G. Pieters ◽

...

Keyword(s):

Therapeutic Relationship ◽

Correlation Matrix ◽

Concurrent Validity ◽

Positive Relationship ◽

Expressed Emotion ◽

Family Interview ◽

Insufficient Time ◽

Perceived Criticism

Summary: Background: This article reports on a study of the concurrent validity between the standard expressed emotion instrument, the Camberwell Family Interview (CFI), and two alternative EE measures, the Level of Expressed Emotion (LEE) and the Perceived Criticism Scale (PCS). Methods: The research sample consisted of 56 schizophrenic clients, who were residing in sheltered residences, and 56 professionals. Results: Based on the results of the correlation matrix between all the subscales of the instruments, a significantly positive relationship was found between the criticism scale of the CFI, the total score of the LEE, and the client version of the PCS. These correlations, however, were rather weak, which implies that the three instruments have little in common with each other. The professionals' version of the PCS does not appear to be an EE instrument. Conclusions: The results suggest that the CFI still remains the best instrument for assessing EE in a therapeutic relationship (between a professional and a client). If there is insufficient time to administer the CFI, then the client version of the PCS and the LEE can be used with the qualification that the PCS and LEE also measure other aspects and thus cannot completely replace the CFI. Nevertheless, the research indicates that asking the clients would seem to provide a better indication of the level of the professionals' criticism rather than asking the professionals themselves directly.

Download Full-text

Psychometric Properties of the German Version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR)

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000105 ◽

2012 ◽

Vol 28 (4) ◽

pp. 255-261 ◽

Cited By ~ 5

Author(s):

Sabine Loos ◽

Reinhold Kilian ◽

Thomas Becker ◽

Birgit Janssen ◽

Harald Freyberger ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Community Mental Health ◽

Mental Health Care ◽

Psychometric Properties ◽

Therapeutic Relationship ◽

Internal Consistency ◽

Convergent Validity ◽

Community Mental Health Care ◽

German Version

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.

Download Full-text