Philosophical, conceptual, and ethical perspectives on working with goals in therapy

2018 ◽  
pp. 15-34
Author(s):  
John McLeod ◽  
Thomas Mackrill
Keyword(s):  
Clinical Practice ◽  
Free Will ◽  
Practical Knowledge ◽  
Moral Dilemmas ◽  
Human Experience ◽  
Contemporary Theory ◽  
Therapeutic Goals ◽  
Critical Perspectives ◽  
Ethical Perspectives ◽  
Power And Authority

This chapter explores the underlying assumptions that inform goal-oriented therapy, with the aim of examining the relevance of different critical perspectives on contemporary theory and research into therapeutic goals. An appreciation of what it means to talk about goals requires thinking about some of the basic questions around human experience and existence, including the nature of free will, time, causality, and explanation; and the ways in which realities are constructed through language and conversation. The chapter also discusses important ethical and moral dilemmas associated with processes through which goals are co-created within relationships characterized by differences in power and authority, and the forms of research and inquiry that might yield practical knowledge of relevance to clinical practice in this area.

Self-Compassion and Psychological Well-being

2017 ◽  
Author(s):  
Kristin Neff ◽  
Christopher Germer
Keyword(s):  
Clinical Practice ◽  
Empirical Evidence ◽  
Well Being ◽  
Human Experience ◽  
Clinical Implications ◽  
Future Directions ◽  
Psychological Well Being ◽  
Daily Lives ◽  
Self Compassion

Self-compassion involves being touched by and open to one’s own suffering, not avoiding or disconnecting from it, generating the desire to alleviate one’s suffering and to heal oneself with kindness. Self-compassion also involves offering nonjudgmental understanding to one’s pain, inadequacies, and failures, so that one’s experience is seen as part of the larger human experience. This chapter will provide an overview of theory and research on self-compassion and its link to psychological well-being, which is the goal of clinical practice. It will discuss what self-compassion is and what it is not (e.g., a form of weakness, selfishness, etc.), and provide empirical evidence to support these distinctions. Finally, it will discuss methods that have been developed to teach individuals how to be more self-compassionate in their daily lives, some clinical implications of self-compassion training, and future directions for research.

scholarly journals Hypodermoclysis: a literature review to assist in clinical practice

2015 ◽  
Vol 13 (1) ◽  
pp. 122-128 ◽  
Author(s):  
Vanessa Galuppo Bruno
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Nursing Staff ◽  
Negative Impact ◽  
Specific Information ◽  
Review Of The Literature ◽  
Therapeutic Goals ◽  
Routes Of Administration ◽  
Safe Option ◽  
Lack Of Information

The aim of this study was to analyze the information available in the literature about the drugs that can be administered through hypodermoclysis and the resulting impact that this information may have on the routine of the pharmacist working at a hospital. The study was based on a review of the literature. The results showed positive points of the procedure, but little specific information about medications such as routes of administration, standard dilutions, optimal doses, etc. Thus, it was possible to verify that there is no definite information as to the correct way to administer the drugs in this route, even though this is an effective and safe option, according to the literature. The lack of information has a negative impact on the support provided by the pharmacist to the nursing staff to ensure that the drug actually reaches its therapeutic goals safely.

Introduction

2013 ◽  
Author(s):  
K.W.M. Fulford ◽  
Martin Davies ◽  
Richard G.T. Gipps ◽  
George Graham ◽  
John Z. Sadler ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Therapeutic Relationship ◽  
Scientific Inquiry ◽  
Moral Dilemmas ◽  
Behavioural Therapy ◽  
Dream Interpretation ◽  
Evidence Based ◽  
Inquiry Science ◽  
Great Effort ◽  
Cognitive Behavioural

This Section examines several moral dilemmas and epistemological aporias in clinical practice and shows how clinicians can benefit from the introduction of philosophical methods and discourse. The authors develop these issues having in mind emblematic mental disorders (e.g. depression, personality disorders, schizophrenia) and typical clinical situations (e.g. how to establish an effective therapeutic relationship with borderline persons, dream interpretation, cognitive-behavioural therapy). One important claim shared by the Authors is that a great effort has been made to ground psychiatry on evidence-based science, and to tie it to our growing understanding of the human brain. This is obviously an exceedingly important project, but it would be a mistake to assume that the central questions of psychiatry can be completely resolved through scientific inquiry. Science offers guidance for clinical practice only in light of our concepts and normative judgments.

scholarly journals Mind and brain: what is the connection? Clinical and philosophical aspects

2021 ◽  
Vol LIII (1) ◽  
pp. 13-18
Author(s):  
Mikhail L. Zobin
Keyword(s):  
Clinical Practice ◽  
Free Will ◽  
Theoretical Models ◽  
Property Dualism ◽  
Analytical Review ◽  
Mind And Brain ◽  
The Relationship

The analytical review touches on clinical, neurobiological and philosophical problems of the relationship between brain and mind. With regard to the needs of clinical practice, the ontological aspects of consciousness and free will are considered, and some theoretical models of behavioral psychopathology are analyzed. A conclusion is made about the priority in psychiatry of the neurobiological paradigm while maintaining interest in modern forms of interactionist and property dualism.

Accounts of Self: Exploring Relationality Through Literature

2016 ◽  
Author(s):  
Maura Spiegel ◽  
Danielle Spencer
Keyword(s):  
Clinical Practice ◽  
Narrative Therapy ◽  
Narrative Medicine ◽  
Critical Perspectives

Literature offers the opportunity to study relationality in many different forms and contexts. This chapter discusses relationality in creative works—Colm Toíbín’s “One Minus One”, Dostoevsky’s Notes from Underground, Alison Bechdel’s Fun Home, and Kazuo Ishiguro’s Never Let Me Go—in combination with selected criticism and theory, exemplifying one approach to the narrative medicine classroom. In these texts characters offer an account of self in contrasting ways—from the vexed, distrustful address of Dostoevsky’s Underground Man to the richly inviting tapestry of Bechdel’s graphic memoir—provoking different readerly experiences. Critical perspectives such as Bakhtin’s analysis of the dialogic nature of the Underground Man’s apparent soliloquy, Rita Felski’s conception of readerly recognition, Michael White’s description of Narrative Therapy, and Judith Butler’s discussion of the ethics of giving an account of self—all enrich our experience of these works and deepen our understanding of relationality, particularly as it relates to clinical practice.

Conflicts of Interest in Clinical Practice

2014 ◽  
Author(s):  
Azgad Gold
Keyword(s):  
Clinical Practice ◽  
Conflicts Of Interest ◽  
Moral Dilemmas ◽  
Medical Professionalism ◽  
Professional Judgment ◽  
Payment Method ◽  
Future Directions ◽  
Financial Interests ◽  
The Difference ◽  
Definition Of

Physicians confront situations in which there is a risk that their professional judgment or actions concerning the treatment of their patients will be unduly influenced by self-serving financial interests. These situations predominantly derive from physicians’ relationships with industry and their payment method. The chapter begins with the definition of conflicts of interest in clinical practice accompanied by an explanation of the difference between conflicts of interest and other moral dilemmas that physicians encounter in their clinical practice. The different approaches toward the conflicts of interest problem are presented, including the underlying philosophical–ideological aspects that relate to opposing views concerning medical professionalism. A discussion pertaining to the merits and disadvantages of the four main types of solutions to the conflicts of interest problem follows. Finally, I outline suggestions for several future directions that could deepen our understanding concerning the conflicts of interest problem and in turn lead to new practical solutions.

scholarly journals The First Two Years of Practice: A Longitudinal Perspective on the Learning and Professional Development of Promising Novice Physical Therapists

2013 ◽  
Vol 93 (3) ◽  
pp. 369-383 ◽  
Author(s):  
Lorna M. Hayward ◽  
Lisa L. Black ◽  
Elizabeth Mostrom ◽  
Gail M. Jensen ◽  
Pamela D. Ritzline ◽  
...  
Keyword(s):  
Professional Development ◽  
Clinical Practice ◽  
Professional Competence ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Practical Knowledge ◽  
Participant Observation ◽  
Health Care Systems ◽  
Professional Role ◽  
Second Year

Background Physical therapists work in complex health care systems requiring professional competence in clinical reasoning and confidence in decision-making skills. For novice physical therapists, the initial practice years are a time for developing professional identity and practical knowledge. Objectives The study purpose was to extend previous research describing the experiences, learning, and professional development of 11 promising novice therapists during their first year of practice. The present study examined the continued development of the same therapists during their second year of clinical practice. Design Seven researchers from 4 physical therapist educational programs in the eastern and midwestern United States used a longitudinal, qualitative, multiple case study approach. Methods Eleven physical therapist graduates identified as “promising novices” were recruited using purposive sampling. Participants ranged in age from 24 to 29 years and entered varied practice settings. Data were collected for 2 years using semistructured interviews, reflective journals, and participant observation. Results A conceptual model describing the participants' ongoing development during the second year of practice emerged. The 3 themes were formal and informal learning, increasing confidence and expansion of skills, and engagement in an environment characterized by collaborative exchange and opportunities for teaching. The second year represented consolidation and elaboration of practice-based learning and skills. The expansion of confidence, skills, and responsibilities and the externalization of learning the participants experienced promoted professional role formation. Learning previously directed inward and self-focused turned outward, fueled by growing self-confidence. Conclusions Research illuminating the professional role formation experienced during early clinical practice is not widely available. The current study and further research into the learning and development of novice practitioners may assist educators in the design of pedagogical strategies and learning environments that enhance the professional development of physical therapists.

Outcomes Assessment: Reliable Change Index (RCI) in Assessing Health Outcomes in Clinical Practice

2017 ◽  
Vol 41 (S1) ◽  
pp. s796-s796 ◽  
Author(s):  
I. Iraurgi ◽  
P. Penas ◽  
S. Gorbeña ◽  
M. Montero ◽  
J. Trujols
Keyword(s):  
Clinical Practice ◽  
Clinical Relevance ◽  
Single Case ◽  
Scientific Evidence ◽  
Statistical Significance ◽  
Reliable Change Index ◽  
Reliable Change ◽  
Therapeutic Goals ◽  
Area Of Interest ◽  
Interpretation Criteria

IntroductionThe assessment of therapeutic outcomes and the evaluation of treatment efficiency and effectiveness is an area of interest for clinicians and researchers. Scientific evidence demands randomized controlled trials and inter-groups comparisons with a minimum number of participants in each treatment modality, a requirement rarely feasible in clinical practice where the assessment of treatment outcomes, with regards to therapeutic goals, is crucial both in terms of statistical significance and clinical relevance.ObjectiveThe aim of this poster is to present an alternative methodology which permits to evaluate the individual's change.MethodThe reliable change index methodology allows for the estimation of statistical significance (statistically reliable change) and clinical relevance (calculation of cutoff points and its interpretation criteria). Two examples are presented: a group of patients with asthma in treatment and a female with major depression who underwent electroconvulsive therapy (ECT).Results/discussionBoth cases were analyzed using standardized statistical analyses and the RCI method in order to estimate clinical change. The results illustrated the adequacy of both procedures for decision making in terms of effectiveness. However the RCI offered greater specificity with regards to individual changes. More specifically, RCI provided a more concrete estimation of the proportion of cases of asthma that showed change after the intervention, and also, indicated if such change were not only statistically significant, but also clinically relevant. Besides, when a single case was assessed (ex: ECT case) this methodology proved useful to estimate the efficacy of a continuation and maintenance program.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Ten years of NovoMix 30 in Russian and international clinical practice

2013 ◽  
Vol 16 (4) ◽  
pp. 101-107
Author(s):  
Elena Viktorovna Surkova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Elderly People ◽  
Insulin Treatment ◽  
Therapeutic Goals ◽  
Biphasic Insulin

Insulin treatment for type 2 diabetes mellitus is challenging in elderly people. Biphasic insulin preparations technically simplify this task, but also increase compliance and facilitate the achievement of therapeutic goals.

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