Session 4: Addressing Barriers to Treatment Success

Author(s):  
Tara S. Peris ◽  
John Piacentini

This chapter describes how to assist families as they apply skills learned in earlier treatment sessions to work on specific problems at home. It begins with a review of their progress with the first family problem, and, if appropriate, guides the therapist in helping families pick a new issue to address. The therapist reviews treatment progress and discusses potential barriers to change, including secondary gain, low motivation, and noncompliance. It is important that the therapist monitors and reframes blame that may arise during these discussions. The therapist should make it clear that OCD symptoms/behaviors are not done on purpose, even if there are aspects that appear to work to the child’s advantage. Strategies for addressing these obstacles are discussed and additional interventions applied as necessary.

2017 ◽  
Vol 26 (1) ◽  
pp. 146-152 ◽  
Author(s):  
Kerry Danahy Ebert

Purpose Clinician–client relationships may influence treatment success in speech-language pathology, but there are no established tools for measuring these relationships. This study describes the development and application of a set of scales for assessing clinician–client relationships in children's speech-language treatment. Method Twenty-two triads of participants completed a longitudinal study. Each triad had 1 school-age child enrolled in speech-language treatment, 1 caregiver, and 1 speech-language pathologist (SLP). The clinician–client relationship scales were administered to all 3 types of participants at study onset and again 2 weeks later. Treatment progress measures were collected 4 months later. Analyses established the reliability and validity of the clinician–client relationship scales. Results Adequate internal consistency reliability and test–retest reliability were established for all 3 versions of the scale (child, caregiver, and SLP). Convergent validity was moderate between SLPs and children but lower when caregivers were included. Predictive validity analyses established significant relationships between caregiver and SLP ratings of the clinician–client relationship and future treatment progress. Conclusions This exploratory study established the viability of the clinician–client relationship scales for further development and application. The importance of establishing and utilizing measures of the clinician–client relationship in speech-language pathology is discussed.


2021 ◽  
Author(s):  
Aijan Taalaibekova ◽  
Alena Oleinik ◽  
Kamila Magdieva ◽  
Gulzada Mirzalieva ◽  
Zainab K. Yusuf ◽  
...  

Abstract Background: After the acute period from SARS-CoV-2 infection, many COVID-19 survivors continue to have ongoing symptoms. There is a need to render assistance to such COVID-19 survivors in Kyrgyzstan but it is unclear how support should be designed. This study aimed to examine what this support should look like, specifically the persisting post-COVID symptoms, views on the optimal timing, suitable delivery methods, content of the support, and obstacles to implementation. Methods: This study was conducted by using two cross-sectional online surveys in the Russian language. The first group included clinical workers of various specialties who worked in the places of treatment for patients with COVID-19. The second group consisted of patients aged ≥18 years who had recovered from COVID-19 who were recruited from family medicine centers using the database of COVID-19 survivors. The survey was conducted anonymously and voluntarily, and consisted of 16 questions. Results: 85 clinical workers and 132 COVID-19 survivors took part in the survey. COVID-19 survivors reported they would be willing to devote 1-3 sessions per a week (84%) with a duration of no more than 1 hour (90%) to post-COVID interventions. Respondents identified the Internet (43%) and separate smartphone applications (42%) as the best media via which to receive support at home. The greatest barrier to accepting help was the risk of re-infection (43%). According to clinical workers, the main goal of post-COVID-19 support should be the amelioration of breathing problems (70%), increased physical exercise (57%) and elements of psychological support (57%). Clinical workers reported that support should begin during treatment for COVID-19 (65%), or immediately after returning from the hospital (59%). Respondents stated that it would be better to carry out support at home via video conference (65%), or by means of telephone calls (47%). The cost of treatment (47%) and the individual’s employment at work (43%) were deemed potential barriers to COVID-19 survivors participating in support interventions.Conclusions: Clinical workers and COVID-19 survivors deemed post-COVID-19 support necessary. Our results will directly inform the development and delivery of post-COVID support interventions in Kyrgyzstan and Central Asia, in combination with the views and needs identified directly from people with persisting post-COVID symptoms.


Thorax ◽  
2016 ◽  
Vol 71 (Suppl 3) ◽  
pp. A201.1-A201
Author(s):  
L Dismore ◽  
C Echevarria ◽  
A Van-Wersch ◽  
AJ Simpson ◽  
GJ Gibson ◽  
...  

Author(s):  
Monnica T. Williams ◽  
Terence Ching

Obsessive-compulsive disorder (OCD) is a multifaceted and functionally disabling condition involving distressing obsessions and repetitive compulsions. Although OCD rates are generally invariant across US ethnoracial minority groups, there remains a paucity of knowledge about the disorder in minorities. This could be due to underrepresentation of these groups in OCD treatment centers, a major source of symptom data for OCD research. Poor minority participation also suggests stigmatic cultural attitudes toward mental illness and related services, among other barriers to treatment, in these groups. Therefore, this chapter reviews symptom presentation, various barriers to treatment, and possible cultural considerations for treatment of OCD in three ethnoracial minority groups in the United States (African Americans, Latino/Hispanic Americans, and Asian Americans). It is hoped that this chapter can help readers better understand how cultural norms can shape the experience of OCD, as well as influence help seeking and treatment success in ethnic and racial minorities.


Author(s):  
John Piacentini ◽  
Audra Langley ◽  
Tami Roblek

The seventh session discusses obstacles that there may be to practicing ERP and ways around them, as well as the concept of secondary gain as a barrier to treatment success.


1981 ◽  
Vol 12 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Barbara Culatta ◽  
Donna Horn

This study attempted to maximize environmental language learning for four hearing-impaired children. The children's mothers were systematically trained to present specific language symbols to their children at home. An increase in meaningful use of these words was observed during therapy sessions. In addition, as the mothers began to generalize the language exposure strategies, an increase was observed in the children's use of words not specifically identified by the clinician as targets.


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