scholarly journals Searching for a Dialogue

2020 ◽  
Vol 42 (1) ◽  
pp. 31-48
Author(s):  
Carlo Delle Donne
Keyword(s):  
Young Patient ◽  
Therapeutic Relationship ◽  
Medical Discourse ◽  
Ancient Medicine ◽  
Idealized Model ◽  
Patient’S Experience

Abstract The paper aims to examine the linguistic relationship between patients and physicians in the context of the therapeutic relationship. It focuses on the Hippocratic treatises and offers a detailed commentary of a controversial passage of Ancient Medicine par. 2.3. The dialogical model of Ancient Medicine is found to be centred on the patient’s experience; this same idealized model of relation is documented in Plato’s Laws. In the second part of the article the author examines some linguistic peculiarities of medical discourse, such as the use of comparisons and metaphors, and a passage from Galen’s On the Affected Parts that reports the case of a young patient and the difficulties inherent in the dialogue between patient and physician.

scholarly journals Self-harm: a strategy for survival and nodal point of change

2006 ◽  
Vol 12 (5) ◽  
pp. 329-337 ◽  
Author(s):  
Jack Nathan
Keyword(s):  
Therapeutic Relationship ◽  
Nodal Point ◽  
States Of Mind ◽  
Clinical Vignettes ◽  
Patient’S Experience ◽  
Key Issues ◽  
Self Harm ◽  
The Common

The author explores key issues related to psychotherapeutic work with people who self-harm. Particular attention is given to the powerful countertransference feelings that practitioners often experience in this work and the importance of managing these. Rather than maintaining a detached distance, therapists should emotionally engage with the patient's experience, creating a unique therapeutic relationship. The common patterns, functions and meanings of self-harm are discussed, with clinical vignettes that highlight the underlying dynamics of the behaviour. Self-harm is a survival stratagem, and methods for helping patients to find other ways to cope are suggested. One such is mentalisation, which can enhance the patient's capacity to think, not impulsively act. If patients learn how to assess more accurately their own and other people's states of mind, less destructive behaviours can emerge.

scholarly journals Establecimiento de la relación terapéutica con niños y adolescentes con dificultades de regulación y violencia

2020 ◽  
Vol 14 (2) ◽  
pp. 431-439
Author(s):  
Carmen Domínguez Peña ◽  
◽  
Raúl Gutiérrez Sebastián ◽  
Keyword(s):  
Young Patient ◽  
Therapeutic Relationship ◽  
Self Regulation ◽  
Shared Experience ◽  
Final Goal ◽  
Adaptive Development ◽  
Therapeutic Space ◽  
Relational Experience ◽  
The Way

The purpose of this paper is encouraging some reflections over the first steps during the establishment of the therapeutic relationship with children and teenagers with a violence behavior and self-regulation problems. We will discuss the importance of building a clear demand with the patient that provides a congruent therapeutic space that allows a curious and shared experience cobuilt by a mutual relational experience between the therapist and the young patient. In addition, we need to have in mind their significant caregivers as an important part of the process so that the change could be generalize. The final goal is that children and teenager could live a new relational experience that makes a difference in the way of bonding giving way to new forms of relationship in other areas of their life allowing a more mature and adaptive development.

Spotlight on the Clinician in the Life Participation Approach to Aphasia: Balancing Relationship-Centered Care and Professionalism

2020 ◽  
Vol 5 (2) ◽  
pp. 414-424
Author(s):  
Rochelle Cohen-Schneider ◽  
Melodie T. Chan ◽  
Denise M. McCall ◽  
Allison M. Tedesco ◽  
Ann P. Abramson
Keyword(s):  
Social Workers ◽  
Therapeutic Relationship ◽  
Interprofessional Collaboration ◽  
Opportunity To Learn ◽  
Subjective Experiences ◽  
Speech Language Pathologists ◽  
Self Disclosure ◽  
Centered Care ◽  
High Standards ◽  
Therapeutic Encounter

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.

Employing Latino Value Orientations to Facilitate Success in Stuttering Treatment

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.

Clinical Update: Pain and Suffering

2003 ◽  
Vol 8 (1) ◽  
pp. 5-5
Author(s):  
Sheila Wendler
Keyword(s):  
Subjective Experience ◽  
Personal Injury ◽  
Treatment Interventions ◽  
Medical Expenses ◽  
Affective Component ◽  
Pain Behaviors ◽  
The Social ◽  
Patient’S Experience ◽  
Pain And Suffering ◽  
And Training

Abstract Attorneys use the term pain and suffering to indicate the subjective, intangible effects of an individual's injury, and plaintiffs may seek compensation for “pain and suffering” as part of a personal injury case although it is not usually an element of a workers’ compensation case. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, provides guidance for rating pain qualitatively or quantitatively in certain cases, but, because of the subjectivity and privateness of the patient's experience, the AMA Guides offers no quantitative approach to assessing “pain and suffering.” The AMA Guides also cautions that confounders of pain behaviors and perception of pain include beliefs, expectations, rewards, attention, and training. “Pain and suffering” is challenging for all parties to value, particularly in terms of financial damages, and using an individual's medical expenses as an indicator of “pain and suffering” simply encourages excessive diagnostic and treatment interventions. The affective component, ie, the uniqueness of this subjective experience, makes it difficult for others, including evaluators, to grasp its meaning. Experienced evaluators recognize that a myriad of factors play a role in the experience of suffering associated with pain, including its intensity and location, the individual's ability to conceptualize pain, the meaning ascribed to pain, the accompanying injury or illness, and the social understanding of suffering.

Expressed Emotion in the Client-Professional Dyad

2004 ◽  
Vol 20 (4) ◽  
pp. 237-246 ◽  
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.

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

2012 ◽  
Vol 28 (4) ◽  
pp. 255-261 ◽  
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.

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