Music Therapy, a Description of Process: Engagement and Avoidance in Five People with Learning Disabilities

1995 ◽  
Vol 9 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Peter Toolan ◽  
Shirley Coleman

A number of approaches exist within the field of music therapy. Some models for evaluating the efficacy of therapy have been adopted in the UK in recent years. These have measured the occurrence of specific behaviours within therapy, or compared music therapy with other interventions. There is a need to find reasonably reliable methods of describing change and the therapeutic process occurring within music therapy. This paper describes change occurring in five people with learning disabilities, in terms of their levels of engagement in therapy and in the therapeutic relationship. A method is provided, to evaluate independent observers ‘perceptions of change in the patients over a 30-session period of therapy. A significant increase in levels of engagement over time was found. It was also found that the degree of change over time was not related to the mean level of engagement. We discuss some subtle factors involved in therapeutic engagement for the five patients in the study, and stress the importance of a therapy which emphasises the dynamics of interpersonal communication for people with limited opportunities to express thoughts and emotions.

2017 ◽  
Vol 22 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Chris Hatton

Purpose The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland. Design/methodology/approach National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use. Findings Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing. Social implications Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care. Originality/value This paper is a first attempt to compare national social care statistics concerning day services and home care for adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.


2017 ◽  
Vol 22 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Chris Hatton

Purpose The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland. Design/methodology/approach National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use. Findings There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK. Social implications Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences. Originality/value This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.


Author(s):  
Ann M. Callahan

Chapter 5 introduces the concept of relational spirituality to suggest how a therapeutic relationship may support a patient’s spiritual experience of enhanced life meaning. Although different types of relationships may inform spirituality, this chapter focuses on the relationship between a hospice social worker and a patient. Research shows that therapeutic engagement involves a balance between technical skills and relational skills relative to caregiver expertise and patient capacity. This chapter suggests that the manner in which the therapeutic process unfolds as part of hospice social work can facilitate enhanced life meaning, called relational spirituality. A relational model for spiritually-sensitive hospice social work is introduced as a means of describing how this spiritual quality of therapeutic engagement can support patient care.


Author(s):  
Harry Joseph Aponte

AbstractThis paper is based on the premises that the conscious, active and purposeful use of self by the therapist in the therapeutic process is an essential aptitude in establishing an effective therapeutic relationship, and that this therapeutically purposeful use of self can and should be incorporated in the training of all therapists in a explicitly systematic manner. The paper will attempt to identify the contributions of the “what and how” the use of self by therapists contributes to the therapeutic process. First of all, therapists’ use of self is meant to be viewed as a Common Factor as defined by Sprenkle, Davis & Lebow (2009), which is a perspective about the effectiveness of therapy that “asserts that the qualities and capabilities of the person offering the treatment are more important than the treatment itself” (p. 4). Secondly, the use of self by therapists emphasizes developing the skill set of the therapist in the conscious, active and purposeful use of self as is in the moment of the therapeutic engagement with clients, and does so without denying the importance of therapists working to resolve personal issues of theirs that may interfere with the therapist's professional effectiveness. Therapists’ use of self gives particular emphasis to the purposeful use of self as is in therapy’s relationship, assessment and interventions whatever the therapy model (Aponte & Kissil, 2016). Thirdly, the use of self represents an aptitude that can be developed and refined through well elaborated structures for schooling therapists in the therapeutic use of all they bring of their personal selves to the therapy relationship including through the use of their human vulnerabilities as they exist at the moment of empathic engagement with clients.


2010 ◽  
Vol 9 (2) ◽  
Author(s):  
Jinah Kim

Therapy often involves the development of an intimate therapeutic relationship between the client and the therapist. By introducing the story of Hyun in music therapy, I invite readers to discover what happens during mutual music making process and what it means to the child and the therapist. I also situate this story within a triadic relationship – the child, the therapist and the family (especially the mother) so that one can see a comprehensive picture of how the happenings of music therapy relate to immediate outside world of music therapy, and vice versa. More importantly, I try to show the inner workings of the therapist and her wonderings in response to the client in order to clarify the core aspects of therapeutic process.


Author(s):  
Christopher Hood ◽  
Rozana Himaz

This chapter draws on historical statistics reporting financial outcomes for spending, taxation, debt, and deficit for the UK over a century to (a) identify quantitatively and compare the main fiscal squeeze episodes (i.e. major revenue increases, spending cuts, or both) in terms of type (soft squeezes and hard squeezes, spending squeezes, and revenue squeezes), depth, and length; (b) compare these periods of austerity against measures of fiscal consolidation in terms of deficit reduction; and (c) identify economic and financial conditions before and after the various squeezes. It explores the extent to which the identification of squeeze episodes and their classification is sensitive to which thresholds are set and what data sources are used. The chapter identifies major changes over time that emerge from this analysis over the changing depth and types of squeeze.


Author(s):  
Simona Malaspina ◽  
Vesa Oikonen ◽  
Anna Kuisma ◽  
Otto Ettala ◽  
Kalle Mattila ◽  
...  

Abstract Purpose This phase 1 open-label study evaluated the uptake kinetics of a novel theranostic PET radiopharmaceutical, 18F-rhPSMA-7.3, to optimise its use for imaging of prostate cancer. Methods Nine men, three with high-risk localised prostate cancer, three with treatment-naïve hormone-sensitive metastatic disease and three with castration-resistant metastatic disease, underwent dynamic 45-min PET scanning of a target area immediately post-injection of 300 MBq 18F-rhPSMA-7.3, followed by two whole-body PET/CT scans acquired from 60 and 90 min post-injection. Volumes of interest (VoIs) corresponding to prostate cancer lesions and reference tissues were recorded. Standardised uptake values (SUV) and lesion-to-reference ratios were calculated for 3 time frames: 35–45, 60–88 and 90–118 min. Net influx rates (Ki) were calculated using Patlak plots. Results Altogether, 44 lesions from the target area were identified. Optimal visual lesion detection started 60 min post-injection. The 18F-rhPSMA-7.3 signal from prostate cancer lesions increased over time, while reference tissue signals remained stable or decreased. The mean (SD) SUV (g/mL) at the 3 time frames were 8.4 (5.6), 10.1 (7) and 10.6 (7.5), respectively, for prostate lesions, 11.2 (4.3), 13 (4.8) and 14 (5.2) for lymph node metastases, and 4.6 (2.6), 5.7 (3.1) and 6.4 (3.5) for bone metastases. The mean (SD) lesion-to-reference ratio increases from the earliest to the 2 later time frames were 40% (10) and 59% (9), respectively, for the prostate, 65% (27) and 125% (47) for metastatic lymph nodes and 25% (19) and 32% (30) for bone lesions. Patlak plots from lesion VoIs signified almost irreversible uptake kinetics. Ki, SUV and lesion-to-reference ratio estimates showed good agreement. Conclusion 18F-rhPSMA-7.3 uptake in prostate cancer lesions was high. Lesion-to-background ratios increased over time, with optimal visual detection starting from 60 min post-injection. Thus, 18F-rhPSMA-7.3 emerges as a very promising PET radiopharmaceutical for diagnostic imaging of prostate cancer. Trial Registration NCT03995888 (24 June 2019).


Author(s):  
Mar Muñoz-Chápuli Gutiérrez ◽  
Ana Durán-Vila ◽  
Javier Ruiz-Labarta ◽  
Pilar Payá-Martínez ◽  
Pilar Pintado Recarte ◽  
...  

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.


2021 ◽  
Vol 9 (3) ◽  
pp. 311
Author(s):  
Ben R. Evans ◽  
Iris Möller ◽  
Tom Spencer

Salt marshes are important coastal environments and provide multiple benefits to society. They are considered to be declining in extent globally, including on the UK east coast. The dynamics and characteristics of interior parts of salt marsh systems are spatially variable and can fundamentally affect biotic distributions and the way in which the landscape delivers ecosystem services. It is therefore important to understand, and be able to predict, how these landscape configurations may evolve over time and where the greatest dynamism will occur. This study estimates morphodynamic changes in salt marsh areas for a regional domain over a multi-decadal timescale. We demonstrate at a landscape scale that relationships exist between the topology and morphology of a salt marsh and changes in its condition over time. We present an inherently scalable satellite-derived measure of change in marsh platform integrity that allows the monitoring of changes in marsh condition. We then demonstrate that easily derived geospatial and morphometric parameters can be used to determine the probability of marsh degradation. We draw comparisons with previous work conducted on the east coast of the USA, finding differences in marsh responses according to their position within the wider coastal system between the two regions, but relatively consistent in relation to the within-marsh situation. We describe the sub-pixel-scale marsh morphometry using a morphological segmentation algorithm applied to 25 cm-resolution maps of vegetated marsh surface. We also find strong relationships between morphometric indices and change in marsh platform integrity which allow for the inference of past dynamism but also suggest that current morphology may be predictive of future change. We thus provide insight into the factors governing marsh degradation that will assist the anticipation of adverse changes to the attributes and functions of these critical coastal environments and inform ongoing ecogeomorphic modelling developments.


1991 ◽  
Vol 68 (3_suppl) ◽  
pp. 1283-1290 ◽  
Author(s):  
P. A. Holland ◽  
I. Bowskill ◽  
A. Bailey

The hypothesis that predictable differences would exist between the mean cognitive style of new entrants and those of the longer serving “established” employees in certain departments while not in others was tested. Data from 99 employees from four departments of a large British pharmaceuticals company who completed the Kirton Adaption-Innovation Inventory provided results broadly in line with the expectations of adaption-innovation theory and past research. The mean innovative cognitive style of new entrants to adaptive departments regressed towards the mean of the establishment and the occupational mean over time. In departments where there was no initial significant difference between the mean cognitive style of the new entrants and the established group, no significant shift was shown over time. Implications of these findings are suggested. The data also indicated norms for two occupational groups where previously they did not exist.


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