The Influence of Play Therapist’s Empathetic Ability, Interpersonal Relationship Tendencies, and Playability on the Therapeutic Relationship

Abstract Background The therapeutic relationship refers to the interpersonal relationship between the healthcare professional and patient (Peplau, 1997). The importance of the therapeutic relationship is widely recognised across healthcare professions (e.g., nurses - Peplau, 1997; physicians - Weeger & Farin, 2017; psychotherapists - Martin et al, 2000; occupational therapists - Weiste, 2018; physiotherapists- Fuentes et al, 2014). Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories. Methods Data collection was based on the Retrospective Interview Technique (RIT) and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.

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Feelings of pleasure of nurses working in primary care

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0518 ◽

2019 ◽

Vol 72 (4) ◽

pp. 1036-1043

Author(s):

Grizielle Sandrine de Araujo Rocha ◽

Maria Sandra de Andrade ◽

Darine Marie Rodrigues da Silva ◽

Marlene Gomes Terra ◽

Sílvia Elizabeth Gomes de Medeiros ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Therapeutic Relationship ◽

Interpersonal Relationship ◽

Descriptive Study ◽

Qualitative Approach ◽

Structured Interviews ◽

Primary Health ◽

Analysis Technique ◽

Primary Care Nurses

ABSTRACT Objective: identify the sources that generate feelings of pleasure at work in the perception of primary care nurses. Methods: this is a descriptive study with a qualitative approach, developed with eleven nurses working in Primary Health Care Units. Data were collected using semi-structured interviews, systematized and analyzed using Bardin’s content analysis technique and based on the theoretical framework of Psychodynamics of Work. Results: pleasure at work was related to the resolubility of the nurse’s work, interpersonal relationship with the team, therapeutic relationship with the community, positive professional return, identification with work in nursing and public health. Final considerations: The factors that generate feelings of pleasure may contribute to guide actions that value the optimization of the nurses’ work and, consequently, the care provided to the primary care user.

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

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00025 ◽

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.

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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.

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Suicide on the Indian Subcontinent

Crisis ◽

10.1027//0227-5910.23.3.104 ◽

2002 ◽

Vol 23 (3) ◽

pp. 104-107 ◽

Cited By ~ 36

Author(s):

Murad M. Khan

Keyword(s):

Sri Lanka ◽

Mental Health Professionals ◽

Indian Subcontinent ◽

Interpersonal Relationship ◽

Public Health Problem ◽

Elderly Subjects ◽

Important Public Health Problem ◽

Policy Makers ◽

Formidable Challenge ◽

Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.

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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.

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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.

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