The privatisation of remembering practices in contemporary inpatient mental healthcare: going beyond Agnes's Jacket

In this paper, we consider changes to memorial practices for mental health service users during the asylum period of the mid-nineteenth up to the end of the twentieth century and into the twenty-first century. The closing of large asylums in the UK has been largely welcomed by professionals and service-users alike, but their closure has led to a decrease in continuous and consistent care for those with enduring mental health challenges. Temporary and time-limited mental health services, largely dedicated to crisis management and risk reduction have failed to enable memory practices outside the therapy room. This is an unusual case of privatised memories being favoured over collective memorial activity. We argue that the collectivisation of service user memories, especially in institutions containing large numbers of long-stay patients, would benefit both staff and patients. The benefit would be in the development of awareness of how service users make sense of their past in relation to their present stay in hospital, how they might connect with others in similar positions and how they may connect with the world and others upon future release. This seems to us central to a project of recovery and yet is rarely practised in any mental health institution in the UK, despite being central to other forms of care provision, such as elderly and children's care services. We offer some suggestions on how collective models of memory in mental health might assist in this project of recovery and create greater visibility between past, present and future imaginings.

American Indian Behavioral Health Treatment Preferences as Perceived by Urban Indian Health Program Providers

Behavioral health services specifically targeted for ethnoracial clients are typically tailored to the specific needs and preferences of these populations; however, little research has been done with American Indian clients specifically. To better understand how clinicians handle provision of treatment to this population, we interviewed 28 behavioral health staff at six Urban Indian Health Programs in the United States and conducted focus groups with 23 staff at five such programs. Thematic analysis of transcripts from these interviews and focus groups suggests that these staff attempt to blend and tailor empirically supported treatments with American Indian cultural values and practices where possible. Simultaneously, staff try to honor the client’s specific preferences and needs and to encourage clients to seek cultural practices and connection outside of the therapy room. In so doing staff members were acutely aware of the limitations of the evidence base and the lack of research with American Indian clients.

How do I Perceive the Silences in my one-to-one Music Therapy Sessions

<p>Music therapy research is predominantly focused on the sounds and words that occur in sessions. The role and place of silence within usual practice is not so well covered in research literature. In this research, I used an auto-ethnographic approach and thematic analysis to try and understand how I perceive the silences in my own individual music therapy sessions with learners at a high school. This approach allowed me to connect with my own personal experience with silence, as it is a highly subjective and context dependent phenomena and tool. I perceived silence in nine major themes. Findings suggest I tend to ‘observe’ the learners when silences occur, for a variety of reasons, and this seems to contrast with my previous understanding of my therapeutic approach. Specifically, I found that I am more behaviourally focussed than I realised before I began my research journey, particularly in the way that I write and recall events in the therapy room. The research process enabled me to find out more about my personal relationship with silence, and to some degree a personal truth about myself.</p>

How do I Perceive the Silences in my one-to-one Music Therapy Sessions

<p>Music therapy research is predominantly focused on the sounds and words that occur in sessions. The role and place of silence within usual practice is not so well covered in research literature. In this research, I used an auto-ethnographic approach and thematic analysis to try and understand how I perceive the silences in my own individual music therapy sessions with learners at a high school. This approach allowed me to connect with my own personal experience with silence, as it is a highly subjective and context dependent phenomena and tool. I perceived silence in nine major themes. Findings suggest I tend to ‘observe’ the learners when silences occur, for a variety of reasons, and this seems to contrast with my previous understanding of my therapeutic approach. Specifically, I found that I am more behaviourally focussed than I realised before I began my research journey, particularly in the way that I write and recall events in the therapy room. The research process enabled me to find out more about my personal relationship with silence, and to some degree a personal truth about myself.</p>

‘Journey to musicking’: Resourcing people to music outside the therapy room

<p>This action research study investigates resourcing people to engage in musicking outside the therapy room. Both the practice and research took place within a residential hospital for people with neurological conditions, situated in Aotearoa New Zealand. Music-centred music therapy, community music therapy, resource-oriented music therapy and the ecological model of music influenced this research. Following three action cycles, the qualitative data collected throughout was thematically analysed. This analysis revealed a framework referred to as the ‘journey to musicking’, which identifies six resources people needed to engage in music: opportunity; motivation; confidence; skills; practical needs; and a problem-solving toolkit. The role of the music therapist in resourcing people in these areas is framed as the role of a tuakana, drawing on an indigenous Māori model predominantly used in education and mentoring programmes: ‘tuakana-teina’. ‘Tuakana-teina’ in this study is defined as a music therapist-participant relationship that is empowering, collaborative and inclusive of the possibility of reciprocity. The personal resources (kete) needed by the tuakana music therapist are also explored, while empowerment and sustainability are highlighted as foundational principles to resourcing people. These principles, especially empowerment, are linked to the Māori concept of restoring rangatiratanga. This research provides a rich qualitative account of practicing music therapy in an empowering, ecological way in Aotearoa New Zealand.</p>

‘Journey to musicking’: Resourcing people to music outside the therapy room

<p>This action research study investigates resourcing people to engage in musicking outside the therapy room. Both the practice and research took place within a residential hospital for people with neurological conditions, situated in Aotearoa New Zealand. Music-centred music therapy, community music therapy, resource-oriented music therapy and the ecological model of music influenced this research. Following three action cycles, the qualitative data collected throughout was thematically analysed. This analysis revealed a framework referred to as the ‘journey to musicking’, which identifies six resources people needed to engage in music: opportunity; motivation; confidence; skills; practical needs; and a problem-solving toolkit. The role of the music therapist in resourcing people in these areas is framed as the role of a tuakana, drawing on an indigenous Māori model predominantly used in education and mentoring programmes: ‘tuakana-teina’. ‘Tuakana-teina’ in this study is defined as a music therapist-participant relationship that is empowering, collaborative and inclusive of the possibility of reciprocity. The personal resources (kete) needed by the tuakana music therapist are also explored, while empowerment and sustainability are highlighted as foundational principles to resourcing people. These principles, especially empowerment, are linked to the Māori concept of restoring rangatiratanga. This research provides a rich qualitative account of practicing music therapy in an empowering, ecological way in Aotearoa New Zealand.</p>

Gamification Design on Invisible Display for Amblyopia Treatment in Indian Children: Preliminary Design Intervention Study (Preprint)

BACKGROUND India has the highest number of patients with amblyopia worldwide. For this study, we have developed a novel gaming tablet for amblyopia treatment, called Occlu-tab, which can present visual stimuli to only one eye while both eyes are open. OBJECTIVE To investigate if Occlu-tab, a gaming tablet with invisible display, is effective in improving visual acuity in children with amblyopia. METHODS We recruited 12 children with amblyopia in India to undergo Occlu-tab training. With Occlu-tab, we used eight games to provide patients with well-known techniques for vision therapy: fixation, eye-hand coordination, and pursuit eye movement. Participants were instructed to play with the Occlu-tab in a silent therapy room for 60 min per day, 3 days per week, for 6 weeks while wearing perfectly corrected glasses. The best-corrected visual acuity was determined every 2 weeks until the end of the treatment. RESULTS All 12 participants showed improved visual acuity after 4-6 weeks of treatment. The treatment games were well received by Indian children, and several requests for additional types of games were made. Parameter estimators for fixed effect showed high significance (P<.001), which suggests an evident improvement effect of the Occlu-tabs. CONCLUSIONS Occlu-tab was effective in improving visual acuity in children with amblyopia. However, game design should be improved based on the analysis of cultural and religious practices. Several patients refused to participate in the trial since they were unable to report to the hospital regularly due to financial reasons. This observation demonstrates the need for home treatment for low-income patients. In addition, home health care will be very important under a pandemic or lockdown caused by coronavirus disease 2019. In the future, this technology will be required in more accessible devices, such as televisions, smartphones, and tablets.

Patientoriented Algorithm for the X-ray Therapy Cabinet of Oncology Dispensary

Results: IIntroduction: Superficial X-ray therapy is a common treatment of non-melanoma skin cancer with a high incidence worldwide. Interrupting the course of radiation therapy can negatively affect patient survival and treatment results. Low treatment adherence may be associated with a lack of a patient-centered approach and ineffective communications. The original study shows that patients undergoing X-ray therapy for cancer may have different needs. Based on the study results an algorithm for a patient-oriented approach has been developed for the X-ray cabinets. Purpose: To develop a patient-oriented algorithm of the X-ray therapy room to address the issues of increasing patient satisfaction and forming their adherence to treatment. The objectives of the study included studying and detailing the needs of the patients who passed the X-ray therapy and to develop the patient-oriented algorithm for the X-ray therapy room. Material and methods: The study of the patient's values was carried out from 2019 to 2020 by interviewing using open-ended questions to find out the deep motives and beliefs of patients. The study was based on Milton Rokich’s (2005) model of value orientations, which was adapted to the objectives of the study. Results: The study included 116 patients undergoing treatment with the X-ray therapy at the City Clinical Oncology Dispensary. As a result of the study, the following patient needs were identified: clinical outcome of the procedure 111 (96 %), safety of treatment and adverse reactions 106 (91 %), cosmetic outcome 53 (46 %), convenience of the treatment schedule 42 (36 %), painlessness of the procedure 39 (34 %), the ability to lead a normal lifestyle 27 (23 %), comfortable conditions for the procedure 16 (14 %), financial costs associated with treatment 10 (9 %), preservation of organ function 4 (3 %). On the basis of the data obtained, a patient-oriented algorithm for the X-ray therapy was developed, including a communication plan with the patient. The study results clearly demonstrate that even with the same disease and condition, patients may have different priorities hat need to be considered to improve patient experience and adherence to treatment. Conclusion: Radiation treatment decision-making based on the patients values is important for the development of the patient-centered management in oncology since this directly affects patients’ adherence to treatment. Exploring the values and needs of patients is an opportunity to influence and improve the metrics of the patient experience. Due to the mass incidence of non-melanoma skin cancer, the introduction of patient-centered approaches is an important part of patient satisfaction and increase of patients adherence to the treatment.

Effects of virtual reality v. biophilic environments on pain and distress in oncology patients: a case-crossover pilot study

This pilot study aimed to determine if a biophilic Green Therapy or Virtual Reality environment can decrease an oncology patient’s pain and distress while receiving chemotherapy. A case-crossover pilot study was conducted in a comprehensive cancer infusion center. 33 participants with breast, gynecologic, gastrointestinal, pancreatic and prostate cancers were all included in three rooms in a random order at different cycles: control room, Green Therapy room, and Virtual Reality room to receive chemotherapy, respectively. Participants’ pain, distress, heart rate, blood pressure, and saliva cortisol were measured before and after infusion in each room. No statistical significance differences were shown in the changes of heart rate, systolic, or diastolic blood pressure, saliva cortisol, pain, or distress before and after infusion between the control, Green Therapy, and Virtual Reality rooms. However, more patients reported the experience as “fun” and “enjoyable” when they were in Green Therapy or Virtual reality room as compared to in the control room. Additionally, since participating in the study, 14 patients reported spending at least 30 min or more outside in nature. In this study, we found that patients’ heart rate, blood pressure, and self-reported distress levels were reduced after each biophilic intervention although results are not statistically significant. The study also suggested that biophilic interventions are safe and feasible and may complement the standard of care for oncology patients.