Interdisciplinary Community-Based Support for Caregivers of Individuals Living with Dementia

Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a community-based, long-term support system for ILwD who are aging-in-place; second, fostering a safe and supportive community for family caregivers, by providing opportunities to collaborate with peers and an interdisciplinary team that includes a Marriage and Family Therapist (MFT), an Occupational Therapist (OT), and a Recreation Therapist (the day program manager). The closed group model established through eight weekly sessions builds trusting relationships in a frame that combines: the OT client-centered and collaborative approach to problem-solving everyday challenges of caregiving, the MFT skills of creating a safe space for discussion and deeper exploration, and program staff insights regarding the ILwD’s current interests and abilities exhibited during Day Program activities. Sessions include an emotional check-in by group members; a brief overview of best-practices and common caregiving concerns related to a weekly topic; and an opportunity for caregivers to explore the integration of best-practices into daily routines, while also attending to their well-being as caregivers. Program evaluation and results related to the program’s effectiveness and implications for scalability will be discussed.

Categorization and Stigmatization of Families Whose Children Are Institutionalized. A Danish Case Study

Stigmatization and labeling in society is one of the challenges that families of institutionalized children face. This research aims to investigate how professionals categorize the children and their families, and how, in turn, the categorization process impacts their daily practice and the relationship with families. The case study was conducted in a local children’s institution in Aalborg, Denmark, following an ethnographic approach that included day-time participant observations, semi-structured interviews with a pedagogue and a family therapist, and a “discovery” exercise with pedagogues. The data were analyzed using the two main concepts of categorization and stigmatization. The results show how professionals categorized parents as “resourceful” and “non-resourceful,” causing barriers in their work with the families. Categorization based on “resourceful parent” is a co-constitutive process influenced by the interactions between the Danish system (macro level), the institutional field in which public and private actors operate (meso level), and the everyday interventions of practitioners (micro level). Overall, the process of categorization and labeling shapes the collaboration between professionals and parents, which leads to an overemphasis of particular family traits, with a direct link to the “myth of meritocracy.”

Role reversal in remote peer supervision: Utilising tools commonly used in dramatherapy and family therapy to facilitate peer supervision

Peer supervision is a dynamic process which highlights constructive and supportive feedback among therapists while minimising feelings of being evaluated. Some of its benefits include decreased dependency on the expertise of a supervisor, freedom, and equality. In this article, we outline the benefits of peer supervision between a dramatherapist and a family therapist and how their common roots based on creativity and action-based approaches could be used remotely to enhance the goals of peer supervision. We discuss how we utilised such methods and more specifically role reversal in a virtual space during the first Covid-19 lockdown to facilitate the process of peer supervision and understand better the needs and perspective of the client. We propose that incorporating creative and spontaneous methods such as role reversal in a virtual peer supervision environment can potentially enhance the supervisory alliance and therapeutic practice.

The Relationship of Psychotherapist Demographic Variables to Discipline Board Misconduct Content

This study was designed as an investigation of psychotherapist variables that correlate with the contents of findings of misconduct. While there is a scarcity of current research regarding clinician characteristics that correlate with professional misconduct, many assumptions and untested hypotheses appear. In particular, gender is often identified as a critical component of professional misconduct. Despite these common assertions, virtually no published research exists regarding correlations between gender and marriage and family therapist (MFT) professional misconduct. This study employed a retrospective cross-sectional study to analyze a randomized convenience sample of the records of final determinations of psychotherapist disciplinary actions across eight states. Four predictor variables (gender, years of experience, geographical region, and type of license) were correlated with five criterion variables consisting of word counts for five linguistic categories (family, substance, finance, sex, friend, and recordkeeping words). Frequency rates of the criterion variables were calculated. Relationships between all variables were evaluated through a multiple linear regression analysis. The data show a wide variation of prevalence rates across the predictor variables. Five of the multiple regression analyses produced statistically significant results. Gender was related to both family and substance use related words, while years of practice was related to family, finance, sex, friend, and recordkeeping words. No relationship was found between recordkeeping words and any of the predictor variables. Similarly, no relationship was found between any of the criterion variables and geographic region or license type.

Remote Care for Caregivers of People With Psychosis: Mixed Methods Pilot Study

Background A reduced availability of resources has hampered the implementation of family work in psychosis. Web-based support programs have the potential to increase access to high-quality, standardized resources. This pilot study tested the Norwegian version of the Relatives Education and Coping Toolkit (REACT), a web-based United Kingdom National Health Service program in combination with phone-based support by trained family therapists. Objective We investigated how the program was perceived by its users and identified the facilitators and barriers to its clinical implementation. Methods Relatives of people with psychosis were offered access to REACT and to weekly family therapist support (with 1 of 2 trained family therapists) for 26 weeks. Level of distress and level of expressed emotion data were collected at baseline and after 26 weeks using the Family Questionnaire and the Relatives Stress Scale. Both family therapists and a subset of the relatives were interviewed about their experiences after completing the program. Results During the program, relatives (n=19) had a median of 8 (range 4-11) consultations with the family therapists. Postintervention, there was a significant reduction in stress and in expressed emotions in the relatives of people with psychosis. Interviews with the relatives (n=7) and the family therapists (n=2) indicated the following themes as important—the intervention turned knowledge into action; the intervention strengthened the feeling of being involved and taken seriously by the health services; and management support and the ability for self-referral were important, while lack of reimbursement and clinician resistance to technology were barriers to implementation. Conclusions The service was found to offer a valued clinical benefit; however, strategies that aim to engage clinicians and increase organizational support toward new technology need to be developed.