Who speaks? Who looks? Who feels? Point of view in autobiographical narratives.

PubMed

Habermas, Tilmann

2006-04-01

In this paper, the author aims to substantiate Freud's claim that neurotic illness creates gaps in autobiographical narratives in terms of the narrator's stating and inducing perspectives. He sketches out the role of narrative perspective and the joint taking of a shared perspective by analyst and patient in psychoanalytic therapy. He introduces four ways of representing perspectives in narratives. Three degrees of narrative distortion are exemplified by three excerpts from life narratives and explored in terms of narrative perspective representation. The most comprehensive perspective representation is achieved in the first example by explicitly stating the present perspective of the narrator as well as the past perspective of the story's protagonist by use of mental verbs. In the second narrative, exclusive use of linguistic forms for inducing the protagonist's perspective both overwhelms the narrator and gives the listener an incomplete picture of what happened. Inconsistent motives, denial of responsibility and omission of detail render the third narrative even more difficult to follow. The author discusses the clinical significance of this exploratory analysis of perspectives in narratives in terms of claiming responsibility for one's past action and of level of defence mechanisms, and by highlighting the emotional impact on listeners, which the author suggests is the stronger the more perspectives are left out. He discusses analogies to countertransference. The analysis of narrative perspectives offers an approach for systematic research in psychoanalytic practice.

Toward an integrative understanding of narrative and emotion processes in Emotion-focused therapy of depression: implications for theory, research and practice.

PubMed

Angus, Lynne

2012-01-01

This paper addresses the fundamental contributions of client narrative disclosure in psychotherapy and its importance for the elaboration of new emotional meanings and self understanding in the context of Emotion-focused therapy (EFT) of depression. An overview of the multi-methodological steps undertaken to empirically investigate the contributions of client story telling, emotional differentiation and meaning-making processes (Narrative Processes Coding System; Angus et al., 1999) in EFT treatments of depression is provided, followed by a summary of key research findings that informed the development of a narrative-informed approach to Emotion-focused therapy of depression (Angus & Greenberg, 2011). Finally, the clinical practice and training implications of adopting a research-informed approach to working with narrative and emotion processes in EFT are described, and future research directions discussed.

The emotional impact of loss narratives: event severity and narrative perspectives.

PubMed

Habermas, Tilmann; Diel, Verena

2010-06-01

Out of the complex influences of event, narrative and listener characteristics on narrative emotions, this paper focuses on event severity, narrative perspectives, mood, and dispositions for emotion regulation and empathy. Event severity and perspective representation were systematically varied in sad autobiographical narratives to study their influence on quantity and quality of readers' emotional response. Each of three stories were manipulated to contain elaborated perspectives, only the past protagonists' perspective (dramatic narration), and very little perspectives at all (impersonal narration). We predicted that event severity influences the quantity of emotional response, while degree of perspective representation influences plausibility and whether emotional responses are sympathetic or interactional, that is, directed against the narrator. Hypotheses were confirmed except for plausibility, and perspective representation had an effect only on anger against and dislike of the narrator. In a second study, impersonal narration evoked anger at and negative evaluations of the narrator which were related to blaming the narrator for showing too little emotional involvement. The generalizability of findings across emotions and implications for sharing of emotions in everyday and clinical settings are discussed.

Culture and meaning: expanding the metaphorical repertoire of family therapy.

PubMed

Paré, D A

1996-03-01

This essay proposes that a family therapy founded on a contemporary, postmodern perspective demands an expanded range of metaphors for the family and the work of therapy. It describes a perspective that emphasizes a view of the family as a culture, as opposed to a system. A cultural perspective naturally addresses issues of meaning and language, narrative, politics, and practices of power-critical contemporary concerns not adequately encompassed by traditional systemic formulations. The essay explores the relationship between theory and metaphor, and contrasts the views of persons and of the family offered by the metaphors of culture and system. Case illustrations demonstrate how a cultural view effectively fashions an expanded therapeutic discourse, shifting the focus of family therapy from normative prescriptions for family "functionality" to issues of intercultural harmony. This shift in emphasis also extends to individual work, where the therapeutic task is construed as a peace-making between conflicting stories that intersect in the client's life.

Archetypal Narratives in Career Counselling: A Chaos Theory Application

ERIC Educational Resources Information Center

Pryor, Robert G. L.; Bright, Jim E. H.

2008-01-01

This paper seeks to extend previous work on narrative career counselling by considering the role of plot within clients' narratives. Seven archetypal narratives derived from the work of Booker (2004) are introduced that represent systems of meaning to provide insight into how individuals interpret their experience. These plots can be understood…

Unique Outcomes in the Narratives of Young Adults Who Experienced Dating Violence as Adolescents.

PubMed

Draucker, Claire Burke; Smith, Carolyn; Mazurczyk, Jill; Thomas, Destini; Ramirez, Patricia; McNealy, Kim; Thomas, Jade; Martsolf, Donna S

2016-01-01

Narrative therapy, an approach based on the reauthoring of life narratives, may be a useful psychotherapeutic strategy for youth who have experienced dating violence. A cornerstone of narrative therapy is the concept of unique outcomes, which are moments that stand in contrast to a client's otherwise problem-saturated narratives. The purpose of this study was to identify and categorize unique outcomes embedded in narratives about adolescent dating violence. Text units representing unique outcomes were extracted from transcripts of interviews with 88 young adults who had experienced dating violence and were categorized using standard content analytic techniques. Six categories of unique outcome stories were identified: facing-facts stories, standing-up-for-myself stories, cutting-it-off stories, cutting-'em-loose stories, getting-back-on-track stories, and changing-it-up stories. This typology of unique outcomes can inform clinicians who work with clients who have a history of adolescent dating violence. © The Author(s) 2015.

Clients' and therapists' stories about psychotherapy.

PubMed

Adler, Jonathan M

2013-12-01

This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

The Narrative-Emotion Process Coding System 2.0: A multi-methodological approach to identifying and assessing narrative-emotion process markers in psychotherapy.

PubMed

Angus, Lynne E; Boritz, Tali; Bryntwick, Emily; Carpenter, Naomi; Macaulay, Christianne; Khattra, Jasmine

2017-05-01

Recent studies suggest that it is not simply the expression of emotion or emotional arousal in session that is important, but rather it is the reflective processing of emergent, adaptive emotions, arising in the context of personal storytelling and/or Emotion-Focused Therapy (EFT) interventions, that is associated with change. To enhance narrative-emotion integration specifically in EFT, Angus and Greenberg originally identified a set of eight clinically derived narrative-emotion integration markers were originally identified for the implementation of process-guiding therapeutic responses. Further evaluation and testing by the Angus Narrative-Emotion Marker Lab resulted in the identification of 10 empirically validated Narrative-Emotion Process (N-EP) markers that are included in the Narrative-Emotion Process Coding System Version 2.0 (NEPCS 2.0). Based on empirical research findings, individual markers are clustered into Problem (e.g., stuckness in repetitive story patterns, over-controlled or dysregulated emotion, lack of reflectivity), Transition (e.g., reflective, access to adaptive emotions and new emotional plotlines, heightened narrative and emotion integration), and Change (e.g., new story outcomes and self-narrative discovery, and co-construction and re-conceptualization) subgroups. To date, research using the NEPCS 2.0 has investigated the proportion and pattern of narrative-emotion markers in Emotion-Focused, Client-Centered, and Cognitive Therapy for Major Depression, Motivational Interviewing plus Cognitive Behavioral Therapy for Generalized Anxiety Disorder, and EFT for Complex Trauma. Results have consistently identified significantly higher proportions of N-EP Transition and Change markers, and productive shifts, in mid- and late phase sessions, for clients who achieved recovery by treatment termination. Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative change. Implications for future research, practice and training are discussed.

Through the client's eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period.

PubMed

van Stenus, Cherelle M V; Gotink, Mark; Boere-Boonekamp, Magda M; Sools, Anneke; Need, Ariana

2017-06-12

The client experience is an important outcome in the evaluation and development of perinatal healthcare. But because clients meet different professionals, measuring such experiences poses a challenge. This is especially the case in the Netherlands, where pregnant women are often transferred between professionals due to the nation's approach to risk selection. This paper explores questions around how clients experience transfers of care during pregnancy, childbirth, and the neonatal period, as well as how these experiences compare to the established quality of care aspects the Dutch Patient Federation developed. Narratives from 17 Dutch women who had given birth about their experiences with transfers were collected in the Netherlands. The narratives, for which informed consent was obtained, were collected on paper and online. Storyline analysis was used to identify story types. Story types portray patterns that indicate how clients experience transfers between healthcare providers. A comparative analysis was performed to identify differences and similarities between existing quality criteria and those clients mentioned. Four story types were identified: 1) Disconnected transfers of care lead to uncertainties; 2) Seamless transfers of care due to proper collaboration lead to positive experiences; 3) Transfers of care lead to disruption of patient-provider connectedness; 4) Transfer of care is initiated by the client to make pregnancy and childbirth dreams come true. Most of the quality aspects derived from these story types were identified as being similar or complementary to the Dutch Patient Federation list. A 'new' aspect identified in the clients' stories was the influencing role of prior experiences with transfers of care on current expectations, fears, and wishes. Transfers of care affect clients greatly and influence their experiences. Good communication, seamless transfers, and maintaining autonomy contribute to more positive experiences. The stories also show that previous experiences influence client's expectations for the next pregnancy, childbirth, and transfers of care.

Counselors' Clinical Use of Definitive Drug Testing Results in Their Work with Substance-Use Clients: a Qualitative Study.

PubMed

Rzetelny, Adam; Zeller, Barbara; Miller, Nicholas; City, Kathy Egan; Kirsh, Kenneth L; Passik, Steven D

We conducted a psychotherapeutic examination of the use of definitive drug testing (liquid chromatography with tandem mass spectrometry) in the treatment of substance use disorders (SUD). Employing a generic qualitative method (Caelli et al. in International Journal of Qualitative Methods, 2 (2), 2003; Merriam, 2009) we asked SUD counselors to provide narratives about cases where drug testing had revealed new or unexpected information about clients' drug-taking behaviors. Semi-structured interviews with 12 SUD counselors were conducted by phone and analyzed for themes derived from the literature. These counselors reported many new positive drug tests in clients previously believed to be adherent with treatment. Key themes assessed in counselors' narratives included initial client denial that was often followed by later acknowledgement of relapse and increased motivation, at times presenting new opportunities for clients to engage in treatment and enhance the therapeutic alliance. These results suggest that definitive drug testing can be used in a non-stigmatizing and therapeutic manner.

Using Piaget's Theory of Cognitive Development to Understand the Construction of Healing Narratives

ERIC Educational Resources Information Center

Cook-Cottone, Catherine P.

2004-01-01

The construction of healing narratives is a framework within which the college counselor can view the progressive development of the counseling process. The level of a client's narrative processing appears to depend on an interaction between experience-specific knowledge and experience-specific emotionality. Implications for college counselors and…

Construction of Narrative Identity Based on Paintings

ERIC Educational Resources Information Center

Garwolinska, Katarzyna; Oles, Piotr K.; Gricman, Anna

2018-01-01

This article presents a new method for encouraging clients to articulate and explore their narrative identities. The method combines the advantages of perception of art and of construction of narrative identity. It is inspired by McAdams 'Life Story Interview' and Hermans and Hermans-Jansen's Self-Confrontation Method. The material is a set of 100…

Story Crafting: Strategies for Facilitating Narrative Career Counselling

ERIC Educational Resources Information Center

McMahon, Mary; Watson, Mark

2012-01-01

Narrative career counselling is a growing force in career guidance and counselling that offers a direction for the field to respond to the needs of increasingly diverse client groups. In this article, we review established and emerging approaches to narrative career counselling, then focus on the emerging story telling approach. We offer examples…

Separating the Problem and the Person: Insights from Narrative Therapy with People Who Stutter

ERIC Educational Resources Information Center

Ryan, Fiona; O'Dwyer, Mary; Leahy, Margaret M.

2015-01-01

Stuttering is a complex disorder of speech that encompasses motor speech and emotional and cognitive factors. The use of narrative therapy is described here, focusing on the stories that clients tell about the problems associated with stuttering that they have encountered in their lives. Narrative therapy uses these stories to understand, analyze,…

A macro perspective for client-centred practice in curricula: Critique and teaching methods.

PubMed

Fleming-Castaldy, Rita P

2015-07-01

Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment. The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice. This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required. Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

Attachment-informed therapy for adults: Towards a unifying perspective on practice.

PubMed

Berry, Katherine; Danquah, Adam

2016-03-01

We aimed to provide an integrated overview of the key goals and strategies of an attachment-informed psychotherapy by summarizing the literature describing the clinical implications of attachment theory for psychological therapy for adults. We carried out a narrative thematic review of 58 texts from a diverse range of therapeutic schools, until we agreed that we had reached a saturation of themes. We identified six key themes: Changing internal working models; the therapeutic relationship and creating a secure base; formulating and processing relationship experiences; countertransference; separation, termination and boundary issues; and working with different attachment styles or patterns. We discuss empirical evidence in relation to each theme and highlight areas for research. Attachment theory provides a useful framework to inform psychological therapy with adults, but there is a pressing need for further research to empirically demonstrate the 'added value' of an attachment perspective. Attachment theory should be used to inform individual psychological therapy in adulthood. From the outset of their careers, therapists should receive training and supervision to enhance their awareness of their own and their clients' attachment experiences and how these play out during therapy. There is a need for greater empirical research to investigate whether the degree to which therapists formulate and meet clients' attachment needs influences outcomes. © 2015 The British Psychological Society.

An Exploration of Hmong Women's Perspectives on Cancer.

PubMed

Baisch, Mary Jo; Vang, Pang C; Peterman, Beth R

2008-06-01

The purpose of this study was to explore the perspectives of Hmong women on cancer, using focus groups as the research method. Two focus group interviews were conducted and the narrative data were analyzed using thematic content analysis. Themes that emerged from the focus group discussions included "fatalistic and 'black and white' thinking", "valuing rumors rather than scientific information", "strong adherence to traditional medicine", "male leaders controlling health care decisions", "embarrassment discussing women's bodies", and "preferred strategies in addressing cancer". Many Hmong people in the United States believe that both traditional and Western health care practices are effective, but when health professionals do not address differences in language, communication, and beliefs about health, trust between the provider and client may erode. The findings of this study provide new insight into the importance of cultural accommodation to improve early cancer detection in the Hmong community.

Narrative and attachment in the process of recovery from substance misuse.

PubMed

Waters, Kathryn; Holttum, Sue; Perrin, Ines

2014-06-01

The aim of this study was to illustrate the individual accounts of a small group of substance misusers who had found psychological therapy helpful in their recovery from substance misuse. The study also aimed to highlight the roles that the psychologists played within these narratives. Narrative analysis, a qualitative design, was used to capture the unique recovery narratives of substance users who had received psychological therapy. Seven participants (three males and four females, age range 40-54 years, six White British, one White European) were recruited via clinical psychologists from an addictions psychology department and participated in 60-90 min interviews. Analysis of the recovery narratives resulted in an overarching theme; role of the psychologists as a secure attachment figure leading to the development of surrogate internal working models, and the following subthemes which developed and maintained the attachments: closeness and proximity leading to positive expectations about the relationship, safe haven leading to increasing capacities for affect regulation, secure base leading to the experience of being able to mentalize regarding ones mental states and associated actions, and separation distress leading to internalizing the psychologists. The study analysed the personal accounts of seven substance misusers regarding their use of psychological therapy in their recovery. The relationship between the therapists and the clients developed as a result of the psychologists serving as secure attachment figures, and providing closeness and proximity, a safe haven and a secure base to the clients. Clients' separation distress also led to the internalizing of the psychologists. Future studies are needed to tease out which substance user clients would most be suited to the above approach. Measures of newer more adaptive internal working models could then be applied to relationships outside of therapy to see in what way the newer, more flexible, and transferable IWMs were truly internalized and influential in the recovering minds of substance misusers. Clinical Psychologists can play a vital role in the recovery of substance misusers who are ready to work through their psychological recovery. Forming a positive therapeutic relationship is dependent on the psychologists fulfilling the role of positive attachment figures for the clients. © 2013 The British Psychological Society.

Perspective taking in children's narratives about jealousy.

PubMed

Aldrich, Naomi J; Tenenbaum, Harriet R; Brooks, Patricia J; Harrison, Karine; Sines, Jennie

2011-03-01

This study explored relationships between perspective-taking, emotion understanding, and children's narrative abilities. Younger (23 5-/6-year-olds) and older (24 7-/8-year-olds) children generated fictional narratives, using a wordless picture book, about a frog experiencing jealousy. Children's emotion understanding was assessed through a standardized test of emotion comprehension and their ability to convey the jealousy theme of the story. Perspective-taking ability was assessed with respect to children's use of narrative evaluation (i.e., narrative coherence, mental state language, supplementary evaluative speech, use of subjective language, and placement of emotion expression). Older children scored higher than younger children on emotion comprehension and on understanding the story's complex emotional theme, including the ability to identify a rival. They were more advanced in perspective-taking abilities, and selectively used emotion expressions to highlight story episodes. Subjective perspective taking and narrative coherence were predictive of children's elaboration of the jealousy theme. Use of supplementary evaluative speech, in turn, was predictive of both subjective perspective taking and narrative coherence. ©2010 The British Psychological Society.

The anthropology of dementia: a narrative perspective.

PubMed

Randall, William L

2009-03-01

This article draws on recent thinking in the field of narrative gerontology to lend support to Mahnaz Hashmi's "anthropological perspective" on dementia. From a narrative perspective, the relational component of human life--and thus of dementia--is underscored. Moreover, when the narrative dimensions of memory are considered, the line between "normal" and "pathological" is revealed as finer than commonly assumed.

Cultural Studies Methodologies and Narrative Family Therapy: Therapeutic Conversations About Pop Culture.

PubMed

Tilsen, Julie; Nylund, David

2016-06-01

Therapists recognize that popular media culture is an influential force that shapes identities and relationships in contemporary society. Indeed, people have serious relationships with the commodities and practices that emerge from pop culture. However, they often lack the conceptual and conversational resources to engage meaningfully with clients about pop culture's influence in their lives. Cultural studies is introduced as an interdisciplinary approach that provides frameworks for both theory and practice that position therapists and clients to critically examine the role of pop culture in their lives. Cultural studies and narrative therapy are discussed as praxis allies that share a populist political intention and counter-hegemonic discursive practices. The integration of cultural studies methodologies into narrative therapy practice with a parent and her teenage daughter is illustrated through a case vignette. © 2016 Family Process Institute.

Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

PubMed

MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

2017-11-28

Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

Struggling against Heteronormativity: The Narratives of Seventeen Heterosexuals

ERIC Educational Resources Information Center

Smith, Lance Christian

2009-01-01

There is a paucity of literature that examines the narratives of heterosexuals who struggle against the discourse of heteronormativity. There is even less literature that discusses how the discourse of heteronormativity may play out between egalitarian heterosexual counselors and clients who identify as sexual minorities. Employing the qualitative…

Narrations of Violence--Strength Approach in Youth Work

ERIC Educational Resources Information Center

Keck, Andreas

2015-01-01

The case of a delinquent hard-to-reach client shows the possibilities and limits of the strength approach in youth work with delinquent adolescents. Issues such as: "How does information about the delinquency of a client influence social workers before even have started to attend to a case?" or "What is necessary to maintain a…

Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

PubMed

Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

2017-12-14

This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

Integrating Narrative and Action Processes in Group Counseling Practice: A Multimodal Approach for Helping Clients

ERIC Educational Resources Information Center

Westwood, Marvin J.; Ewasiw, Joan F.

2011-01-01

The aim of this article is to introduce an integrated approach for helping clients. The approach combines and builds on two group-based interventions: guided autobiography and therapeutic enactment. Descriptions of the two interventions individually and a transtheoretical model for change are provided. How change occurs through the proposed…

Role of Narrative Perspective and Modality in the Persuasiveness of Public Service Advertisements Promoting HPV Vaccination.

PubMed

Nan, Xiaoli; Futerfas, Michelle; Ma, Zexin

2017-03-01

In the context of public service advertisements promoting human papillomavirus (HPV) vaccination, the current research examines 1) the relative persuasiveness of narrative vs. non-narrative messages and 2) the influence of narrative perspective (first- vs. third-person) and modality (text-based vs. audio-based) on message effectiveness. Results of a controlled experiment (N = 121) suggested that both a non-narrative message and a first-person narrative message led to greater perceived risk of getting HPV than a third-person narrative message. There was no difference in risk perception between the non-narrative and first-person narrative conditions. These findings were confined to the text-based condition, however. When the messages were audio-based, no differential message effects were detected. The analysis also provided partial evidence for an indirect effect of narrative perspective on intentions to vaccinate against HPV through HPV risk perception. Theoretical and practical implications of the findings are discussed.

Enriching Careers and Lives: Introducing a Positive, Holistic, and Narrative Career Counseling Method that Bridges Theory and Practice

ERIC Educational Resources Information Center

Zikic, Jelena; Franklin, Mark

2010-01-01

CareerCycles (CC) career counseling framework and method of practice integrates and builds on aspects of positive psychology. Through its holistic and narrative approach, the CC method seeks to collaboratively identify and understand clients' career and life stories. It focuses on their strengths, desires, preferences, assets, future…

The Body Tells the Story: Using Art to Facilitate Children's Narratives

ERIC Educational Resources Information Center

Hecker, Lorna; Lettenberger, Cassandra; Nedela, Mary; Soloski, Kristy L.

2010-01-01

This article illustrates an art activity for use in psychotherapy with children or adolescents. The purpose of the activity is to utilize creativity to increase problem solving for child clients and to allow their narratives to expand therapeutically. The processing of the activity allows the art to be transformed into language, thereby involving…

Administering Narrative Career Counselling in a Diverse Setting: Trimming the Sails to the Wind

ERIC Educational Resources Information Center

Maree, Kobus; Ebersöhn, Liesel; Liesel, Maisha

2006-01-01

The purpose of this article was to investigate the extent to which a postmodern, narrative approach to career counselling can be utilized to address complexities in career counselling settings characterized by diversity. We also contemplated whether the inclusion of multiple approaches towards the data collection for assisting clients in career…

Perspectives on barriers to eating healthy among food pantry clients

USDA-ARS?s Scientific Manuscript database

The objective of this study was to explore perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Qua...

Transnational commercial surrogacy in India: gifts for global sisters?

PubMed

Pande, Amrita

2011-11-01

In this ethnography of transnational commercial surrogacy in a small clinic in India, the narratives of two sets of women involved in this new form of reproductive travel – the transnational clients and the surrogates themselves – are evaluated. How do these women negotiate the culturally anomalous nature of transnational surrogacy within the unusual setting of India? It is demonstrated that while both sets of women downplay the economic aspect of surrogacy by drawing on predictable cultural tools like 'gift', 'sisterhood' and 'mission', they use these tools in completely unexpected ways. Previous ethnographies of surrogacy in other parts of the world have revealed that women involved in surrogacy use these narratives to downplay the contractual nature of their relationship with each other. Ironically, when used in the context of transnational surrogacy in India, these narratives further highlight and often reify the inequalities based on class, race and nationality between the clients and suppliers of reproductive tourism in India. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The effects of colours, shapes and boundaries of landscapes on perception, emotion and mentalising processes promoting health and well-being.

PubMed

Lengen, Charis

2015-09-01

Place has a special characteristic - a physical visual shape - that operates as an intensive visual idea. Drawing from the 'therapeutic landscape' concept (Gesler, 1992), this study focuses on the clients in a psychiatric clinic in Switzerland and how they experience place through a psychotherapeutic painting and autobiographical narration process. Based on an inductive qualitative approach, the narratives are structured in an open coding process orientated toward 'blue' and 'green' space, based on the space and place discourse of Relph (1976). Two dimensions of Relph's (1976) 'perceptual and existential' space exist in the narratives of the clients: firstly an individual dimension associated with perception and feelings, with meaning and symbolism, as well as with health and wellbeing; and secondly, a place-landscape dimension with diversification of colours, shapes and borders. In the interaction between individuals and place and landscape, a perceptional, emotional, mentalising process emerges that contributes meaningfully to health and well-being. Copyright © 2015. Published by Elsevier Ltd.

Telling Tales: On Evaluation and Narrative. Advances in Program Evaluation. Volume 6.

ERIC Educational Resources Information Center

Abma, Tineke, Ed.

Essays in this collection explore what a narrative perspective can mean for the practice of program evaluation. Narratives illuminate the value and meaning of a program or policy and can indicate the actions that need to be taken to improve it or to prevent failures in the future. The essays are: (1) "Introduction: Narrative Perspectives on…

Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning.

PubMed

Kenny, Belinda; Lincoln, Michelle; Balandin, Susan

2010-05-01

To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.

Client's view of a successful helping relationship.

PubMed

Ribner, David S; Knei-Paz, Cigal

2002-10-01

This study asked clients from multiproblem families to describe a successful helping relationship. The replies were analyzed using narrative research techniques and results are presented in conceptual categories with illustrative quotations from the interviews. The article offers conclusions about client preferences in the areas of working relationship, work styles, and worker characteristics. The results revealed two general domains of the client-worker relationship: factors that provided a sense of equality in the relationship, for example, love, friendship, and a nonjudgmental stance; and the notion that the helping relationship should parallel more normative contacts and include components such as flexibility, chemistry, luck, and going the extra distance.

Narrative Processes across Childhood

ERIC Educational Resources Information Center

Mulvaney, Matthew Keefe

2011-01-01

According to the narrative perspective on personality development, personality is constructed largely by interpreting and representing experience in story format (scripts) over the course of the lifespan. The focus of this paper is to describe briefly the narrative perspective on personality development during childhood and adolescence, to discuss…

Addressing metacognitive capacity for self reflection in the psychotherapy for schizophrenia: a conceptual model of the key tasks and processes.

PubMed

Lysaker, Paul H; Buck, Kelly D; Carcione, Antonino; Procacci, Michelle; Salvatore, Giampaolo; Nicolò, Guiseppe; Dimaggio, Giancarlo

2011-03-01

Recognition that recovery from schizophrenia may involve a deepening of the experience of being in the world has led to the possibility that psychotherapy may play a key role in treatment by enhancing metacognition, or the capacity to think about thinking. While the potential of psychotherapy to enhance metacognition in non-psychotic disorders has been discussed in depth, little has been written about how psychotherapy may systematically address metacognition in schizophrenia. Accordingly, the current paper formulates a model of how psychotherapy might address one specific element of metacognition, namely self-reflectivity. Procedures are outlined for assessing clients' capacity for self-reflectivity within narrative contexts during psychotherapy. Targeted interventions are identified which are tailored to clients' capacities in the moment and which assist clients to think about their own thinking at the level of which they are capable. This may lead clients over time to develop a greater ability to engage in acts of increasingly complex self-reflectivity. Individual psychotherapy can be modified and utilized to assist persons with schizophrenia to move towards recovery by assisting them to develop the capacity for self-reflectivity. This may lead to clients having a fuller experience of themselves as a being in the world with a richer and more coherent personal narrative. © 2010 The British Psychological Society.

Critical Narrative Analysis: The Interplay of Critical Discourse and Narrative Analyses

ERIC Educational Resources Information Center

Souto-Manning, Mariana

2014-01-01

In this article, I question the micro-macro separation in discourse analysis, the separation of personal and institutional discourses. I apply a mostly macroanalytic perspective (critical discourse analysis [CDA]) to inform a predominantly microanalytic perspective (analysis of conversational narratives) and vice versa. In the combination of these…

Living in the Fragments of Dreams: Analysis of the Dual-Narrative Structure in Kenneth MacMillan's "Winter Dreams" from Narratological and Psychoanalytical Perspectives

ERIC Educational Resources Information Center

Kodera, Ryota

2012-01-01

This essay investigates the ways dance narratives are constructed and aims to reconfirm the significance of dance narratives in the creation of meanings within dance practices. It draws on key concepts in narratology and psychoanalysis. These two critical perspectives are applied to the analysis of the narrative in Kenneth MacMillan's 1991 one-act…

Treating Traumatized Offenders and Veterans by Means of Narrative Exposure Therapy

PubMed Central

Hecker, Tobias; Hermenau, Katharin; Crombach, Anselm; Elbert, Thomas

2015-01-01

Violent offenders and soldiers are at high risk of developing appetitive aggression and trauma-related disorders, which reduce successful integration into societies. Narrative exposure therapy (NET) for forensic offender rehabilitation (FORNET) aims at reducing symptoms of traumatic stress (e.g., posttraumatic stress disorder) and controlling readiness for aggressive behavior. It follows the logic of the evidence-based trauma-focused NET with special emphasis on violent acts in past and future behavior. In NET, the therapist guides the client by means of exposure through his traumatic experiences in chronological order linking the negative emotions, such as fear, shame, and disgust, to the past context and integrating the traumatic experiences into the autobiographical memory. During FORNET, we also encourage verbalization of any positive emotions and experiences linked to past violent and aggressive behaviors. This recall of positive emotions (linked to the there and then) is contrasted with feelings that emerge during the narration process (here and now). In this way, the therapist helps the client to anchor the whole range of sensory and bodily experiences, cognitions, and emotions to the contextual cues. Over the process of the therapy, we support the client to begin the role change from a violent offender to a citizen, who is capable of living a non-violent and socially adjusted life. Finally, the client develops visions and wishes for the future to support a successful integration into society. Several studies with veterans and violent youths have proven the feasibility of FORNET, found evidence of a positive outcome (recovered mental health, fewer offenses committed, less drug intake, and improved integration into civil society), and highlighted the importance of addressing the whole range of experiences while treating violent offenders or veterans. PMID:26157395

“I tried so many diets, now I want to do it differently”—A single case study on coaching for weight loss

PubMed Central

Stelter, Reinhard

2015-01-01

In this single case study, the author presented an in-depth description and analysis of a coaching intervention with focus on weight loss, conducted over 10 sessions in the course of 17 months. The client was a well-educated woman in her late 30s, who had tried many different forms of dieting over the years—with little and no lasting effect. In his coaching approach, the author went beyond a pure behavioural change model, that is, based on the Health Belief Model, and tried to take a whole-life perspective, where the client learned to link specific events and habits in her work life and everyday life with specific eating habits. In their collaborative practice, coach and coachee initiated changes both in regard to diet, physical activity, and healthy life style, in general. In a theoretical section, the change in understanding with regard to overeating was presented. Finally, an intra-active model—viewing the client as a self-reflective individual—was used as theoretical basis. A narrative analysis of the first session and a cross-session examination was presented to show, analyse, and understand the procedure of the coaching approach. Finally, the voice of the coachee was heard in regard to her personal experiences during the process. The data material was based on audio recordings of selected sessions, notes written by the coach from every session, and final written reflections by the coachee. PMID:26282867

Staff members' negotiation of power in client engagement: analysis of practice within an Australian aged care service.

PubMed

Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

2015-04-01

With increasing focus on client control and active client roles in aged care service provision, client engagement is highlighted as fundamental to contemporary care practice. Client engagement itself, however, is complex and is impacted by a range of issues including the relationships and power dynamics inherent in the care context. These dynamics do not simply reflect the roles that are available to or taken up by clients; just as important are the roles and positions that staff of aged care services are offered, and take up, in client engagement. This paper presents the findings of a study that explored client engagement practice within a large Australian service provider. Analysis of interview and focus group discussions addressed the ways in which staff were positioned - by both themselves and by clients - in terms of the roles that they hold within engagement practice and the power relations inherent within these. Analysis of power from the dominant policy perspective of choice and control, and the alternative perspective of an ethic of care suggests that power relations within the care context are dynamic, complex and involve on-going negotiation and regulation by clients and staff members in aged care. The use of these two contrasting perspectives reveals a more dynamic and complex understanding of power in care practice than dominant uni-dimensional approaches to critique suggest. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation of indicators through balanced scorecards in a nutritional therapy company.

PubMed

de Matos Nasser, Emanuele; Reis da Costa, Stella Regina

2013-01-01

The Balanced Scorecard (BSC) is a tool that helps in strategic management under the four following perspectives: the financial one, the client s, the internal processes of the company's, the growth and learning processes. In order to measure the performance of the entities, the BSC uses as a basis financial and non-financial indicators. To implement the BSC in a nutrional therapy company. This research deals with a case study that took place in a nutrional therapy company from January to November 2010. For analysis of the learning and growth perspective all 45 of the company's collaborators were considered and for client analysis 124 home-care clients were considered. The study sample consisted of 39 collaborators and 44 clients participating in the research. Material was elaborated for collection of data and verification of perspective tendencies through analysis of the main processes of the company, questionnaires of client's satisfaction, questionnaires of collaborator s satisfaction and spread sheets for the verification of net renvenue and percentage of disallowances. The data was launched in the spread sheet of the Excel Application Program. The indicators were chosen conforming to the strategic objectives and organizational profiles. Learning perspectives and personal growth: efficacy in capacitaion 94%, participation 77%, fidelity/retention 93%, satisfaction 75%, organizational environment 88%, well being 100%, process perspective: microbiological analysis 100%, internal auditing 100%, productivity 100%, nutritional evaluation 81%, nutritional support 100%, indication for domicile hospital care 94%, home-care visits 98%, client perspective: company perception 97%, prioritizating 94%, retention 59%, insatisfaction 24%, logistics 94%, customers ervice (SAC) 88%, motivation: trust, financial perspectives, disallowances 5% and positive company net revenue. The implementation of indicators under the four perspectives of the Balanced Scorecard were favourable in the organizational performance, in helping the decision making process. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Cultural elements underlying the community health representative - client relationship on Navajo Nation.

PubMed

Gampa, Vikas; Smith, Casey; Muskett, Olivia; King, Caroline; Sehn, Hannah; Malone, Jamy; Curley, Cameron; Brown, Chris; Begay, Mae-Gilene; Shin, Sonya; Nelson, Adrianne Katrina

2017-01-09

Navajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families. The success of the CHRs' interventions depends on the interactions between the CHRs and their clients. This research investigates the culturally specific factors that build and sustain the CHR-client interaction. In-depth interviews were conducted with 16 CHRs on Navajo Nation. Interviews were transcribed and coded according to relevant themes. Code summaries were organized into a narrative using grounded theory techniques. The analysis revealed four findings critical to the development of a CHR-client relationship. Trust is essential to this relationship and provides a basis for providing quality services to the client. The ability to build and maintain trust is defined by tradition and culture. CHRs must be respectful of the diverse traditional and social practices. Lastly, the passing of clients brings together the CHR, the client's family, and the community. Understanding the cultural elements of the CHR-client relationship will inform the work of community partners, clinical providers, and other indigenous communities working to strengthen CHR programs and obtain positive health outcomes among marginalized communities.

Relational interaction in occupational therapy: Conversation analysis of positive feedback.

PubMed

Weiste, Elina

2018-01-01

The therapeutic relationship is an important factor for good therapy outcomes. The primary mediator of a beneficial therapy relationship is clinician-client interaction. However, few studies identify the observable interactional attributes of good quality relational interactions, e.g. offering the client positive feedback. The present paper aims to expand current understanding of relational interaction by analyzing the real-time interactional practices therapists use for offering positive feedback, an important value in occupational therapy. The analysis is based on the conversation analysis of 15 video-recorded occupational therapy encounters in psychiatric outpatient clinics. Two types of positive feedback were identified. In aligning feedback, therapists encouraged and complimented clients' positive perspectives on their own achievements in adopting certain behaviour, encouraging and supporting their progress. In redirecting feedback, therapists shifted the perspective from clients' negative experiences to their positive experiences. This shift was interactionally successful if they laid the foundation for the shift in perspective and attuned their expressions to the clients' emotional states. Occupational therapists routinely provide their clients with positive feedback. Awareness of the interactional attributes related to positive feedback is critically important for successful relational interaction.

The reconstruction of narrative identity during mental health recovery: a complex adaptive systems perspective.

PubMed

Kerr, Douglas J R; Crowe, Trevor P; Oades, Lindsay G

2013-06-01

1) to understand the reconstruction of narrative identity during mental health recovery using a complex adaptive systems perspective, 2) to address the need for alternative approaches that embrace the complexities of health care. A narrative review of published literature was conducted. A complex adaptive systems perspective offers a framework and language that can assist individuals to make sense of their experiences and reconstruct their narratives during an often erratic and uncertain life transition. It is a novel research direction focused on a critical area of recovery and addresses the need for alternative approaches that embrace the complexities of health care. A complexity research approach to narrative identity reconstruction is valuable. It is an accessible model for addressing the complexities of recovery and may underpin the development of simple, practical recovery coaching tools. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

How collaboration in therapy becomes therapeutic: the therapeutic collaboration coding system.

PubMed

Ribeiro, Eugénia; Ribeiro, António P; Gonçalves, Miguel M; Horvath, Adam O; Stiles, William B

2013-09-01

The quality and strength of the therapeutic collaboration, the core of the alliance, is reliably associated with positive therapy outcomes. The urgent challenge for clinicians and researchers is constructing a conceptual framework to integrate the dialectical work that fosters collaboration, with a model of how clients make progress in therapy. We propose a conceptual account of how collaboration in therapy becomes therapeutic. In addition, we report on the construction of a coding system - the therapeutic collaboration coding system (TCCS) - designed to analyse and track on a moment-by-moment basis the interaction between therapist and client. Preliminary evidence is presented regarding the coding system's psychometric properties. The TCCS evaluates each speaking turn and assesses whether and how therapists are working within the client's therapeutic zone of proximal development, defined as the space between the client's actual therapeutic developmental level and their potential developmental level that can be reached in collaboration with the therapist. We applied the TCCS to five cases: a good and a poor outcome case of narrative therapy, a good and a poor outcome case of cognitive-behavioural therapy, and a dropout case of narrative therapy. The TCCS offers markers that may help researchers better understand the therapeutic collaboration on a moment-to-moment basis and may help therapists better regulate the relationship. © 2012 The British Psychological Society.

Fostering the development of effective person-centered healthcare communication skills: an interprofessional shared learning model.

PubMed

Cavanaugh, James T; Konrad, Shelley Cohen

2012-01-01

To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

The influence of child sexual abuse on the self from adult narrative perspectives.

PubMed

Krayer, Anne; Seddon, Diane; Robinson, Catherine A; Gwilym, Hefin

2015-01-01

The impact of child sexual abuse on the adult self is not yet clearly understood. We explored adult perspectives through the use of narrative interviews (N = 30). Three key themes or views of self were identified in all narratives to varying degrees: the worthless self, the self as unknown, and the potential/developing self. Ambivalence and tension were present in all narratives. Individuals were challenged to integrate the sexual abuse experience in a constructive way and develop a more coherent perception of the self. The narrative method highlighted the dynamic nature of peoples' experiences at the same time recognizing that the narratives themselves are in progress. Reactions to disclosure, social support, and interpersonal connections are crucial at every turn.

Suggested Perspectives in Counseling the American Indian Client.

ERIC Educational Resources Information Center

Paisano-Suazo, Aleta

The standard western theoretical approach to mental health counseling is not applicable to the views held by Native American clients. Consideration must be given to their unique differences, if the therapist is to provide maximum effectiveness. Several perspectives offer alternative counseling procedures. For instance, Indians place great…

Development of the Vicarious Resilience Scale (VRS): A measure of positive effects of working with trauma survivors.

PubMed

Killian, Kyle; Hernandez-Wolfe, Pilar; Engstrom, David; Gangsei, David

2017-01-01

Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors' resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach's alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely "the opposite" of CF or burnout. The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

'Wakey wakey baby': narrating four-dimensional (4D) bonding scans.

PubMed

Roberts, Julie

2012-02-01

Commercial companies market 4D ultrasound scans to expectant parents for the stated purpose of reassurance, to promote bonding, and to get 'baby's first picture'. This article describes in detail the process of commercial 4D scanning in the UK, paying particular attention to the discursive exchanges in the scan room. It is argued that sonographers and clients engage in a process of 'collaborative coding' that, despite the realism of 4D, is essential to making the imagery on the screen personally and socially meaningful. While sonographers first help clients to get their bearings, expectant parents and others often engage in a complex process of narrating the images on the screen as they are created. The capacities of 4D ultrasound to image facial features and movements inform stories about fetal experience and family resemblances as well as enabling playfully imagined interactions with the fetus. While these stories are primarily based in experiences of the visual, there is also evidence that pregnant women seek to map the image onto their bodies and to reintroduce some elements of their embodied experiences into the narratives. © 2011 The Author. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

The Therapeutic Alliance: Clients' Categorization of Client-Identified Factors

ERIC Educational Resources Information Center

Simpson, Arlene J.; Bedi, Robinder P.

2012-01-01

Clients' perspectives on the therapeutic alliance were examined using written descriptions of factors that clients believed to be helpful in developing a strong alliance. Fifty participants sorted previously collected statements into thematically similar piles and then gave each set of statements a title. Multivariate concept mapping statistical…

Exploring how prison-based drug rehabilitation programming shapes racial disparities in substance use disorder recovery.

PubMed

Kerrison, Erin M

2018-02-01

Prison-based therapeutic community (TC) programming is derived from the perspective that drug addiction is primarily symptomatic of cognitive dysfunction, poor emotional management, and underdeveloped self-reliance skills, and can be addressed in a collaborative space where a strong ideological commitment to moral reform and personal responsibility is required of its members. In this space, evidence of rehabilitation is largely centered on the client's relationship to language and the public adoption of a "broken self" narrative. Failure to master these linguistic performances can result in the denial of material and symbolic resources, thus participants learn how to use TC language to present themselves in ways that support existing institutionalized hierarchies, even if that surrender spells their self-denigration. This research examines the interview narratives of 300 former prisoners who participated in a minimum of 12 months of prison-based TC programming, and described how programming rhetoric impacted their substance abuse treatment experiences. While many of the respondents described distressing experiences as TC participants, White respondents were more likely to eventually embrace the "addict" label and speak of privileges and reintegrative support subsequently received. Black respondents were more likely to defy the treatment rhetoric, and either fail to complete the program or simulate a deficit-based self-narrative without investing in the content of those stories. The following explores the significance of language and identity construction in these carceral spaces, and how treatment providers as well as agency agendas are implicated in the reproduction of racial disparities in substance abuse recovery. Published by Elsevier Ltd.

Client reflections on confirmation and disconfirmation of expectations in cognitive behavioral therapy for generalized anxiety disorder with and without motivational interviewing.

PubMed

Button, Melissa L; Norouzian, Nikoo; Westra, Henny A; Constantino, Michael J; Antony, Martin M

2018-01-22

Addressing methodological shortcomings of prior work on process expectations, this study examined client process expectations both prospectively and retrospectively following treatment. Differences between clients receiving cognitive behavioral therapy (CBT) versus motivational interviewing integrated with CBT (MI-CBT) were also examined. Grounded theory analysis was used to study narratives of 10 participants (N = 5 CBT, 5 MI-CBT) who completed treatment for severe generalized anxiety disorder as part of a larger randomized controlled trial. Clients in both groups reported and elaborated expectancy disconfirmations more than expectancy confirmations. Compared to CBT clients, MI-CBT clients reported experiencing greater agency in the treatment process than expected (e.g., that they did most of the work) and that therapy provided a corrective experience. Despite nearly all clients achieving recovery status, CBT clients described therapy as not working in some ways (i.e., tasks did not fit, lack of improvement) and that they overcame initial skepticism regarding treatment. Largely converging with MI theory, findings highlight the role of key therapist behaviors (e.g., encouraging client autonomy, validating) in facilitating client experiences of the self as an agentic individual who is actively engaged in the therapy process and capable of effecting change.

Intersectionality in psychotherapy: The experiences of an AfroLatinx queer immigrant.

PubMed

Adames, Hector Y; Chavez-Dueñas, Nayeli Y; Sharma, Shweta; La Roche, Martin J

2018-03-01

Culturally responsive and racially conscious psychotherapeutic work requires that therapists recognize the ways clients are impacted by their multiple marginalized identities and by systems of oppression (e.g., racism, ethnocentrism, sexism, heterosexism, and nativism). Attending exclusively to clients' marginalized identities (i.e., weak intersectionality) may drive therapists to only focus on internal, subjective, and emotional experiences, hence, missing the opportunity to consider and address how multiple sociostructural dimensions (i.e., strong intersectionality) may be impacting the client's presenting problems. Alternatively, focusing solely on the impact of sociostructural dimensions on the lives of clients may miss the more nuanced and variable individual personal experiences. In this article, we highlight the challenge of maintaining a culturally responsive and racially conscious stance when considering multiple marginalized identities, overlapping systemic inequities, and how both affect clients' lives and experiences. The case of an AfroLatinx queer immigrant is presented to illustrate some of the challenges and opportunities while simultaneously considering (a) the client's multiple marginalized identities, (b) the way clients are impacted by systemic oppression, and (c) integrating the client's personal experiences and narratives in psychotherapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Teaching Contested Narratives: Identity, Memory and Reconciliation in Peace Education and Beyond

ERIC Educational Resources Information Center

Bekerman, Zvi; Zembylas, Michalinos

2012-01-01

In troubled societies narratives about the past tend to be partial and explain a conflict from narrow perspectives that justify the national self and condemn, exclude and devalue the 'enemy' and their narrative. Through a detailed analysis, Teaching Contested Narratives reveals the works of identity, historical narratives and memory as these are…

Constructions of Battered Asian Indian Marriage Migrants: The Narratives of Domestic Violence Advocates.

PubMed

Kapur, Sonia; Zajicek, Anna

2018-03-01

How are the images of abused South Asian marriage migrants shaped by domestic violence advocates? We explore the social constructions of battered Asian Indian marriage migrants in the victim advocates' narratives. First, we find the narratives both reproduce and challenge the dominant stereotypes, utilizing some individualistic typifications while constructing these images with an understanding of the broader context of battered South Asian women's experiences. Second, depending on the issue (e.g., economic dependence or religion), the advocates paint either a multidimensional or a one-dimensional picture of their clients. We emphasize the need for further intersectional studies of the images of abused immigrants constructed by victim advocates.

"My Home and My School": Examining Immigrant Adolescent Narratives from the Critical Sociocultural Perspective

ERIC Educational Resources Information Center

Li, Jun

2010-01-01

Privileging the voices of 12 recent Chinese immigrant adolescents, this multiple-case narrative study examined their home and school experiences from the critical sociocultural perspective. The adolescent stories about home testified to the significant influence of immigrant poverty, parental sacrificial altruism, and disciplinary Chinese…

Barriers to healthy eating among food pantry clients

USDA-ARS?s Scientific Manuscript database

This study explored perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Quantitative data were ana...

Understanding personal narratives: an approach to practice.

PubMed

Gaydos, H Lea

2005-02-01

This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.

Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: a methodological perspective.

PubMed

Wain, Toni; Sim, Moira; Bessarab, Dawn; Mak, Donna; Hayward, Colleen; Rudd, Cobie

2016-06-02

Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients' experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians' experiences with health care in Western Australia. The purpose of these narratives is to provide health students and professionals with an opportunity to 'walk-in the shoes' of Aboriginal people where face-to-face interaction is not feasible. With the incorporation of Indigenous peoples' voices being an important link in cultural safety, the project was led by an Indigenous Reference group, who encouraged active participation of Aboriginal people in all areas of the project. Using a phenomenological approach and guided by the Indigenous Reference group, yarning data collection was implemented to collect stories focusing on Aboriginal people's experiences with health care services. An open-access, on-line website was established to host education resources developed from these "yarns". Yarning provided a rich source of information on personal experiences and encouraged the story provider to recognise their facilitative role in the research process. While the methodology used in this project was lengthy and labour-intensive it afforded a respectful manner for story collection and highlighted several innate flaws when Western methods are applied to an Indigenous context. Engagement of an Indigenous Reference Group was pivotal to designing an appropriate methodology that incorporated the voices of Aboriginal people in a multimedia resource of Aboriginal narratives. However further research is warranted to understand how the resources are being used and integrated into curricula, and their impact on students and health care outcomes.

Improving client-provider communication: evaluation of a training program for women, infants and children (WIC) professionals in New York state.

PubMed

Newes-Adeyi, Gabriella; Helitzer, Deborah L; Roter, Debra; Caulfield, Laura E

2004-11-01

Results are presented from evaluation of an intensive 1 day training program to improve the growth monitoring counseling skills of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) providers. The training was framed by the patient-centered approach, and focused on a seven-step technique that emphasized eliciting client perspective on the child's health and negotiating follow-up strategies. Changes in skill were assessed during audiotaped mock counseling sessions with simulated clients. Observed intervention effects were moderate but encouraging for future training programs. After the training, more providers elicited client perspective, and provider level of engagement in negotiating with the client increased. At post-test providers asked more open-ended questions than at pre-test, and provider-to-client talk ratio decreased. Increases in provider total and competence-related satisfaction paralleled improvements in counseling proficiency. Study results suggest that counseling skills of non-physician health providers can change after a 1 day focused training: providers were more client-centered in their discussions. Limitations and implications of the study are discussed.

The Client's Perspective on Voluntary Stuttering.

PubMed

Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin

2016-08-01

Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

Empowering Interviews: Narrative Interviews in the Study of Information Literacy in Everyday Life Settings

ERIC Educational Resources Information Center

Eckerdal, Johanna Rivano

2013-01-01

Introduction: This paper presents a way to design and conduct interviews, within a sociocultural perspective, for studying information literacy practices in everyday life. Methods: A framework was developed combining a socio-cultural perspective with a narrative interview was developed. Interviewees were invited to participate by talking and using…

Deleuze and Narrative Investigation: The Multiple Literacies of Sudanese Families in Australia

ERIC Educational Resources Information Center

Cole, David R.

2013-01-01

Sudanese families arriving in Australia bring with them a wealth of language and cultural resources that are currently not recognised by the Australian education system. This paper challenges such a position by investigating the narratives of the Sudanese Australians from a Deleuzian perspective. A Deleuzian perspective in education promotes the…

Mentally Simulating Narrative Perspective Is Not Universal or Necessary for Language Comprehension

ERIC Educational Resources Information Center

Brunyé, Tad T.; Ditman, Tali; Giles, Grace E.; Holmes, Amanda; Taylor, Holly A.

2016-01-01

Readers differentially adopt an agent's perspective as a function of pronouns encountered during reading. The present study assessed the reliability of this effect across narrative contexts and self-reported variation in levels of engagement during reading. Experiment 1 used an extended sample (N = 263) and replicated an interactive influence of…

Creating a Self: A Narrative and Holistic Perspective

ERIC Educational Resources Information Center

Beattie, Mary

2007-01-01

The paper presents insights into the creation and re-creation of a narrative from the perspective of two female students, Phillipa and Eva, at Corktown Community High School. Corktown is an alternative high school which focuses on the development of the whole person--creative, intellectual, social, emotional, aesthetic and physical. The school is…

Cognitive Behavioural Therapy from the Perspective of Clients with Mild Intellectual Disabilities: A Qualitative Investigation of Process Issues

ERIC Educational Resources Information Center

Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.

2013-01-01

Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…

Evaluation of a liaison librarian program: client and liaison perspectives.

PubMed

Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae

2006-10-01

This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Men's constructions of masculinity and male sexuality through talk of buying sex.

PubMed

Huysamen, Monique; Boonzaier, Floretta

2015-01-01

Commercial sex is an everyday occurrence across a range of contexts in South Africa. In this paper we turn our attention to the often-marginalised role of the buyers of sex by drawing on narrative interviews with male clients of female sex workers recruited through online advertisements in order to explore the ways in which heterosexual men construct, negotiate and perform their masculinity and sexuality through talking about their experiences of paying for sex. We highlight parallels between men's narratives of paying for sex and dominant discourses of gender and heterosexuality. We show how men draw on heteronormative sexual scripts in constructing and making sense of paid sexual encounters and how men are simultaneously able to construct and enact a particular idealised version of masculinity and male sexuality through their talk on paying for sex. Finally, we discuss how online resources could be used more extensively in future research with the male clients of sex workers.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

Types and patterns of safety concerns in home care: client and family caregiver perspectives

PubMed Central

Tong, Catherine E.; Sims-Gould, Joanie; Martin-Matthews, Anne

2016-01-01

Objective Drawing on interviews with home care clients and their family caregivers, we sought to understand how these individuals conceptualize safety in the provision and receipt of home care, how they promote safety in the home space and how their safety concerns differ from those of home support workers. Design In-depth, semi-structured interviews were conducted with clients and family caregivers. The analysis included topic and analytical coding of participants' verbatim accounts. Setting Interviews were completed in British Columbia, Canada. Participants Totally 82 clients and 55 caregivers participated. Results Clients and family caregivers identified three types of safety concerns: physical, spatial and interpersonal. These concerns are largely multi-dimensional and intersectional. We present a conceptual model of client and caregiver safety concerns. We also examine the factors that intensify and mitigate safety concerns in the home. Conclusions In spite of safety concerns, clients and family caregivers overwhelmingly prefer to receive care in the home setting. Spatial and physical concerns are the most salient. The financial burden of creating a safe care space should not be the client's alone to bear. The conceptualization and promotion of safety in home care must recognize the roles, responsibilities and perspectives of all of the actors involved, including workers, clients and their caregivers. PMID:26832159

Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.

PubMed

Joseph, Stephen

2004-03-01

In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.

[On the ultimate goal of management in Spanish hospitals].

PubMed

Pastor Tejedor, Jesús

2009-01-01

The European Foundation for Quality Management (EFQM) is the most introduced model in Spanish hospitals. The main target of this model is the internal and external client's satisfaction. The model of strategic management Balanced Scorecard (BSC) facilitates the alignment between management and the mission and vision of hospitals. For this reason, we propose a model of integrated management: EFQM-BSC. In order to obtain the items of this research, a survey was conducted among managers of Spanish hospitals on a battery of 46 indicators, selected from the EFQM model, and prioritised and included in the four perspectives of the BSC model. The research shows two possible models of hypothesis: the client model, where the final effect would be the client perspective (patient, staff and society's satisfaction), or the financial model, where the final effect would be the economic and financial results. After a reliability, dimension analysis and a discriminant analysis, it was obtained more consistent indicators which better explain each perspective. The relationship among these perspectives are determined by structural equations based on methods of partial least squares. The research confirms that the client model reflects a better consistency in its hypothesis.

[Narratives in the study of mental health care practices: contributions of the perspectives of Paul Ricoeur, Walter Benjamin and of medical anthropology].

PubMed

Onocko-Campos, Rosana Teresa; Palombini, Analice de Lima; Leal, Erotildes; de Serpa, Octavio Domont; Baccari, Ivana Oliveira Preto; Ferrer, Ana Luiza; Diaz, Alberto Giovanello; Xavier, Maria Angélica Zamora

2013-10-01

Narratives are ever more frequent in qualitative studies seeking to interpret experiences and the different viewpoints of individuals in a given context. Starting from this concept, the tradition that addresses narrative is reexamined, including the philosophy of Paul Ricoeur, the historical perspective of Walter Benjamin and the field of medical anthropology grounded in phenomenology. In Ricoeur, with hermeneutics as a variation derived from phenomenology, narrative is linked to temporality. In Benjamin, narrative comprised of bits and pieces, always inconclusive, emerges in spite of the official stories. If Ricoeur retrieves tradition from Gadamer as a fundamental component for the construction of the world of a text that makes imitation of life possible, Benjamin, faced with the collapse of tradition, suggests the invention of narrative forms outside the traditional canons, making it possible to hark to the past in order to change the present. Assumptions of medical anthropology are also presented, as they consider narrative a dimension of life and not its abstraction, namely an embodied and situated narrative. Lastly, three distinct research projects in mental health that use narrative linked to the theoretical concepts cited with their differences and similarities are presented.

World Views and Counseling

ERIC Educational Resources Information Center

Sue, Derald Wing

1978-01-01

Counselors who hold world views different from their clients' views and who are unaware of the bases for these differences are most likely to impute negative traits to their clients. Culturally different clients such as Asian-Americans, Blacks, Chicanos, and native Americans have a greater probability of holding different perspectives. (Author)

Girls Discuss Choice of an All-Girl Middle School: Narrative Analysis of an Early Adolescent Identity Project

ERIC Educational Resources Information Center

Baron, Emilia; Bell, Nancy J.; Corson, Kimberly; Kostina-Ritchey, Erin; Frederick, Helyne

2012-01-01

The narrative creation of identity by young adolescents has so far been addressed mainly from an identity-in-interaction perspective, focusing attention on the multiplicity and variability of identity negotiation as adolescents interact with others, typically with peers. In contrast, a sociocultural/dialogical perspective draws attention to the…

Reverberating Echoes: Challenging Teacher Candidates to Tell and Learn from Entwined Narrations of Canadian History

ERIC Educational Resources Information Center

Den Heyer, Kent; Abbott, Laurence

2011-01-01

A key challenge confronting teacher educators is to help their students identify perspectives that depart from dominant historical narratives of a nation-state's development so as to potentially derive alternative meanings of shared pasts from marginalized perspectives. In this article, we examine the nature of this challenge both as a theoretical…

Confidentiality in Crisis Counseling: A Philosophical Perspective.

ERIC Educational Resources Information Center

Mayo, David J.

1984-01-01

Crisis interventionists frequently confront a moral dilemma when violating client trust seems necessary if self-destructive behavior is to be prevented. Concern for client welfare and respect for client rights and autonomy which are grounded in Utilitarianism and Kantian Formalism, respectively, conflict in such cases. These theories are examined,…

A Call for Feminist Research: A Limited Client Perspective

ERIC Educational Resources Information Center

Murray, Kirsten

2006-01-01

Feminist approaches embrace a counselor stance that is both collaborative and supportive, seeking client empowerment. On review of feminist family and couple counseling literature of the past 20 years using several academic databases, no research was found that explored a clients experience of feminist-informed family and couple counseling. The…

Effects of Systematic Group Counseling on Work Adjustment Clients

ERIC Educational Resources Information Center

Roessler, Richard; And Others

1977-01-01

When compared with a group of clients who had received work adjustment services and a placebo treatment (personal hygiene training), experimental clients given Personal Achievement Skills (PAS) and work adjustment services reported greater gains on self-ratings of life perspective (optimism), work-related attitudes, and goal attainment. (Author)

Rapport-Building with Resistant Children: Re-Conceptualizing Relational Dynamics

ERIC Educational Resources Information Center

Gold, Joshua M.

2006-01-01

This paper briefly reviews existing conceptualizations of resistance in counseling children. The author posits that resistance is an "expected" aspect of all counseling and offers an alternative orientation toward client resistance based on exploring the child's "helping narratives." Two case studies illustrate the implementation of this…

Northern Territory perspectives on heart failure with comorbidities – understanding trial validity and exploring collaborative opportunities to broaden the evidence base.

PubMed

Iyngkaran, P; Majoni, W; Cass, A; Sanders, Prashanthan; Ronco, C; Brady, S; Kangaharan, N; Ilton, M; Hare, D L; Thomas, M C

2015-06-01

Congestive Heart Failure (CHF) is an ambulatory care sensitive condition, associated with significant morbidity and mortality, rarely with cure. Outpatient based pharmacological management represents the main and most important aspect of care, and is usually lifelong. This narrative styled opinion review looks at the pharmacological agents recommended in the guidelines in context of the Northern Territory (NT) of Australia. We explore the concept of validity, a term used to describe the basis of standardising a particular trial or study and the population to which it is applicable. We aim to highlight the problems of the current guidelines based approach. We also present alternatives that could utilise the core principles from major trials, while incorporating regional considerations, which could benefit clients living in the NT and remote Australia. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Gadè deceptions and lies told by the ill: The Caribbean sociocultural construction of truth in patient-healer encounters.

PubMed

Massé, Raymond

2002-08-01

A constructivist approach in medical anthropology suggests that the boundary between lies and truth in sickness narratives is thin. Based on fieldwork in the French (Martinique) and English (Saint-Lucia) Carribbean with gadé and quimboiseurs (local folk healers), this paper addresses the gap between naïve romanticism and radical cynicism in the anthropological analysis of patient-healer encounters. Is the sick person lying when she accuses evil spirits for her behaviour or sickness? Is the quimboiseur who is building a meaningful explanation or diagnosis simply a liar taking advantage of his client's credulity? The challenge for anthropology is not to determine whether or not a person is lying when attributing their ill fortune to witchcraft. Instead, in this paper, the author approaches lying as a language-game played by both patients and folk healers. Concepts of lying as games, tactical lies, pragmatic creativity, and constructive lies are introduced here as a perspective for a reconsideration of lying as a pertinent research object.

Comparative study of group treatments for posttraumatic stress disorder.

PubMed

Maxwell, Kendal; Callahan, Jennifer L; Holtz, Pamela; Janis, Beth M; Gerber, Monica M; Connor, Dana R

2016-12-01

Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow-up. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client-therapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

What Do Medical Students Perceive as Meaningful in the Psychiatry Clerkship Learning Environment? A Content Analysis of Critical Incident Narratives.

PubMed

Gathright, Molly M; Thrush, Carol; Guise, J Benjamin; Krain, Lewis; Clardy, James

2016-04-01

In order to better understand the professional development of medical students during their psychiatry clerkship, this study identifies common themes and characteristics of students' critical incident narratives which are designed to capture a recount of clerkship experiences they perceived as meaningful. A total of 205 narratives submitted by psychiatry clerkship students in 2010-2011 were subjected to a thematic analysis using a methodological approach and adaptation of categories derived from prior similar research. Descriptive content analysis was also carried out to assess the valence of the narrative content, characters involved, and whether there was evidence that the experience changed students' perspectives in some way. Narratives contained a variety of positive (19%) and negative content (24%) and many contained a hybrid of both (57%). The most common theme (29%) concerned issues of respect and disrespect in patient, clinical, and coworker interactions. In general, the majority (68%) of students' meaningful experience narratives reflected a change in their perspective (e.g., I learned that...). Narratives containing positive and hybrid content were associated with a change in students' perspective (χ(2) = 10.61, df = 2, p < 0.005). Medical students are keenly aware of the learning environment. Positive and hybrid critical incident narratives were associated with a stated change in their beliefs, attitudes, or behaviors due to the experience. Understanding the events that are meaningful to students can also provide rich feedback to medical educators regarding the ways in which students perceive clinical learning environments and how to best foster their professional development.

Assessment of ART centres in India: client perspectives.

PubMed

Sogarwal, Ruchi; Bachani, Damodar

2009-05-01

Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

Clients' perspective on quality of audiology care: Development of the Consumer Quality Index (CQI) 'Audiology Care' for measuring client experiences.

PubMed

Hendriks, Michelle; Dahlhaus-Booij, Judith; Plass, Anne Marie

2017-01-01

Clients' perspective on the quality of audiology care has not been investigated thoroughly. Research has focused primarily on satisfaction with, and limitations of hearing aids. We developed a Consumer Quality Index (CQI) questionnaire 'Audiology Care' to systematically assess client experiences with audiology care. The CQI Audiology Care was developed in three steps: (1) posing open-ended questions through e-mail (n = 14), (2) two small-scale surveys assessing psychometric properties of the questionnaire (n = 188) and importance of quality aspects (n = 118), and (3) a large-scale survey (n = 1793) assessing psychometric properties and discriminatory power of the questionnaire. People with complex hearing impairments and/or balance and communicative disorders who visited an audiology care centre during the past year. Important quality aspects were translated into seven reliable scales: accommodation and facilities, employees' conduct and expertise, arrangement of appointments, waiting times, client participation and effectiveness of treatment. Client experiences differed among the participating centres concerning accommodation and facilities, arrangement of appointments, waiting times and client participation. The CQI Audiology Care is a valid and reliable instrument to assess clients' experiences with audiology care. Future implementation will reveal whether results can be used to monitor and improve the quality of audiology care.

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

PubMed

Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

2004-12-01

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

A Narrative Study of Counsellors' Understandings of Inuit Spirituality

ERIC Educational Resources Information Center

Wihak, Christine; Merali, Noorfarah

2005-01-01

Eight non-Indigenous counsellors who temporarily lived in Nunavut to serve Inuit clients were interviewed regarding what they learned about Inuit spirituality during their cultural immersion experience. They were also asked about how they applied their understandings of the Inuit spiritual worldview in their professional practice. Counsellors'…

Shifting between Third and First Person Points of View in EFL Narratives

ERIC Educational Resources Information Center

Shokouhi, Hossein; Daram, Mahmood; Sabah, Somayeh

2011-01-01

This article reports on the difference between points of view in narrating a short story. The EFL learners taking part in the control group were required to recount the events from the third person perspective and the subjects in the experimental group from the first person perspective. The methodological frame of the study was based on Koven's…

Transformative occupational therapy: We are wired to be transformers.

PubMed

Dubouloz, Claire-Jehanne

2014-10-01

Transformative learning involves critical self-reflection as the motor for transforming values, beliefs, knowledge, and feelings and discovering the new meaning of daily life following a catastrophic injury or illness. Transformation has been conceptualized in various disciplines as a transcendent experience, rebirth process, and meaning-making process and within occupational therapy as a meaning perspective process. This Muriel Driver lecture explores the concept of transformation and presents the newly developed Meaning Perspectives Transformation model, constructed from research conducted with several different rehabilitation client groups. The model is characterized by three phases: trigger, changing, and outcomes. A client's critical self-reflection acts as a catalyst for moving between the phases and is represented in the model as a moment of readiness for change leading to the development of alternative ways of performing. The Meaning Perspectives Transformation model provides a tool for being an effective occupational therapist, encouraging therapists to listen closely to their clients to identify their weakening and emerging meaning perspectives and enable their occupational evolution and transformation.

Ethical Issues in the Assessment and Treatment of a Rational Suicidal Client.

ERIC Educational Resources Information Center

Snipe, Rosetta M.

1988-01-01

Notes that rational client's decision to commit suicide may present complex ethical issues for therapist. Presents and discusses three-month account of therapy with client, from perspective of ethical values and principles upon which assessment and treatment decisions were made, and complex ethical dilemmas encountered as therapist juxtaposed…

Religiosity Gap Reversed: How Religious Counsellors' Belief System Presents When Working with Clients in a Non-Religious Environment

ERIC Educational Resources Information Center

Motalová, Katarína; Rihácek, Tomáš

2016-01-01

Most studies exploring the religiosity gap are concerned with non-religious counsellors and religious clients. Approaching this phenomenon from a reversed perspective, this study explores how counsellors' religiosity presents when working with clients in a predominantly non-religious environment. Semi-structured interviews with 11 Czech…

Client-Controlled Case Information: A General System Theory Perspective

ERIC Educational Resources Information Center

Fitch, Dale

2004-01-01

The author proposes a model for client control of case information via the World Wide Web built on principles of general system theory. It incorporates the client into the design, resulting in an information structure that differs from traditional human services information-sharing practices. Referencing general system theory, the concepts of…

Exploring the Experiences of Living With Stroke Through Narrative: Stroke Survivors' Perspectives.

PubMed

Nasr, Nasrin; Mawson, Susan; Wright, Peter; Parker, Jack; Mountain, Gail

2016-01-01

Chronic illness models are normally used to explain and predict the experience of living with a long-term condition. The aim of this study was to present the findings of narrative interviews with stroke survivors and their family carers to understand their experiences of stroke. We interviewed five people with stroke and three family carers from the United Kingdom. We used thematic analysis to generate themes from their narrative accounts and then linked them to broader theoretical perspectives while influenced by the concept of reinterpretation of life. The narrative accounts of participants are mainly structured based on how their changed bodies poststroke changed their identities and roles and consequently their relationships with others. In this study, we underline the need for using methods like narrative to explain strategies that people use to make sense of their experiences of living with a long-term condition such as stroke.

'Imagine if I gave up smoking ...': a qualitative exploration of Aboriginal participants' perspectives of a self-management pilot training intervention.

PubMed

Chapple, Kimberley; Kowanko, Inge; Harvey, Peter; Chong, Alwin; Battersby, Malcolm

2016-01-01

This paper reports on a pilot qualitative study investigating Aboriginal participants' perspectives of the Flinders Living Well Smoke Free (LWSF) 'training intervention'. Health workers nationally have been trained in this program, which offers a self-management approach to reducing smoking among Aboriginal clients. A component of the training involves Aboriginal clients volunteering their time in a mock care-planning session providing the health workers with an opportunity to practise their newly acquired skills. During this simulation, the volunteer clients receive one condensed session of the LWSF intervention imitating how the training will be implemented when the health workers have completed the training. For the purpose of this study, 10 Aboriginal clients who had been volunteers in the mock care-planning process, underwent a semi-structured interview at seven sites in Australia, including mainstream health services, Aboriginal community controlled health services and remote Aboriginal communities. The study aimed to gauge their perspectives of the training intervention they experienced. Early indications suggest that Aboriginal volunteer clients responded positively to the process, with many reporting substantial health behaviour change or plans to make changes since taking part in this mock care-planning exercise. Enablers of the intervention are discussed along with factors to be considered in the training program.

'Getting things done': an everyday-life perspective towards bridging the gap between intentions and practices in health-related behavior.

PubMed

van Woerkum, Cees; Bouwman, Laura

2014-06-01

In this paper, we aim to add a new perspective to supporting health-related behavior. We use the everyday-life view to point at the need to focus on the social and practical organization of the concerned behavior. Where most current approaches act disjointedly on clients and the social and physical context, we take the clients' own behavior within the dynamics of everyday context as the point of departure. From this point, healthy behavior is not a distinguishable action, but a chain of activities, often embedded in other social practices. Therefore, changing behavior means changing the social system in which one lives, changing a shared lifestyle or changing the dominant values or existing norms. Often, clients experience that this is not that easy. From the everyday-life perspective, the basic strategy is to support the client, who already has a positive intention, to 'get things done'. This strategy might be applied to those cases, where a gap is found between good intentions and bad behavior.

Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness.

PubMed

Browne, Julia; Mihas, Paul; Penn, David L

2016-05-01

The health benefits of exercise are well established, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having examined interventions with limited feasibility and sustainability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exercise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pedometer based walking program for individuals with SMI. Future research should consider examining walking programs for this population.

Narcissistic deficits in drug abusers: a self-psychological approach.

PubMed

Nighorn, S

1988-09-01

Using empathic abilities and basing understanding of clients on information as the client sees the situation, one can become much more able to detect what individual clients need to begin to feel better about themselves. This would truly add substance to the intervention by increasing self-esteem. By beginning to apply the client's perspective to one's understanding, the practitioner will discover greater depth and meaning, thus helping to change addictions treatment for the better.

Mid-Life Nuances and Negotiations: Narrative Maps and the Social Construction of Mid-Life in Sport and Physical Activity

ERIC Educational Resources Information Center

Partington, Elizabeth; Partington, Sarah; Fishwick, Lesley; Allin, Linda

2005-01-01

This paper adopts a narrative perspective on the study of mid-life experiences in sport. Different types of stories about sporting mid-life are identified and discussed. Drawing upon the concept of narrative mapping, the potential of these stories to serve as narrative maps for those approaching mid-life is considered. Data from an interview study…

Listening to Narratives: An Experimental Examination of Storytelling in the Classroom

ERIC Educational Resources Information Center

Glonek, Katie L.; King, Paul E.

2014-01-01

In an age of PowerPoint, much everyday public communication is semantically organized as an expository presentation. This contrasts with traditional approaches such as storytelling that are episodically organized and presented as narratives. The constructivist theory of narrative comprehension, along with other theoretical perspectives, suggests…

Personal Narratives in Life History Research

ERIC Educational Resources Information Center

Germeten, Sidsel

2013-01-01

In this article I discuss how to create personal narratives in life history research methodology. People tell stories of their lives, and the researchers make these stories into life histories. Based on theoretical perspectives on "discourse" inspired by Michel Foucault, narratives are seen as ways of positioning oneself as a…

Re-Conceptualizing Teachers' Narrative Inquiry as Professional Development

ERIC Educational Resources Information Center

Golombek, Paula R.; Johnson, Karen E.

2017-01-01

We offer a more nuanced characterization of teachers' narrative inquiry as professional development (Johnson & Golombek, 2002) by grounding our definition of and empirical research on teachers' narrative inquiry from a Vygotskian sociocultural theoretical perspective. Our goal is to reaffirm our belief in the educational value of teachers'…

Expressing Emotions as Evidence in Osteoporosis Narratives: Effects on Message Processing and Intentions

ERIC Educational Resources Information Center

Volkman, Julie E.; Parrott, Roxanne L.

2012-01-01

This study examined the use of different narratives expressing positive or negative emotions, and varying the narrator's perspective on the arousal of discrete emotions, dominant cognitions, perceived evidence quality, and perceived message effectiveness related to osteoporosis behavioral intentions. Formative research led to the creation of…

Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research.

PubMed

D'Cruz, Kate; Douglas, Jacinta; Serry, Tanya

2017-08-09

Although narrative storytelling has been found to assist identity construction, there is little direct research regarding its application in rehabilitation following traumatic brain injury (TBI). The aim of this review was to identify published evidence on the use of personal narrative approaches in rehabilitation following TBI and to synthesise the findings across this literature. A systematic search of four databases was conducted in December 2016. No limit was set on the start date of the search. Personal narrative approaches were defined as direct client participation in sharing personal stories using written, spoken or visual methods. The search retrieved 12 qualitative research articles on the use of personal narrative approaches in TBI rehabilitation. Thematic synthesis of the narrative data and authors' reported findings of the 12 articles yielded an overall theme of building a strengths-based identity and four sub-themes: 1) expressing and communicating to others; 2) feeling validated by the act of someone listening; 3) reflecting and learning about oneself; and 4) being productive. The findings of this review support the use of personal narrative approaches in addressing loss of identity following TBI. Healthcare professionals and the community are encouraged to seek opportunities for survivors of TBI to share their stories.

NEGOTIATING HEALTH: patients' and guardians' perspective on "failed" patient-professional interactions in the context of the Swedish health care system.

PubMed

Koch, Roland; Joos, Stefanie; Ryding, Elsa-Lena

2018-05-11

Sweden has a largely tax-funded health care system that aims at providing equal access for everyone. However, the individual's perception and experience of the health care system remains a relevant topic for researchers. The aim of this study is to learn the patient's perspective on how patients and professionals negotiate in the social context of the Swedish health care system. Eight essays that had spontaneously been contributed to a medical writing contest were analyzed using narrative methods. Narratives were defined as a sequence of clauses that correspond to an order of events in the narrator's biography. The analysis comprised a three-step process. First, the essays were read and narratives were extracted. Second, an agency analysis was performed. Third, an analysis of social positioning was employed. The Swedish health care system provides the social context and background for negotiations between patients and professionals. The narrators position the protagonists of the illness narratives as either patients or guardians of underage patients. The protagonists meet health care representatives in negotiation situations. Due to the lack of emotional connection between the negotiating parties, impossible situations arise. False promises are made which ultimately result in the patients' suffering. Thus, all negotiations failed from the narrators' perspective. The narrators invited their audience to solve negotiation situations differently. This study discusses some actions that may help navigate negotiation situations: Health care providers should acknowledge the patient's or guardian's social position and dilemma, allow emotions, involve all parties in the decision-making process and manage expectations. Writing competitions may provide a tool for experience-based assessment of health care systems.

THE LOSS OF BOYSTOWN AND TRANSITION TO ONLINE SEX WORK: STRATEGIES AND BARRIERS TO INCREASE SAFETY AMONG MEN SEX WORKERS AND CLIENTS OF MEN

PubMed Central

Argento, Elena; Taylor, Matthew; Jollimore, Jody; Taylor, Chrissy; Jennex, James; Krusi, Andrea; Shannon, Kate

2017-01-01

Men sex workers in Vancouver have largely transitioned from street to online solicitation coinciding with losing “Boystown,” the main outdoor sex work stroll for men. This article explores strategies and barriers to increase safety among men and trans sex workers and clients of men in Vancouver, Canada. Qualitative interviews were conducted (2012–2013) with 61 self-identified men who currently buy and/or sell sex in a community-based research project known as CHAPS (Community Health Assessment of Men Who Purchase and Sell Sex). Drawing on a socioecological framework, thematic analysis of interview transcripts was conducted utilizing ATLAS.ti 7 software among men (39 workers; 8 buyers). Narratives indicate that gentrification and urban planning led to social isolation and loss of social support networks among men in the sex industry. Concurrently, the restructuring of sex work to online increased workers’ safety and control. Narratives reveal how the Internet can provide greater opportunities to negotiate terms of sex work and enhanced screening using webcams, reducing risks of violence, stigma, and police harassment for both workers and clients compared with the street. This study highlights how losing Boystown led to a loss of community and solidarity: key protective measures for sex workers. Online solicitation increased workers’ capacity to screen prospective clients and prevent violence. Recent legal reforms in Canada to further criminalize sex work raise significant concern for human rights and health of individuals in the sex industry, and point to the critical need to include voices of men and trans sex workers and buyers in policy discussions. PMID:27352925

The Loss of Boystown and Transition to Online Sex Work: Strategies and Barriers to Increase Safety Among Men Sex Workers and Clients of Men.

PubMed

Argento, Elena; Taylor, Matthew; Jollimore, Jody; Taylor, Chrissy; Jennex, James; Krusi, Andrea; Shannon, Kate

2016-06-28

Men sex workers in Vancouver have largely transitioned from street to online solicitation coinciding with losing "Boystown," the main outdoor sex work stroll for men. This article explores strategies and barriers to increase safety among men and trans sex workers and clients of men in Vancouver, Canada. Qualitative interviews were conducted (2012-2013) with 61 self-identifed men who currently buy and/or sell sex in a community-based research project known as CHAPS (Community Health Assessment of Men Who Purchase and Sell Sex). Drawing on a socioecological framework, thematic analysis of interview transcripts was conducted utilizing ATLAS.ti 7 software among men (39 workers; 8 buyers). Narratives indicate that gentrification and urban planning led to social isolation and loss of social support networks among men in the sex industry. Concurrently, the restructuring of sex work to online increased workers' safety and control. Narratives reveal how the Internet can provide greater opportunities to negotiate terms of sex work and enhanced screening using webcams, reducing risks of violence, stigma, and police harassment for both workers and clients compared with the street. This study highlights how losing Boystown led to a loss of community and solidarity: key protective measures for sex workers. Online solicitation increased workers' capacity to screen prospective clients and prevent violence. Recent legal reforms in Canada to further criminalize sex work raise significant concern for human rights and health of individuals in the sex industry, and point to the critical need to include voices of men and trans sex workers and buyers in policy discussions. © The Author(s) 2016.

Serenity: caring with perspective.

PubMed

Roberts, K T; Fitzgerald, L

1991-01-01

It is possible to care too much. Thus, there is a need to assist clients to achieve a state of caring with perspective (i.e., caring that lies in the gray area between excessive caring and not caring). Serenity is a concept that offers direction for attainment of this perspective; the concept of serenity is valued by many clients. Yet, the term is missing in nursing literature and the meaning of serenity in the literature that exists on the topic is vague. This article presents results of a concept analysis of serenity and discusses the relationship of serenity to the concept of caring.

Adaptations of Professional Ethics among Counselors Living and Working in a Remote Native Canadian Community

ERIC Educational Resources Information Center

Wihak, Christine; Merali, Noorfarah

2007-01-01

Eight non-Native counselors who temporarily relocated to the Native Canadian community of Nunavut were interviewed upon their return about experiences working with Inuit clients that challenged their professional training. Analysis of the counselors' narratives suggested that they used a social constructivism approach to manage confidentiality,…

An Existential Framework for Understanding the Counseling Needs of Clients

ERIC Educational Resources Information Center

Spillers, Cindy S.

2007-01-01

Purpose: To offer an existential framework for understanding some of the emotional and grieving issues that can accompany communication disorders. Method: A narrative review of selected existential psychology literature is provided. I. Yalom's (1980, 1986) model is used as a foundation to explore the 4 existential issues of death,…

Topology of Awareness: Therapeutic Implications of Logical Modalities of Multiple Levels of Awareness.

ERIC Educational Resources Information Center

Levine, Shellie

2000-01-01

Describes a theory of a topology of awareness, in which higher levels organize reality through dialectical logic, whereas lower levels construct reality based on Aristotelian logic, binary oppositions, and experiencing entities as discreet and independent. Argues that metaphor, poetry, and narrative are linguistic tools that enable clients to…

Open Source Communities in Technical Writing: Local Exigence, Global Extensibility

ERIC Educational Resources Information Center

Conner, Trey; Gresham, Morgan; McCracken, Jill

2011-01-01

By offering open-source software (OSS)-based networks as an affordable technology alternative, we partnered with a nonprofit community organization. In this article, we narrate the client-based experiences of this partnership, highlighting the ways in which OSS and open-source culture (OSC) transformed our students' and our own expectations of…

Leaps of Faith: Trainees' Experiences of Not Knowing in Psychotherapy

ERIC Educational Resources Information Center

Gottlieb, Rachel F.

2016-01-01

This study presents a qualitative analysis of four clinical psychology PhD students' experiences of not knowing how to proceed in sessions with clients, and how they handled those experiences. A narrative analysis of each participant interview was employed, in which tone, rhetorical function, and identity work were closely examined. Participants…

Our Heroic Adventure: Creating a Personal Mythology

ERIC Educational Resources Information Center

Rubin, Lawrence C.

2009-01-01

Utilizing Joseph Campbell's concept of the hero's adventure, this article provides a technique through which clients can story their lives and challenges as an unfolding personal myth or epic adventure. The use of personal narrative and storytelling has found efficacy in the counseling field and, as such, forms a useful foundation for clinical…

Tales of Tutors: The Role of Narrative in Language Learning and Service-Learning

ERIC Educational Resources Information Center

Polansky, Susan G.; Andrianoff, Timothy; Bernard, Jaclyn B.; Flores, Ana; Gardocki, Isabel A.; Handerhan, Ryan J.; Park, Jihea; Young, Lisa

2010-01-01

This article examines the role of narrative in the learning process of language tutors in a university service-learning course involving collaboration between an institution of higher learning and public high schools in an urban setting. The tutors' personal narrative reflections offer multiple perspectives on interactions of tutors with high…

Resisting Anorexia/Bulimia: Foucauldian Perspectives in Narrative Therapy

ERIC Educational Resources Information Center

Lock, Andrew; Epston, David; Maisel, Richard; de Faria, Natasha

2005-01-01

Foucault's analysis of unseen power as it operates in discourses that construct "practices of discipline" and "technologies of the self" has been a central conceptual resource in the development of narrative therapy. Narrative therapists take the view that ?unseen aspects of power work to construct both how a person understands their situation,…

[On the clients of public health organizations].

PubMed

Duran, Júlia; Villalbí, Joan R; Guix, Joan

2004-01-01

Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.

Do Children and Adolescents Have Different Types of Trauma Narratives and Does It Matter? Reliability and Face Validation for a Narrative Taxonomy.

PubMed

Scheeringa, Michael S; Lilly, Megan E; Staiger, Allison B; Heller, Maren L; Jones, Edward G; Weems, Carl F

2017-06-01

The construction of trauma narratives is a major component of several psychotherapy approaches for trauma-related problems, but questions remain as to whether fully expressive narratives are necessary and whether it is detrimental to ask avoidant youths to tell their narratives repeatedly. Characteristics of trauma narratives during psychotherapy have not been examined in youths and this represents a salient gap in knowledge. This study aimed to begin filling this gap by identifying categories of trauma narratives and empirically validating them. Youths (N = 47) aged 7 to 18 years, who were involved in a randomized controlled trial, received cognitive behavioral therapy. Transcripts of all narrative exposure therapy sessions for each youth were rated. Four categories were identified and were named expressive, avoidant, fabricated, and undemonstrative. Interrater reliability for identifying these categories was good, and face validation of the categories was supported by statistically significant differences between categories on the number of data elements of the trauma events, negative emotion words, and positive emotion words. These promising findings indicate that different types of narrative styles can be reliably identified. There was strong evidence for reduction of posttraumatic stress symptoms in each of the categories (Cohen's d = 0.9 to 2.5). Favorable treatment outcomes for all categories suggest that more remembering is not always better and clients appeared to effectively deal with memories in different ways. Copyright © 2017 International Society for Traumatic Stress Studies.

Using Written Narratives in Public Health Practice: A Creative Writing Perspective

PubMed Central

Kreuter, Matthew W.

2014-01-01

Narratives have become an increasingly common health communication tool in recent years. Vivid, engaging writing can help audiences identify with storytellers and understand health messages, but few public health practitioners are trained to create such stories. A transdisciplinary perspective, informed by both creative writing advice and evidence-based public health practices, can help public health professionals use stories more effectively in their work. This article provides techniques for creating written narratives that communicate health information for chronic disease prevention. We guide public health professionals through the process of soliciting, writing, and revising such stories, and we discuss challenges and potential solutions. PMID:24901794

Theoretical and clinical perspectives of client stalking behavior.

PubMed

Laskowski, Cheryl

2003-11-01

This article applies theoretical perspectives of client stalking behavior to vignettes of clinical nurse specialists (CNSs) who have experienced stalking incidents. A description of stalking behavior, estimations of the frequency of stalking behavior, characteristics of stalkers, and the impact of stalking on victims are addressed. Health care professionals, including CNSs, may inadvertently become victims of stalking behavior. Firm and clear boundary setting is important in all CNS-client relationships. CNSs who believe that they are becoming the objects of attention for particular individuals are advised to convey a clear message that they have no interest in the development of such a relationship. In this article CNS responses to actual client stalking behavior, including confrontation by the CNS, police involvement, restraining orders, and use of the CNS's attorney, are explored. The use of clinical consultation and the need for agencies to develop safety plans for all employees are also addressed.

The Mental Health Nurse Incentive Program: the benefits from a client perspective.

PubMed

Happell, Brenda; Palmer, Christine

2010-10-01

It is now acknowledged that a substantial proportion of the Australian population will experience a mental health condition at some time during their lives. Only a small proportion will access care and treatment for these conditions, and those who do are more likely to access general medical practitioners than specialist mental health providers. The Mental Health Nurse Incentive Program (MHNIP) was introduced by the Commonwealth Government to enhance access to mental health care by engaging mental health nurses in collaboration with general practitioners and private psychiatrists. The aim of the current study was to explore the experiences and opinions of clients utilising these services. A qualitative exploratory approach involving in-depth semi-structured interviews was utilised to enhance understanding of the client perspective. Interviews were conducted with 14 clients. Data were analysed using NVivo to assist with the identification of major themes. The findings revealed the major themes to be: initial reactions; a comfortable setting; flexibility; holistic care; and affordable care. These findings suggest that clients perceive the MHNIP as a valuable intervention that met the mental health needs of clients to a greater extent than had previously been possible.

Narrative health psychology: once more unto the breach. Introduction.

PubMed

Sools, Anneke M; Murray, Michael; Westerhof, Gerben J

2015-03-01

In this editorial, we position narrative health psychology as a variety of narrative psychology, a form of qualitative research in health psychology, and a psychological perspective that falls under the interdisciplinary term narrative health research. The aim of this positioning is to explore what are the most important features of the proposed approach and how they are relevant. We illustrate each positioning with the scope and diversity of narrative health psychology brought together in this special issue. Finally, we reflect on where narrative health psychology is now and how it could develop in the future. © The Author(s) 2015.

Narrative Changes Predict a Decrease in Symptoms in CBT for Depression: An Exploratory Study.

PubMed

Gonçalves, Miguel M; Silva, Joana Ribeiro; Mendes, Inês; Rosa, Catarina; Ribeiro, António P; Batista, João; Sousa, Inês; Fernandes, Carlos F

2017-07-01

Innovative moments (IMs) are new and more adjusted ways of thinking, acting, feeling and relating that emerge during psychotherapy. Previous research on IMs has provided sustainable evidence that IMs differentiate recovered from unchanged psychotherapy cases. However, studies with cognitive behavioural therapy (CBT) are so far absent. The present study tests whether IMs can be reliably identified in CBT and examines if IMs and symptoms' improvement are associated. The following variables were assessed in each session from a sample of six cases of CBT for depression (a total of 111 sessions): (a) symptomatology outcomes (Outcome Questionnaire-OQ-10) and (b) IMs. Two hierarchical linear models were used: one to test whether IMs predicted a symptom decrease in the next session and a second one to test whether symptoms in one session predicted the emergence of IMs in the next session. Innovative moments were better predictors of symptom decrease than the reverse. A higher proportion of a specific type of IMs-reflection 2-in one session predicted a decrease in symptoms in the next session. Thus, when clients further elaborated this type of IM (in which clients describe positive contrasts or elaborate on changes processes), a reduction in symptoms was observed in the next session. A higher expression and elaboration of reflection 2 IMs appear to have a facilitative function in the reduction of depressive symptoms in this sample of CBT. Copyright © 2016 John Wiley & Sons, Ltd. Elaborating innovative moments (IMs) that are new ways of thinking, feeling, behaving and relating, in the therapeutic dialogue, may facilitate change. IMs that are more predictive of amelioration of symptoms in CBT are the ones focused on contrasts between former problematic patterns and new adjusted ones; and the ones in which the clients elaborate on processes of change. Therapists may integrate these kinds of questions (centred on contrasts and centred on what allowed change from the client's perspective), in the usual CBT techniques. When elaborating these IMs successfully, therapists may expect an improvement in symptoms in the next session of psychotherapy. Copyright © 2016 John Wiley & Sons, Ltd.

Qualitative analysis of bibliotherapy as a tool for adults who stutter and graduate students.

PubMed

Gerlach, Hope; Subramanian, Anu

2016-03-01

The purpose of this study was to investigate the use of bibliotherapy as a therapeutic tool for adults who stutter (AWS) and as an educational tool for graduate students in speech-language pathology. Bibliotherapy refers to the process of reading, reflecting upon, and discussing literature, often first person illness or disability narratives, to promote cognitive shifts in the way clients and clinicians conceptualize the experience of disability. Five AWS and six graduate students participated in supervised bibliotherapy using a stuttering memoir during therapy sessions. An inductive, qualitative analysis was utilized to analyze data collected from questionnaires and interviews. An additional deductive qualitative approach was utilized to explore how client data fit into an existing five-outcome model of bibliotherapy from the psychology literature. Graduate students reported developing essential clinical skills for working with clients who stutter, including an improved understanding of the experience of people who stutter and an increased ability to form and strengthen the therapeutic alliance. Clients reported experiencing shifts in the cognitive and affective components of the disorder. Imposing the five-outcome model on client data indicates that at least two clients in the current study experienced all five outcomes of bibliotherapy. These include client experiences of involvement, identification, catharsis, insight and universalism. Both graduate students and clients reported benefits from reading and discussing a memoir about stuttering. Bibliotherapy can be an effective tool in therapy and clinical education when used appropriately. Copyright © 2015 Elsevier Inc. All rights reserved.

Exploring the health visiting service from the view of South Asian clients in England: a grounded theory study.

PubMed

Abdu, Lena; Stenner, Karen; Vydelingum, Vasso

2016-09-01

The fact that health inequalities disproportionately affect the minority ethnic population is not new and projections are that the minority ethnic population will continue to increase. The importance of early intervention and the key role that health visitors can play in attempting to reduce health inequalities is well documented as is the requirement for health providers to establish culturally sensitive services. To date, much of the research has focused on the perspectives of healthcare professionals caring for minority ethnic clients in hospital-based settings and little is known about the perspectives of minority ethnic clients regarding the health visiting service (HVS). The aim of this study was to explore the perspectives of South Asians regarding their experiences with the HVS. The study was conducted in a small town in the South of England between March and June 2013. A qualitative study using a grounded theory approach was used to capture the perspectives of this group regarding their interactions with the HVS. The sample consisted of 15 participants and data were collected through audio-recorded semi-structured interviews and analysed using constant comparative approach. Three key categories were identified: 'understanding the health visitor's role', 'sensitivity of services' and 'the significance of family'. While clients valued one-to-one support from health visitors, there was some evidence of poor communication and ethnocentric tendencies within the service. It was found that South Asian clients distinguish between health and parenting advice, being more likely to accept health advice from their health visitor and more likely to accept parenting advice from their family. The findings, although limited in their generalisability, offer important insights into how South Asians perceive the service and will equip health visitors with a better understanding of how best to improve the experience of South Asian clients accessing the health visiting. © 2015 John Wiley & Sons Ltd.

National Weatherization Assistance Program Impact Evaluation - Client Satisfaction Survey: WAP Service Delivery from the Client's Perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, Carolyn; Carroll, David; Berger, Jacqueline

This report presents the results of a survey of recipients to measure satisfaction with services provided by local weatherization agencies being supported by funding from Department of Energy's Weatherization Assistance Program.

Linguistic and Socio-Cognitive Predictors of School-Age Children's Narrative Evaluations about Jealousy

ERIC Educational Resources Information Center

Aldrich, Naomi J.; Brooks, Patricia J.

2017-01-01

This study investigated children's narrative evaluations about jealousy in relation to performance on a higher-order perspective-taking task and assessments of receptive vocabulary and nonverbal intelligence. Eighty children (5;0-11;11) narrated a wordless picture book about a jealous frog, answered probe questions about the plot, and generated a…

Barbie Princesses and Dinosaur Dragons: Narration as a Way of Doing Gender

ERIC Educational Resources Information Center

Anggard, Eva

2005-01-01

In this article, young children's narration in words and pictures is discussed from a gender perspective. The article is based on a project in which eight pre-school children made their own books. In their stories, the children reused narratives picked up from different media, both traditional fairytales and popular cultural products. The reuse of…

Negotiating Indigenous Language Narratives from Canada and South Africa: A Comparative Approach

ERIC Educational Resources Information Center

Iseke, Judy M.; Ndimande, Bekisizwe S.

2014-01-01

Indigenous cultural and language negotiations ongoing in the contexts of South Africa and Canada are documented in two studies, one sharing narratives from Black parents in South Africa and the other sharing narratives of Métis Elders in Canada. Black parents' perspectives on Indigenous language and cultures and the role of education in…

It Should Not Be a Pit Stop: Voices and Perspectives of Homeless Youth on Labeling and Placement in Special Education

ERIC Educational Resources Information Center

Saldanha, Kennedy

2017-01-01

Although the incomplete school histories of homeless youths are often highlighted, little is written about their school careers involving special education. This study is based on the educational narratives of homeless youths in special education. Their narratives were constructed using "direct scribing" and narrative ethnography. The…

Experimenting with Visual Storytelling in Students' Portfolios: Narratives of Visual Pedagogy for Pre-Service Teacher Education

ERIC Educational Resources Information Center

Rifa-Valls, Montserrat

2011-01-01

This article interprets the repercussions of visual storytelling for art education and arts-based narrative research and, particularly, it approaches visual storytelling as a critical tool for pre-service teacher education. After reinterpreting storytelling from the perspective of visual critical pedagogy, I will narratively reconstruct the use of…

Ethnocultural variations in mental illness discourse: some implications for building therapeutic alliances.

PubMed

Alverson, Hoyt S; Drake, Robert E; Carpenter-Song, Elizabeth A; Chu, Edward; Ritsema, Mieka; Smith, Beverly

2007-12-01

In the delivery of mental health services over the past decade, the field has attempted to shift from paternalism to client-centered care, in which treatment and recovery are based on client-practitioner collaboration. Such a shift requires that providers elicit and work with clients' discursive accounts of their illness experiences and understand these accounts in the context of clients' ethnocultural backgrounds. The purpose of this ethnography was to elucidate ethnocultural aspects of illness accounts and interactions with the mental health system. Over 18 months, 25 ethnically diverse, unemployed, inner-city residents with severe and long-term mental disorders participated in an ethnographic (participant observation) study of illness accounts and their relationship to sociocultural background. Field ethnographers shared in activities with participants at many of their regular haunts, engaging in observation, conversation, and informal interviewing in many real-world contexts and settings. The study revealed significant differences between the ways that European Americans, African Americans, and Puerto Rican Americans discursively constructed their illness experiences and their interactions with the mental health system. The clients' narratives of their illness experiences provided valuable information, which clinicians could use to open up topics for discussion, insert themselves into an engaging relationship with clients, and link clinical advice or guidance with the clients' own conceptions of how mental illness fits into their larger lived world. To develop a working therapeutic partnership with clients, mental health service providers must become aware through context-sensitive, context-informed dialog of the differences in how individual clients "en-story," communicate, and experience their illnesses.

Conceptualizing the therapist's role in therapy in psychosis.

PubMed

Dilks, Sarah; Tasker, Fiona; Wren, Bernadette

2013-09-01

This paper reports on a subset of findings from a wider ranging grounded theory analysis of therapy and recovery processes in psychosis. It describes therapist activities involved in maintaining an observational perspective during therapy and the links between these and other therapist activities. Grounded theory was used to examine the qualitative data collected. An initial sample of 19 taped therapy sessions and 23 interviews with psychologists and their clients was collected. This sample was extended through the collection of three further interviews with psychoanalytically aware psychologists. The data were analysed using grounded theory. A grounded theory model of therapy processes in psychosis was developed that conceptualized therapist actions as providing an observational scaffold to support the client's efforts in moving to new perspectives on their situation. Consistent with the understanding of the core therapy activity as a dialogical process, this set of therapist actions was understood as occurring alongside other therapist activities involved in managing emotion and building a relationship in therapy. The central activity of therapy in psychosis was understood as a dialogical process continuously negotiated between therapist and client in conversation and was conceptually summarized in the grounded theory as 'building bridges to observational perspectives'. However, the active and strategic efforts of psychologists to sustain the dialogue implied a particular assumption of responsibility for maintaining this process. In particular, therapists appeared to be 'working to maintain observational perspectives', 'managing emotion', and 'doing relationship' during the therapy conversation as part of the joint effort with clients to build bridges to new observational perspectives on distress and psychosis. © 2012 The British Psychological Society.

Identity as "knowing your place": the narrative construction of space in a healthcare profession.

PubMed

van Vuuren, Mark; Westerhof, Gerben J

2015-03-01

The construction of space in which a story takes place can have important consequences for the evaluation of health interventions. In this article, we explore the ways professionals narratively position themselves in a situation, treating identity literally as "knowing one's place." More specifically, we explore the spatial language health professionals use to describe their work. Using descriptions of professionals in a drug habilitation organization, we illustrate how they use route (i.e., an active tour through the space), survey (i.e., a stationary viewpoint from above), and gaze perspectives (i.e. a stable viewpoint onto a place) to explain the work situations they encounter. Each of these perspectives facilitates a different mode of evaluation in terms of distance, emotion, and identity. We propose opportunities for research and implications of the ways in which spaces and spatial perspectives set the scene in the narratives of healthcare professionals. © The Author(s) 2015.

Where is the client/patient voice in interprofessional healthcare team assessments? Findings from a one-day forum.

PubMed

Soklaridis, Sophie; Romano, Donna; Fung, Wai Lun Alan; Martimianakis, Maria Athina Tina; Sargeant, Joan; Chambers, Jennifer; Wiljer, David; Silver, Ivan

2017-01-01

There is a growing interest in interprofessional care (IPC) as a way to provide better healthcare. However, it is difficult to evaluate this mode of healthcare delivery because identifying the appropriate measurement tool is a challenge, given the wide diversity in team composition and settings. Adding to this complexity is a key gap in the IPC evaluation research: the client/patient perspective. This perspective has generally not been included in the development of IPC healthcare team evaluations. The authors received a Canadian Institute for Health Research Planning Grant to host a one-day forum with 24 participants from across Canada representing health professions such as social work, medicine, occupational therapy, and physical therapy, in addition to researchers, client/patient advocates, and hospital administrators. The overarching goal of the forum was to create a demonstration project that supports the development of an IPC assessment tool for healthcare teams that includes clients/patients. Using a concept mapping methodology, participants discussed client/patient inclusion in IPC assessments, and through a consensus process, chose a demonstration project for further development.

Becoming a Client, Becoming a Practitioner: Student Narratives of a Dance Movement Therapy Group

ERIC Educational Resources Information Center

Payne, Helen

2004-01-01

This paper documents one of several themes arising from a larger research study which invited trainees' views on their experience in a weekly, 2 year, dance movement therapy (DMT) personal development group. This group formed part of their post-graduate training. The study used a phenomenological, grounded theory and collaborative methodology…

Hidden Stories: Uncovering the Visual Metaphor for Education and Communication

ERIC Educational Resources Information Center

Hube, Amy M.; Tremblay, Kenneth R., Jr.; Leigh, Katharine E.

2015-01-01

Design solutions have become increasingly complex and based on a rapidly growing body of knowledge. In order to articulate a design solution to a client, the graphic use of the design narrative can effectively communicate complex ideas. Two case study interventions were conducted in an interior design program in which students were introduced to…

From Client to Pimp: Male Violence against Female Sex Workers

ERIC Educational Resources Information Center

Karandikar, Sharvari; Prospero, Moises

2010-01-01

The present study explores intimate partner violence (IPV) among female sex workers from the red-light area based in Mumbai, India. Using a grounded theory approach, in-depth interviews were conducted with ten sex workers to explore their experiences of IPV in the context of commercial sex work. Narratives were analyzed and themes constructed. A…

Narrative and emotion process in psychotherapy: an empirical test of the Narrative-Emotion Process Coding System (NEPCS).

PubMed

Boritz, Tali Z; Bryntwick, Emily; Angus, Lynne; Greenberg, Leslie S; Constantino, Michael J

2014-01-01

While the individual contributions of narrative and emotion processes to psychotherapy outcome have been the focus of recent interest in psychotherapy research literature, the empirical analysis of narrative and emotion integration has rarely been addressed. The Narrative-Emotion Processes Coding System (NEPCS) was developed to provide researchers with a systematic method for identifying specific narrative and emotion process markers, for application to therapy session videos. The present study examined the relationship between NEPCS-derived problem markers (same old storytelling, empty storytelling, unstoried emotion, abstract storytelling) and change markers (competing plotlines storytelling, inchoate storytelling, unexpected outcome storytelling, and discovery storytelling), and treatment outcome (recovered versus unchanged at therapy termination) and stage of therapy (early, middle, late) in brief emotion-focused (EFT), client-centred (CCT), and cognitive (CT) therapies for depression. Hierarchical linear modelling analyses demonstrated a significant Outcome effect for inchoate storytelling (p = .037) and discovery storytelling (p = .002), a Stage × Outcome effect for abstract storytelling (p = .05), and a Stage × Outcome × Treatment effect for competing plotlines storytelling (p = .001). There was also a significant Stage × Outcome effect for NEPCS problem markers (p = .007) and change markers (p = .03). The results provide preliminary support for the importance of assessing the contribution of narrative-emotion processes to efficacious treatment outcomes in EFT, CCT, and CT treatments of depression.

Is it time for a comprehensive approach in older home care clients' care planning in Finland?

PubMed

Turjamaa, Riitta; Hartikainen, Sirpa; Kangasniemi, Mari; Pietilä, Anna-Maija

2015-06-01

Home-care services require access to high quality information. Apart from the provision of right-time organised planning of care and to document information about clients' needs, in home care, the care planning is intended to facilitate continuity and individual nursing through nursing documentation of the assessment of the client. The aim was to describe the contents of older (+75 years) home-care clients' electronic care and service plans and to evaluate how the clients' resources have been taken into account. The data were collected from the care and service plans (n = 437) of home-care services during July 2010. The data were analysed by quantitative methods and by thematic content analysis. Based on the analysis, medication was the most reported component in all plans (92.7%); other commonly reported components were self-care (85.4%) and coping (78.0%). Components within respiratory, follow-up treatment, life cycle and health behaviour were forgotten. Most of the care and service plans were designed from the home-care professionals' point of view but the plans lacked the perspective of older clients. To be able to promote older home clients' ability to live at home, home-care planning needs to be individually designed and must take into account clients' needs and their perspectives regarding meaningful activities and social relationships. In addition, there is a need to develop a more comprehensive care planning system, based on the clients' individual needs and standards of care planning. © 2014 Nordic College of Caring Science.

Strengthening the working alliance through a clinician's familiarity with the 12-step approach.

PubMed

Dennis, Cory B; Roland, Brian D; Loneck, Barry M

2018-01-01

The working alliance plays an important role in the substance use disorder treatment process. Many substance use disorder treatment providers incorporate the 12-Step approach to recovery into treatment. With the 12-Step approach known among many clients and clinicians, it may well factor into the therapeutic relationship. We investigated how, from the perspective of clients, a clinician's level of familiarity with and in-session time spent on the 12-Step approach might affect the working alliance between clients and clinicians, including possible differences based on a clinician's recovery status. We conducted a secondary study using data from 180 clients and 31 clinicians. Approximately 81% of client participants were male, and approximately 65% of clinician participants were female. We analyzed data with Stata using a population-averaged model. From the perspective of clients with a substance use disorder, clinicians' familiarity with the 12-Step approach has a positive relationship with the working alliance. The client-estimated amount of in-session time spent on the 12-Step approach did not have a statistically significant effect on ratings of the working alliance. A clinician's recovery status did not moderate the relationship between 12-Step familiarity and the working alliance. These results suggest that clinicians can influence, in part, how their clients perceive the working alliance by being familiar with the 12-Step approach. This might be particularly salient for clinicians who provide substance use disorder treatment at agencies that incorporate, on some level, the 12-Step approach to recovery.

Narrative inquiry: Locating Aboriginal epistemology in a relational methodology.

PubMed

Barton, Sylvia S

2004-03-01

This methodology utilizes narrative analysis and the elicitation of life stories as understood through dimensions of interaction, continuity, and situation. It is congruent with Aboriginal epistemology formulated by oral narratives through representation, connection, storytelling and art. Needed for culturally competent scholarship is an experience of research whereby inquiry into epiphanies, ritual, routines, metaphors and everyday experience creates a process of reflexive thinking for multiple ways of knowing. Based on the sharing of perspectives, narrative inquiry allows for experimentation into creating new forms of knowledge by contextualizing diabetes from the experience of a researcher overlapped with experiences of participants--a reflective practice in itself. The aim of this paper is to present narrative inquiry as a relational methodology and to analyse critically its appropriateness as an innovative research approach for exploring Aboriginal people's experience living with diabetes. Narrative inquiry represents an alternative culture of research for nursing science to generate understanding and explanation of Aboriginal people's 'diabetic self' stories, and to coax open a window for co-constructing a narrative about diabetes as a chronic illness. The ability to adapt a methodology for use in a cultural context, preserve the perspectives of Aboriginal peoples, maintain the holistic nature of social problems, and value co-participation in respectful ways are strengths of an inquiry partial to a responsive and embodied scholarship.

Beyond Narratives: "Free Drawings" as Visual Data in Addiction Research.

PubMed

Klingemann, Justyna; Klingemann, Harald

2016-05-11

The study presented here explores the usefulness of visual data when assessing addiction careers from various methodological perspectives. The database consists of 14 "free life-course drawings" produced by seven Swiss and seven Polish male alcohol ex-users, and their life history narratives collected in the context of earlier studies on self-change. The analysis follows the principles of the Barthian visual semiotics approach including the author and the viewer perspective. This is followed by the investigation of the interplay between drawings and narratives in Polish and German. Compared to the detailed narratives following few sub-storylines at the same time, the drawings provide a more coherent and differentiated overall picture especially of the emotional state over the life course: the relative subjective importance of highs and lows; and clearer visualisation of mixed positive and negative feelings; as well as identity concepts, such as the interplay between Mead's I & me.

Rorty's Social Theory and the Narrative of U.S. History Curriculum

ERIC Educational Resources Information Center

Goodman, Jesse; Montgomery, Sarah; Ables, Connie

2010-01-01

This paper explores the implications for creating a U.S. history narrative from a Rortyan perspective. First, we review Rorty's social theory. Second, we discuss implications of his ideas regarding the creation of a U.S. history narrative based upon his ideas. Finally, we examine two concerns that would likely emerge if a Rortyan U.S. history…

'I am not a tragedy. I am full of hope': communication impairment narratives in newspapers.

PubMed

O Malley-Keighran, Mary-Pat; Coleman, Mary

2014-01-01

Individual attitudes and more general attitudes in society can negatively influence the functioning of people with communication disorders according to the World Health Organisation's (WHO) International Classification of Functioning, Disability, and Health (ICF) (2002). Personal narratives have been recommended as the best means to convey and understand a person's life experience and have been investigated extensively. Investigations of personal narratives of communication impairment in mass media continue to be relatively rare in the literature. Published narratives can enrich understandings of clients' experiences by elucidating available representations of lived experiences of communication impairment. To answer the following research questions: What types of personal narratives of communication impairments are currently being disseminated in Irish newspapers? How are experiences of communication impairments represented in these narratives? The study was qualitative, deploying inductive analysis and drawing on Frank's (1995) typology of illness narratives to analyse narratives that were published in two Irish national newspapers over a 12-month period. The results illustrate the under-representation of communication impairments in Irish newspapers as ten out of 51 narratives in the corpus pertained to conditions that may have associated communication impairments. None of the narratives related the lived experience of a person with communication impairment in depth. A combination of quest and chaos narrative types was identified in six out of the ten narratives. Three out of the ten narratives featured a combination of chaos and restitution narrative types. One narrative was identified as being entirely a quest narrative. Three narratives contained elements of restitution. Inductive analysis revealed six main themes in the data (two for each narrative type) with one sub-theme identified for each main theme. The six main themes are: positive stances, re-evaluation of life, despair, fear, hope and support of others. The under-representation of the lived experience of people with communication impairments in Irish national newspapers may be seen as contributing to a general lack of understanding and awareness of communication impairments. This under-representation, coupled with a lack of awareness, may potentially affect the ability of people with communication impairments to re-engage with and reintegrate into their communities. © 2013 Royal College of Speech and Language Therapists.

Taking the Scientist's Perspective. The Nonfiction Narrative Engages Episodic Memory to Enhance Students' Understanding of Scientists and Their Practices

NASA Astrophysics Data System (ADS)

Larison, Karen D.

2018-03-01

The Next Generation Science Standards (NGSS Lead States 2013) mandates that schools provide students an understanding of the skills and knowledge that scientists use to engage in scientific practices. In this article, I argue that one of the best ways to accomplish this goal is to have students take the perspective of the scientist by reading nonfiction narratives written by scientists and science writers. I explore the anthropological and neurological evidence that suggests that perspective-taking is an essential component in the learning process. It has been shown that by around age 4, the human child begins to be able to take the perspective of others—a process that neuroscientists have shown engages episodic memory, a memory type that some neurocognitive scientists believe is central in organizing human cognition. Neuroscientists have shown that the brain regions in which episodic memory resides undergo pronounced anatomical changes during adolescence, suggesting that perspective-taking assumes an even greater role in cognition during adolescence and young adulthood. Moreover, I argue that the practice of science itself is narrative in nature. With each new observation and experiment, the scientist is acting to reveal an emerging story. It is the story-like nature of science that motivates the scientist to push onward with new experiments and new observations. It is also the story-like nature of the practice of science that can potentially engage the student. The classroom studies that I review here confirm the power of the narrative in increasing students' understanding of science.

Clinical Diagnosis among Diverse Populations: A Multicultural Perspective.

ERIC Educational Resources Information Center

Solomon, Alison

1992-01-01

Discusses four ways in which clinical diagnosis can be detrimental to minority clients: (1) cultural expressions of symptomatology; (2) unreliable research instruments; (3) clinician bias; and (4) institutional racism. Recommendations to avoid misdiagnosis begin with accurate assessment of a client's history and cultural background. (SLD)

The Wheelchair Procurement Process: Perspectives of Clients and Prescribers

PubMed Central

Mortenson, William B; Miller, William C

2014-01-01

Back ground Increasing choices in assistive technology has made the process of procuring a wheelchair more complex and challenging. Purpose To explore the intricacies of the procurement process from the perspectives of clients and therapists. Methods Thirty-four participants were interviewed, including 13 wheelchair prescribers, 14 wheelchair users, and 7 wheelchair associates (family members and caregivers). Findings Analysis revealed five main themes. 1) “Who decides?” described varying degrees of client involvement in the procurement process. 2) “Expert knowledge” reflected the expert knowledge that all parties possessed. 3) “Form versus function” captured the primary and, at times, conflicting outcomes that participants wanted to achieve. 4) “Fitting in” depicted the environmental factors that affected wheelchair procurement. 5) “(Re)solutions” illustrated strategies that participants felt improved the process. Implications This study reveals clients’ experiences with wheelchair procurement, identifies potential issues therapists may encounter, and suggests possible remedies they might consider when prescribing wheelchairs within a client-centred framework. PMID:18615928

Well-being dialogue: Elderly women's subjective sense of well-being from their course of life perspective

PubMed Central

Svensson, Ann-Marie; Mårtensson, Lena B.

2012-01-01

In this article, we are concerned with narratives of elderly women's well-being from their perspectives of the latter parts of their life, living at special housing accommodation (SHA) in the context of Swedish elderly care. In focusing on narratives about well-being, we have a two-fold focus: (1) how the elderly women create their own identity and meaning-making based on lifetime experience; and (2) how narratives of well-being are reflected through the filter of life in situ at the SHA. Based on empirical data consisting of well-being narratives, a dialogical performance analysis was undertaken. The results show how relationships with important persons during various stages of life, and being together and enjoying fellowship with other people as well as enjoying freedom and self-determination, are central aspects of well-being. The conclusions drawn are that the characteristic phenomena of well-being (the what) in the narratives are continuity, identity, and sociality for the elderly person, and this is manifested (the how) as a question of contrasting the state of self-management and self-decline. PMID:23237627

Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships.

PubMed

Easter, Alison; Pollock, Michele; Pope, Leah Gogel; Wisdom, Jennifer P; Smith, Thomas E

2016-07-01

This study explores the nature of clinical therapeutic relationships between mental health treatment providers and high-need clients with serious mental illness who had recently discontinued treatment. Semi-structured qualitative interviews of 56 clients with serious mental illness who had recently discontinued care and 25 mental health treatment providers were completed. Both clients with serious mental illness and treatment providers emphasized the importance of client-focused goal setting, time and availability of treatment providers, a caring approach, and trust and honesty in the relationship. However, clients with serious mental illness placed greater emphasis on goals involving tangible services, a notable area of discord between the two groups. Individuals with serious mental illness and treatment providers agreed regarding several key elements to a positive clinical relationship. Further attention to client goals related to tangible services may serve to improve relationships between treatment providers and high-need clients with serious mental illness.

Foster Care: Creating Interpersonal Change through Story-Telling and Family Play. Strategies to Support Client Assessment and Intervention.

ERIC Educational Resources Information Center

Schatz, Mona Struhsaker; Gaddis, Stephen R.; Zimmerman, Toni Schindler

Story-telling and family play can exert powerful effects on children. Some beliefs, values, and personal life-style choices that relate to how play is created are examined. Using the primary concepts in "narrative therapy,""adventure-based programming," and "family play therapy," play is employed to create an empowerment framework to consider the…

Narrative as a Means of Understanding the Multi-Dimensional Benefits of Telehealth: An Exploration of Telehealth Stories

ERIC Educational Resources Information Center

Carter, Lorraine Mary; Muir, Linda; McLean, Doris

2011-01-01

Telehealth is a wide range of health services delivered across distance through technology. In this technology-supported health world, sometimes, the client and his or her family can get lost as clinical consultations are counted for reporting purposes and new technologies are implemented. As a response to this situation and building on the…

Narrative Medicine: Suggestions for Clinicians to Help Their Clients Construct a New Identity Following Acquired Brain Injury

ERIC Educational Resources Information Center

Fraas, Michael R.

2015-01-01

Survivors of brain injury from trauma and stroke often lose their sense of identity and face a series of lifelong obstacles that challenge their ability to integrate back into their communities and live meaningful and productive lives. Their stories provide powerful accounts of these challenges, which can inform clinical decision-making. Arguably,…

Associations between social understanding, sibling relationship quality, and siblings' conflict strategies and outcomes.

PubMed

Recchia, Holly E; Howe, Nina

2009-01-01

Sibling relationship quality and social understanding (second-order false belief, conflict interpretation, and narrative conflict perspective references) were examined as unique and interactive correlates of sibling conflict behavior in 62 dyads (older M age = 8.39 years and younger M age = 6.06 years). High-quality relationships were associated with positive conflict processes. Younger siblings' second-order false belief scores were negatively associated with constructive conflict strategies, and older siblings' narrative self-referential focus was negatively associated with compromise. Associations between younger children's social understanding (conflict interpretation and narrative perspective references) and siblings' dyadic conflict behavior were moderated by relationship quality. Results suggest that links between social understanding and conflict behavior should be considered in conjunction with the quality of children's relationships.

Empathy from the client's perspective: A grounded theory analysis.

PubMed

MacFarlane, Peter; Anderson, Timothy; McClintock, Andrew S

2017-03-01

Although empathy is one of most robust predictors of client outcome, there is little consensus about how best to conceptualize this construct. The aim of the present research was to investigate clients' perceptions and in-session experiences of empathy. Semi-structured, video-assisted interpersonal process recall interviews were used to collect data from nine clients receiving individual psychotherapy at a university psychology clinic. Grounded theory analysis yielded a model consisting of three clusters: (1) relational context of empathy (i.e., personal relationship and professional relationship), (2) types of empathy (i.e., psychotherapists' cognitive empathy, psychotherapists' emotional empathy, and client attunement to psychotherapist), and (3) utility of empathy (i.e., process-related benefits and client-related benefits). These results suggest that empathy is a multi-dimensional, interactional process that affects-and is affected by-the broader relationship between client and psychotherapist.

Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: a qualitative study.

PubMed

Ho, Rainbow Tin Hung; Chan, Caitlin Kar Pui; Lo, Phyllis Hau Yan; Wong, Ping Ho; Chan, Cecilia Lai Wan; Leung, Pamela Pui Yu; Chen, Eric Yu Hai

2016-04-02

Spirituality has received increased attention in the psychiatric literature; however, it remains underexplored on a global level. Knowledge about spirituality of persons with schizophrenia is often hampered by positive and negative symptoms, which limit their expression of spiritual needs and shift mental-health professionals' focus from spiritual care to symptom control. Differences in the ways that the two parties understand spirituality may create different expectations and further hinder the provision of high-quality holistic care. This study investigated the meaning and roles of spirituality from the perspectives of persons with schizophrenia and mental-health professionals. A qualitative design with semi-structured individual interviews was adopted. The analysis was based on data collected from interviews with 18 clients diagnosed with schizophrenia and 19 mental-health professionals from public hospitals and mental-health community rehabilitation centres in Hong Kong. Data were collected and analysed based on grounded theory principles. Both clients and professionals regarded spirituality as an inherent part of a person's well-being, clients' rehabilitation, and their lives in general. At the personal level, the clients' descriptions were more factual, concrete, short term, and affective, whereas the professionals' descriptions were more abstract, complex, and cognitive. At the communal level, both parties had a similar understanding of spirituality but different interpretations of its role in recovery from mental illness. The clients regarded spirituality as a source of giving and receiving love and care, whereas the professionals regarded it as a means of receiving support and managing symptoms. Building a common understanding on the concept of spirituality and the significant role it plays in rehabilitation between clients and mental-health professionals is an essential first step to support clients' spiritual health. Clients tend to seek for stability, peace, and growth rather than an existential quest; while professionals hold a more pathological perspective, viewing spirituality as a means to relieve symptoms, increase social acceptance, and cope with illness experiences. The differential understanding of the two perspectives provides insight and perhaps a roadmap for developing spiritual assessments and holistic care in the psychiatric context.

When Fiction Is Just as Real as Fact: No Differences in Reading Behavior between Stories Believed to be Based on True or Fictional Events.

PubMed

Hartung, Franziska; Withers, Peter; Hagoort, Peter; Willems, Roel M

2017-01-01

Experiments have shown that compared to fictional texts, readers read factual texts faster and have better memory for described situations. Reading fictional texts on the other hand seems to improve memory for exact wordings and expressions. Most of these studies used a "newspaper" vs. "literature" comparison. In the present study, we investigated the effect of reader's expectation to whether information is true or fictional with a subtler manipulation by labeling short stories as either based on true or fictional events. In addition, we tested whether narrative perspective or individual preference in perspective taking affects reading true or fictional stories differently. In an online experiment, participants (final N = 1,742) read one story which was introduced as based on true events or as fictional (factor fictionality ). The story could be narrated in either 1st or 3rd person perspective (factor perspective ). We measured immersion in and appreciation of the story, perspective taking, as well as memory for events. We found no evidence that knowing a story is fictional or based on true events influences reading behavior or experiential aspects of reading. We suggest that it is not whether a story is true or fictional, but rather expectations toward certain reading situations (e.g., reading newspaper or literature) which affect behavior by activating appropriate reading goals. Results further confirm that narrative perspective partially influences perspective taking and experiential aspects of reading.

When Fiction Is Just as Real as Fact: No Differences in Reading Behavior between Stories Believed to be Based on True or Fictional Events

PubMed Central

Hartung, Franziska; Withers, Peter; Hagoort, Peter; Willems, Roel M.

2017-01-01

Experiments have shown that compared to fictional texts, readers read factual texts faster and have better memory for described situations. Reading fictional texts on the other hand seems to improve memory for exact wordings and expressions. Most of these studies used a “newspaper” vs. “literature” comparison. In the present study, we investigated the effect of reader's expectation to whether information is true or fictional with a subtler manipulation by labeling short stories as either based on true or fictional events. In addition, we tested whether narrative perspective or individual preference in perspective taking affects reading true or fictional stories differently. In an online experiment, participants (final N = 1,742) read one story which was introduced as based on true events or as fictional (factor fictionality). The story could be narrated in either 1st or 3rd person perspective (factor perspective). We measured immersion in and appreciation of the story, perspective taking, as well as memory for events. We found no evidence that knowing a story is fictional or based on true events influences reading behavior or experiential aspects of reading. We suggest that it is not whether a story is true or fictional, but rather expectations toward certain reading situations (e.g., reading newspaper or literature) which affect behavior by activating appropriate reading goals. Results further confirm that narrative perspective partially influences perspective taking and experiential aspects of reading. PMID:28983269

A Cognitive Perspective in the Treatment of Incarcerated Clients.

ERIC Educational Resources Information Center

Walsh, Thomas C.

1990-01-01

Proposes a cognitive therapy model as a workable approach in treating incarcerated clients. Reviews principal components and techniques of cognitive theory. Uses case vignettes to illustrate application of this approach. Delineates key features of cognitive model which relate to treatment of incarcerated population. (Author/ABL)

Competing for the Hearts and Minds of Students and the Community

ERIC Educational Resources Information Center

McShane, Dave

2005-01-01

As much as academia doesn't like it, community colleges have to begin thinking from a marketing perspective. As a business, community colleges compete for "eyeballs" and satisfy its clients. Here, the author describes how Harper College meets the demands of their prospective clients.

Client Centeredness and Health Reform: Key Issues for Occupational Therapy

PubMed Central

Pitonyak, Jennifer S.; Fogelberg, Donald; Leland, Natalie E.

2015-01-01

Health reform promotes the delivery of patient-centered care. Occupational therapy’s rich history of client-centered theory and practice provides an opportunity for the profession to participate in the evolving discussion about how best to provide care that is truly patient centered. However, the growing emphasis on patient-centered care also poses challenges to occupational therapy’s perspectives on client-centered care. We compare the conceptualizations of client-centered and patient-centered care and describe the current state of measurement of client-centered and patient-centered care. We then discuss implications for occupational therapy’s research agenda, practice, and education within the context of patient-centered care, and propose next steps for the profession. PMID:26356651

Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales.

PubMed

Luther, Lauren; Fukui, Sadaaki; Garabrant, Jennifer M; Rollins, Angela L; Morse, Gary; Henry, Nancy; Shimp, Dawn; Gearhart, Timothy; Salyers, Michelle P

2018-04-12

Measuring quality of care can transform care, but few tools exist to measure quality from the client's perspective. The aim of this study was to create concordant clinician and client self-report quality-of-care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools.

'I sang Amazing Grace for about 3 hours that day': understanding Indigenous Australians' experience of seclusion.

PubMed

Sambrano, Rachel; Cox, Leonie

2013-12-01

Research shows that Indigenous Australians' suspicion and fear of being 'locked up' may influence mental health service avoidance. Given this, the aim of this study was to explore, by qualitative analysis of in-depth interviews (n = 3), how three Indigenous people experienced the controversial practice of seclusion. Hans-Georg Gadamer's phenomenology guided analysis of the material, and allowed narrated experiences to be understood within their cultural and historical context. Participants viewed seclusion negatively: police involvement in psychiatric care; perceptions of being punished and powerless; occasions of extreme use of force; and lack of care were prominent themes throughout the interviews. While power imbalances inherent in seclusion are problematic for all mental health clients, the distinguishing factor in the Indigenous clients' experience is that seclusion is continuous with the discriminatory and degrading treatment by governments, police, and health services that many Indigenous people have experienced since colonization. The participants' experiences echoed Goffman's findings that institutional practices act to degrade and dehumanize clients whose resulting conformity eases the work of nursing staff. While some nurses perceive that seclusion reduces clients' agitation, one must ask at what cost to clients' dignity, humanity, and basic human rights. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.

Stories of change in drug treatment: a narrative analysis of 'whats' and 'hows' in institutional storytelling.

PubMed

Andersen, Ditte

2015-06-01

Addiction research has demonstrated how recovering individuals need narratives that make sense of past drug use and enable constructions of future, non-addict identities. However, there has not been much investigation into how these recovery narratives actually develop moment-to-moment in drug treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both 'the whats' (story content) and 'the hows' (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged. The demonstration of how local narrative environments shape stories contributes to the general understanding of interactive storytelling in encounters between professionals and clients in treatment settings. © 2015 The Author. Sociology of Health & Illness published by John Wiley & Sons Ltd. on behalf of Foundation for Sociology of Health & Illness.

Feminist therapy with people who self-inflict violence.

PubMed

Brown, Laura S; Bryan, Tracy C

2007-11-01

In this article, the authors describe how a feminist therapist approaches work with clients who practice self-inflicted violence (SIV). They begin by discussing feminist therapy, with its focus on empowerment of clients and the use of noncoercive strategies. The feminist perspective on understanding SIV behaviors is described, with SIV being defined as a coping strategy used by survivors of complex trauma as a means of self-care. Feminist therapy is illustrated with a case example of a woman who used SIV, and the challenges to a therapist wishing to promote client safety while empowering the client. Practice recommendations and cautions are advanced.

African Urbanism: Preparation for Multi-Ethnic Schools' Counselors.

ERIC Educational Resources Information Center

Makinde, Olu

1987-01-01

Focuses on cross-cultural perspectives of urbanization and urbanism by comparing the Yoruba cities of western Nigeria with cities of Europe and North America. Concludes that cross-cultural counselors working with Yoruba clients must understand Yoruba city clients and their home life, physical environment, family structure, parent attitudes, and…

The Ethics of Assisted Suicide.

ERIC Educational Resources Information Center

Callahan, Jay

1994-01-01

From social work perspective, considers ethics of assisted suicide. Discusses traditional social work value of client self-determination and identifies tensions in this ideal and conflicts with value of client well-being. Finds assisted suicide unethical, arguing that studies have shown judgment of most suicidal people to be impaired as result of…

Practicum Students' Verbal Responses to Different Clients

ERIC Educational Resources Information Center

Palisi, Anthony T.; Ruzicka, Mary F.

1974-01-01

Counselor trainees' verbal behavior in two initial interview settings, one each with an active and passive client, was significantly different. Verbal behavior was viewed from two perspectives; along the dimension of broad classification by categories of behavior and along the dimension of 3-6 second units of verbal interaction. (Author)

A Hypnotic Intervention for Anger Reduction and Shifting Perceptual Predispositions.

ERIC Educational Resources Information Center

Chandler, Gerald M.

1993-01-01

Presents method of interventions that is designed to expedite therapy process by reducing client's tension state and providing him or her with new memory associations (affective, cognitive, proprioceptive, etc.) that allow the client to view the world from healthier perspective. Notes that intervention was developed by linking several different…

Referential shift in Nicaraguan Sign Language: a transition from lexical to spatial devices

PubMed Central

Kocab, Annemarie; Pyers, Jennie; Senghas, Ann

2015-01-01

Even the simplest narratives combine multiple strands of information, integrating different characters and their actions by expressing multiple perspectives of events. We examined the emergence of referential shift devices, which indicate changes among these perspectives, in Nicaraguan Sign Language (NSL). Sign languages, like spoken languages, mark referential shift grammatically with a shift in deictic perspective. In addition, sign languages can mark the shift with a point or a movement of the body to a specified spatial location in the three-dimensional space in front of the signer, capitalizing on the spatial affordances of the manual modality. We asked whether the use of space to mark referential shift emerges early in a new sign language by comparing the first two age cohorts of deaf signers of NSL. Eight first-cohort signers and 10 second-cohort signers watched video vignettes and described them in NSL. Narratives were coded for lexical (use of words) and spatial (use of signing space) devices. Although the cohorts did not differ significantly in the number of perspectives represented, second-cohort signers used referential shift devices to explicitly mark a shift in perspective in more of their narratives. Furthermore, while there was no significant difference between cohorts in the use of non-spatial, lexical devices, there was a difference in spatial devices, with second-cohort signers using them in significantly more of their narratives. This suggests that spatial devices have only recently increased as systematic markers of referential shift. Spatial referential shift devices may have emerged more slowly because they depend on the establishment of fundamental spatial conventions in the language. While the modality of sign languages can ultimately engender the syntactic use of three-dimensional space, we propose that a language must first develop systematic spatial distinctions before harnessing space for grammatical functions. PMID:25713541

Referential shift in Nicaraguan Sign Language: a transition from lexical to spatial devices.

PubMed

Kocab, Annemarie; Pyers, Jennie; Senghas, Ann

2014-01-01

Even the simplest narratives combine multiple strands of information, integrating different characters and their actions by expressing multiple perspectives of events. We examined the emergence of referential shift devices, which indicate changes among these perspectives, in Nicaraguan Sign Language (NSL). Sign languages, like spoken languages, mark referential shift grammatically with a shift in deictic perspective. In addition, sign languages can mark the shift with a point or a movement of the body to a specified spatial location in the three-dimensional space in front of the signer, capitalizing on the spatial affordances of the manual modality. We asked whether the use of space to mark referential shift emerges early in a new sign language by comparing the first two age cohorts of deaf signers of NSL. Eight first-cohort signers and 10 second-cohort signers watched video vignettes and described them in NSL. Narratives were coded for lexical (use of words) and spatial (use of signing space) devices. Although the cohorts did not differ significantly in the number of perspectives represented, second-cohort signers used referential shift devices to explicitly mark a shift in perspective in more of their narratives. Furthermore, while there was no significant difference between cohorts in the use of non-spatial, lexical devices, there was a difference in spatial devices, with second-cohort signers using them in significantly more of their narratives. This suggests that spatial devices have only recently increased as systematic markers of referential shift. Spatial referential shift devices may have emerged more slowly because they depend on the establishment of fundamental spatial conventions in the language. While the modality of sign languages can ultimately engender the syntactic use of three-dimensional space, we propose that a language must first develop systematic spatial distinctions before harnessing space for grammatical functions.

Translingual Practice in L2 Japanese: Workplace Narratives

ERIC Educational Resources Information Center

Menard-Warwick, Julia; Leung, Genevieve

2017-01-01

Translingual practice is an emergent theoretical perspective which emphasizes the capacity and disposition for meaning-making across linguistic boundaries. Following on studies of globalized workplaces that have focused on lingua franca English, this article explores translingual practice as represented in interview and blog narratives recounted…

The Role of Ventromedial Prefrontal Cortex in Text Comprehension Inferences: Semantic Coherence or Socio-Emotional Perspective?

PubMed Central

Burin, Debora I.; Acion, Laura; Kurczek, Jake; Duff, Melissa C.; Tranel, Daniel; Jorge, Ricardo E.

2015-01-01

Two hypotheses about the role of the ventromedial prefrontal cortex (vmPFC) in narrative comprehension inferences, global semantic coherence versus socio-emotional perspective, were tested. Seven patients with vmPFC lesions and seven demographically matched healthy comparison participants read short narratives. Using the consistency paradigm, narratives required participants to make either an emotional or visuo-spatial inference, in which a target sentence provided consistent or inconsistent information with a previous emotional state of a character or a visuo-spatial location of an object. Healthy comparison participants made the inferences both for spatial and emotional stories, as shown by longer reading times for inconsistent critical sentences. For patients with vmPFC lesions, inconsistent sentences were read slower in the spatial stories, but not in the emotional ones. This pattern of results is compatible with the hypothesis that vmPFC contributes to narrative comprehension by supporting inferences about socio-emotional aspects of verbally described situations. PMID:24561428

Perspectives and concerns of clients at primary health care facilities involved in evaluation of a national mental health training programme for primary care in Kenya

PubMed Central

2013-01-01

Background A cluster randomised controlled trial (RCT) of a national Kenyan mental health primary care training programme demonstrated a significant impact on the health, disability and quality of life of clients, despite a severe shortage of medicines in the clinics (Jenkins et al. Submitted 2012). As focus group methodology has been found to be a useful method of obtaining a detailed understanding of client and health worker perspectives within health systems (Sharfritz and Roberts. Health Transit Rev 4:81–85, 1994), the experiences of the participating clients were explored through qualitative focus group discussions in order to better understand the potential reasons for the improved outcomes in the intervention group. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 10 clients from the intervention group clinics where staff had received the training programme, and 10 clients from the control group where staff had not received the training during the earlier randomised controlled trial. Results These focus group discussions suggest that the clients in the intervention group noticed and appreciated enhanced communication, diagnostic and counselling skills in their respective health workers, whereas clients in the control group were aware of the lack of these skills. Confidentiality emerged from the discussions as a significant client concern in relation to the volunteer cadre of community health workers, whose only training comes from their respective primary care health workers. Conclusion Enhanced health worker skills conferred by the mental health training programme may be responsible for the significant improvement in outcomes for clients in the intervention clinics found in the randomised controlled trial, despite the general shortage of medicines and other health system weaknesses. These findings suggest that strengthening mental health training for primary care staff is worthwhile even where health systems are not strong and where the medicine supply cannot be guaranteed. Trial registration ISRCTN 53515024. PMID:23343127

The Confluence of Technology and Narrative Approaches in Group Work: Techniques and Suggestions for Using Interactive E-Journals

ERIC Educational Resources Information Center

Haberstroh, Shane; Trepal, Heather; Parr, Gerald

2005-01-01

This article illustrates procedures for using e-journals as a creative and adjunctive approach in group work. Incorporating e-mail based journaling as an ancillary form of group interaction allows members to communicate via written channels, and creates new ways for clients to relate in the group. This article outlines how leaders can use…

Moral development and reproductive health decisions.

PubMed

McFadden, E A

1996-01-01

This article reviews the concepts of biomedical ethics, the justice perspective, and the care perspective of moral development and moral decision making; integrates key aspects of each to women's reproductive health nursing practice; and gives examples of application of these models to use as a framework for the assessment of moral development in guiding women in making reproductive health decisions. Emphasis is placed on the need for an integrated approach to assessment of the recognition of and response to what an individual identifies as a moral dilemma. Discussion of two different perspectives, justice and caring, is presented with application to women's health concerns. Nurses are encouraged to assess their moral development and appraisal of issues that constitute moral dilemmas and their ensuing decision making processes and those of clients. Techniques for obtaining information about moral reasoning are suggested. Rather than a traditional framework for the assessment of moral development, the uniqueness of individual women's experiences as they pertain to the case context is recommended to assess the client's appraisal of the circumstances of a perceived moral situation from the client's vantage point.

Assuring quality in narrative analysis.

PubMed

Bailey, P H

1996-04-01

Many nurse-researchers using qualitative strategies have been concerned with assuring quality in their work. The early literature reveals that the concepts of validity and reliability, as understood from the positivist perspective, are somehow inappropriate and inadequate when applied to interpretive research. More recent literature suggests that because of the positivist and interpretive paradigms are epistemologically divergent, the transfer of quality criteria from one perspective to the other is not automatic or even reasonable. The purpose of this article, therefore, is to clarify what the terms quality, trustworthiness, credibility, authenticity, and goodness mean in qualitative research findings. The process of assuring quality, validation, in qualitative research will be discussed within the context of the interpretive method, narrative analysis. A brief review of quality in narrative analysis nursing research will also be presented.

The types and characteristics of clients' perceptions of the Bonny method of Guided Imagery and Music.

PubMed

Choi, Byungchuel; Lee, Nan Bok

2014-01-01

Developed by Helen Bonny, Guided Imagery and Music (BMGIM) has mainly been used to assist people with mental health issues. In order to provide clients with the most effective therapy, we need to examine the BMGIM process from the clients' perspective, rather than the therapists.' Understanding the types and characteristics of clients' experiences within the BMGIM process would be helpful to therapists. In order to assess clients' experiences more objectively, a different research methodology is needed to measure and compare the perspectives of clients in the BMGIM process. The purpose of this study was to identify the types and characteristics of perceptions in clients with mental health problems of the BMGIM experience. Q methodology was used to characterize client BMGIM perceptions. Scores from Q samples were coded into Q sample scores in order to calculate Q sort collected from a P sample of 20 participants. Participants were involved in the Q sorting as Q sorters and P sample. Q factor analysis was conducted using the QUANL program. The types and characteristics of the participants' perceptions were analyzed for three segments of the BMGIM session. From a factor analysis, (a) two factors were identified in the before music experience segment, (b) three factors in the during music experience segment, and (c) three factors in the after music experience segment. Factors that intervened in the therapeutic process of BMGIM were obtained from participants' direct GIM experiences. The knowledge of the types and characteristics of participants' perceptions of the GIM process will help therapists deliver more effective therapeutic interventions. Q methodology may also contribute to gaining a better understanding of BMGIM process. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nursing gaze of the Eastern Front in World War II: a feminist narrative analysis.

PubMed

Georges, Jane M; Benedict, Susan

2008-01-01

Grounded in a feminist perspective, a narrative analysis of letters written by Martha Lohmann, a nurse who served with the German Army on the Eastern Front in World War II, is undertaken. Utilizing "gaze" as a focus, an exploration of the narrative and the multiple gazes embedded within it is performed. Implications for future analysis of nurses' textual accounts of violence, armed conflict, and war are presented.

Narrative Therapies with Children and Adolescents.

ERIC Educational Resources Information Center

Smith, Craig, Ed.; Nylund, David, Ed.

Through transcripts and case examples this book explores how drama, art, play, and humor can be used to engage children of different ages in therapy and to honor their idiosyncratic language, knowledge, and perspectives. Chapters are: (1) "Introduction: Comparing Traditional Therapies with Narrative Approaches" (C. Smith); (2) "'I…

[Measuring client satisfaction in youth mental health care: qualitative methods and satisfaction questionnaires].

PubMed

Vanderfaeillie, J; Stroobants, T; van West, D; Andries, C

2015-01-01

Quality youth care and decisions about youth care should ideally be based on a combination of empirical data, the clinical judgment of health professionals and the views and preferences of clients. Additionally, the treatment provided needs to fit in with the client's social and cultural background. Clients' views about their treatment are often collected via satisfaction measurements and particularly via satisfaction questionnaires. To make a critical analysis of the factors that determine both client satisfaction and the content of the satisfaction questionnaires used as a measurement method in youth care. We made a selective study of the relevant literature. Our results show that client satisfaction is not an indicator of the effectiveness of treatment and that the degree of client satisfaction varies according to the client's outlook and perspective. Apparently, there are many disadvantages of using questionnaires as a measurement method. For the collection of a young person's views, qualitative methods seem to be more effective than questionnaires.

Storytelling by community-dwelling older adults: perspectives of home care workers.

PubMed

Mastel-Smith, Beth; Binder, Brenda; Hersch, Gayle; Davidson, Harriett A; Walsh, Teresa

2011-04-01

The purpose of this exploratory, qualitative study was to investigate storytelling by home care clients to their home care workers (HCWs). Specific research questions were: (a) When does storytelling by a care recipient occur during usual care?; (b) How do HCWs engage older clients in storytelling?; (c) How do HCWs respond to the stories told by clients?; and (d) What is the perceived effect of storytelling by older clients on the relationship between the client and the HCW? Two focus groups consisting of 10 HCWs each were conducted. Verbatim transcripts of both focus groups were analyzed using the constant comparative analysis method. Categories and concepts were identified. Characteristics of the HCW and client set the stage for storytelling. The process of storytelling included context, triggers, and temporal aspects. HCWs also shared the content of stories, the impact on their relationship with the client, and the perceived effect on each individual. A visual model depicting the nature of storytelling in association with the care of older clients is presented. Copyright 2011, SLACK Incorporated.

Stakeholder perspectives on national policy for regulating the school food environment in Mexico.

PubMed

Monterrosa, Eva C; Campirano, Fabricio; Tolentino Mayo, Lizbeth; Frongillo, Edward A; Hernández Cordero, Sonia; Kaufer-Horwitz, Martha; Rivera, Juan A

2015-02-01

In Mexico, the school environment has been promoting sale of unhealthy foods. There is little empirical evidence on multi-stakeholder perspectives around national school food policy to regulate this. We studied stakeholders' perspectives on the proposed regulation for school sale of unhealthy foods. Comments about the regulation were available from an open consultation process held in June 2010 before the approval and implementation of the regulation. To examine perspectives, we coded 597 comments for beliefs, expectations and demands in NVivo. We created matrices by actors: academics, parents, citizens, health professionals and food industry. For academics, citizens and health professionals, the primary issue regarding the regulation was obesity, while for parents it was health of children. Academics, citizens, health professionals and parents believed that government was responsible for health of citizens, expected that this regulation would improve eating habits and health (i.e. less obesity and chronic diseases), and demanded that unhealthy foods be removed from schools. Parents demanded immediate action for school food policy that would protect their children. Citizens and health professionals demanded nutrition education and healthy food environment. Food industry opposed the regulation because it would not solve obesity or improve diet and physical activity behaviours. Instead, industry would lose income and jobs. Food industry demanded policy aimed at families that included nutrition education and physical activity. There was substantial consensus in narratives and perspectives for most actor types, with the primary narrative being the food environment followed by shared responsibility. Food industry rejected both these narratives, espousing instead the narrative of personal responsibility. Consensus among most actor groups supports the potential success of implementation of the regulation in Mexican schools. With regard to addressing childhood obesity, sound government policy is needed to balance different perspectives and desired outcomes among societal actors, particularly in Mexico between food industry and other actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Dentists versus auto mechanics: are there ethical differences?

PubMed

Riley, Crystal

2013-01-01

The different ethical perspectives of dentists and auto mechanics include primary concern, billing procedures, advertising, emergency care, the level of autonomy granted to their patients/ clients, the amount of disclosure given to their patients/clients, the ability to judge the work of others, and the freedom to pursue romantic relationships with their patients/clients. In analyzing these differences, one finds dentists to have much greater ethical obligations than auto mechanics. There are subtle differences between the ethical expectations of Canadian and United States dentists.

in e-mail and in chat.

PubMed

Stommel, Wyke; Van Der Houwen, Fleur

2015-01-01

In this article, we examine problem presentations in e-mail and chat counseling. Previous studies of online counseling have found that the medium (e.g., chat, email) impacts the unfolding interaction. However, the implications for counseling are unclear. We focus on problem presentations and use conversation analysis to compare 15 chat and 22 e-mail interactions from the same counseling program. We find that in e-mail counseling, counselors open up the interactional space to discuss various issues, whereas in chat, counselors restrict problem presentations and give the client less space to elaborate. We also find that in e-mail counseling, clients use narratives to present their problem and orient to its seriousness and legitimacy, while in chat counseling, they construct problem presentations using a symptom or a diagnosis. Furthermore, in email counseling, clients close their problem presentations stating completeness, while in chat counseling, counselors treat clients’ problem presentations as incomplete. Our findings shed light on how the medium has implications for counseling.

Spiritual and Sexual Identity: Exploring Lesbian, Gay, and Bisexual Clients' Perspectives of Counseling.

PubMed

Goodrich, Kristopher M; Buser, Juleen K; Luke, Melissa; Buser, Trevor J

2016-06-01

Although religious and spiritual issues have emerged as areas of focus in counseling, very few scholars have explored the meaning and experiences of lesbian, gay, and bisexual (LGB) clients who addressed their sexual and religious/spiritual identities in counseling. Using consensual qualitative research (CQR; Hill, 2012), the current study explores the perspectives of 12 LGB persons who sought counseling that involved religious/spiritual concerns. Four themes in participant interviews are identified, including (a) self-acceptance, (b) goals of counseling, (c) identification with counselor, and (d) counseling environment and relationship. Implications of findings for the counseling field are discussed.

Spiritual Needs in Health Care Settings: A Qualitative Meta-Synthesis of Clients' Perspectives

ERIC Educational Resources Information Center

Hodge, David R.; Horvath, Violet E.

2011-01-01

Spiritual needs often emerge in the context of receiving health or behavioral health services. Yet, despite the prevalence and salience of spiritual needs in service provision, clients often report their spiritual needs are inadequately addressed. In light of research suggesting that most social workers have received minimal training in…

Satisfaction with the Advertising Agency: From the Advertisers' Perspective.

ERIC Educational Resources Information Center

Salmon, Caryn C.; And Others

Based on the idea that the relationship between a client and its advertising agency is primarily a "people" relationship, a study was undertaken to examine the factors that influence a client's satisfaction with its agency, particularly in the day-to-day, or maintenance, phase of the relationship. Data were taken from responses given by…

The Impact of Collective Bargaining on Public and Client Interests in Education.

ERIC Educational Resources Information Center

Mitchell, Douglas E.

This paper proposes an analytical perspective that illuminates the major variables in the establishment of labor relations policy in education. It describes the relationships that exist between collective bargaining, the pursuit of the public interest, and the protection of client interests in the processes of schooling. The anslysis is based on…

Therapist Self-Disclosure and the Therapeutic Relationship: A Phenomenological Study from the Client Perspective

ERIC Educational Resources Information Center

Audet, Cristelle T.; Everall, Robin D.

2010-01-01

Therapist self-disclosure is gaining empirical attention amidst theoretical discourse and ethical debate, particularly with regards to its influence on the therapeutic relationship. This paper presents part of a larger qualitative study that explored client experiences of therapist self-disclosure and specifically focuses on the therapeutic…

Power and promise of narrative for advancing physical therapist education and practice.

PubMed

Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

2015-06-01

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

Therapeutic Assessment of a Violent Criminal Offender: Managing the Cultural Narrative of Evil.

PubMed

Chudzik, Lionel

2016-01-01

Therapeutic Assessment (TA) emphasizes the importance of the clinical relationship and the core values of collaboration, respect, humility, compassion, and curiosity, which guide all aspects of the endeavor (Finn, 2007 ). Those values are not easy to apply with violent offenders. However, this article explains how TA can significantly contribute to the treatment of those clients by helping the therapist avoid common cultural narratives about evil. We see that these culturally based myths permit us to explain violent behaviors, but also prevent us from treating them because they lead us to a circular countertransference-transference process. Through a clinical case, I show how the TA process can help us to work empathically with violent people while addressing the dangerousness effectively.

Client expectations and satisfaction of quality in home care services. A consumer perspective.

PubMed

Samuelsson, G; Wister, A

2000-12-01

This study examines clients' expectations of quality in home care services and their perceived satisfaction with services among a random sample of 76 home care recipients in Vancouver, Canada. The researchers conducted face-to-face interviews that applied Multiattribute Utility Technology, a procedure that organizes several quality attributes of "ideal" home care into a tree structure to compare their relative importance and ranking from the clients' perspective. Participants also were asked to state their satisfaction or dissatisfaction with the services received in these domains. Among the five main quality attributes identified, the subjects ranked suitability of the home helper and its subset, personal competence, as the most important indicators of quality, followed by continuity in service. In addition, clients tended to have a high level of satisfaction with regard to the attributes of overall home care services. The highest level of satisfaction was reported for elements of personal dispositions of home care staff. The lowest level of satisfaction involved the time/availability components of the service. Finally, comparisons between client expectations and satisfaction of received home care services showed the highest discrepancy for the attributes of influence and time/availability and the greatest congruence for personal attributes of the staff. The results are discussed in terms of their implications for the delivery of home care services.

Diversity within African American, female therapists: variability in clients' expectations and assumptions about the therapist.

PubMed

Kelly, Jennifer F; Greene, Beverly

2010-06-01

Despite the presence of some literature that has addressed the characteristics of the African American female therapist, most psychotherapy training proceeds with the assumption that therapists are members of dominant groups, and most of the psychological and psychotherapy literature has been written by therapists and psychologists who come from dominant cultural perspectives. Not as much has been written about psychological paradigms or the process of psychotherapy from the perspective of the therapist who is not a dominant group member. This article explores both the common and divergent experiences that we, the authors, share as African American female therapists and the different reactions we frequently elicit in clients. We also explore how individual differences in our physical appearances, personal backgrounds, and different characteristics of our respective practices elicit distinct responses from clients that we believe are based on differences between us, despite the fact that we are both African American women. We believe that many of the stereotypes that affect perceptions of African American female clients also exist for African American female therapists. We will address how the intersection of gender, race, and sexual orientation of the client highlights the complexity of culturally competent practice. PsycINFO Database Record (c) 2010 APA, all rights reserved.

[Narrative-based medicine and clinical knowledge].

PubMed

Saito, Seiji

2006-01-01

Narrative Based Medicine (NBM) can be defined as follows; a) It views the patient's illness as an unfolding story within the wider story of the patient's life and life-world; b) It acknowledges the patient as the narrator of the story and the subject of the tale; c) It recognizes that all medical theories, hypothesis and pathophysiologies as socially constructed narratives and accepts the coexistence of multiple different narratives; d) It regards the emergence of new stories from dialogue and discourse between patients and healthcare professionals as part of the treatment. Because psychiatry is the only area of specialist medicine where talking and listening are explicitly understood to be therapeutic, NBM can be adopted an effective perspective and method in psychiatry.

Using client feedback in psychotherapy from an interpersonal process perspective.

PubMed

Reese, Robert J; Slone, Norah C; Miserocchi, Kristin M

2013-09-01

The process of monitoring treatment outcome, also known as "client feedback," is increasingly becoming a recommended practice for psychotherapy. One concern, however, is how to integrate such a process into the work that psychotherapists typically do. Three clinical examples are presented, illustrating how a client feedback system can be used in conjunction with a specific theoretical framework, interpersonal process therapy (Teyber, 2006). The examples highlight that client feedback not only can be of minimal disruption to the psychotherapy process, but may also offer the potential to augment a clinician's approach to helping. Theoretical and research support are provided for each example. 2013 APA, all rights reserved

SocioDynamic Perspective and the Practice of Counselling.

ERIC Educational Resources Information Center

Peavy, R. Vance

SocioDynamic Counseling, a registered Canadian Trademark, is a new type of counseling created to meet the needs of a changing world. It places a greater emphasis on creativity and cooperation between counselor and client, and upon acknowledging the importance of context in counseling. The SocioDynamic perspective is both a spanning perspective and…

A cross-linguistic study of the development of gesture and speech in Zulu and French oral narratives.

PubMed

Kunene Nicolas, Ramona; Guidetti, Michèle; Colletta, Jean-Marc

2017-01-01

The present study reports on a developmental and cross-linguistic study of oral narratives produced by speakers of Zulu (a Bantu language) and French (a Romance language). Specifically, we focus on oral narrative performance as a bimodal (i.e., linguistic and gestural) behaviour during the late language acquisition phase. We analyzed seventy-two oral narratives produced by L1 Zulu and French adults and primary school children aged between five and ten years old. The data were all collected using a narrative retelling task. The results revealed a strong effect of age on discourse performance, confirming that narrative abilities improve with age, irrespective of language. However, the results also showed cross-linguistic differences. Zulu oral narratives were longer, more detailed, and accompanied by more co-speech gestures than the French narratives. The parallel effect of age and language on gestural behaviour is discussed and highlights the importance of studying oral narratives from a multimodal perspective within a cross-linguistic framework.

'If I can walk that far': space and embodiment in stories of illness and recovery.

PubMed

Heavey, Emily

2018-05-17

Illness and recovery transform embodied experience, and transform the experience of space. Space, in turn, is a valuable resource in the telling of an illness narrative. Starting from a phenomenological perspective that takes the body to be the centre of experience, and hence of selfhood and storytelling, this article offers an argument for and an approach to analysing space as a narrative resource in stories about illness and recovery. Using a case study of one woman's stories about her amputation, it demonstrates how both narrated space and narrating space can be used as devices to structure the narrative and position its characters and interlocutors to construct the narrator's embodied experiences and identities. The article reveals intersections between embodied experience, space, and narrative identity construction, offering a new way of attending to illness narratives and a new way of engaging with narrative space. © 2018 Foundation for the Sociology of Health & Illness.

Elementary Reading Specialists' Perspectives towards Their Work

ERIC Educational Resources Information Center

Bunker, Wendy Woods

2017-01-01

The purpose of this qualitative interview study was to explore the narratives of 22 elementary reading specialists about their work. It asked: What were reading specialists' narratives about their work and their influences? The study looked at reading specialists' day-to-day functioning within an institution and at reading specialists'…

Chronicles of Change: The Narrative Turn and E-Learning Research

ERIC Educational Resources Information Center

Friesen, Norm

2008-01-01

Narrative case research has been widely utilized in educational inquiry to investigate different and changing positions and perspectives on questions of identity, curriculum and classroom practice. Despite the fact that case-study research of this kind is well suited to the investigation of changing technologies and their interpretation in…

Silent Speech: Narration, Gender and Intersubjectivity in Two Young Adult Novels

ERIC Educational Resources Information Center

Hartley-Kroeger, Fiona

2011-01-01

Combining feminist and narratological perspectives, this paper examines the construction of subjectivity in two young adult novels with a range of narratorial positions. The investigation is grounded in Robyn McCallum's work on intersubjectivity, in which interrelationships affecting subjectivity are only possible when the narrative permits a…

Queer English Language Teacher Identity: A Narrative Exploration in Colombia

ERIC Educational Resources Information Center

Lander, Roderick

2018-01-01

This article presents partial results of research exploring links between language teacher identity and queer identity in English language teachers working in Colombia. Three gay male teachers participated in a narrative research project framed within a poststructural perspective on identity. I conducted and recorded semi-structured interviews…

Measuring Self-Perceptions of Oral Narrative Competencies and Anxiety in the EFL Context

ERIC Educational Resources Information Center

Faber, Gunter

2012-01-01

Introduction: Due to a considerable lack in empirical efforts and appropriate instruments, and theoretically rooted in a cognitive-motivational perspective on academic personality development, the present study analyzes a questionnaire for measuring EFL learners' self-perceptions of oral narrative competencies and perceived anxiety concerning oral…

Well-Being Narratives and Young Children

ERIC Educational Resources Information Center

Estola, Eila; Farquhar, Sandy; Puroila, Anna-Maija

2014-01-01

Whereas research on children's well-being in education has largely focused on adult perspectives rather than on children's understandings, recent scholarship argues for a stronger focus on children's experience and perceptions of their own well-being. Adopting a narrative approach, this article puts children's stories centre stage as we explore a…

Turning Tricks: Sexuality and Trickster Language in Vizenor's "The Heirs of Columbus"

ERIC Educational Resources Information Center

Lush, Rebecca M.

2012-01-01

First published in anticipation of the quincentennial of Christopher Columbus's "discovery" of the Americas, Gerald Vizenor's novel "The Heirs of Columbus" (1991) appropriates the European narrative of discovery to privilege a Native perspective that follows "trickster discourse," a mode that rejects the tragic narratives of the European…

Story-Telling and Narrative: A Neurophilosophical Perspective.

ERIC Educational Resources Information Center

Liston, Delores D.

Theories of neuroscience are presented to demonstrate the significance of storytelling and narrative to education by relating brain function to learning. A few key concepts are reviewed to establish a common working vocabulary with regard to neural networks. The tensor network theory and the neurognosis theory are described to provide…

Narratives boost entrepreneurial attitudes: Making an entrepreneurial career attractive?

PubMed

Fellnhofer, Katharina

2018-06-01

This article analyses the impact of narratives on entrepreneurial attitudes and intentions. To this end, a quasi-experiment was conducted to evaluate web-based entrepreneurial narratives. The paired-sample tests and regression analysis use a sample of 466 people from Austria, Finland, and Greece and indicate that individuals' perceptions of the desirability of entrepreneurship and entrepreneurial intention are significantly different before and after exposure to entrepreneurial narratives. Furthermore, the findings indicate that perceptions of the feasibility of entrepreneurship are more strongly affected by videos than by cases. From a policy perspective, this study raises awareness that entrepreneurship is an attractive career path.

Narrative research on mental health recovery: two sister paradigms.

PubMed

Spector-Mersel, Gabriela; Knaifel, Evgeny

2017-06-24

Despite the breadth of narrative studies on individuals with severe mental illness, the suitability of narrative inquiry to exploring mental health recovery (MHR) has not been examined. (1) Examining the appropriateness of narrative inquiry to studying MHR; (2) assessing the extent to which narrative studies on MHR conform to the unique features of narrative research, as a distinctive form of qualitative inquiry. Review of empirical, theoretical and methodological literature on recovery and narrative inquiry. Considering the perspectives of recovery and narrative as paradigms, the similarity between their ontology and epistemology is shown, evident in 10 common emphases: meaning, identity, change and development, agency, holism, culture, uniqueness, context, language and giving voice. The resemblance between these "sister" paradigms makes narrative methodology especially fruitful for accessing the experiences of individuals in recovery. Reviewing narrative studies on MHR suggests that, currently, narrative research's uniqueness, centered on the holistic principle, is blurred on the philosophical, methodological and textual levels. Well-established narrative research has major implications for practice and policy in recovery-oriented mental health care. The narrative inquiry paradigm offers a possible path to enhancing the distinctive virtues of this research, realizing its potential in understanding and promoting MHR.

Science as Story: "Communicating the Nature of Science through Historical Perspectives on Science"

ERIC Educational Resources Information Center

Wieder, Will

2006-01-01

Historical perspectives on science serve to humanize the sciences, increase student motivation, communicate academic content, and convey the nature of science. This paper briefly reviews pertinent literature regarding the history of science and narrates the author's experiences of incorporating historical perspectives in high school biology…

Enhancing nursing students' clinical experiences using aesthetics.

PubMed

Northington, Ladonna; Wilkerson, Robin; Fisher, Wanda; Schenk, Laura

2005-01-01

Traditional nursing education is based strongly in empiric knowledge. However, just as important as empiric knowledge is aesthetic knowledge. Nursing involves multiple ways of knowing, and as such, educational institutions have a responsibility to assist students in gaining knowledge in nontraditonal ways. This article describes an assignment implemented in a pediatric course in a baccalaureate nursing program. Books and movies were used in a an undergraduate nursing course to help students gain insight into illness and disability from the client and family perspective. The students in the course were required to reflect on the meaning of the movie/book and the influence the book/movie had on the student. Based on student responses, this assignment was successful in meeting the objectives originally proposed. The books and movies provided a beginning introduction to, and an appreciation for, client and family experiences. Students were helped to understand illness, abuse, disability, and/or death from the client and/or family perspective.

The therapeutic alliance in internet interventions: A narrative review and suggestions for future research.

PubMed

Berger, Thomas

2017-09-01

Research on Internet interventions has grown rapidly over the recent years and evidence is growing that Internet-based treatments often result in similar outcomes as conventional face-to-face psychotherapy. Yet there are still unanswered concerns such as whether a therapeutic alliance can be established over the Internet and whether the alliance is important in this new treatment format. A narrative review of studies formally assessing the therapeutic alliance in Internet interventions was conducted. It is the first review summarizing findings on the therapeutic alliance that (i) distinguishes between different forms of Internet interventions and (ii) does not restrict itself to specific Internet-based treatment formats such as guided self-help treatments, e-mail or videoconferencing therapies. Independent of communication modalities, diagnostic groups and amount of contact between clients and therapists, client-rated alliance scores were high, roughly equivalent to alliance ratings found in studies on face-to-face therapy. Mixed results were found regarding the therapist-rated alliance and alliance-outcome associations. The review points to the limitations of the available evidence and identifies unanswered questions. It is concluded that one of the major tasks for future research is to identify unique characteristics of the therapeutic alliance in the different treatment formats.

Street-Level Strategies of Child Welfare Social Workers in Flanders: The Use of Electronic Client Records in Practice

PubMed Central

De Witte, Jasper; Declercq, Anja; Hermans, Koen

2016-01-01

The use of information and communication technology (ICT) in child welfare services has increased significantly during the last decades, and so have the possibilities to process health data. Parton (2009) states that this evolution has led to a shift in the nature of social work itself: from ‘the social’ to ‘the informational’. It is claimed that social workers primarily are becoming information processors concerned with the gathering, sharing and monitoring of information, instead of being focused on the relational dimensions of their work. However, social workers have considerable discretion concerning the way they use ICT. In this paper, we investigate (i) the street-level strategies social workers develop regarding ICT and (ii) how these relate to a narrative social work approach. To illustrate this, an evaluation of Charlotte was conducted, a client registration system that is used by social workers in child welfare services in Flanders, Belgium. Based on fifteen interviews, we find that social workers develop various strategies regarding Charlotte to preserve a relational and narrative work approach. These strategies not only result in a gap between ICT policy and the execution of that policy in practice, but also decrease the extent to which accountability can be realised via registration data. PMID:27559226

Street-Level Strategies of Child Welfare Social Workers in Flanders: The Use of Electronic Client Records in Practice.

PubMed

De Witte, Jasper; Declercq, Anja; Hermans, Koen

2016-07-01

The use of information and communication technology (ICT) in child welfare services has increased significantly during the last decades, and so have the possibilities to process health data. Parton (2009) states that this evolution has led to a shift in the nature of social work itself: from 'the social' to 'the informational'. It is claimed that social workers primarily are becoming information processors concerned with the gathering, sharing and monitoring of information, instead of being focused on the relational dimensions of their work. However, social workers have considerable discretion concerning the way they use ICT. In this paper, we investigate (i) the street-level strategies social workers develop regarding ICT and (ii) how these relate to a narrative social work approach. To illustrate this, an evaluation of Charlotte was conducted, a client registration system that is used by social workers in child welfare services in Flanders, Belgium. Based on fifteen interviews, we find that social workers develop various strategies regarding Charlotte to preserve a relational and narrative work approach. These strategies not only result in a gap between ICT policy and the execution of that policy in practice, but also decrease the extent to which accountability can be realised via registration data.

Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia.

PubMed

Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha

2016-01-01

Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.

Companion animal veterinarians' use of clinical communication skills.

PubMed

McArthur, M L; Fitzgerald, J R

2013-09-01

To describe the communication techniques used by clients and veterinarians during companion animal visits in Australia. A cross-sectional descriptive study. A total of 64 veterinary consultations were audiotaped and analysed with the Roter Interaction Analysis System (RIAS); clients completed appointment level measures, including their satisfaction and perceptions of relational communication. Participants were 24 veterinarians and 64 clients. Statements intended to reassure clients were expressed frequently in the consultations, but in 59% of appointments empathy statements were not expressed towards either the client or the patient. In 10% of appointments, veterinarians did not used any open-ended questions. Overall client satisfaction was high and veterinarians' expressions of empathy directed to the client resulted in higher levels of client satisfaction. Clients' perceptions of relational communication were related to several veterinarian and client nonverbal scales. A focus on developing evidence-based clinical communication skills is expected to further enhance the veterinarian-client-patient relationship and associated clinical outcomes. Particular recommendations include the development of a broader emotion-handling repertoire, increased emphasis on the use of open-ended enquiry, including assessment of the client's perspective, as well as attention to aspects of nonverbal communication. The study provides preliminary evidence for the importance of verbal expressions of empathy during the companion animal consultation. © 2013 Australian Veterinary Association.

Triads in Equine-Assisted Social Work Enhance Therapeutic Relationships with Self-Harming Adolescents.

PubMed

Carlsson, Catharina

2017-01-01

Despite an increasing number of studies, there is still a lack of knowledge about the unique features that underlie the process in equine assisted social work (EASW). This study aimed to reveal, through qualitative methods, the dyads within the triad that become stronger during the process of EASW, as well as the effect of the participation of the horse on the relationship between the counselor and client. Data were collected through in-depth interviews with nine female self-harming clients aged 15-21 years and eight staff members. The interviews, together with video-recorded human-horse interactions with three staff members and four clients were analyzed, resulting in additional issues answered by these three staff members and four clients in a second interview. Critical dialogues between patterns and fragmentations in the narratives and video-recordings, as well as a dialogue with the participants while they were viewing videos of their own EASW sessions, led to the conclusion that adding a horse qualitatively changes therapeutic relationships in EASW. The different triads consist of different liaisons between actors in the triad, giving rise to unique combinations. The quality of the relationships depends on both the staff and the clients' attachment orientations. Further research is needed to investigate how the degree of emotional connection to the horse affects the impact that horses have on triads in EASW.

The Client Company Marginally Utilises the Knowledge of Highly Skilled Temporary Staff

ERIC Educational Resources Information Center

Augustsson, Gunnar

2016-01-01

This study is based on the presumption that there is often an underuse of temporary staff in client companies (CC) with highly skilled professionals. The study combines theories of the flexible organisation and a sociocultural perspective on learning within the framework of an inter-organisational context. The data are based partly on 17…

A Bending Willow Tree: A Japanese (Morita Therapy) Model of Human Nature and Client Change.

ERIC Educational Resources Information Center

Ishiyama, F. Ishu

2003-01-01

Japanese Morita therapy is discussed to highlight its culturally and theoretically unique perspectives on human nature and client change. Key features of this theory are: theory of the nervous trait; multiple-dimensional model of causes and treatment of nervous neurosis; theory of mental attachment; reframing anxiety into constructive desires; and…

Perceived Barriers and Facilitators to Positive Therapeutic Change for People with Intellectual Disabilities: Client, Carer and Clinical Psychologist Perspectives

ERIC Educational Resources Information Center

Ramsden, Sarah; Tickle, Anna; Dawson, David L.; Harris, Samantha

2016-01-01

Studies have highlighted successful outcomes of psychological therapies for people with intellectual disabilities. However, processes underlying these outcomes are uncertain. Thematic analysis was used to explore the perceptions of three clinical psychologists, six clients and six carers of barriers and facilitators to therapeutic change for…

Case of the Drunken Holon: An Integral Performative Co-Inquiry

ERIC Educational Resources Information Center

Fisher, R. Michael; Davis, Tess

2012-01-01

A postmodern and integral co-inquiry led by the authors, with Lucinda as "client," offered a unique unconventional and postconventional perspective on a client's case review. Utilizing integral theory (Wilber) as a guideline for a theory of holons and change, the co-investigators reflect upon and trans(per)form a learning experiment around the…

Counter-responses as organizers in adolescent analysis and therapy.

PubMed

Richmond, M Barrie

2004-01-01

The author introduces Counter-response as a phenomological term to replace theory-burdened terms like counter-transference, counter-identification, and counter-resistance. He discusses the analyst's use of self (drawing on the comparison with Winnicott's use of the object) in processing the expectable destabilizing counter-reactions that occur in working therapeutically with disturbed adolescents and their parents. Further; he discusses the counter-reaction to the patient's narrative, acting-out, and how re-enactments can serve as an organizer for understanding the patient's inner life when the analyst formulates his/her counter-response. Emphasis is placed on the therapist forming his or her own narrative with the adolescent that takes into account the evoked counter-reaction. For this purpose, the author recommends the use of a combined counter-response and metaphor-orienting perspective to acknowledge and work with the denial, illusions, reversal of perspective, and catastrophic anxieties experienced with these adolescents. The counter-response perspective permits the emergence of the disturbed adolescent's novel narrative; however, since these experiences can be destabilizing or disruptive, the author also recommends the use of a personal metaphor to anticipate the reluctance to examining, processing, and formulating the analyst's dysphoric counter-reaction. With the use of the counter-response, the analyst's therapeutic ideal is to achieve a more optimal balance between using accepted narrative theories and exploring novel enactment experiences. His swimming metaphor stratagem is designed to keep the analyst in these difficult encounters.

The architect's perspective on the tour and map perspective.

PubMed

Papadopoulou, Athina

2015-09-01

Literature in linguistics suggests that when people are asked to provide an oral spatial description, they usually provide a body-centered narrative; they adopt a Tour Perspective, that is, an imaginary tour of the space rather than a Map Perspective, that is, a description focused on spatial relations as seen from above (Linde and Labov in Language 51(1):924-939, 1975; Howald in Discursive constraints on space in narrative: evidence from guilty plea discourse, eVox 3, 2009). I conducted a pilot experiment to address the following questions: Does the formal knowledge of architects--their familiarity with plan drawings and maps--override the tendency to adopt the tour perspective? Does the tour perspective depend on the actual experience of space? Twenty-two graduate students in architecture were asked to respond to the following questions: (1) "Can you describe the layout of your apartment?" (2) "Can you describe the layout of an ideal apartment?" In the responses to the first question most participants used the tour perspective. In the responses to the second question most participants used the map perspective. The results provide evidence that architects' formal knowledge does not override the preference of the tour perspective in descriptions of experienced space. Moreover, that the tour perspective is associated with the actual experience of space.

Communication--a core concept in client supervision by public health nurses.

PubMed

Tveiten, Sidsel; Severinsson, Elisabeth

2006-04-01

The aim of this study was to explore public health nurses' reflections on client supervision. Reflection on actions represents a possible basis for constructing and refining assumptions on current theories used in practice thus making knowledge development possible. Transcript-based qualitative content analysis was used to analyse the findings from individual interviews with 13 female public health nurses. Communication is a core concept of client supervision by public health nurses and includes the following themes: (1) building a trusting relationship, (2) looking beyond the current situation, (3) creating a partnership and equality and (4) considering the challenge involved in trying to act in the clients' best interests. This study shows that public health nurses' reflection and reflecting related to their provision of client supervision revealed one possible assumption regarding their theories-in-use; communication is a core concept in client supervision. Communication is viewed from a hermeneutic perspective--as the meaning of the interaction between the public health nurses and the client in the supervision is reflected upon and interpreted.

The 1925 Fort Union Indian Congress: Divergent Narratives, One Event

ERIC Educational Resources Information Center

Blee, Lisa

2007-01-01

This essay investigates how various perspectives differ and converge in the span of an afternoon, thus illustrating how divergent narratives, through their very difference, enhance one's understanding of the past. The case study of the 1925 Fort Union Indian Congress points to the process of narrativizing experience and underscores how meaning is…

Short Research Report: Exploring Resilience Development in a Taiwanese Preschooler's Narrative--An Emerging Theoretical Mode

ERIC Educational Resources Information Center

Lin, Kuan-Ling Olivia

2016-01-01

It is important to foster resilience in early childhood as this quality is, according to this author, "an individual's progressing development to adjust to life difficulties." This narrative study provides a cultural perspective by investigating a Taiwanese context and shifts the attention to preschoolers' resilience development in both…

Narratives from the Road to Social Justice in PETE: Teacher Educator Perspectives

ERIC Educational Resources Information Center

Dowling, Fiona; Fitzgerald, Hayley; Flintoff, Anne

2015-01-01

Developing teacher education programmes founded upon principles of critical pedagogy and social justice has become increasingly difficult in the current neoliberal climate of higher education. In this article, we adopt a narrative approach to illuminate some of the dilemmas which advocates of education for social justice face and to reflect upon…

Education, Language, and Identity: A Narrative Inquiry on Perspectives in Rural South Africa

ERIC Educational Resources Information Center

O'Donnell, Kristie

2017-01-01

This qualitative study takes a narrative approach to inquiring into the lived experiences of linguistically diverse students. As students are often placed into developmental education courses due to factors that point back to their linguistic diversity, scholarly literature demonstrates a need for inquiry that informs both research and practice.…

Fostering Wakefulness: Narrative as a Curricular Tool in Teacher Education

ERIC Educational Resources Information Center

Blair, Deborah V.

2009-01-01

In a music education graduate class addressing teaching and learning strategies for learners with special needs, teachers were invited to consider the experience of the children in their music classrooms. Using narrative to enter into the learner's experience of school, teachers confronted their own perspectives and reconsidered those of their…

Suicide and Suicide Prevention: Greek versus Biblical Perspectives.

ERIC Educational Resources Information Center

Kaplan, Kalman J.

1992-01-01

Compares suicide in Greek tragedy and Hebrew Bible, concentrating on life situations portrayed in two sets of narratives promoting or preventing suicide. Notes frequency of suicides in Greek tragedy and infrequency of suicides in Bible. Compares stories of Narcissus and Jonah in attempt to pinpoint what is suicide-promoting in Greek narratives and…

An Autobiographical Narrative towards Critical Practitioner Inquiry and a Counter Hegemonic Southern Network

ERIC Educational Resources Information Center

Dahlström, Lars

2016-01-01

This paper is an autobiographical narrative to demonstrate how educational practices and ideas travel through time. It demonstrates how pedagogy based on solidarity and counter hegemonic ideas combined with scholastic perspectives build coherent practices in different social contexts. The work as a teacher, teacher educator, and researcher in…

Young African American Boys Narrating Identities in Science

ERIC Educational Resources Information Center

Kane, Justine M.

2016-01-01

The goal of this study is to bring the voices of African American boys front and center in science education research in an effort to strengthen our understandings of their experiences of school and science. Using an interpretivist perspective within a narrative inquiry approach, I focus on the student and science-student identities two African…

Between Continuity and Change: Identities and Narratives within Teacher Professional Development

ERIC Educational Resources Information Center

Curwood, Jen Scott

2014-01-01

This year-long ethnographic case study examined high school teachers' participation in technology-focused professional development. By pairing a dialogical perspective on teacher identity with a micro-level analysis of narratives, findings indicate that teachers use language and other semiotic resources to express their own identity as well as to…

Narrating a Critical Indigenous Pedagogy of Place: A Literary Métissage

ERIC Educational Resources Information Center

Lowan-Trudeau, Gregory

2017-01-01

This essay responds to a persistent paucity of narrative and Indigenous perspectives in scholarship related to a critical pedagogy of place. In it Gregory Lowan-Trudeau explores interrelated concepts such as diasporic indigeneity, identity, and critical, place-based education and research through a literary métissage that weaves together Western…

Understanding Principal Leadership: An International Perspective and a Narrative Approach

ERIC Educational Resources Information Center

Slater, Charles L.

2011-01-01

This article reviews recent literature in educational administration that supports the argument that leadership matters. School principals exert influence on teachers, who in turn affect student achievement. There is a need for an international approach both to replicate large studies and to use a narrative approach to study leaders in their…

Making Sense of HIV in Southeastern Nigeria Fictional Narratives, Cultural Meanings, and Methodologies in Medical Anthropology

PubMed Central

Winskell, Kate; Brown, Peter J.; Patterson, Amy E.; Burkot, Camilla; Mbakwem, Benjamin C.

2018-01-01

Fictional narratives have rarely been used in medical anthropological research. This article illustrates the value of such narratives by examining how young people in southeastern Nigeria navigate the cultural resources available to them to make sense of HIV in their creative writing. Using thematic data analysis and narrative-based methodologies, it analyzes a sample (N = 120) from 1,849 narratives submitted by Nigerian youth to the 2005 Scenarios from Africa scriptwriting contest on the theme of HIV. The narratives are characterized by five salient themes: tragedy arising from the incompatibility of sex outside marriage and kinship obligations; female vulnerability and blame; peer pressure and moral ambivalence; conservative Christian sexual morality; and the social and family consequences of HIV. We consider the strengths and limitations of this narrative approach from a theoretical perspective and by juxtaposing our findings with those generated by Daniel Jordan Smith using standard ethnographic research methods with a similar Igbo youth population. [HIV, Igbo, youth, narrative, methodology] PMID:23804317

Linguistic and pragmatic aspects of narration in Finnish typically developing children and children with specific language impairment.

PubMed

Mäkinen, Leena; Loukusa, Soile; Laukkanen, Päivi; Leinonen, Eeva; Kunnari, Sari

2014-06-01

This study investigates narratives of Finnish children with specific language impairment (SLI) from linguistic and pragmatic perspectives, in order to get a comprehensive overview of these children's narrative abilities. Nineteen children with SLI (mean age 6;1 years) and 19 typically developing age-matched children participated in the study. Their picture-elicited narrations were analysed for linguistic productivity and complexity, grammatical and referential accuracy, event content, the use of mental state expressions and narrative comprehension. Children with SLI showed difficulties in every aspect of narration in comparison to their peers. Only one measure of productivity, the number of communication units, did not reach statistical significance. Not only was linguistic structure fragile but also pragmatic aspects of storytelling (referencing, event content, mental state expressions and inferencing) were demanding for children with SLI. Results suggest that pragmatic aspects of narration should be taken into account more often when assessing narrative abilities of children with SLI.

Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

PubMed Central

Layer, Erica H.; Kennedy, Caitlin E.; Beckham, Sarah W.; Mbwambo, Jessie K.; Likindikoki, Samuel; Davis, Wendy W.; Kerrigan, Deanna L.; Brahmbhatt, Heena

2014-01-01

Progression through the HIV continuum of care, from HIV testing to lifelong retention in antiretroviral therapy (ART) care and treatment programs, is critical to the success of HIV treatment and prevention efforts. However, significant losses occur at each stage of the continuum and little is known about contextual factors contributing to disengagement at these stages. This study sought to explore multi-level barriers and facilitators influencing entry into and engagement in the continuum of care in Iringa, Tanzania. We used a mixed-methods study design including facility-based assessments and interviews with providers and clients of HIV testing and treatment services; interviews, focus group discussions and observations with community-based providers and clients of HIV care and support services; and longitudinal interviews with men and women living with HIV to understand their trajectories in care. Data were analyzed using narrative analysis to identify key themes across levels and stages in the continuum of care. Participants identified multiple compounding barriers to progression through the continuum of care at the individual, facility, community and structural levels. Key barriers included the reluctance to engage in HIV services while healthy, rigid clinic policies, disrespectful treatment from service providers, stock-outs of supplies, stigma and discrimination, alternate healing systems, distance to health facilities and poverty. Social support from family, friends or support groups, home-based care providers, income generating opportunities and community mobilization activities facilitated engagement throughout the HIV continuum. Findings highlight the complex, multi-dimensional dynamics that individuals experience throughout the continuum of care and underscore the importance of a holistic and multi-level perspective to understand this process. Addressing barriers at each level is important to promoting increased engagement throughout the continuum. PMID:25119665

Failures of reproduction: problematising 'success' in assisted reproductive technology.

PubMed

Peters, Kathleen; Jackson, Debra; Rudge, Trudy

2007-06-01

This paper scrutinises the many ways in which 'success' is portrayed in representing assisted reproductive technology (ART) services and illuminates how these definitions differ from those held by participant couples. A qualitative approach informed by feminist perspectives guided this study and aimed to problematise the concept of 'success' by examining literature from ART clinics, government reports on ART, and by analysing narratives of couples who have accessed ART services. As many ART services have varying definitions of 'success' and as statistics are manipulated to promote further patronage of ART services, the likelihood of 'success' is often overstated. This paper is concerned with the effects this promotion has on the participants. We suggest that this very mobilisation of statistical success changes the ability of those who access ART services to make productive decisions about themselves inside these treatment regimes, as the basis for decision-making is hidden by the way numbers, objectivity and clinical reasoning operate to maintain participation in the program. In such an operation, the powerful mix of hope and technology kept participants enrolled far longer than they originally planned. Moreover, how success rates are manipulated raises ethical issues for all involved: clients, counsellors, and nursing and medical professionals.

A tool to enhance occupational therapy reasoning from ICF perspective: The Hasselt Occupational Performance Profile (H-OPP).

PubMed

Ghysels, R; Vanroye, E; Westhovens, M; Spooren, A

2017-03-01

In order to enhance occupational therapy reasoning in clinical practice, different elements such as client-centred approach, evidence-based care and interdisciplinary work should be taken into account, but is a challenge. To describe the development of the digital Hasselt Occupational Performance Profile (H-OPP © ) that enhances occupational therapy reasoning from ICF perspective. A participative qualitative design was used to create the H-OPP © in an iterative way in which occupational therapy lectures, ICF experts, students and occupational therapists in the field were involved. After linking occupational therapy terminology to the ICF, different stages of the H-OPP were identified and elaborated with main features: generating an occupational performance profile based on inventarization of problems and possibilities, formulating an occupational performance diagnosis and enabling to create an intervention plan. In all stages, both the perspectives of the client and the occupational therapist were taken into account. To increase practical use, the tool was further elaborated and digitalized. The H-OPP © is a digital coach that guides and facilitates professional reasoning in (novice) occupational therapists. It augments involvement of the client system. Furthermore, it enhances interdisciplinary communication and evidence-based care.

Haemodialysing at home: the client experience of self-treatment.

PubMed

Polaschek, N

2005-01-01

This paper reports a study that sought to describe the experience of people using home haemodialysis as their modality of renal replacement therapy. The study employed a critical interpretive methodology. After developing a framework for the research, a small group of renal clients who haemodialyse themselves in their own homes were intensively interviewed. This study describing the renal client perspective indicates that, although more demanding for them than in-centre treatment, self-treatment at home can enable a superior quality of life for many people living on dialysis.

Substance Abuse and Counseling: An Epilogue.

ERIC Educational Resources Information Center

Sales, Amos

This chapter discusses current issues and future perspectives in relation to substance abuse counseling. Current issues include: abstinence versus controlled use; coercive versus voluntary treatment; and career development and counseling with clients with substance abuse problems. Future perspectives include: the impact of managed care; the…

Saying good goodbyes to your clients: A functional analytic psychotherapy (FAP) perspective.

PubMed

Tsai, Mavis; Gustafsson, Tore; Kanter, Jonathan; Plummer Loudon, Mary; Kohlenberg, Robert J

2017-03-01

Functional analytic psychotherapy (FAP) promotes client growth by shaping clients' daily life problems that also show up in session with their therapists. FAP therapists create evocative contexts within therapy that afford clients the opportunity to practice, refine, and be reinforced for new, more adaptive behaviors which then can be generalized into their outside lives. In FAP, the termination process will vary from client to client depending on the nature of the client's problems and targets. For many clients, the process can be a rich, multifaceted, final opportunity to evoke, reinforce, and promote generalization of clients' in-session improvements, particularly improvements related to vulnerable self-expression in the service of intimate and close relationships. By making explicit agreements at the outset of therapy to participate in an intentional termination process, and by later providing an evocative structure for ending therapy with vulnerable emotional expression, clients have the opportunity to develop more adaptive behaviors in the context of relationship endings which can be a painful part of the human experience. Equipped with the skills of open-hearted communication developed from an authentic relationship with their therapist, clients can leave therapy on a trajectory of further growth in interpersonal connection and living more boldly. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Working across Our Differences--Perspectives on Oppression.

ERIC Educational Resources Information Center

Brooks, Catherine; And Others

1993-01-01

Four narratives present perspectives of a white woman working in Botswana, a black South African man studying in Canada, a nonnative woman working in a northern Canada native community, and a Canadian aboriginal woman working with native women. (SK)

Narratives boost entrepreneurial attitudes: Making an entrepreneurial career attractive?†

PubMed Central

2018-01-01

Abstract This article analyses the impact of narratives on entrepreneurial attitudes and intentions. To this end, a quasi‐experiment was conducted to evaluate web‐based entrepreneurial narratives. The paired‐sample tests and regression analysis use a sample of 466 people from Austria, Finland, and Greece and indicate that individuals’ perceptions of the desirability of entrepreneurship and entrepreneurial intention are significantly different before and after exposure to entrepreneurial narratives. Furthermore, the findings indicate that perceptions of the feasibility of entrepreneurship are more strongly affected by videos than by cases. From a policy perspective, this study raises awareness that entrepreneurship is an attractive career path. PMID:29863170

Is ownership the decisive factor in collaborations between occupational health services and client companies?

PubMed

Schmidt, Lisa; Sjöström, John; Antonsson, Ann-Beth

2017-01-01

Swedish employers are required to use external resources such as Occupational Health Services (OHS providers) if their own knowledge of occupational health and safety is insufficient. Some large employers have their own in-house OHS units but it is more common to engage the services of an external provider. However, no studies have been carried out from a critical perspective regarding how ownership of the OHS provider is related to a successful collaboration with client companies. This study explores the extent to which the six key factors for a successful collaboration are related to ownership and seeks to identify the challenges that the different models of ownership pose. Interviews with 15 client companies and their OHS providers were conducted in order to identify key factors in achieving a successful collaboration with an OHS provider. This study utilizes existing data to identify challenges related to ownership. Two key factors were identified with challenges related to ownership of the OHS provider: The importance of having a long-term perspective when building a relationship; and ensuring that collaboration extends beyond the client's HR Department to the various organisational levels of the company. Whatever form the ownership of an OHS provider may take, each comes with its own specific set of challenges that must be managed in order to achieve a successful collaboration with the client company.

Family Planning Programs: The Clients' Perspective. World Bank Staff Working Papers No. 676 and Population and Development Series No. 1.

ERIC Educational Resources Information Center

Ainsworth, Martha

Lowering fertility will require both a reduction in desired family size and provision of family planning services that respond to clients' needs. The World Fertility Survey and the Contraceptive Prevalence Survey found sizable groups of women with an "unmet need" for contraception. Investigators have also found evidence of unanswered…

Work in the Lives of Social Work Clients: Perspectives of Field Instructors

ERIC Educational Resources Information Center

Root, Lawrence S.; Choi, Y. Joon

2011-01-01

Although employment is central to the lives of social work clients, it is seldom a focus in social work education. The authors conducted a survey of field instructors in a large MSW program to assess the importance of work-related issues in the lives of those they serve in their social service agencies. This experienced group of practitioners…

Measuring Perceptions of Romantic Love from Three Theoretical Perspectives: Implications for Counseling.

ERIC Educational Resources Information Center

Davenport, Donna; And Others

Love is an issue raised with some frequency by counseling clients. Research investigating the nature of love may be useful in providing a framework that counselors can use to conceptualize the signs and symptoms of clients who present with relationship issues when seeking help. This study was conducted to examine the nature of love as measured by…

Race, Color-Blind Racial Attitudes, and Judgments About Mental Health: A Shifting Standards Perspective

ERIC Educational Resources Information Center

Gushue, George V.

2004-01-01

A fictitious counseling center intake report was given to a sample of 158 White graduate students in counseling and clinical psychology to examine the impact of reported client race (Black or White) on perceptions of clients' symptom severity. As predicted by the shifting standards model of social judgment (M. Biernat, M. Manis, & T. E. Nelson,…

What, Why, How - Creative Activities in Occupational Therapy Practice in Sweden.

PubMed

Müllersdorf, Maria; Ivarsson, Ann-Britt

2016-12-01

Creative activities have historically been used in occupational therapy, and although their usage has declined in recent decades, they are still used in Swedish practice. The aim of this study was to better understand how occupational therapists use creative activities in practice. A web-based survey was sent to 520 occupational therapists, of which 304 (58.5%) responded. The main reason identified for using creative activities was to strengthen the client's occupational performance, well-being and self-esteem. The expected outcomes of applying creative activities were to support the client in self-expression and experiencing joy and desire. More than half of the occupational therapist respondents did not use creative activities to the extent they desired. Creative activities in occupational therapy are still used as a vital treatment to strengthen the clients' occupational performance abilities. The survey has looked at only a professional perspective on effectiveness of applying creative activities in occupational therapy. More research is needed to evaluate how occupational therapists internationally apply creative activities. There is also a need to gain information from the client's perspective on the therapeutic value of creative activities. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Social exchange as a framework for client-nurse interaction during public health nursing maternal-child home visits.

PubMed

Byrd, Mary E

2006-01-01

The purpose of this paper was to develop a nursing-focused use of social exchange theory within the context of maternal-child home visiting. The nature of social exchange theory, its application to client-nurse interaction, and its fit with an existing data set from a field research investigation were examined. Resources exchanged between the nurse and clients were categorized and compared across the patterns of home visiting, nursing strategies based on exchange notions were identified, and variations in exchange were linked with client outcomes. The nurse provided resources within the categories of information, status, service, and goods. Clients provided time, access to the home, space within the home to conduct the visit, opportunities to observe maternal-child interaction, access to the infant, and information. The ease and breadth of resource exchange varied across the patterns of home visiting. The social exchange perspective was useful in categorizing resources, specifying and uncovering new resource categories, understanding nursing strategies to initiate and maintain the client-nurse relationship, and linking client-nurse interactive phenomena with client outcomes. Social exchange theory is potentially useful for understanding client-nurse interaction in the context of maternal-child home visits.

A Chronological Perspective on Suicide--The Last Days of Life

ERIC Educational Resources Information Center

Orbach, I.; Gilboa-Schechtman, E.; Ofek, H.; Lubin, G.; Mark, M.; Bodner, E.; Cohen, D.; King, R.

2007-01-01

A combined psychological autopsy and narrative approach was used to study the completed suicides of 67 Israeli soldiers. Three issues were addressed. First, the authors examined the typology of the life narratives of suicide completed during active army duty. Second, focusing on the last 3 weeks of the soldiers' lives, they sought to examine their…

Polymorphous Narrative of Gothic Tradition in Linguistic Perspective: Comparing Fiction and Opera Libretto

ERIC Educational Resources Information Center

Ihina, Zoia

2015-01-01

This article is dedicated to revealing linguistic means that realise "the event" in the gothic narrative--H. James's novella "The Turn of the Screw" and the opera libretto of the same name. The event is treated as a situational change of states and presupposes that "the real" and "the unknown" should meet.…

New Perspective on Visual Communication Design Education: An Empirical Study of Applying Narrative Theory to Graphic Design Courses

ERIC Educational Resources Information Center

Yang, Chao-Ming; Hsu, Tzu-Fan

2017-01-01

Visual communication design (VCD) is a form of nonverbal communication. The application of relevant linguistic or semiotic theories to VCD education renders graphic design an innovative and scientific discipline. In this study, actual teaching activities were examined to verify the feasibility of applying narrative theory to graphic design…

Toward Embracing Multiple Perspectives in World History Curricula: Interrogating Representations of Intercultural Exchanges between Ancient Civilizations in Quebec Textbooks

ERIC Educational Resources Information Center

Abdou, Ehaab D.

2017-01-01

Guided by critical discourse analysis, this study analyzes how ancient civilizations are constructed in high school history textbooks used in Quebec, Canada. The findings suggest that the narrative generally ignores 2-way intercultural exchanges. The narrative is also Eurocentric, silencing sub-Saharan Africa's contributions and nonmaterial…

Knowledge of Love: Narratives of Romance Told by 12-Year-Old Children

ERIC Educational Resources Information Center

Haldar, Marit

2013-01-01

This article reports research on young people's conceptualisations of love and romance through a gender perspective. The data are stories written by 12-year-old girls and boys in Norway who were asked to fantasise about their future love life. Their narratives are explored through discourse analysis and semiotics and analysed within a sociological…

Understanding Teacher Identity from a Symbolic Interactionist Perspective: Two Ethnographic Narratives

ERIC Educational Resources Information Center

Smit, Brigitte; Fritz, Elzette

2008-01-01

In this ethnographic inquiry we portray two teacher narratives reflecting educational change in the context of two South African schools. The study was conducted as part of a larger inquiry into ten schools in urban South Africa. A decade of democracy begs some attention to educational progress and reform, from the viewpoint of teachers and with…

Why School-Based Narrative Inquiry in Physical Education Research? An International Perspective

ERIC Educational Resources Information Center

Craig, Cheryl J.; You, JeongAe; Oh, Suhak

2012-01-01

While conducting a comparative research study in secondary Physical Education in South Korea and the United States, the question arose as to why the narrative inquiry research method we employed was chosen to study the experiences of teachers teaching the particular subject area to youth enrolled in four secondary schools (middle and high) in…

"And We Told Wonderful Stories Also": Reflections on a Preschool Language Game To Promote Narrative Development.

ERIC Educational Resources Information Center

Mardell, Benjamin

Using a teacher-researcher perspective, a study assessed a preschool storytelling program designed to promote children's narrative development. The program included workshops, child-teacher conferences, and adult and child performances. A preschool class of 17 four-year-olds listened to adult-told stories, rehearsed their own stories with a…

The quest for connection in interpersonal and therapeutic relationships.

PubMed

Wiseman, Hadas

2017-07-01

This paper focuses on the need for connection as a common core theme at the heart of both close relationships and therapeutic relationships and explores ways to connect these two research domains that have evolved as separate fields of study. Bowlby's attachment theory provides a strong conceptual and empirical base for linking human bonds and bonds in psychotherapy. The growing body of research intersecting attachment and psychotherapy (1980-2014) is documented, and meta-analytic studies on attachment-outcome and attachment-alliance links are highlighted. Five ways of studying attachment as a variable in psychotherapy are underscored: as moderator, as mediator, as outcome, client-therapist attachment match, and as process. By integrating conceptualizations and methods in studying relational narratives of client-therapist dyads (Core Conflictual Relationship Theme), measures of alliance, and client attachment to therapist during psychotherapy, we may discover unique client-therapist relational dances. Future fine-grained studies on how to promote core authentic relational relearning are important to clinicians, supervisors and trainers, who all share the common quest to alleviate interpersonal distress and enhance wellbeing. Directions for advancing research on interpersonal and therapeutic relationships are suggested. Learning from each other, both researchers of close relationships and of psychotherapy relationships can gain a deeper and multidimensional understanding of complex relational processes and outcomes.

Social and Gendered Readings of Illness Narratives.

PubMed

Lederman, Muriel

2016-09-01

This essay recognizes that the interactions that define medical care are problematic and that narrative is invoked to overcome these strains. Being grounded in science, medicine, too, might be influenced by a particular world-view that arose in the natural philosophy of the Scientific Revolution. If narrative responds to this sort of medicine, it may retain traces of this mindset. A feminist approach responds to this viewpoint and may used beneficially to analyze both the story of medicine and the stories within medicine. Tensions discussed from this perspective are those between sickness and health and those between patient and provider; also questioned are suitable form(s) of narrative and whose narratives are valued. Suggestions for broadening narrative to address these issues include letting the body speak for itself, overcoming the power differential in the patient/provider interaction and using standpoints to foster a more equal and just medical system.

Analyzing women's roles through graphic representation of narratives.

PubMed

Hall, Joanne M

2003-08-01

A 1992 triangulated international nursing study of women's health was reported. The researchers used the perspectives of feminism and symbolic interactionism, specifically role theory. A narrative analysis was done to clarify the concept of role integration. The narrative analysis was reported in 1992, but graphic/visual techniques used in the team dialogue process of narrative analysis were not reported due to space limitations. These techniques have not been reported elsewhere and thus remain innovative. Specific steps in the method are outlined here in detail as an audit trail. The process would be useful to other qualitative researchers as an exemplar of one novel way that verbal data can be abstracted visually/graphically. Suggestions are included for aspects of narrative, in addition to roles, that could be depicted graphically in qualitative research.

Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada—a qualitative study

PubMed Central

Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

2014-01-01

Objectives To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers’ working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Design Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Setting Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers’ safety over arrest, while continuing to target clients. Participants 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Outcome measures Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers’ working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January–November 2013). Results Sex workers’ narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants’ accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. Conclusions These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. PMID:24889853

Understanding physical activity participation in spinal cord injured populations: Three narrative types for consideration

PubMed Central

Papathomas, Anthony; Williams, Toni L.; Smith, Brett

2015-01-01

The aim of this study was to identity the types of physical activity narratives drawn upon by active spinal injured people. More than 50 h of semi-structured life-story interview data, collected as part of larger interdisciplinary program of disability lifestyle research, was analysed for 30 physically active male and female spinal cord injury (SCI) participants. A structural narrative analysis of data identified three narrative types which people with SCI draw on: (1) exercise is restitution, (2) exercise is medicine, and (3) exercise is progressive redemption. These insights contribute new knowledge by adding a unique narrative perspective to existing cognitive understanding of physical activity behaviour in the spinal cord injured population. The implications of this narrative typology for developing effective positive behavioural change interventions are critically discussed. It is concluded that the identified narratives types may be constitutive, as well as reflective, of physical activity experiences and therefore may be a useful tool on which to base physical activity promotion initiatives. PMID:26282868

The relationship between clinician turnover and adolescent treatment outcomes: An examination from the client perspective

PubMed Central

Garner, Bryan R.; Funk, Rodney R.; Hunter, Brooke D.

2012-01-01

The turnover of substance use disorder (SUD) treatment staff has been assumed to adversely impact treatment effectiveness, yet only limited research has empirically examined this assumption. Representing an extension of prior organizational-level analyses of the impact of staff turnover on client outcomes, this study examined the impact of SUD clinician turnover on adolescent treatment outcomes using a client perspective. Multilevel regression analysis did reveal that relative to those adolescents who did not experience clinician turnover, adolescents who experienced both direct and indirect clinician turnover reported a significantly higher percentage of days using alcohol or drugs at 6-month follow-up. However, clinician turnover was not found to have significant associations (negative or positive) with the other five treatment outcomes examined (e.g., substance-related problems, involvement in illegal activity). Thus, consistent with our prior findings, the current study provides additional evidence that turnover of SUD clinicians is not necessarily associated with adverse treatment outcomes. PMID:23083980

Temporal Immediacy: A Two-System Theory of Mind for Understanding and Changing Health Behaviors.

PubMed

Cook, Paul F; Schmiege, Sarah J; Reeder, Blaine; Horton-Deutsch, Sara; Lowe, Nancy K; Meek, Paula

Health promotion and chronic disease management both require behavior change, but people find it hard to change behavior despite having good intentions. The problem arises because patients' narratives about experiences and intentions are filtered through memory and language. These narratives inaccurately reflect intuitive decision-making or actual behaviors. We propose a principle-temporal immediacy-as a moderator variable that explains which of two mental systems (narrative or intuitive) will be activated in any given situation. We reviewed multiple scientific areas to test temporal immediacy as an explanation for findings. In an iterative process, we used evidence from philosophy, cognitive neuroscience, behavioral economics, symptom science, and ecological momentary assessment to develop our theoretical perspective. These perspectives each suggest two cognitive systems that differ in their level of temporal immediacy: an intuitive system that produces behavior in response to everyday states and a narrative system that interprets and explains these experiences after the fact. Writers from Plato onward describe two competing influences on behavior-often with moral overtones. People tend to identify with the language-based narrative system and blame unhelpful results on the less accessible intuitive system, but neither is completely rational, and the intuitive system has strengths based on speed and serial processing. The systems differ based on temporal immediacy-the description of an experience as either "now" or "usually"-with the intuitive system generating behaviors automatically in real time and the narrative system producing beliefs about the past or future. The principle of temporal immediacy is a tool to integrate nursing science with other disciplinary traditions and to improve research and practice. Interventions should build on each system's strengths, rather than treating the intuitive system as a barrier for the narrative system to overcome. Nursing researchers need to study the roles and effects of both systems.

Addressing Phonological Memory in Language Therapy with Clients Who Have Down Syndrome: Perspectives of Speech-Language Pathologists

ERIC Educational Resources Information Center

Faught, Gayle G.; Conners, Frances A.; Barber, Angela B.; Price, Hannah R.

2016-01-01

Background: Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech-language pathologists (SLPs) find ways to do so in their practices. Aims: This study asked if and how…

Conceptualizing Group Dynamics from Our Clients' Perspective: Development of the Conceptualization of Group Dynamics Inventory

ERIC Educational Resources Information Center

Tate, Kevin A.; Rivera, Edil Torres; Conwill, William L.; Miller, M. David; Puig, Ana

2013-01-01

There is a clear call in group counseling practice and training for evidence-based practice (ACA, 2005; ASGW, 2008; CACREP, 2009). At the same time, group counselors also are asked to keep clients' experience at the center of their work (ASGW, 2012). This article outlines the authors' effort to develop and study an instrument designed to measure…

[Anthropology, ethnography, and narrative: intersecting paths in understanding the processes of health and sickness].

PubMed

Costa, Gabriela M C; Gualda, Dulce M R

2010-12-01

The article discusses anthropology, ethnographic method, and narrative as possible ways of coming to know subjects' experiences and the feelings they attribute to them. From an anthropological perspective, the sociocultural universe is taken as a point of reference in understanding the meaning of the processes of health and sickness, using a dense ethnographic description from an interpretivist analytical approach. In this context, narratives afford possible paths to understanding how subjective human experiences are shared and how behavior is organized, with a special focus on meaning, the process by which stories are produced, relations between narrator and other subjects, processes of knowledge, and the manifold ways in which experience can be captured.

Narratives about illness and medication: a neglected theme/new methodology within pharmacy practice research. Part II: medication narratives in practice.

PubMed

Ryan, Kath; Bissell, Paul; Morecroft, Charles

2007-08-01

Part 2 of this paper aims to provide a methodological framework for the study of medication narratives, including a semi-structured interview guide and suggested method of analysis, in an attempt to aid the development of narrative scholarship within pharmacy practice research. Examples of medication narratives are provided to illustrate their diversity and usefulness. The framework is derived from the work of other researchers and adapted for our specific purpose. It comes from social psychology, narrative psychology, narrative anthropology, sociology and critical theory and fits within the social constructionist paradigm. The suggested methods of analysis could broadly be described as narrative analysis and discourse analysis. Examples of medication narratives are chosen from a variety of sources and brief interpretations are presented by way of illustration. Narrative analysis, a neglected area of research in pharmacy practice, has the potential to provide new understanding about how people relate to their medicines, how pharmacists are engaged in producing narratives and the importance of narrative in the education of students. IMPACT OF THE ARTICLE: This article aims to have the following impact on pharmacy practice research: Innovative approach to researching and conceptualising the use of medicines. Introduction of a new theoretical perspective and methodology. Incorporation of social science research methods into pharmacy practice research. Development of narrative scholarship within pharmacy.

A qualitative study of professional and client perspectives on information flows and decision aid use.

PubMed

Stirling, Christine; Lloyd, Barbara; Scott, Jenn; Abbey, Jenny; Croft, Toby; Robinson, Andrew

2012-03-29

This paper explores the meanings given by a diverse range of stakeholders to a decision aid aimed at helping carers of people in early to moderate stages of dementia (PWD) to select community based respite services. Decision aids aim to empower clients to share decision making with health professionals. However, the match between health professionals' perspectives on decision support needs and their clients' perspective is an important and often unstudied aspect of decision aid use. A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity. Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients. Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information.

The use of narrative in Jewish medical ethics.

PubMed

Jotkowitz, Alan

2013-09-01

Anne Jones has pointed out that over the last three decades, stories have been important to medical ethics in at least three ways: (1). Stories as cases for teaching principle-based medical ethics (2). Narratives for moral guides on what is considered living a good life (3). Stories as testimonials written by both patients and physicians. A pioneer in this effort, particularly in regard to using narratives as moral guides, has been the ethicist and philosopher Stanley Hauerwas. Heavily influenced by virtue ethics, Hauerwas believes that it is a person's particular narrative tradition that provides one with convictions that form the basis of one's morality. Befitting a Protestant theologian, he is particularly concerned with the Christian narrative. From a Jewish perspective, there has been much less written on the use of narrative in medical ethics. However, it is a mistake to think that narrative has little, if any, role in Rabbinic ethical decision making. The purpose of this article is to demonstrate the centrality of narrative in the thought of Orthodox Jewish decisors and the problems inherent in this methodology.

Narratives of Violence, Pathology, and Empowerment: Mental Health Needs Assessment of Home-Based Female Sex Workers in Rural India.

PubMed

Sardana, Srishti; Marcus, Marina; Verdeli, Helen

2016-08-01

This study explores the narratives of psychological distress and resilience among a group of female sex workers who use residential spaces to attend to clients in rural India. The narratives reflect the lived experiences of these women. They describe the women's reasons for opting into sex work; guilt, shame, and stigma related to their sex worker status; experiences with intimate partner and domestic violence; health-related problems; communication with their family members about their sex worker status; mental health referral practices among the women; and elements of resilience and strength that they experience within themselves and within their community of fellow sex workers. The article also offers elements of our own experiences of recruiting the women to participate in the focus group, training local outreach workers in conducting focus group discussions, and forging a collaboration with a local community-based organization to highlight important barriers, challenges, and strategies for planning a group-based discussion to explore the mental health needs of home-based sex workers. © 2016 Wiley Periodicals, Inc.

The Cocreation of Crazy Patchworks: Becoming Rhizomatic in Systemic Therapy.

PubMed

Sermijn, Jasmina; Loots, Gerrit

2015-09-01

In the field of systemic therapy, there has been much discussion recently about the narrative self. This concept refers to the idea that the self is narratively constructed in and through the stories which someone tells about him/herself. The story is thereby not only viewed as a metaphor for selfhood: Selfhood is not compared to a story, it is a story. But what kind of story are we talking about here? If the self is a story, what does that story look like? These questions are explored in this article. Starting from the possibilities and limitations of traditional and postmodern visions on the self as a story, an alternative vision is illustrated. By considering the self as a rhizomatic story, we not only create a useful view of the way narrative selfhood is constructed within a therapy context, but we also stimulate therapists to coconstruct-together with their clients-patchworks of self-stories. By using story fragments of our own practice, we illustrate the rhizomatic thinking and its possibilities in therapy. © 2015 Family Process Institute.

Negotiating: experiences of community nurses when contracting with clients.

PubMed

Duiveman, Trudie; Bonner, Ann

2012-04-01

A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: 'assessment of needs', 'education towards enablement', and 'negotiation'. 'Assessment of needs' identified that community nurses assess both the client's requirements for health care as well as the ability of the nurse to provide that care. 'Education towards enablement' described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, 'negotiation', involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.

Forgotten resources of older home care clients: focus group study in Finland.

PubMed

Turjamaa, Riitta; Hartikainen, Sirpa; Pietilä, Anna-Maija

2013-09-01

In this qualitative focus group study, the resources available to older home-dwelling people, particularly incoming and existing home care clients, are described from the viewpoint of home care professionals (n = 32). The data were analyzed using inductive content analysis. There were three categories of older people requiring resources from the viewpoint of interviewers: home-dwelling people, incoming home care clients, and existing home care clients. Based on the analysis, the resources of older home-dwelling people were categorized in terms of support, meaningful life, everyday activities, and environment. Incoming home care client resources were support, out-of-home activities, in-home activities, and environment. Existing client resources were described in terms of support, everyday activities, and environment. Home care professionals described the resources of the older home-dwelling people in diverse ways, but those of the perspective of existing clients were reduced. The biggest difference was in everyday activities. Psychological and social resources, including meaningful life and social relationships, seemed to be forgotten. All available resources must be taken into account, especially in the everyday home care services for existing home care clients. © 2013 Wiley Publishing Asia Pty Ltd.

Diversity Education across the Undergraduate Curriculum: Student Perspectives

ERIC Educational Resources Information Center

Baillargeon, Jane

2013-01-01

This qualitative study uses narrative inquiry methodologies informed by Indigenous research methods to examine the changes in students' perspectives of diversity, including race, ethnicity, gender, religion, politics, sexual orientation, socioeconomic status, physical and cultural diversity, as they are exposed to the "other" in their…

Career Theory from an International Perspective

ERIC Educational Resources Information Center

Guichard, Jean; Lenz, Janet

2005-01-01

The Career Theory in an International Perspective group highlighted 7 approaches: action theory, self-construction model, transition model, dynamics of entering the workforce, narrative in career guidance, dilemma approach, and interactive identity construction. Three main characteristics appear to be common to these different contributions: (a)…

Clients' reasons for terminating psychotherapy: a quantitative and qualitative inquiry.

PubMed

Roe, David; Dekel, Rachel; Harel, Galit; Fennig, Shmuel

2006-12-01

To study private-practice clients' perspective on reasons for psychotherapy termination and how these are related to demographic and treatment variables and to satisfaction with therapy. Eighty-four persons who had been in extended private-practice psychotherapy which ended in the preceding three years participated in the study. Mean number of months in treatment was 27.70 (SD = 18.70). Assessment included rating scales and open-ended questions assessing demographic variables, reasons for terminating therapy, and satisfaction with therapy. Quantitative results revealed that the most frequent reasons for termination were accomplishment of goals, circumstantial constraints and dissatisfaction with therapy, and that client satisfaction was positively related to positive reasons for termination. Qualitative results revealed two additional frequently mentioned reasons for termination: the client's need for independence and the client's involvement in new meaningful relationships. Findings suggest that psychotherapy termination may at times be required to facilitate the pursuit of personally meaningful goals.

The Effects of Psychotherapist's and Clients' Interpersonal Behaviors during a First Simulated Session: A Lab Study Investigating Client Satisfaction

PubMed Central

Moors, François; Zech, Emmanuelle

2017-01-01

The purpose of this study was to examine the effects of psychotherapists' behaviors during a first simulated therapy session on clients' satisfaction, including their intention to pursue or drop out from therapy. The importance of psychotherapists' warmth on clients' satisfaction was examined to check previous findings stressing this determining factor. Examining the role of warm behaviors is however insufficient according to the interpersonal perspective. We therefore tested the role of the psychotherapist's agentic behaviors since only a few studies provide contradictory results about the role of this interpersonal dimension on clients' satisfaction and how it is influenced by matching up client and therapist's profiles. To test our hypotheses and control for alternative therapy-related explanatory variables, we used different videos as experimental conditions manipulating the therapist's behaviors. Seventy-five participants had to imagine themselves as potential clients arriving for a first therapy session. They successively watched a role-playing therapist behaving according to five randomized interpersonal profiles. Results confirmed that warmth was a major dimension predicting client satisfaction. They revealed that agency was also a determinant of client satisfaction and that its effects depended on the client's own interpersonal agentic profile. Dominant clients were found to be more satisfied with the dominant psychotherapist than the submissive one while submissive clients preferred only the warm psychotherapist. These findings are discussed and suggest that therapists may need to be flexible and adapt their behaviors according to their client's interpersonal profile to increase their client satisfaction and decrease drop outs. PMID:29163262

Monoglossic Echoes in Multilingual Spaces: Language Narratives from a Vietnamese Community Language School in Australia

ERIC Educational Resources Information Center

Reath Warren, Anne

2018-01-01

This article reports on language narratives in the ecology of a Vietnamese community language school (VCLS) in Australia. The study takes a dialogical perspective, where the stories about language that informants in the research setting tell are understood to shape and be shaped by the contexts in which they are told. Systematic analysis of…

Fictional Narratives as Didactical Tools: Using Frank McCourt's "Teacher Man" in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Mottart, Andre; Vanhooren, Steven; Rutten, Kris; Soetaert, Ronald

2009-01-01

In this article we describe a teaching project that focuses on the introduction of fictional narratives as basis for critical reflection about major issues in the teaching profession. Our main aim is to help pre-service teachers to make appropriate decisions at particular moments of interaction in their classroom. From a theoretical perspective we…

Tuning Frequencies of Multicultural Education Objectives to Distinct Society Perspectives: Two Teacher Candidate Interviews Transmitted through Narrative Inquiry

ERIC Educational Resources Information Center

Tan, Eloise; Lefebvre, Haidee Smith

2010-01-01

Through a qualitative approach of narrative inquiry, this paper examines how Quebec's distinct society identity interacted with objectives of a Multicultural Education course in Montreal. The authors, one of whom was a teaching assistant in the course and the other a student in the course, interviewed seven students and the professor. The…

Utilising Biographical Narrative Interpretive Methods: Rich Perspectives on Union Learning Journeys and Learner Motivations

ERIC Educational Resources Information Center

Ross, C.; Moore, S.

2016-01-01

This article explores the use of Biographical Narrative Interpretive Methods (BNIM) in research on motivations for trade union learning. Our use of BNIM--a new methodological approach for us--was intended to test our own research practice in an effort to get further inside the "felt world" and "lived life" of the union learner.…

Writing Out of the Unexpected: Narrative Inquiry and the Weight of Small Moments

ERIC Educational Resources Information Center

Gordon, Erick; McKibbin, Kerry; Vasudevan, Lalitha; Vinz, Ruth

2007-01-01

In this tale of a single event told from the perspectives of multiple narrators, Erick Gordon, Kerry McKibbin, Lalitha Vasudevan, and Ruth Vinz write about their work together on a Student Press Initiative (SPI) writing project at Horizon Academy, the Department of Correction/Department of Education high school at Rikers Island Jail in New York…

Bearing Witness: Teaching the Holocaust from a Victim-Centered Perspective

ERIC Educational Resources Information Center

Blutinger, Jeffrey C.

2009-01-01

A fundamental problem faced by anyone who wishes to teach the Holocaust, or any other mass slaughter, is the tension between the desire " to allow the dead their voices to make the silence heard," and a historical narrative that often deals almost exclusively on perpetrator actions. This bias in the narrative derives from the tendency in history,…

Advising an Urban FFA Chapter: A Narrative of Two Urban FFA Advisors

ERIC Educational Resources Information Center

Martin, Michael J.; Kitchel, Tracy

2015-01-01

Advising an urban FFA chapter can be a challenge for urban agriculture teachers. The contextual differences between the rural-oriented FFA and urban FFA members can make bridging the gap difficult. This narrative study sought to explore how the urban context shapes the work of an FFA chapter from the perspectives of two FFA advisors at the same…

Bringing Ethics into the Classroom: Making a Case for Frameworks, Multiple Perspectives and Narrative Sharing

ERIC Educational Resources Information Center

Mathur, Sarup R.; Corley, Kathleen M.

2014-01-01

This article argues for the need to discuss the topic of ethics in the classroom and presents five frameworks of ethics that have been applied to education. A case analysis used in workshops with educators in the field of Special Education is described, and the benefits of sharing narratives are discussed. The authors offer suggestions, grounded…

The Participants' Perspective: How Biographic-Narrative Intervention Influences Identity Negotiation and Quality of Life in Aphasia

ERIC Educational Resources Information Center

Corsten, Sabine; Schimpf, Erika J.; Konradi, Jürgen; Keilmann, Annerose; Hardering, Friedericke

2015-01-01

Background: People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such…

Arts, literature and reflective writing as educational strategies to promote narrative reasoning capabilities among physiotherapy students.

PubMed

Caeiro, Carmen; Cruz, Eduardo Brazete; Pereira, Carla Mendes

2014-11-01

The use of arts, literature and reflective writing has becoming increasingly popular in health professionals education. However, research examining its contribution as an educational strategy to promote narrative reasoning capabilities is limited, particularly from the students' perspective. This study aimed to explore the final year physiotherapy students' perspectives about the contribution of arts, literature and reflective writing in facilitating narrative reasoning capabilities. Three focus group meetings using a semi-structured interview schedule were carried out to collect data. Focus group sessions were audiotaped and transcribed verbatim. Interpretative phenomenological analysis was used to conduct the study and analyze the transcripts. Three themes emerged: (1) developmental understanding of the patients' experiences; (2) developmental understanding about the self; and (3) embedding reflection in clinical practice. Students emphasized an increasing capability to be sensitive and vicariously experience the patient's experience. Through reflective writing, students reported they became more capable of thinking critically about their practice and learning needs for continuous professional development. Finally, students highlighted the contribution of these strategies in making reflection part of their practice. Final year physiotherapy students reported enhanced skills of narrative reasoning. The findings support the inclusion of these strategies within the undergraduate physiotherapy curricula.

Client experiences of motivational interviewing: An interpersonal process recall study.

PubMed

Jones, Sarah A; Latchford, Gary; Tober, Gillian

2016-03-01

To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse. A qualitative study using grounded theory. Interviews with nine clients were conducted using interpersonal process recall (IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour. These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship. Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. © 2015 The British Psychological Society.

Development and construct validation of the Client-Centredness of Goal Setting (C-COGS) scale.

PubMed

Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim

2015-07-01

Client-centred philosophy is integral to occupational therapy practice and client-centred goal planning is considered fundamental to rehabilitation. Evaluation of whether goal-planning practices are client-centred requires an understanding of the client's perspective about goal-planning processes and practices. The Client-Centredness of Goal Setting (C-COGS) was developed for use by practitioners who seek to be more client-centred and who require a scale to guide and evaluate individually orientated practice, especially with adults with cognitive impairment related to acquired brain injury. To describe development of the C-COGS scale and examine its construct validity. The C-COGS was administered to 42 participants with acquired brain injury after multidisciplinary goal planning. C-COGS scores were correlated with the Canadian Occupational Performance Measure (COPM) importance scores, and measures of therapeutic alliance, motivation, and global functioning to establish construct validity. The C-COGS scale has three subscales evaluating goal alignment, goal planning participation, and client-centredness of goals. The C-COGS subscale items demonstrated moderately significant correlations with scales measuring similar constructs. Findings provide preliminary evidence to support the construct validity of the C-COGS scale, which is intended to be used to evaluate and reflect on client-centred goal planning in clinical practice, and to highlight factors contributing to best practice rehabilitation.

Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

PubMed

Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

2016-08-01

This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Intimidades: confianza, gender, and hierarchy in the construction of Latino-Latina therapeutic relationships.

PubMed

Bracero, W

1998-01-01

The intimate nature of psychotherapy requires psychotherapists be educated to deal with the sexualization of the sharing of intimate feelings and interpersonal closeness. Latino cultures have relatively rigid sex role expectations and norms that privilege men at the expense of women. Experiences of emotional intimacy threaten this Latino cultural discourse of boundaries between men and women and may lead to impasses in therapy and enactments of pathogenic aspects of machismo and marianismo in the therapeutic relationship. Clinical vignettes illustrating the embeddedness of such gender discourses within therapeutic conversations between a Latino therapist and his Latina clients are presented, with discussion of how an intersubjective--relational approach can be used to deconstruct oppressive machista metaphors and cultural narratives and then aid in the coconstruction of reparative narratives within a context of intergender mutuality.

Palliative care needs of terminally ill people living alone: a service provider perspective.

PubMed

Aoun, Samar M; Wall, David; Kristjanson, Linda J; Shahid, Shaouli

2013-01-01

Community-based palliative care services face challenges in meeting the needs of terminally ill clients who live alone without a primary caregiver. Yet, there is a dearth of literature on the perceptions of health service providers (HSPs) regarding the care needs and possible management options to assist this growing group to remain at home. This paper investigated the support needs of people living alone with a terminal illness from a service provider perspective. In depth semi-structured interviews were conducted with nine HSPs from community based services in three Australian states. Four main themes emerged: care challenges, differences in care provision, appropriate approaches to care and essentials for an effective service such as 24 h care, cost-free provision of personal alarm systems, supported and coordinated housekeeping services, funded respite care and financial care packages. HSPs expressed a respect for the autonomy and independence of the clients, yet felt pressured to ensure that safe and attentive care was possible. HSPs recognised the central importance of maintaining the independence and autonomy of palliative care clients living alone. This study is the first in-depth account of what HSPs perceive they need to effectively look after home alone dying clients. The study provided directions to inform service planning for this growing and challenging population group regarding adequate and timely services that will lead to more complying with the clients' wishes, more care being delivered at home, a reduction in hospitalisations, a better quality of life and a capacity to die at home.

Health seeking narratives of unwell Sri Lankan Tamil refugees in Melbourne Australia.

PubMed

Samuel, Sophia; Advocat, Jenny; Russell, Grant

2018-03-01

Sri Lankan Tamil refugees are among the largest group of refugees to resettle in Australia in the last decade. The aim of this study is to characterise the narratives of health-seeking among unwell Sri Lankan Tamil refugees in Melbourne, Victoria, Australia. Drawing on a qualitative, phenomenological perspective, we conducted in-depth interviews in Tamil and English with 12 participants who identified as being unwell for 6 months or more. Findings revealed three narratives of health-seeking: the search for the 'good life' that was lost or never experienced, seeking help from familiar channels in an unfamiliar context, and the desire for financial and occupational independence. These three narratives are undergirded by the metanarrative of a hope-filled recovery. These narratives of Tamil refugees' lived experience provide new insights into clinical care and health service delivery.

Role and Success of Finnish Early Childhood Education and Care in Supporting Child Welfare Clients: Perspectives from Parents and Professionals

ERIC Educational Resources Information Center

Pölkki, Pirjo L.; Vornanen, Riitta H.

2016-01-01

Day care in Finland comprising care, education and teaching--called Educare or the ECEC model--can be used as an open care (community care) support measure for children whose development is at risk. The general aim of the study was to investigate whether the needs of child welfare client children and their parents are fulfilled in day care…

Client perceptions of the Tree Theme Method™: a structured intervention based on storytelling and creative activities.

PubMed

Gunnarsson, A Birgitta; Peterson, Kerstin; Leufstadius, Christel; Jansson, Jan-Ake; Eklund, Mona

2010-09-01

The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: “From feeling a pressure to perform to becoming focused and expressive”, “Expressing oneself and one's life situation led to awakening of memories and feelings”, “New perspectives of self-image, everyday life and relations to others”, “Story-making led to shaping and reconstructing one's life story”, “Interaction was of importance when reconstructing one's life story” and, finally, “The attitude of the occupational therapist was of importance for the development of the therapeutic relationship”. There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client–therapist relationship.

A story of change: The influence of narrative on African-Americans with diabetes

PubMed Central

Goddu, Anna P.; Raffel, Katie E.; Peek, Monica E.

2015-01-01

Objective To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. Methods In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. Results African-American adults (n = 36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative – discussing stories, rehearsing their messages with role-play, and building social support through storytelling – was reported as especially influential. Conclusion Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. Practice implications Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants. PMID:25986500

A story of change: The influence of narrative on African-Americans with diabetes.

PubMed

Goddu, Anna P; Raffel, Katie E; Peek, Monica E

2015-08-01

To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. African-American adults (n=36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative - discussing stories, rehearsing their messages with role-play, and building social support through storytelling - was reported as especially influential. Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Women's narratives on quality in prenatal care: a multicultural perspective.

PubMed

Wheatley, Robyn R; Kelley, Michele A; Peacock, Nadine; Delgado, Jaime

2008-11-01

Although significant progress has been made to increase prenatal care access, national organizations concerned with health equity emphasize that eliminating disparities will require greater attention to quality of care, assessed from both the biomedical and patient perspectives. In this study, we examined narratives about pregnancy experiences from low-income primiparous African American, Mexican American, Puerto Rican, and White women who participated in focus groups conducted in 1996. We reanalyzed transcripts from these discussions, extracting passages in which women talked about the content and quality of their prenatal care experiences. Data were mapped to four domains reflecting patient-centeredness markers identified in the 2005 U.S. National Healthcare Disparities Report (NHDR). These markers include the extent to which the women perceived that their provider listened carefully, explained things, showed respect, and spent enough time with them. The narratives provided by the study participants suggest a critical and intuitive understanding of the NHDR patient-centeredness markers and some shared understanding across cultural groups. Implications for improving quality and its measurement in prenatal care are discussed.

Nurses and the sterilization experiments of Auschwitz: a postmodernist perspective.

PubMed

Benedict, Susan; Georges, Jane M

2006-12-01

The medical experiments conducted on non-consenting prisoners of Nazi concentration camps during World War II necessitated the codification of principles to protect human subjects of research. Auschwitz was the largest and one of the most infamous of the camps and the site of numerous 'medical' experiments. This historical study uses primary source documents obtained from archives in England and Germany to describe one type of experiment carried out at Auschwitz - the sterilization experiments. The purpose of these experiments was to perfect a technique in which non-Aryans could be prevented from reproducing while still being able to work as slave laborers. These narratives regarding the sterilization experiments at Auschwitz are remarkable in that they contain previously undocumented information regarding the voluntary and involuntary involvement of nurses. Following these narratives, a discussion of ethics in relation to the Holocaust is presented with a specific focus on the work of Agamben. Implications of the Auschwitz narratives for the application of codes of ethical principles and contemporary nursing are discussed from a postmodernist perspective.

Benefit–Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself”?

PubMed Central

Ettner, Susan L; Huang, David; Evans, Elizabeth; Rose Ash, Danielle; Hardy, Mary; Jourabchi, Mickel; Hser, Yih-Ing

2006-01-01

Objective To examine costs and monetary benefits associated with substance abuse treatment. Data Sources Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9-month follow-up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise investment. PMID:16430607

A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes.

PubMed

King, Gillian; Imms, Christine; Stewart, Debra; Freeman, Matt; Nguyen, Tram

2018-07-01

A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy - a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients' lives and transactional processes of change over the life course. The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. The utility of the framework is considered for research, practice, service organizations, and policy. Implications for Rehabilitation The framework supports practitioners going beyond person and environment as separate entities, to provide services to the "situated person" in real-life contexts The framework shifts the focus from "body structures/functions" and "person in activity" to "person in changing and challenging life contexts" Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy opportunities The framework suggests the benefit of greater focus on resiliency processes to support client self-efficacy, self-determination, and autonomy, and socialization processes to enhance ability to enact new life roles at times of transition.

Perspectives of Taiwanese pastoral counselors on the use of scripture and prayer in the counseling process.

PubMed

Der Pan, Peter Jen; Deng, Liang-Yu F; Tsai, Shiou Ling; Yuan, S S Jenny

2015-04-01

Interviews were carried out with 10 Christian pastoral counselors to explore their perspectives on the use of Scripture and prayer in the counseling process. Grounded Theory was utilized. Five main categories including a theological framework of pastoral counseling, counselors' considerations of using Scripture and prayer, preparation for Christian spiritual intervention, implications of spiritual resources, and ethical issues in the pastoral counseling process were generated. The results suggest the theological framework of pastoral counseling is crucial to the use of Scripture and prayer, and the issue of a neutral response should first be clarified for clients. Basic guidelines for ethically using Scripture and prayer for working with Christian clients are proposed for further pastoral counselor training, practice, and research.

College Students' Perspectives on Their Career Decision Making

ERIC Educational Resources Information Center

Bubany, Shawn T.; Krieshok, Thomas S.; Black, Michael D.; McKay, Robyn A.

2008-01-01

This mixed methods study examined how college student participants discussed their approach to making career decisions, with a focus on how their perspective may be consistent with various models of career decision making. Brief telephone interviews were conducted with 20 college students, and the narrative data were analyzed using qualitative…

Kuwaiti Female Leaders' Perspectives: The Influence of Culture on Their Leadership

ERIC Educational Resources Information Center

Al-Suwaihel, Omaymah E.

2010-01-01

This research revealed the interactions between the Kuwaiti culture, gender, and leadership from the perspective of five Kuwaiti female leaders. Within a qualitative design approach and narrative inquiry methodology, the researcher interviewed five Kuwaiti females who shared their stories of their personal and professional experiences about the…

The Technology Principal: To Be or Not to Be?

ERIC Educational Resources Information Center

Anthony, Anika Ball; Patravanich, Supawaree

2014-01-01

This case provides principal licensure candidates a strategic perspective on leading and managing educational technology initiatives. It presents issues related to vision setting, planning, implementation, organizational structure, and decision making. The case narrative is presented from the perspective of a principal, but it can also be used to…

Multiple Perspectives on Elementary Teachers' Science Identities: A Case Study

ERIC Educational Resources Information Center

Madden, Lauren; Wiebe, Eric

2015-01-01

This narrative case study examined the relationship between teacher identity and elementary science teaching. Teacher identity was described using a modification of Gee's framework incorporating three perspectives: the teachers' self-described identity, the researchers' view of teacher identity, and the students' views of teacher identity. Over…

Children Writing Ethnography: Children's Perspectives and Nomadic Thinking in Researching School Classrooms

ERIC Educational Resources Information Center

Hohti, Riikka

2016-01-01

This article makes a connection between narrative ethnography, childhood studies and new materialist theories in studying children's perspective on school. It presents "children writing ethnography" as an approach based on complexity and involving participatory research. The question of "what is happening in the classroom" is…

Children's Perspectives on Disorder and Violence in Urban Neighbourhoods

ERIC Educational Resources Information Center

de Carvalho, Maria Joao Leote

2013-01-01

Based on the analysis of 312 children's neighbourhood drawings and narratives, this article discusses children's socialization in six public housing neighbourhoods in Portugal, through children's personal accounts of their lives. It then examines their perspectives on disorder and violence. Most complained about living in their neighbourhoods,…

Defining Diversity: Ethnic Differences in Black Students' Perceptions of Racial Climate

ERIC Educational Resources Information Center

Griffin, Kimberly A.; Cunningham, Emil L.; George Mwangi, Chrystal A.

2016-01-01

This qualitative study addresses the potential range of perspectives within the Black student community, focusing specifically on differences by ethnicity and nativity. Narratives were collected from 43 Black students (15 native, 28 immigrants) enrolled at a predominantly White research institution, analyzing their perspectives on diversity and…

Feeling our way into empathy: Carl rogers, Heinz Kohut, and Jesus.

PubMed

Goodman, G

1991-09-01

Throughout their academic careers Carl Rogers and Heinz Kohut developed two contrasting definitions of empathy that influenced the ways in which both men sought to help their clients cope with emotional suffering. These two different understandings of empathy are contrasted to each other and finally compared with the understanding of empathy demonstrated in the teachings and actions of Jesus. It is hoped that through studying these ancient religious narratives we might be able to recover a deeper meaning of empathy.

Client-controlled case information: a general system theory perspective.

PubMed

Fitch, Dale

2004-07-01

The author proposes a model for client control of case information via the World Wide Web built on principles of general system theory. It incorporates the client into the design, resulting in an information structure that differs from traditional human services information-sharing practices. Referencing general system theory, the concepts of controller and controlled system, as well as entropy and negentropy, are applied to the information flow and autopoietic behavior as they relate to the boundary-maintaining functions of today's organizations. The author's conclusions synthesize general system theory and human services values to lay the foundation for an information-sharing framework for human services in the 21st century.

Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives.

PubMed

Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy

2011-09-01

In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative ethics' and 'philosophical hermeneutics' provide a theoretical base for clinical ethics by focusing on human identities entangled in stories and on moral understanding as a dialogical process. Second, we consider the role of theoretical notions in helping practitioners to understand their situation in clinical ethics practice, by using notions like 'story', 'responsibility', or 'vulnerability' to make explicit and explain their practical experience. Such theoretical notions help us to interpret clinical situations from an ethical perspective and to foster moral awareness of practitioners. And, thirdly, we examine how new theoretical concepts are developed by interpreting practice, using practice to form and improve our ethical theory. In this paper, we discuss this threefold use of theory in clinical ethics support services by reflecting on our own theoretical assumptions, methodological steps and practical experiences as ethicists, and by providing examples from our daily work. In doing so, we illustrate that theory and practice are interwoven, as theoretical understanding is dependent upon practical experience, and vice-versa. © 2011 Blackwell Publishing Ltd.

Development of two measures of client engagement for use in home aged care.

PubMed

Baker, Jess Rose; Harrison, Fleur; Low, Lee-Fay

2016-05-01

The aim of the study was to develop and validate measures of client engagement in aged homecare. The Homecare Measure of Engagement-Staff questionnaire (HoME-S) is a self-complete measure of six dimensions of client engagement: client acceptance, attention, attitude, appropriateness, engagement duration and passivity. The Homecare Measure of Engagement-Client/Family report (HoME-CF) is a researcher-rated interview which obtains client and/or family perspectives regarding frequency and valence of conversational and recreational engagement during care worker visits. Care workers (n = 84) completed the HoME-S and a measure of relationship bond with client. Researchers interviewed clients (n = 164) and/or their family (n = 117) and completed the HoME-CF, and measures of agitation, dysphoria, apathy and cognitive functioning. The HoME-S and HoME-CF demonstrated good test-retest and inter-rater reliability, and showed significant negative correlations with apathy, agitation and non-English-speaking background. Controlling for client and care service characteristics, a stronger care worker-client relationship bond and English-speaking background were independently associated with higher HoME-S scores, and apathy was independently associated with higher HoME-CF scores. In conclusion, the HoME-S and HoME-CF are psychometrically sound engagement measures for use in homecare. Clients who are apathetic or from non-English-speaking backgrounds may be less responsive to traditional care worker engagement strategies. Engagement may be augmented in clients who have stronger relationships with their care workers. © 2015 John Wiley & Sons Ltd.

Comparison of the perspectives of managers, employees and clients regarding the individual barriers of family planning counseling in healthcare centers of isfahan in 2012.

PubMed

Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaze; Farzi, Saba; Jaafarpour, Molouk; Direkvand-Moghaddam, Ashraf

2014-03-01

Family planning is a lifestyle that is selected voluntarily and is based on the knowledge, attitude and responsible decision making by couples in order to promote the health and welfare of the family and the advancement of the society. In this regard, family planning counseling plays an important role in making informed decisions if used properly and in a responsible way. Detection of individual barriers in family planning counseling based on the viewpoints of managers, employees and clients who are key participants in the healthcare service provision is a major step towards appropriate planning to modify or eliminate such barriers. The present study was conducted with the goal of comparing managers', employees' and clients' viewpoints about individual barriers in family planning counseling in health care centers in Isfahan in 2012. This was a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees and 126 clients in medical health care centers in Isfahan in 2012. The managers and employees were selected by census sampling, and the clients were recruited through convenient random sampling. The data collection tool was a researcher-designed questionnaire, which was designed in two sections of fertility and personal characteristics, and viewpoint measurement. Descriptive and inferential statistical tests were used to analyze the data. The obtained results showed significant differences between mean scores of viewpoints in three groups of managers, employees and clients concerning individual barriers in family planning counseling. In addition, most of the managers, employees and clients reported individual barriers as an intermediate level barrier in the process of family planning counseling. Results indicate that subjects in three studied groups hold different views regarding the individual barriers in family planning counseling. This difference in the perspectives may be a factor that affects the quality of the provided services. Therefore, it is necessary for the healthcare providers to consider the main concerns of their clients regarding family planning.

Exploring the Experiences of Living With Stroke Through Narrative

PubMed Central

Nasr, Nasrin; Mawson, Susan; Wright, Peter; Parker, Jack; Mountain, Gail

2016-01-01

Chronic illness models are normally used to explain and predict the experience of living with a long-term condition. The aim of this study was to present the findings of narrative interviews with stroke survivors and their family carers to understand their experiences of stroke. We interviewed five people with stroke and three family carers from the United Kingdom. We used thematic analysis to generate themes from their narrative accounts and then linked them to broader theoretical perspectives while influenced by the concept of reinterpretation of life. The narrative accounts of participants are mainly structured based on how their changed bodies poststroke changed their identities and roles and consequently their relationships with others. In this study, we underline the need for using methods like narrative to explain strategies that people use to make sense of their experiences of living with a long-term condition such as stroke. PMID:28462337

"Everything that I thought that they would be, they weren't:" family systems as support and impediment to recovery.

PubMed

EnglandKennedy, Elizabeth Sara; Horton, Sarah

2011-10-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA, these were collected as part of a larger, long-term study. We examine the latter's concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members' actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees' perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. Copyright © 2011 Elsevier Ltd. All rights reserved.

“Everything that I thought that they would be, they weren’t:” Family systems as support and impediment to recovery

PubMed Central

Kennedy, Elizabeth Sara England; Horton, Sarah

2011-01-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA these were collected as part of a larger, long-term study. We examine the latter’s concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members’ actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees’ perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. PMID:21880408

How The Fault in Our Stars illuminates four themes of the Adolescent End of Life Narrative.

PubMed

Kirkman, Anna Obergfell; Hartsock, Jane A; Torke, Alexia M

2018-05-26

Adolescents who face life-limiting illness have unique developmental features and strong personal preferences around end of life (EOL) care. Understanding and documenting those preferences can be enhanced by practising narrative medicine. This paper aims to identify a new form of narrative, the Adolescent End of Life Narrative, and recognise four central themes. The Adolescent EOL Narrative can be observed in young adult fiction, The Fault in Our Stars , which elucidates the notion that terminally ill adolescents have authentic preferences about their life and death. Attaining narrative competence and appreciating the distinct perspective of the dying adolescent allows medical providers and parents to support the adolescent in achieving a good death. By thinking with the Adolescent EOL Narrative, adults can use Voicing my CHOiCES, an EOL planning guide designed for adolescents, to effectively capture the adolescent's preferences, and the adolescent can make use of this type of narrative to make sense of their lived experience. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Feelings in context: countertransference and the real world in feminist therapy.

PubMed

Brown, L S

2001-08-01

The concept of countertransference has been seen as problematic by feminist therapists. However, feminist therapy theory is intensely interested in the symbolic levels of the relationships between therapists and clients, with an emphasis on how the here and now social context informs and transforms those symbols. This article describes a feminist perspective on the therapist's symbolic relationships to clients, and the positive and challenging ramifications of those symbolic encounters.

Business recovery at an arson damaged office.

PubMed

Stewart, Russell

2010-07-01

This paper is in the form of a case study that relates how KPMG's crisis management, business recovery and risk mitigation plans, methods and organisation were applied to ensure its clients' services were not compromised following significant damage to a major office following an arson attack. The paper describes the firm's overall business continuity management (BCM) approach and its key principles, drawn from established BCM, emergency services and psychology sources. The narrative element of the article tracks the event timeline and the firm's corresponding response. The overall management of the incident and its consequences were deemed successful, validating a lean BCM training and exercise regime. A significant learning point was the need to manage numerous stakeholders' interests, engaging on several fronts in parallel, to engender consensus and to expedite decision making. The paper offers practical suggestions to help organisations manage the impact of crisis events on their employees and clients.

Occupation emerges in the process of therapy.

PubMed

Price, Pollie; Miner, Stephanie

2007-01-01

The current literature offers no cohesive definition of occupation-based practice. Current definitions emphasize intervention forms and contexts, which do not reflect the complexity of practice. This article demonstrates that the therapeutic relationship and the meanings that are created in the therapy process are central aspects of occupation-based practice. Occupation, as an idea that emerges in the therapeutic process, has aspects of both doing and becoming. The authors conducted observation sessions and interviews with an occupational therapist, Nancy, who used multiple therapeutic strategies with one child, Hannah, as they worked toward Hannah's goals of going to preschool and becoming a friend. Strategies include changing therapeutic conditions, using cognitive strategies, bridging the person-task-social context, pushing participation, and engaging in narrative micronegotiations. Occupation emerged in the therapeutic processes as the occupational therapist and client co-created meaning about the client moving toward or away from who she wanted to become.

Online counseling: a narrative and critical review of the literature.

PubMed

Richards, Derek; Viganó, Noemi

2013-09-01

This article aimed to critically review the literature on online counseling. Database and hand-searches were made using search terms and eligibility criteria, yielding a total of 123 studies. The review begins with what characterizes online counseling. Outcome and process research in online counseling is reviewed. Features and cyberbehaviors of online counseling such as anonymity and disinhibition, convenience, time-delay, the loss of social signaling, and writing behavior in cyberspace are discussed. Ethical behavior, professional training, client suitability, and clients' and therapists' attitudes and experiences of online counseling are reviewed. A growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face-to-face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables. © 2013 Wiley Periodicals, Inc.

Symbolic interactionism and critical perspective: divergent or synergistic?

PubMed

Burbank, Patricia M; Martins, Diane C

2010-01-01

Throughout their history, symbolic interactionism and critical perspective have been viewed as divergent theoretical perspectives with different philosophical underpinnings. A review of their historical and philosophical origins reveals both points of divergence and areas of convergence. Their underlying philosophies of science and views of human freedom are different as is their level of focus with symbolic interactionism having a micro perspective and critical perspective using a macro perspective. This micro/macro difference is reflected in the divergence of their major concepts, goals and basic tenets. While their underlying philosophies are different, however, they are not necessarily contradictory and areas of convergence may include the concepts of reference groups and looking glass self within symbolic interactionism and ideological hegemony within critical perspective. By using a pragmatic approach and combining symbolic interactionism and critical perspectives, both micro and macro levels come into focus and strategies for change across individual and societal levels can be developed and applied. Application of both symbolic interactionism and critical perspective to nursing research and scholarship offers exciting new opportunities for theory development and research methodologies. In nursing education, these two perspectives can give students added insight into patients' and families' problems at the micro level while, at the same time, giving them a lens to see and tools to apply to problems at the macro level in health care. In nursing practice, a combined symbolic interactionism/critical perspective approach assists nurses to give high-quality care at the individual level while also working at the macro level to address the manufacturers of illness. New research questions emerge from this combination of perspectives with new possibilities for theory development, a transformation in nursing education, and the potential for new practice strategies that can address individual client and larger system problems through empowerment of clients and nurses.

Narrative pedagogy and simulation: future directions for nursing education.

PubMed

Walsh, Mike

2011-05-01

Narrative pedagogy has been developed over the last decade in nursing as a means of complementing a conventional content and competency driven pedagogy. It focuses attention on the human experience of health care by deriving shared meanings from interpretation of stories. This allows students to explore the different perspectives of those involved. The emotional experiences of participants can be understood, conventional wisdom challenged and new knowledge emerge as students work together to construct their learning. Individual stories are embedded within the narrative and teachers have successfully used literature and film as narratives to help them explore the meaning of health care with students. Modern technology has opened up a new range of electronic narratives such as virtual simulation. These are considered and rejected as devices for a health care narrative due to their dehumanized and unrealistic nature. However it is argued that a multimedia online simulation of a typical neighbourhood can achieve the goal of providing a suitable narrative. Human actors replace avatars and real world settings replace gaming environments as the stories of people in this community are related and used to support narrative pedagogy. An example of such a narrative developed jointly in the UK and Canada is discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

A Consideration of the Perspectives of Healing Practitioners on Research Into Energy Healing

PubMed Central

Bruyere, Rosalyn L.; Weintrub, Ken; Dieppe, Paul

2015-01-01

Energy healing is a complex intervention with the purpose of enhancing wholeness within the client. Approaches to complex interventions require thoughtful utilization of a wide range of research methods. In order to advance the research in this field, we sought to understand the healing practitioners' point of view by reviewing qualitative literature, research reviews, and commentary written by and about practitioners. Further, we conducted a brief survey among healers, asking their opinions on types and topics of research in this field. Emerging from this inquiry is an overview of the healers' state required for successful healing, the importance of the clients' contribution, the heterogeneity of the process of healing, and the importance of choosing appropriate outcomes to reflect the goal of wholeness. Beyond attending to measurement of these nuanced aspects, we propose utilization of research designs appropriate for complex interventions, more use of qualitative research techniques, consideration of large data registries, and adoption of the perspectives of realist research. An important gap identified was the overall lack of understanding of the clients' experience and contribution to the healing encounter. PMID:26665045

Trainee and Client Experiences of Therapeutic Assessment in a Required Graduate Course: A Qualitative Analysis.

PubMed

Smith, Justin D; Egan, Kaitlyn N

2017-01-01

Surveys indicate that practice and training in psychological assessment, and personality assessment (PA) to a lesser degree, has been stable or increasing over the past quarter-century. However, its future arguably remains threatened due to changes in doctoral training programs and beliefs in the field concerning the utility of PA for treatment success. To increase interest in and use of PA, studies of training methods that include trainees' perspectives are needed. This study evaluated the experiences of 10 graduate trainees and their clients who were trained in and conducted a brief Therapeutic Assessment (TA). Qualitative responses to a self-evaluation administered post-TA were coded using directed content analysis. Results indicated that trainees viewed TA/PA as having clinical utility; they had positive feelings about TA/PA, and they desired or intended to use or continue learning about TA/PA. Clients' responses reflected positive feelings about the TA, having gained new self-awareness or understanding, and having a positive relationship with the assessor. The findings suggest that teaching PA from a TA perspective could produce positive benefits for psychology trainees.

Message in a Battle: An Analysis of Presidential Communication Since 9/11

DTIC Science & Technology

2013-03-01

Rumsfeld as quoted in Michael Jacobson, “ Learning Counter-Narrative Lessons from Cases of Terrorist Dropouts,” Countering Violent Extremist Narratives...October 29. 2012, http://www.cfr.org/terrorism/improving-us-public-diplomacy-campaign-war-against-terrorism/p4215. 21 Michael Jacobson, “ Learning Counter...States Government as potential new perspectives are introduced through which lessons can be learned regarding the construction and expression of a

Algorithms for detecting and predicting influenza outbreaks: metanarrative review of prospective evaluations

PubMed Central

Spreco, A; Timpka, T

2016-01-01

Objectives Reliable monitoring of influenza seasons and pandemic outbreaks is essential for response planning, but compilations of reports on detection and prediction algorithm performance in influenza control practice are largely missing. The aim of this study is to perform a metanarrative review of prospective evaluations of influenza outbreak detection and prediction algorithms restricted settings where authentic surveillance data have been used. Design The study was performed as a metanarrative review. An electronic literature search was performed, papers selected and qualitative and semiquantitative content analyses were conducted. For data extraction and interpretations, researcher triangulation was used for quality assurance. Results Eight prospective evaluations were found that used authentic surveillance data: three studies evaluating detection and five studies evaluating prediction. The methodological perspectives and experiences from the evaluations were found to have been reported in narrative formats representing biodefence informatics and health policy research, respectively. The biodefence informatics narrative having an emphasis on verification of technically and mathematically sound algorithms constituted a large part of the reporting. Four evaluations were reported as health policy research narratives, thus formulated in a manner that allows the results to qualify as policy evidence. Conclusions Awareness of the narrative format in which results are reported is essential when interpreting algorithm evaluations from an infectious disease control practice perspective. PMID:27154479

Imposed Identities and Limited Opportunities: Advocacy Agency Staff Perspectives on the Construction of their Clients with Intellectual Disabilities

ERIC Educational Resources Information Center

Dorozenko, Kate P.; Roberts, Lynne D.; Bishop, Brian J.

2015-01-01

Intellectual disability is commonly conceptualised as stigmatised identity; however, within the literature, the notion of a damaged identity is contested. The aim of this research was to explore the social construction of intellectual disability from the perspective of staff who work closely with people with intellectual disabilities. Informed by…

Language and hope in schizophrenia-spectrum disorders.

PubMed

Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; Lysaker, Paul H; Minor, Kyle S; Salyers, Michelle P

2016-11-30

Hope is integral to recovery for those with schizophrenia. Considering recent advancements in the examination of clients' lexical qualities, we were interested in how clients' words reflect hope. Using computerized lexical analysis, we examined social, emotion, and future words' relations to hope and its pathways and agency components. Forty-five clients provided detailed narratives about their life and mental illness. Transcripts were analyzed using the Linguistic Inquiry and Word Count program (LIWC), which assigns words to categories (e.g., "anxiety") based on a pre-existing dictionary. Correlations and linear multiple regression were used to examine relationships between lexical qualities and hope. Hope and its subcomponents had significant or trending bivariate correlations in expected directions with several emotion-related word categories (anger and sadness) but were not associated with expected categories such as social words, positive emotions, optimism, achievement, and future words. In linear multiple regressions, no LIWC variable significantly predicted hope agency, but anger words significantly predicted both total hope and hope pathways. Our findings indicate lexical analysis tools can be used to investigate recovery-oriented concepts such as hope, and results may inform clinical practice. Future research should aim to replicate our findings in larger samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

What Role Can Avatars Play in e-Mental Health Interventions? Exploring New Models of Client-Therapist Interaction.

PubMed

Rehm, Imogen C; Foenander, Emily; Wallace, Klaire; Abbott, Jo-Anne M; Kyrios, Michael; Thomas, Neil

2016-01-01

In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and among peers. Avatars are digital self-representations, which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified (1) in the formation of online peer support communities; (2) replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3) using avatar technology to facilitate or augment face-to-face treatment; (4) as part of serious games; and (5) communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement by (1) facilitating the development of a virtual therapeutic alliance; (2) reducing communication barriers; (3) promoting treatment-seeking through anonymity; (4) promoting expression and exploration of client identity; and (5) enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.

PubMed

Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia

2016-08-01

Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

A "client perspective" helps improve services.

PubMed

1998-01-01

Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

Being White in Black Spaces: Teaching and Learning at a Predominately Black Institution

ERIC Educational Resources Information Center

Harrington, Timothy E.; Thomas, Michael

2018-01-01

This paper serves as a beginning conversation of how two White males perspectives' were shaped and how those perspectives evolved while attending and teaching at a Predominately Black Institution (PBI). Their initial understandings of Whiteness are introduced. This is an ethnographic study that utilized personal narratives from a college professor…

The Personal Struggles of "National" Educators Working in "International" Schools: An Intercultural Perspective

ERIC Educational Resources Information Center

Savva, Maria

2017-01-01

This paper looks at how personal struggles associated with the overseas setting caused changes in the intercultural perspective of 30 Anglophone educators working in international schools. Situated within a social constructivist framework, interview methods were utilised to build a collective narrative shared by educators. Findings reveal that…

Narrative of a Teaching Practice. An Autoethnography about Being a Geriatrics Professor

ERIC Educational Resources Information Center

Bulgarelli, Alexandre F.; Toassi, Ramona F. C.

2018-01-01

This study was developed to show a professor's perspective to comprehend his difficulties and challenges, within a different scenario and culture of teaching geriatric dentistry in a nursing home. It was a self-analysis theoretically supported by the Social Constructionism and the Interpretative Autoethnography perspective. Data were constructed…

Countering the Narrative: A Layered Perspective on Supporting Black Males in Education

ERIC Educational Resources Information Center

Goings, Ramon B.; Smith, Aaron; Harris, Daniel; Wilson, Tanneshala; Lancaster, Demetrius

2015-01-01

The challenges facing Black males throughout the educational pipeline have been discussed by researchers in detail. However, missing from this research are discussions from the perspective of researchers, educators, and community members united on how to better support Black males. The purpose of this reflective piece is twofold. First, we address…

Perspectives of HIV Clinic Staff on the Implementation of a Client Financial Incentives Program Targeting Viral Suppression.

PubMed

Anderson, Susannah; Jenner, Eric; Lass, Katherine; Burgess, Samuel

We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. Many providers and staff welcomed the program, but some were concerned about sustainability and the ethics of a program that paid patients to receive care. Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future. Copyright © 2017 Association of Nurses in AIDS Care. All rights reserved.

Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada-a qualitative study.

PubMed

Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

2014-06-02

To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers' working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers' safety over arrest, while continuing to target clients. 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers' working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January-November 2013). Sex workers' narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants' accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Recovery-promoting professional competencies: perspectives of mental health consumers, consumer-providers and providers.

PubMed

Russinova, Zlatka; Rogers, E Sally; Ellison, Marsha Langer; Lyass, Asya

2011-01-01

The purpose of this study was to empirically validate a set of conceptually derived recovery-promoting competencies from the perspectives of mental health consumers, consumer-providers and providers. A national sample of 603 consumers, 153 consumer-providers and 239 providers completed an anonymous survey via the Internet. The survey evaluated respondents' perceptions about a set of 37 competencies hypothesized to enhance clients' hope and empowerment and inquired about interactions with providers that enhanced clients' recovery process. We used descriptive statistics and ranking to establish the relevance of each competency and generalized linear models and post-hoc tests to examine differences in the consumers', consumer-providers' and providers' assessments of these competencies. Analyses confirmed the recovery relevance of several competencies and their relative importance within each group of study participants. They also revealed that while most competencies tended to have universal significance, others depended more strongly on the client's preferences. Finally, differences in the perceptions of consumers, consumer-providers and providers about the recovery relevance of these competencies were established. The study highlighted the crucial role practitioners play in enhancing recovery from serious mental illnesses through specific strategies and attitudes that acknowledge clients' personhood and foster their hopefulness, empowerment and illness management. It informed the development of a new instrument measuring providers' recovery-promoting competence and provides guidelines for sharpening the recovery focus of a wide range of mental health and rehabilitation services.

Tattooist-customer relationships in a diversified environment of professional tattooists and 'scratchers'.

PubMed

Kristensen, Mads Wedel

2015-01-01

The world of tattooing and body art has never been like it is today. This chapter seeks to investigate this situation through the lens of tattooing. One of the areas in which tattooing has changed is the relationship between the tattoo artist and his or her clients. Whereas being a tattoo artist used to be impersonal and very much just a job like any other, it has transformed tremendously today. The cause of this and, even more so, what exactly has changed are what this chapter will seek to shed light on. First of all, the format of the shops and how the art is done have changed, which allows for much greater flexibility from the perspective of the artist. Second, from the perspective of the client/customer, a transformation has also occurred, in some part thanks to developments such as the internet and other social/communication media, which give the client much more room and opportunity to discover and research tattoos. However, most importantly, this chapter seeks to map out a change in discourse when it comes to the relationship between the client and the tattoo artist and to explain how it has changed into a relationship based on mutual and reciprocated communication as well as focussed on making a product/piece of art that both can be satisfied with. © 2015 S. Karger AG, Basel.

Integrating substance abuse treatment and criminal justice supervision.

PubMed

Marlowe, Douglas B

2003-08-01

Proponents of a pure public safety perspective on the drug problem hold that drug-involved offenders require consistent and intensive supervision by criminal justice authorities in order to stay off drugs and out of trouble. In contrast, proponents of a thoroughgoing public health perspective commonly argue that clients perform better if they are left alone to develop an effective therapeutic alliance with counselors. Both may be correct, but with respect to different groups of offenders. One approach has shown consistent promise for reducing drug use and criminal recidivism: an integrated public health-public safety strategy that combines community-based drug abuse treatment with ongoing criminal justice supervision. This article presents promising findings from programs implementing this strategy and discusses best treatment practices to meet the needs of both low-risk and high-risk clients.

Cognitive therapy for performance anxiety.

PubMed

Rodebaugh, Thomas L; Chambless, Dianne L

2004-08-01

We present and illustrate the major components of cognitive therapy for performance anxiety, focusing on the performance fears of a client treated with a protocol designed for social phobia. The basic supposition of cognitive theory is that a client's thoughts and beliefs about situations maintain distressing feelings, such as anxiety. Changing these beliefs involves detection and disputation of anxiety-provoking thoughts, as well as testing of these thoughts through exposure to feared situations. Through a process of identifying existing beliefs about performance situations and challenging these beliefs, clients can gain a more realistic and less anxiety-producing perspective on performance tasks. Specific techniques, along with common difficulties and potential solutions, are presented in a detailed case study. Copyright 2004 Wiley Periodicals, Inc.

Ubuntu-Praxis: Re-Modelling the Balanced Scorecard Model at a University, an Afrocentric Perspective

ERIC Educational Resources Information Center

Ndoda, Gladys Ruvimbo; Sikwila, Mike Nyamazana

2014-01-01

The authors design the innovation and learning perspective of the Balanced Scorecard (BSC) of "Ubuntu and client service charter nexus." This article borrows and advances the research carried out by Khomba, Vermaak and Gouws (2011). The point of departure is on praxis of ubuntu/unhu as a holistic approach in the re-modelling of the BSC…

Practitioners' Perspectives on the Use of Clinical Supervision in Their Therapeutic Engagement with Asylum Seekers and Refugee Clients

ERIC Educational Resources Information Center

Apostolidou, Zoe; Schweitzer, Robert

2017-01-01

The present study is the first study undertaken in Australia that seeks to explore practitioners' perspectives on the use of clinical supervision in their therapeutic engagement with asylum seekers and refugees. We used thematic analysis to analyse extracts of interviews that were conducted with nine professionals who worked therapeutically with…

Women's Perspectives of Personal Trainers: A Qualitative Study.

PubMed

Melton, Deana; Dail, Teresa K; Katula, Jeffrey A; Mustian, Karen M

2011-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers.

Women's Perspectives of Personal Trainers: A Qualitative Study

PubMed Central

Melton, Deana; Dail, Teresa K.; Katula, Jeffrey A.; Mustian, Karen M.

2015-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers. PMID:26005398

Client-provider relationships in a community health clinic for people who are experiencing homelessness.

PubMed

Oudshoorn, Abe; Ward-Griffin, Catherine; Forchuk, Cheryl; Berman, Helene; Poland, Blake

2013-12-01

Recognizing the importance of health-promoting relationships in engaging people who are experiencing homelessness in care, most research on health clinics for homeless persons has involved some recognition of client-provider relationships. However, what has been lacking is the inclusion of a critical analysis of the policy context in which relationships are enacted. In this paper, we question how client-provider relationships are enacted within the culture of community care with people who are experiencing homelessness and how clinic-level and broader social and health policies shape relationships in this context. We explore these questions within a critical theoretical perspective utilizing a critical ethnographic methodology. Data were collected using multiple methods of document review, participant observation, in-depth interviews and focus groups. The participants include both clients at a community health clinic, and all clinic service providers. We explore how clients and providers characterized each other as 'good' or 'bad'. For providers, this served as a means by which they policed behaviours and enforced social norms. The means by which both providers' and clients' negotiated relationships are explored, but this is couched within both local and system-level policies. This study highlights the importance of healthcare providers and clients being involved in broader policy and systemic change. © 2013 John Wiley & Sons Ltd.

Discharge experiences of speech-language pathologists working in Cyprus and Greece.

PubMed

Kambanaros, Maria

2010-08-01

Post-termination relationships are complex because the client may need additional services and it may be difficult to determine when the speech-language pathologist-client relationship is truly terminated. In my contribution to this scientific forum, discharge experiences from speech-language pathologists working in Cyprus and Greece will be explored in search of commonalities and differences in the way in which pathologists end therapy from different cultural perspectives. Within this context the personal impact on speech-language pathologists of the discharge process will be highlighted. Inherent in this process is how speech-language pathologists learn to hold their feelings, anxieties and reactions when communicating discharge to clients. Overall speech-language pathologists working in Cyprus and Greece experience similar emotional responses to positive and negative therapy endings as speech-language pathologists working in Australia. The major difference is that Cypriot and Greek therapists face serious limitations in moving their clients on after therapy has ended.

The Prince Edward Island Conceptual Model for Nursing: a nursing perspective of primary health care.

PubMed

Munro, M; Gallant, M; MacKinnon, M; Dell, G; Herbert, R; MacNutt, G; McCarthy, M J; Murnaghan, D; Robertson, K

2000-06-01

The philosophy of primary health care (PHC) recognizes that health is a product of individual, social, economic, and political factors and that people have a right and a duty, individually and collectively, to participate in the course of their own health. The majority of nursing models cast the client in a dependent role and do not conceptualize health in a social, economic, and political context. The Prince Edward Island Conceptual Model for Nursing is congruent with the international move towards PHC. It guides the nurse in practising in the social and political environment in which nursing and health care take place. This model features a nurse/client partnership, the goal being to encourage clients to act on their own behalf. The conceptualization of the environment as the collective influence of the determinants of health gives both nurse and client a prominent position in the sociopolitical arena of health and health care.

Family Traditions, Cultural Values, and the Clinician's Countertransference: Therapeutic Assessment of a Young Sicilian Woman.

PubMed

Fantini, Francesca

2016-01-01

Despite recent advances in models and instruments to understand the role of a client's cultural background, clinical psychologists are not immune to implicit cultural biases that are potentially damaging to the therapeutic alliance. In this article, I present a Therapeutic Assessment with a young Sicilian woman conducted in a university-based student clinic in Italy. During the assessment, I assumed that because we were both Italians, my client shared my perspective (northern Italian) about family and individual values, which resulted in a therapeutic impasse when I responded on the basis of my individual and culturally shaped view of interpersonal and family relationships without appreciating important differences between my own and my client's microcultures. To overcome the impasse, I had to openly acknowledge such differences and reorient myself to my client's goals. I discuss the core processes involved in such a repair in the context of a cross-cultural psychological assessment.

An Urban Mid-Western Adult Education Program: Perspectives of Stakeholders

ERIC Educational Resources Information Center

Willis, Dedria Lynette

2017-01-01

The purpose of this qualitative research study is two-fold: (1) to narrate the realities and perspectives of adult students' learning experiences in a General Education Development (GED) preparation program in a Mid-western urban city; and (2) to document the thinking of the former director of adult education at the state level to understand the…

Multiculturalism and a Research Perspective in Initial Teacher Education: Possible Dialogues

ERIC Educational Resources Information Center

Canen, Ana

2007-01-01

This article describes action research within a multicultural pedagogical praxis orientation in a teacher education course at a higher education institution in Brazil during the academic year 2003. The narrative draws on the ways in which the course sought to develop a research perspective that could equip student teachers with elements that allow…

The Perspectives of Elementary Teachers Regarding the Integration of the JASON Project into the Science Curriculum

ERIC Educational Resources Information Center

George, Belinda Chantelle Richardson

2015-01-01

This phenomenological narrative study was to explore nine elementary teachers' perspectives of the integration of the JASON Project virtual field trip into the science curriculum. Study findings indicated that the teachers saw an increase in student participation when implementing the JASON Project virtual field trip. The most significant findings…

Situated Environmental Learning in Southern Africa at the Start of the UN Decade of Education for Sustainable Development

ERIC Educational Resources Information Center

O'Donoghue, Rob; Lotz-Sisitka, Heila

2006-01-01

Within the globalising trajectory of modernism, conservation, then environmental (EE) and now sustainability education (ESD) have each emerged as developing responses to risk produced by and in the modern state. Through adopting a long term process perspective, this paper narrates the emergence of situated learning perspectives and a developing…

A Feminist Post-Structuralist Analysis of an Exemplar South African School History Text

ERIC Educational Resources Information Center

Fardon, Jill; Schoeman, Sonja

2010-01-01

A feminist post-structuralist perspective offers an alternative paradigm for the study of gender bias in History texts. It focuses on multiple perspectives and open interpretation, opens up space for female voices of the past and present, and deconstructs realist historical narrative. Our aim in this article is to discuss feminist…

Perspectives on an Induction Process for International Exchange Teachers: A Leadership Perspective

ERIC Educational Resources Information Center

Siler, James Thomas

2012-01-01

This study traces the first year experiences of six international exchange teachers employed in three public and charter schools settings from three districts in two southeastern states. Interviews with these teachers from China, Germany and Colombia, and with their school and district leaders enabled me to produce a narrative of how international…

Integrating Recovery and the Narrative Attachment Systems Perspective to Working through Borderline Personality Disorder

ERIC Educational Resources Information Center

Bernardon, Stephanie; Pernice-Duca, Francesca

2012-01-01

Borderline personality disorder (BPD) presents a number of symptoms and adjustment issues for individuals, but it is also associated with a myriad of risks for the larger family system. A systemic perspective is crucial to comprehending the development of BPD. Promoting healthy relationships with one or more supportive adult enables the child to…

Evaluating healing for cancer in a community setting from the perspective of clients and healers: a pilot study.

PubMed

Vaghela, C; Robinson, N; Gore, J; Peace, B; Lorenc, A

2007-11-01

The real-life practice of 'healing' for cancer in the community as perceived by clients and healers was investigated in a multi-method pilot study. Fifteen clients received six weekly healing sessions. Pre- and post-changes in perception towards well-being and client experience were assessed by EuroQol (EQ-5D), measure yourself concerns and well-being (MYCaW) and a client satisfaction tool. Qualitative methods, including focus groups, explored the perceived effects of healing in more depth and the participants' experience of taking part in research. The study was not designed to test the effect of healing on disease. Quantitative data showed perceived significant improvements in 'concerns/problems' for which clients wanted help (p<0.01), well-being (p<0.01) and anxiety/depression (p<0.05) over the course of healing. Significant effects were not seen in all areas of quality of life. Qualitative analysis showed clients mainly sought help for psychological and emotional concerns and reported only beneficial effects of healing. Clients attributed many of the quantitative improvements to healing itself. Despite some concerns, healers and clients engaged fully with the research process, and were enthusiastic about the importance of research into healing. Our study suggests that, while there are some confounding issues and study limitations to address, clients and healers perceive healing to have a range of benefits, particularly in terms of coping with cancer, and regard it as a useful approach that can be applied in a community setting alongside conventional medicine.

Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies

PubMed Central

2012-01-01

Background Case management has been applied in community aged care to meet frail older people’s holistic needs and promote cost-effectiveness. This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes. Methods We searched Web of Science, Scopus, Medline, CINAHL (EBSCO) and PsycINFO (CSA) from inception to 2011 July. Inclusion criteria were: no restriction on date, English language, community-dwelling older people and/or carers, case management in community aged care, published in refereed journals, randomized control trials (RCTs) or comparative observational studies, examining client or carer outcomes. Quality of studies was assessed by using such indicators as quality control, randomization, comparability, follow-up rate, dropout, blinding assessors, and intention-to-treat analysis. Two reviewers independently screened potentially relevant studies, extracted information and assessed study quality. A narrative summary of findings were presented. Results Ten RCTs and five comparative observational studies were identified. One RCT was rated high quality. Client outcomes included mortality (7 studies), physical or cognitive functioning (6 studies), medical conditions (2 studies), behavioral problems (2 studies) , unmet service needs (3 studies), psychological health or well-being (7 studies) , and satisfaction with care (4 studies), while carer outcomes included stress or burden (6 studies), satisfaction with care (2 studies), psychological health or well-being (5 studies), and social consequences (such as social support and relationships with clients) (2 studies). Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group, while all the three studies consistently reported fewer unmet service needs among the intervention participants. In contrast, available studies reported mixed results regarding client physical or cognitive functioning and carer stress or burden. There was also limited evidence indicating significant effects of the interventions on the other client and carer outcomes as described above. Conclusions Available evidence showed that case management in community aged care can improve client psychological health or well-being and unmet service needs. Future studies should investigate what specific components of case management are crucial in improving clients and their carers’ outcomes. PMID:23151143

Patterns of client behavior with their most recent male escort: an application of latent class analysis.

PubMed

Grov, Christian; Starks, Tyrel J; Wolff, Margaret; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

2015-05-01

Research examining interactions between male escorts and clients has relied heavily on data from escorts, men working on the street, and behavioral data aggregated over time. In the current study, 495 clients of male escorts answered questions about sexual behavior with their last hire. Latent class analysis identified four client sets based on these variables. The largest (n = 200, 40.4 %, labeled Typical Escort Encounter) included men endorsing behavior prior research found typical of paid encounters (e.g., oral sex and kissing). The second largest class (n = 157, 31.7 %, Typical Escort Encounter + Erotic Touching) included men reporting similar behaviors, but with greater variety along a spectrum of touching (e.g., mutual masturbation and body worship). Those classed BD/SM and Kink (n = 76, 15.4 %) reported activity along the kink spectrum (BD/SM and role play). Finally, men classed Erotic Massage Encounters (n = 58, 11.7 %) primarily engaged in erotic touch. Clients reporting condomless anal sex were in the minority (12.2 % overall). Escorts who engage in anal sex with clients might be appropriate to train in HIV prevention and other harm reduction practices-adopting the perspective of "sex workers as sex educators."

!Claro, se puede! Critical resilience: A critical race perspective on resilience in the baccalaureate achievement of Latino/a engineering and life science students

NASA Astrophysics Data System (ADS)

Cruz, Gary Anthony

An under representation of Latino/as in the fields of science, technology, engineering and math (STEM) still persists. In Rising Above the Gathering Storm, the National Academies sounded an alarm in response to data indicating a "troubling decline" in the number of U.S. citizens trained to become scientists and engineers at a time when the number of technical jobs is outpacing the rate of the U.S. workforce. The shrinking technical talent pipeline threatens the country's future in technology innovation, energy alternatives, national security, and education. This study purported to contextualize resilience and discern the cultural capital and persistence behaviors of STEM Latino/a students succeeding in two adverse environments---higher education and science and engineering. Through a critical race perspective the student cuentos were thematically analyzed. Student narratives were then triangulated with the narrative of the researcher---a Mexican American, first-generation college student, who pursued a life science bachelor's degree through the two institutions in this study. The theoretical framework was guided by Critical Race Theory, Resiliency, Persistence Theory, and Social Construction of Technology. The study consisted of a pilot survey and narrative inquiry. The survey contained pilot questions on the use and perception of information technologies in STEM education. The narrative inquiry was guided by critical race that enabled both positionality and storytelling through narratives and counter-narratives. Twenty-two Latino/a graduating seniors majoring in the biological sciences or engineering/engineering technology at a Hispanic-Serving Institution (HSI) and a Predominantly-White Institution (PWI) in Texas were recruited. The narratives of these students were collected through one-time, semi-structured interviews during the last semester of their studies. Results from the study indicate that these Latino/a STEM students are conscious of their ethnicity; however, they are not critically conscious of the master narrative of what it means to be a Latino/a in a STEM discipline. These students have bought into the master narrative of colorblind science and engineering. The students understood that to succeed in STEM, they had to survive based on their proficiency with institutional norms, practices and cultures and then maintain a sense of self through a respect for their Latino culture.

Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga district eastern Uganda, a qualitative study.

PubMed

Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

2013-01-01

Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.

The distinguishing characteristics of narrative identity in adults with features of borderline personality disorder: an empirical investigation.

PubMed

Adler, Jonathan M; Chin, Erica D; Kolisetty, Aiswarya P; Oltmanns, Thomas F

2012-08-01

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes.

The distinguishing characteristics of narrative identity in adults with features of Borderline Personality Disorder: An empirical investigation

PubMed Central

Adler, Jonathan M.; Chin, Erica D.; Kolisetty, Aiswarya P.; Oltmanns, Thomas F.

2011-01-01

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes. PMID:22867502

Motor and verbal perspective taking in children with Autism Spectrum Disorder: Changes in social interaction with people and tools.

PubMed

Studenka, Breanna E; Gillam, Sandra L; Hartzheim, Daphne; Gillam, Ronald B

2017-07-01

Children with Autism Spectrum Disorder (ASD) have difficulty communicating with others nonverbally, via mechanisms such as hand gestures, eye contact and facial expression. Individuals with ASD also have marked deficits in planning future actions (Hughes, 1996), which might contribute to impairments in non-verbal communication. Perspective taking is typically assessed using verbal scenarios whereby the participant imagines how an actor would interact in a social situation (e.g., Sally Anne task; Baron-Cohen, Leslie, & Frith, 1985). The current project evaluated motor perspective taking in five children with ASD (8-11 years old) as they participated in a narrative intervention program over the course of about 16 weeks. The goal of the motor perspective-taking task was to facilitate the action of an experimenter either hammering with a tool or putting it away. Initially, children with ASD facilitated the experimenter's action less than neurotypical control children. As the narrative intervention progressed, children with ASD exhibited increased motor facilitation that paralleled their increased use of mental state and causal language, indicating a link between verbal and motor perspective taking. Motoric perspective taking provides an additional way to assess understanding and communication in children with ASD and may be a valuable tool for both early assessment and diagnosis of children with ASD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intellectual property : national and international perspectives.

DOT National Transportation Integrated Search

2009-06-01

A consistent approach to managing intellectual property (IP) permits the effective transfer of the results of research : and encourages the use of products and services by client organizations. This Preliminary Investigation seeks to : capture curren...

Integrating Substance Abuse Treatment and Criminal Justice Supervision

PubMed Central

Marlowe, Douglas B.

2003-01-01

Proponents of a pure public safety perspective on the drug problem hold that drug-involved offenders require consistent and intensive supervision by criminal justice authorities in order to stay off drugs and out of trouble. In contrast, proponents of a thoroughgoing public health perspective commonly argue that clients perform better if they are left alone to develop an effective therapeutic alliance with counselors. Both may be correct, but with respect to different groups of offenders. One approach has shown consistent promise for reducing drug use and criminal recidivism: an integrated public health-public safety strategy that combines community-based drug abuse treatment with ongoing criminal justice supervision. This article presents promising findings from programs implementing this strategy and discusses best treatment practices to meet the needs of both low-risk and high-risk clients. PMID:18552716

Anthropological perspectives on money management: considerations for the design and implementation of interventions for substance abuse.

PubMed

Carpenter-Song, Elizabeth

2012-01-01

There remains a long-standing argument regarding the need for money management strategies to control poor spending habits among people with substance use disorders. The objective was to review issues relevant to the design and implementation of money-management-based interventions for substance abuse. Using a comparative, cross-cultural framework of anthropology, this manuscript examines three challenges for the design and implementation of money management interventions for substance abuse: (i) clients may not trust mental health centers to manage their money, (ii) clients may have different economic perspectives from clinicians and researchers, and (iii) clients may obtain substances through informal networks of exchange. This article clarifies the inherently complex symbolic and social dimensions of money and addiction and illustrates the need for researchers and clinicians to be mindful of the cultural assumptions that underlie money management interventions for substance abuse. Using an anthropological approach toward understanding the issues surrounding money management for individuals struggling with addiction and mental illness has the potential to strengthen the design and implementation of money-management-based interventions in a manner that is acceptable and meaningful for this target population.

Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences.

PubMed

Coates, Dominiek

2016-12-01

In mental health settings, feedback from clients and carers is central to service evaluation, development and delivery. Increasingly, client and carer feedback is considered an integral part of service planning, and recognized as a critical element of the provision of recovery oriented service. This paper outlines the findings of a qualitative evaluation of a Youth Mental Health (YMH) service from the perspective of discharged clients and their parents. The service researcher conducted telephone interviews with 39 parents of discharged clients, and 17 young people themselves. Participants reported positive or mixed experiences with the service. In addition to more generic positive statements about the service, analysis identified two key themes: the importance of 'family inclusive practice' and the importance of 'working with client preferences'. Young people and their parents want to be actively engaged in treatment and have their treatment preferences considered in treatment planning. Participants expressed the importance of "a good fit" between the client and the worker in terms of the clinician's gender, personality and treatment style/modality. While for some participants these themes were raised in the context of service strengths, others identified them as limitations or opportunities for service improvement. The extent to which clients and their parents felt engaged and heard by their allocated clinician is critical to their satisfaction or dissatisfaction with the service, depending on their unique experience. As an outcome of this evaluation, a range of service improvement strategies have been recommended. © 2016 Australian College of Mental Health Nurses Inc.

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

PubMed

Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers need to work closely with the compensation and rehabilitation sector as well as governments to establish robust evidence of the benefits and costs of payment models, from the perspectives of clients/consumers, funders, service providers and rehabilitation professionals.

Military Personnel Who Seek Health and Mental Health Services Outside the Military.

PubMed

Waitzkin, Howard; Cruz, Mario; Shuey, Bryant; Smithers, Daniel; Muncy, Laura; Noble, Marylou

2018-05-01

Although research conducted within the military has assessed the health and mental health problems of military personnel, little information exists about personnel who seek care outside the military. The purpose of this study is to clarify the personal characteristics, mental health diagnoses, and experiences of active duty U.S. military personnel who sought civilian sector services due to unmet needs for care. This prospective, multi-method study included 233 clients, based in the United States, Afghanistan, South Korea, and Germany, who obtained care between 2013 and 2016 from a nationwide network of volunteer civilian practitioners. A hotline organized by faith-based and peace organizations received calls from clients and referred them to the network when the clients described unmet needs for physical or mental health services. Intake and follow-up interviews at 2 wk and 2 mo after intake captured demographic characteristics, mental health diagnoses, and reasons for seeking civilian rather than military care. Non-parametric bootstrap regression analyses identified predictors of psychiatric disorders, suicidality, and absence without leave (AWOL). Qualitative analyses of clients' narratives clarified their experiences and reasons for seeking care. The research protocol has been reviewed and approved annually by the Institutional Review Board at the University of New Mexico. Depression (72%), post-traumatic stress disorder (62%), alcohol use disorder (27%), and panic disorder (25%) were the most common diagnoses. Forty-eight percent of clients reported suicidal ideation. Twenty percent were absence without leave. Combat trauma predicted post-traumatic stress disorder (odds ratio [OR] = 8.84, 95% confidence interval [CI] 1.66, 47.12, p = 0.01) and absence without leave (OR = x3.85, 95% CI 1.14, 12.94, p = 0.03). Non-combat trauma predicted panic disorder (OR = 3.64, 95% CI 1.29, 10.23, p = 0.01). Geographical region was associated with generalized anxiety disorder (OR 0.70, 95% CI 0.49, 0.99, p = 0.05). Significant predictors were not found for major depression, alcohol use disorder, or suicidal ideation. Clients' narrative themes included fear of reprisal for seeking services, mistrust of command, insufficient and unresponsive services, cost as a barrier to care, deception in recruitment, voluntary enlistment remorse, guilt about actual or potential killing of combatants or non-combatant civilians, preexisting mental health disorders, family and household challenges that contributed to distress, and military sexual trauma. Our work clarified substantial unmet needs for services among active duty military personnel, the limitations of programs based in the military sector, and the potential value of civilian sector services that are not linked to military goals. We and our institutional review board opted against using a control group that would create ethical problems stemming from the denial of needed services. For future research, an evaluative strategy that can assess the impact of civilian services and that reconciles ethical concerns with study design remains a challenge. Due to inherent contradictions in the roles of military professionals, especially the double agency that makes professionals responsible to both clients and the military command, the policy alternative of providing services for military personnel in the civilian sector warrants serious consideration, as do preventive strategies such as non-military alternatives to conflict resolution.

Embedding technology into inter-professional best practices in home safety evaluation.

PubMed

Burns, Suzanne Perea; Pickens, Noralyn Davel

2017-08-01

To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.

Health/Service Providers' Perspectives on Barriers to Healthy Weight Gain and Physical Activity in Pregnant, Urban First Nations Women.

PubMed

Darroch, Francine E; Giles, Audrey R

2016-01-01

The purpose of this article is to examine health/service providers' perspectives of barriers to healthy weight gain and physical activity for urban, pregnant First Nations women in Ottawa, Canada. Through the use of semi-structured interviews, we explored 15 health/service providers' perspectives on the complex barriers their clients face. By using a postcolonial feminist lens and a social determinants of health framework, we identified three social determinants of health that the health/service providers believed to have the greatest influence on their clients' weight gain and physical activity during pregnancy: poverty, education, and colonialism. Our findings are then contextualized within existing Statistics Canada and the Ottawa Neighbourhood Study data. We found that health/service providers are in a position to challenge colonial relations of power. We conclude by urging health/service providers, researchers, and policymakers alike to take into consideration the ways in which these social determinants of health and their often synergistic effects affect urban First Nations women during pregnancy. © The Author(s) 2015.

[BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].

PubMed

Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M

2015-07-01

Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

It Happened to Me: A Qualitative Analysis of Boys' Narratives About Child Sexual Abuse.

PubMed

Foster, Jennifer M

2017-10-01

Previous research on children's narratives about sexual abuse written predominately by girls uncovered several themes, including: (a) memories of the abuse, (b) the disclosure and subsequent events, and (c) the healing journey and a meta-theme titled "fear and safety." This follow-up study explored how boys describe their life prior to, during, and after sexual abuse in the form of trauma narratives and if there are distinctive features of boys' experiences that differ from those of girls. Analysis of narratives written by males ages 3 to 17 (N = 19) found that boys ascribe to the same themes as the initial research but also have experiences and perspectives that are unique to being male survivors. This article focuses on the first two themes: memories of the abuse and the disclosure and subsequent events. Gender differences are discussed along with recommendations for prevention of male sexual abuse.

Advance directives in psychiatric care: a narrative approach

PubMed Central

Widdershoven, G.; Berghmans, R.

2001-01-01

Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives (or so-called "Ulysses contracts"), it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be minimised. Ulysses contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition. Key Words: Medical ethics • narrative ethics • advance directives • psychiatry PMID:11314165

Service users' self-narratives on their journey from shame to pride: tales of transition.

PubMed

Natland, Sidsel; Celik, Hilde Dalen

2015-01-01

As part of a course on changing attitudes developed by KREM, a Norwegian service user organization, narratives are used to explore and understand identity formation. The process is based on the role of shame in the lives of those whose life experiences lead to a reliance on government social benefits to sustain themselves. Shame is identified as an obstacle that affects everyday life and undermines one's capacity to take actions that can lead to and support self-sufficiency. Exploring oneself through the construction of the fairy tale can provide service users with a renewed sense of empowerment. Using identity formation and the concept of shame as the conceptual framework, this analysis focuses on the use of narratives to construct and interpret stories. It concludes with both practice and research implications of using narratives to acquire an understanding and sensitivity to service user perspectives.

Conducting a narrative analysis.

PubMed

Emden, C

1998-07-01

This paper describes the process of narrative analysis as undertaken within a nursing study on scholars and scholarship. If follows an earlier paper titled: Theoretical perspectives on narrative inquiry that described the influencing ideas of Bruner (1987) and Roof (1994) upon the same study. Analysis procedures are described here in sufficient detail for other researchers wishing to implement a similar approach to do so. The process as described has two main components: (A) strategies of 'core story creation' and 'employment'; and (B) issues and dilemmas of narrative analysis, especially relating to rigour. The ideas of Polkinghorne (1988), Mishler (1986), and Labov (in Mishler 1986a) are introduced in so far as they impinge upon the analysis process. These relate especially to the development of key terms, and to the analysis strategies of core story creation and employment. Outcomes of the study in question are termed 'Signposting the lived-world of scholarship'.

The use of abstract paintings and narratives to foster reflective capacity in medical educators: a multinational faculty development workshop

PubMed Central

Karkabi, Khaled; Wald, Hedy S; Cohen Castel, Orit

2014-01-01

Reflective capacity is integral to core healthcare professional practice competencies. Reflection plays a central role in teacher education as reflecting on teaching behaviours with critical analysis can potentially improve teaching practice. The humanities including narrative and the visual arts can serve as a valuable tool for fostering reflection. We conducted a multinational faculty development workshop aiming to enhance reflective capacity in medical educators by using a combination of abstract paintings and narratives. Twenty-three family physicians or physicians-in-training from 10 countries participated in the workshop. Qualitative assessment of the workshop showed that the combined use of art and narrative was well received and perceived as contributing to the reflective exercise. Participants generally felt that viewing abstract paintings had facilitated a valuable mood transformation and prepared them emotionally for the reflective writing. Our analysis found that the following themes emerged from participants’ responses: (1) narratives from different countries are similar; (2) the use of art helped access feelings; (3) viewing abstract paintings facilitated next steps; (4) writing reflective narratives promoted examination of educational challenges, compassion for self and other, and building an action plan; and (5) sharing of narrative was helpful for fostering active listening and appreciating multiple perspectives. Future research might include comparing outcomes for a group participating in arts–narrative-based workshops with those of a control group using only reflective narrative or in combination with figurative art, and implementing a combination of qualitative and quantitative methods of assessment. PMID:24273319

Accounting for Intimate Partner Violence: A Biographical Analysis of Narrative Strategies Used by Men Experiencing IPV From Their Female Partners.

PubMed

Corbally, Melissa

2015-10-01

Intimate partner violence (IPV) is a serious social issue which affects the medium- and long-term health outcomes of many individuals worldwide. The cost of IPV on the physical and psychological well-being of individuals, in addition to its wider economic costs in responding to abused persons, is significant. Presently, there is a lack of understanding about the nature of female-initiated IPV and how men account for their experiences of it. This study examined male victims' life stories of their IPV experiences from their intimate partners. Using the biographical narrative interpretive method, three cases were analyzed from a social constructionist perspective to examine what narrative strategies men used to account for their experiences of being abused by their female partners. Three dominant narrative strategies were used by respondents: the fatherhood narrative, the good husband narrative, and the abuse narrative. The abuse narrative had a unique narrative form, which reflected respondents' disassociation between their identities as men and also as abused persons. Dominant conflicting discourses of masculinity and intimate partner abuse disadvantaged men in identifying IPV and secondly in responding appropriately. This study found that men prefer to use dominant discursive identities as legitimate means from which to disclose IPV experiences. The findings from this study illustrate that broad questioning by professionals regarding fatherhood may be most helpful in promoting disclosures of IPV if this is suspected. © The Author(s) 2014.

Client and Provider Perspectives of the Efficiency and Quality of Care in the Context of Rapid Scale-Up of Antiretroviral Therapy

PubMed Central

Wanyenze, Rhoda; Alamo, Stella; Kwarisiima, Dalsone; Sunday, Pamela; Sebikaari, Gloria; Kamya, Moses; Wabwire-Mangen, Fred; Wagner, Glenn

2010-01-01

Abstract Global scale-up of antiretroviral therapy (ART) has focused on clinical outcomes with little attention on its impact on existing health systems. In June–August 2008, we conducted a formative evaluation on ART scale-up and clinic operations at three clinics in Uganda to generate lessons for informing policy and larger public health care systems. Site visits and semistructured interviews with 10 ART clients and 6 providers at each clinic were used to examine efficiency of clinic operations (patient flow, staff allocation to appropriate duties, scheduling of clinic visits, record management) and quality of care (attending to both client and provider needs, and providing support for treatment adherence and retention). Clients reported long waiting times but otherwise general satisfaction with the quality of care. Providers reported good patient adherence and retention, and support mechanisms for clients. Like clients, providers mentioned long waiting times and high workload as major challenges to clinic expansion. Providers called for more human resources and stress-release mechanisms to prevent staff burnout. Both providers and clients perceive these clinics to be delivering good quality care, despite the recognition of congested clinics and long waiting times. These findings highlight the need to address clinic efficiency as well as support for providers in the context of rapid scale-up. PMID:21034243

Meaning in life in psychotherapy: The perspective of experienced psychotherapists.

PubMed

Hill, Clara E; Kanazawa, Yoshi; Knox, Sarah; Schauerman, Iris; Loureiro, Darren; James, Danielle; Carter, Imani; King, Shakeena; Razzak, Suad; Scarff, Melanie; Moore, Jasmine

2017-07-01

Our goal was to explore the meaning experienced psychotherapists derive from providing psychotherapy, their beliefs about the role of meaning in life (MIL) in psychotherapy, how they worked with MIL with a client who explicitly presented concerns about MIL, and how they worked with a different client for whom MIL was a secondary and more implicit concern. Thirteen experienced psychotherapists were interviewed and data were analyzed using consensual qualitative research. Therapists derived self-oriented meaning (e.g., feeling gratified, fulfilled, connected) and other-oriented meaning (helping others, making the world a better place) from providing psychotherapy. They believed that MIL is fundamental and underlies all human concerns, including those brought to therapy. In contrast to the clients who had implicit MIL concerns, clients who explicitly presented MIL concerns were reported to have more interpersonal problems and physical problems, but about the same amount of psychological distress and loss/grief. Therapists used insight-oriented interventions, support, action-oriented interventions, and exploratory interventions to work with MIL with both types of clients, but used more exploratory interventions with implicit than explicit MIL clients. MIL is a salient topic for experienced, existentially oriented psychotherapists; they work with MIL extensively with some clients in psychotherapy. We recommend that therapists receive training to work with MIL in therapy, and that they pay attention to MIL concerns when they conduct psychotherapy. We also recommend additional research on MIL in psychotherapy.

Ten-Year Recovery Outcomes for Clients With Co-Occurring Schizophrenia and Substance Use Disorders

PubMed Central

Drake, Robert E.; McHugo, Gregory J.; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara

2006-01-01

The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 “recovery outcomes,” identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non–substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088

Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders.

PubMed

Drake, Robert E; McHugo, Gregory J; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara

2006-07-01

The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 "recovery outcomes," identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non-substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients.

Expert patient illness narratives as a teaching methodology: A mixed method study of student nurses satisfaction.

PubMed

Feijoo-Cid, Maria; Moriña, David; Gómez-Ibáñez, Rebeca; Leyva-Moral, Juan M

2017-03-01

To evaluate nursing students' satisfaction with Expert Patient Illness Narratives as a teaching and learning methodology based on patient involvement. Mixed methods were used in this study: online survey with quantitative and qualitative items designed by researchers. Sixty-four nursing students of the Universitat Autònoma de Barcelona, attending a Medical Anthropology elective course. Women more frequently considered that the new learning methodology was useful in developing the competency "to reason to reason the presence of the triad Health-Illness-Care in all the groups, societies and historical moments" (p-value=0.02) and in that it was consolidated as a learning outcome (p-value=0.022). On the other hand, men considered that this methodology facilitated the development of critical thinking (p=0.01) and the ability to identify normalized or deviant care situations (p=0.007). Students recognized the value of Expert Patient Illness Narratives in their nursing training as a way to acquire new nursing skills and broaden previously acquired knowledge. This educational innovation improved nursing skills and provided a different and richer perspective of humanization of care. The results of the present study demonstrate that nursing students found Expert Patient Illness Narratives satisfactory as a learning and teaching methodology, and reported improvement in different areas of their training and also the integration of new knowledge, meaning, theory applicability, as well las critical and reflective thinking. Involvement of patients as storytellers also provides a new humanizing perspective of care. Nonetheless, further studies of Expert Patient Illness Narratives are needed in order to improve its benefits as a teaching and learning methodology. Copyright © 2016 Elsevier Ltd. All rights reserved.

Narrative and the social construction of adulthood.

PubMed

Hammack, Phillip L; Toolis, Erin

2014-01-01

This chapter develops three points of elaboration and theoretical expansion upon Cohler's (1982) treatise on personal narrative and life course. First, we highlight Cohler's emphasis on an interpretive, idiographic approach to the study of lives and reveal the radicalism of this approach, particularly in its ability to interrogate the lived experience of social categorization. Second, we link Cohler's position directly to cultural-historical activity theory (CHAT) and consider the link between inner and social speech through the idea of narrative engagement. Finally, following Cohler's life course perspective on human development, we suggest that adulthood is best conceived as a cultural discourse to which individuals orient their personal narratives through a dynamic process of narrative engagement rather than a clearly demarcated life stage. Emerging adulthood is linked to cultural and economic processes of globalization in the 21st century and challenges static notions of social roles traditionally associated with compulsory heterosexuality (e.g., marriage and parenthood). Narrative processes in emerging adulthood occur through both situated storytelling and the formation of a life story that provides coherence and social meaning, both of which have key implications for social stasis and change. © 2014 Wiley Periodicals, Inc.

[Sexual initiation, masculinity and health: narratives of young men].

PubMed

Rebello, Lúcia Emilia Figueiredo de Sousa; Gomes, Romeu

2009-01-01

The main objective of this study was to analyze the narratives of young university students about the experience of sexual initiation. The theoretical and conceptual references used were the sexual scripts of our society that inform people about when, how, where and with whom they should have their sexual experiences, indicating how to act sexually and the reasons why they have to practice some kind of sexual activity. The method used was a qualitative study of narratives from the perspective of dialectic hermeneutics. The methodological design involves the comprehension of sceneries, contexts, environments and characters of the narratives about sexual initiation. The analysis refers to narratives of university students in the city of Rio de Janeiro. Among the meanings of sexual initiation, we emphasize sexual intercourse, the demarcation of a stage of life, the awakening to the opposite sex and the discovery of the body. We observed that the young men's narratives were coherent with what is considered masculine, present in the discourse of different generations. It is concluded that the young men should be encouraged to participate in actions combining health and education aimed at promotion of sexual and reproductive health.

Education biographies from the science pipeline: An analysis of Latino/a student perspectives on ethnic and gender identity in higher education

NASA Astrophysics Data System (ADS)

Lujan, Vanessa Beth

This study is a qualitative narrative analysis on the importance and relevance of the ethnic and gender identities of 17 Latino/a (Hispanic) college students in the biological sciences. This research study asks the question of how one's higher education experience within the science pipeline shapes an individual's direction of study, attitudes toward science, and cultural/ethnic and gender identity development. By understanding the ideologies of these students, we are able to better comprehend the world-makings that these students bring with them to the learning process in the sciences. Informed by life history narrative analysis, this study examines Latino/as and their persisting involvement within the science pipeline in higher education and is based on qualitative observations and interviews of student perspectives on the importance of the college science experience on their ethnic identity and gender identity. The findings in this study show the multiple interrelationships from both Latino male and Latina female narratives, separate and intersecting, to reveal the complexities of the Latino/a group experience in college science. By understanding from a student perspective how the science pipeline affects one's cultural, ethnic, or gender identity, we can create a thought-provoking discussion on why and how underrepresented student populations persist in the science pipeline in higher education. The conditions created in the science pipeline and how they affect Latino/a undergraduate pathways may further be used to understand and improve the quality of the undergraduate learning experience.

Coaching the Multiplicity of Mind: A Strengths-based Model

PubMed Central

2013-01-01

Professional health and wellness coaches are passionate about helping people learn, change, and grow. We are lifelong students of what enables humans to perform at our best. The phrase coaching the whole person is common coaching parlance; full engagement in self-care often requires that clients shift a spectrum of beliefs, motives, and perspectives in order to make changes that are sustainable. Just as important is the need for coaches to fully engage in their own self-care in order to best serve their clients. PMID:24416685

Using and joining a franchised private sector provider network in Myanmar.

PubMed

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor.

Using and Joining a Franchised Private Sector Provider Network in Myanmar

PubMed Central

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Background Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Methods and Findings Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor. PMID:22180781

Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

PubMed

Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

2015-01-01

The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

Addressing phonological memory in language therapy with clients who have Down syndrome: Perspectives of speech-language pathologists.

PubMed

Faught, Gayle G; Conners, Frances A; Barber, Angela B; Price, Hannah R

2016-11-01

Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech-language pathologists (SLPs) find ways to do so in their practices. This study asked if and how SLPs address PM in language therapy with clients who have DS. It also asked about SLPs' opinions of the importance, practicality and difficulty of addressing PM in clients with DS. SLPs participated in an online survey that asked if they address PM in clients with DS and, if so, how often and with which techniques. The survey also asked SLPs to rate their opinions of addressing PM in clients with DS with Likert scales. To contrast clients with DS, SLPs were asked about their practices and opinions with clients who have specific language impairment (SLI) and autism spectrum disorders (ASD). SLPs were recruited through e-mails sent from state organizations and researchers. To compare SLPs' practices and opinions across client types, frequency analyses and analyses of variance (ANOVAs) were run. In all, 290 SLPs from 28 states completed the survey. Nearly all SLPs were currently practising at the time data were collected, and all worked with at least one of the three client types. Findings indicated SLPs less often addressed PM and used less variety when addressing PM with clients who have DS compared with clients who have SLI or ASD. Further, SLPs considered it less important, less practical and more difficult to address PM in clients who have DS when compared with clients who have SLI, whereas a similar pattern was found with clients who have ASD. SLPs' opinions could be one reason they under-address PM with clients who have DS. Other reasons include there are no evidence-based practice (EBP) guidelines on this topic, and there is not enough familiarity with the DS phenotype among SLPs. Future research on ways to address PM in clients with DS successfully are essential so that EBP guidelines can be established and language therapy can be made more effective. © 2016 Royal College of Speech and Language Therapists.

Addressing phonological memory in language therapy with clients who have Down syndrome: Perspectives of speech–language pathologists

PubMed Central

Faught, Gayle G.; Conners, Frances A.; Barber, Angela B.; Price, Hannah R.

2018-01-01

Background Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech–language pathologists (SLPs) find ways to do so in their practices. Aims This study asked if and how SLPs address PM in language therapy with clients who have DS. It also asked about SLPs’ opinions of the importance, practicality and difficulty of addressing PM in clients with DS. Methods & Procedures SLPs participated in an online survey that asked if they address PM in clients with DS and, if so, how often and with which techniques. The survey also asked SLPs to rate their opinions of addressing PM in clients with DS with Likert scales. To contrast clients with DS, SLPs were asked about their practices and opinions with clients who have specific language impairment (SLI) and autism spectrum disorders (ASD). SLPs were recruited through e-mails sent from state organizations and researchers. To compare SLPs’ practices and opinions across client types, frequency analyses and analyses of variance (ANOVAs) were run. Outcomes & Results In all, 290 SLPs from 28 states completed the survey. Nearly all SLPs were currently practising at the time data were collected, and all worked with at least one of the three client types. Findings indicated SLPs less often addressed PM and used less variety when addressing PM with clients who have DS compared with clients who have SLI or ASD. Further, SLPs considered it less important, less practical and more difficult to address PM in clients who have DS when compared with clients who have SLI, whereas a similar pattern was found with clients who have ASD. Conclusions & Implications SLPs’ opinions could be one reason they under-address PM with clients who have DS. Other reasons include there are no evidence-based practice (EBP) guidelines on this topic, and there is not enough familiarity with the DS phenotype among SLPs. Future research on ways to address PM in clients with DS successfully are essential so that EBP guidelines can be established and language therapy can be made more effective. PMID:27150499

A Day in the Life (and Death) of a Public University

ERIC Educational Resources Information Center

Kelly, Frances

2015-01-01

This is a narrative of an actual day in the author's working life at a large public university in the southern hemisphere. It is an enquiry into life, and death, at the university. It attempts to balance a critical and informed perspective with a lived perspective and, as a story that contributes to a developing genre of academic writing, it works…

Families parenting adolescents with substance abuse--recovering the mother's voice: a narrative literature review.

PubMed

Smith, Jackie M; Estefan, Andrew

2014-11-01

Alcohol and substance dependency are complex, problematic phenomena, which are growing worldwide. In particular, drug use and abuse among young people is a significant concern. Although addiction presents as a problem of dependent individuals, families are also profoundly affected by the family member's addiction. In this narrative literature review, we review published research from 1937 to 2014 to capture a narrative and historical perspective of addiction and family. We condense and analyze the experiences of parents with alcohol- and drug-dependent children, to emphasize the need for a more specific, in-depth exploration of mothers' experiences. Such exploration may advance nurses' understandings of individual, familial, and social complexities of parenting an addicted child. © The Author(s) 2014.

Narrative Therapy's Relational Understanding of Identity.

PubMed

Combs, Gene; Freedman, Jill

2016-06-01

We describe how we think of identity as relational, distributed, performed, and fluid, and we illustrate the use of this conceptualization within a narrative worldview. Drawing on the work of Michael White, we describe how this relational view of identity leads to therapeutic responses that give value to interconnection across multiple contexts and that focus on becoming rather than on being. We show how a narrative worldview helps focus on the relational, co-evolving perspective that was the basis of our early attraction to family therapy. We offer detailed examples from our work of practices that help us stay firmly situated in a relational worldview that is counter to the pervasive influence of individualism in our contemporary culture. © 2016 Family Process Institute.

To Stay or Not To Stay: Adolescent Client, Parent, and Counselor Perspectives on Leaving Substance Abuse Treatment Early

PubMed Central

Landrum, Brittany; Knight, Danica K.; Becan, Jennifer E.; Flynn, Patrick M.

2013-01-01

Increasing motivation and raising retention rates are considerable challenges for providers of adolescent substance abuse treatment. Research has shown that motivation for treatment, social influences (peers, family, counselors), and for some clients external pressure from the juvenile justice system, can serve as key factors in successful retention. To further understand influences on motivation and retention, focus groups were conducted in two residential treatment facilities. Adolescent clients, parents, and treatment staff were asked to describe their experiences with the treatment process focusing specifically on factors related to treatment attrition and retention. Qualitative data analysis revealed five themes affecting retention either positively or negatively. Themes included relationships (with family, peers, and counselors), responsibility (degree to which clients embrace jobs, roles, and rules), emotional regulation (ability to express feelings appropriately), thinking (identifying behavior patterns and recognizing consequences), and self-efficacy (feelings of empowerment). Implications for future research and for developing strategies aimed at increasing motivation and retention are discussed. PMID:26457049

Moving from affirmation to liberation in psychological practice with transgender and gender nonconforming clients.

PubMed

Singh, Anneliese A

2016-11-01

While affirmative approaches with transgender and gender nonconforming (TGNC) clients are gaining momentum within psychological practice (American Counseling Association, 2010; American Psychological Association, 2015), there is a simultaneous and pressing need to move beyond TGNC-affirmative to TGNC-liberatory approaches to more fully address how societal gender binaries influence both psychologist and client. Psychologists may use the lens of liberation psychology (Martín-Baró, 1996) to transform the ways they work with TGNC clients. Using this perspective, psychologists can reflect on their own gender journey and experiences, identify how cisgender privilege influences counseling and psychological practice, and advocate for TGNC people to be better served in the settings in which they work. Psychologists are then able to engage in social change on behalf of, and in collaboration with, TGNC people in ways that simultaneously liberate psychologists from their own gender oppression experiences. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A clinical treatment intervention for dysphoria: externalizing metaphors therapy.

PubMed

McGuinty, Everett; Armstrong, David; Carrière, Anne-Marie

2014-01-01

The purpose of this article is to explore a novel, short-term treatment intervention for internalizing behaviours. This intervention is primarily based upon an externalizing process, transforming of metaphoric imagery, and shifting of underlying maladaptive emotional schemas. This article addresses the clinical population of children and youth, specifically through outlining the protocol, externalizing metaphors therapy. A selective review of significant works regarding the efficacy of short-term therapy was conducted, including the process of change within narrative therapy. It is proposed that two specific processes account for the mental health change experienced by clients who receive this new treatment intervention: (1) externalization of problems and (2) purposeful client-generated metaphor manipulation, impacting upon underlying schemas. From these theoretical constructs, the present article outlines a three-session treatment protocol that manualizes these key clinical processes. A case study is presented to illustrate this intervention for anxiety and depression. Further clinical research is underway to address the testable hypotheses resulting from the current theoretical model. Clinical trials in brief psychotherapy are suggested to empirically evaluate the efficacy of this new treatment intervention for dysphoria. This article outlines a short-term treatment intervention for anxiety and depression (dysphoira) through a novel 3-session model, where the clinician-practitioner can obtain competency through a one-day workshop.Its relevance for the clinical researcher and the mental health community is in its versatility in addressing internalizing behavior for four clinical populations: (1) children and adolescents; (2) children and adolescents on the autism spectrum; (3) adults in general; and, (4) adults with a dual-diagnosis. The treatment protocol described within is based upon the externalizing and deconstructive properties of Narrative Therapy, and the transformation of metaphoric imagery of Metaphor Therapy; both of which have little empirical support with narrative practices gaining international attention and widespread usage - through brief therapy, long-term therapy, and walk-in clinics in North America. For the first time, the theoretical constructs of the 3-session model are described and a case example illustrates the interlinking concepts. Copyright © 2013 John Wiley & Sons, Ltd.

Moving Perspectives on Patient Competence: A Naturalistic Case Study in Psychiatry.

PubMed

Ruissen, A M; Abma, T A; Van Balkom, A J L M; Meynen, G; Widdershoven, G A M

2016-03-01

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder (OCD), and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient's autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient's and the therapist's perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist's approach, who used motivational interventions with a view to appealing to the patient's responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions.

Information fusion: telling the story (or threat narrative)

NASA Astrophysics Data System (ADS)

Fenstermacher, Laurie

2014-06-01

Today's operators face a "double whammy" - the need to process increasing amounts of information, including "Twitter-INT"1 (social information such as Facebook, You-Tube videos, blogs, Twitter) as well as the need to discern threat signatures in new security environments, including those in which the airspace is contested. To do this will require the Air Force to "fuse and leverage its vast capabilities in new ways."2 For starters, the integration of quantitative and qualitative information must be done in a way that preserves important contextual information since the goal increasingly is to identify and mitigate violence before it occurs. To do so requires a more nuanced understanding of the environment being sensed, including the human environment, ideally from the "emic" perspective; that is, from the perspective of that individual or group. This requires not only data and information that informs the understanding of how the individuals and/or groups see themselves and others (social identity) but also information on how that identity filters information in their environment which, in turn, shapes their behaviors.3 The goal is to piece together the individual and/or collective narratives regarding threat, the threat narrative, from various sources of information. Is there a threat? If so, what is it? What is motivating the threat? What is the intent of those who pose the threat and what are their capabilities and their vulnerabilities?4 This paper will describe preliminary investigations regarding the application of prototype hybrid information fusion method based on the threat narrative framework.

Mothering differently: narratives of mothers with intellectual disability whose children have been compulsorily removed.

PubMed

Mayes, Rachel; Llewellyn, Gwynnyth

2012-06-01

Despite the frequency with which mothers with intellectual disability have their children removed, little theoretical or empirical work has understood the mothers' perspectives on this. A few studies have reported mothers' feelings of grief and loss and their sense of powerlessness in the child protection system. This qualitative study explores the daily life narratives of 7 mothers with intellectual disability following the involuntarily removal of their children. For most mothers, having a child removed was not a one-off experience. The serial nature of the experience yielded 3 different narratives, lived out in different ways. In some cases, women told a different narrative for each of their removed children. All women remained focused on their children in care. The multiple and varied narratives of mothers with intellectual disability who have children in care suggest that their support needs may differ from each other and over time. How their support needs might best be met remains an unanswered question. Further research is also needed to identify any adverse health and social consequences for mothers with children in care as well as the effects on their children.

Narrative, emotion and action: analysing 'most memorable' professionalism dilemmas.

PubMed

Rees, Charlotte E; Monrouxe, Lynn V; McDonald, Laura A

2013-01-01

Although previous studies have explored medical learners''most memorable' experiences, these have typically focused on patient deaths or mistakes. Drawing on multiple theoretical perspectives to understand the interplay between narrative, emotion and action, this paper aims to explore the whats and hows of written narratives of most memorable professionalism dilemmas: what types of dilemma are most memorable? When and where do they take place? How do students act? What characteristics relate to these dilemmas? How are dilemmas narrated? A total of 680 students from 29 of 32 UK medical schools provided a written narrative of their most memorable dilemma as part of their responses to an online questionnaire exploring the impact of professionalism dilemmas on moral distress. We employed quantitative thematic and discourse analysis of all narratives using Linguistic Inquiry Word Count software (LIWC) and conducted a narrative analysis of one exemplar. The most common themes across all narratives concerned dilemmas that related to issues of patient care with reference to the actions of health care professionals or students, student abuse, and consent and intimate examination. A total of 41.1% of experiences had occurred over 6 months previously and 80.1% had taken place in hospital settings. Overall, 54.9% of narrators reported having done something in the face of their dilemma, although only 13.2% described taking obvious or direct action. Numerous characteristics were related to most memorable dilemmas (e.g. narratives citing intimate examinations were more likely to take place in surgical settings). A total of 92.6% of narratives included negative emotion talk and numerous significant relationships emerged between types of emotion talk and most memorable dilemmas (e.g. more anger talk in abuse narratives). Our narrative analysis of one exemplar illustrates the richness of emotion talk and more subtle devices to establish emotional tone. Findings extend previous research into issues related to professionalism by exploring relationships between narrative, emotion and action in the context of written narratives of most memorable dilemmas. We encourage medical educators to help students construct coherent and emotionally integrated narratives to make sense of negative professionalism dilemmas. © Blackwell Publishing Ltd 2013.

MPS Editor

NASA Technical Reports Server (NTRS)

Mathews, William S.; Liu, Ning; Francis, Laurie K.; OReilly, Taifun L.; Schrock, Mitchell; Page, Dennis N.; Morris, John R.; Joswig, Joseph C.; Crockett, Thomas M.; Shams, Khawaja S.

2011-01-01

Previously, it was time-consuming to hand-edit data and then set up simulation runs to find the effect and impact of the input data on a spacecraft. MPS Editor provides the user the capability to create/edit/update models and sequences, and immediately try them out using what appears to the user as one piece of software. MPS Editor provides an integrated sequencing environment for users. It provides them with software that can be utilized during development as well as actual operations. In addition, it provides them with a single, consistent, user friendly interface. MPS Editor uses the Eclipse Rich Client Platform to provide an environment that can be tailored to specific missions. It provides the capability to create and edit, and includes an Activity Dictionary to build the simulation spacecraft models, build and edit sequences of commands, and model the effects of those commands on the spacecraft. MPS Editor is written in Java using the Eclipse Rich Client Platform. It is currently built with four perspectives: the Activity Dictionary Perspective, the Project Adaptation Perspective, the Sequence Building Perspective, and the Sequence Modeling Perspective. Each perspective performs a given task. If a mission doesn't require that task, the unneeded perspective is not added to that project's delivery. In the Activity Dictionary Perspective, the user builds the project-specific activities, observations, calibrations, etc. Typically, this is used during the development phases of the mission, although it can be used later to make changes and updates to the Project Activity Dictionary. In the Adaptation Perspective, the user creates the spacecraft models such as power, data store, etc. Again, this is typically used during development, but will be used to update or add models of the spacecraft. The Sequence Building Perspective allows the user to create a sequence of activities or commands that go to the spacecraft. It provides a simulation of the activities and commands that have been created.

Occupational therapists' perceptions of gender - a focus group study.

PubMed

Liedberg, Gunilla M; Björk, Mathilda; Hensing, Gunnel

2010-10-01

Women and men are shaped over the courses of their lives by culture, society and human interaction according to the gender system. Cultural influences on individuals' social roles and environment are described in occupational therapy literature, but not specifically from a gender perspective. The purpose of this qualitative study was to explore how a sample of occupational therapists perceives the 'gender' concept. Four focus group interviews with 17 occupational therapists were conducted. The opening question was: 'How do you reflect on the encounter with a client depending on whether it is a man or a woman?' The transcribed interviews were analysed and two main themes emerged: 'the concept of gender is tacit in occupational therapy' and 'client encounters'. The occupational therapists expressed limited theoretical knowledge of 'gender'. Furthermore, the occupational therapists seemed to be 'doing gender' in their encounters with the clients. For example, in their assessment of the client, they focussed their questions on different spheres: with female clients, on the household and family; with male clients, on their paid work. This study demonstrated that occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. There is a need to increase occupational therapists' awareness of their own behaviour of 'doing gender'. Furthermore, there is a need to investigate whether gendered perceptions will shorten or lengthen a rehabilitation period and affect the chosen interventions, and in the end, the outcome for the clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Measuring client experiences in long-term care in the Netherlands: a pilot study with the Consumer Quality Index Long-term Care.

PubMed

Triemstra, Mattanja; Winters, Sjenny; Kool, Rudolf B; Wiegers, Therese A

2010-04-12

This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index) Long-term Care, for measuring client experiences with long-term care in the Netherlands. Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for interviews with residents of nursing or residential care homes and postal surveys among representatives of psychogeriatric residents and homecare clients. From July to November 2006 a pilot study was conducted among 2,697 clients of 68 nursing or residential care homes, 2,164 representatives of clients in 57 psychogeriatric care institutions, and 1,462 clients of 19 homecare organizations. We performed psychometric analyses and descriptive analyses, and evaluated the pilot study. The pilot study showed the feasibility and usability of the instruments, supported the multidimensionality of the questionnaires and showed first findings on client experiences and possibilities for quality improvement. Nine scales applied to all care settings: shared decision making, attitude and courtesy, information, body care, competence and safety of care, activities, autonomy, mental well-being, and availability of personnel. The pilot resulted in three optimized questionnaires and recommendations for nationwide implementation. The CQ-index Long-term Care provides a good basis to investigate the quality of nursing homes, residential care homes and homecare from the clients' perspective. This standardized instrument enables a nationwide comparison of the quality of long-term care for the purpose of transparency and quality assurance.

Counselor and Participant Perspectives of Trauma-Focused Cognitive Behavioral Therapy for Children in Zambia: A Qualitative Study

PubMed Central

Murray, Laura K.; Skavenski, Stephanie; Michalopoulos, Lynn M.; Bolton, Paul A.; Bass, Judith K.; Familiar, Itziar; Imasiku, Mwiya; Cohen, Judy

2014-01-01

Objective This study examined Zambian counselors, children, and caregivers' perceptions of an evidence-based treatment (EBT) for trauma (Trauma-Focused Cognitive Behavioral Therapy, TF-CBT) utilized in Zambia to address mental health problems in children. Method Semi-structured interviews were conducted with local counselors trained in TF-CBT (N=19; 90% of those trained; 12 Female) and children/caregivers who had received TF-CBT in a small feasibility study (N=18; 86% of the children and N=16; 76% of the caregivers) who completed TF-CBT (Total completed; N=21). Each client was asked six open-ended questions, and domain analysis was used to explore the data. Results Counselors were positive about the program, liked the structure and flexibility, reported positive changes in their clients, and discussed the cultural adaptation around activities and language. Counselors stated the training was too short, and the supervision was necessary. Challenges included client engagement and attendance, availability of location, funding, and a lack of community understanding of “therapy.” Children and caregivers stated multiple positive changes they attributed to TF-CBT, such as better family communication, reduction of problem behaviors, and ability to speak about the trauma. They recommended continuing the program. Conclusion This study brings a critical examination of providers' and clients' perspectives of the implementation of an EBT for children in a low-resource setting. Clinical implications include changing implementation methods based on responses. Research implications include future study directions such as an effectiveness trial of TF-CBT and an examination of implementation factors. PMID:24400677

Building Economic Security Today: making the health-wealth connection in Contra Costa county's maternal and child health programs.

PubMed

Parthasarathy, Padmini; Dailey, Dawn E; Young, Maria-Elena D; Lam, Carrie; Pies, Cheri

2014-02-01

In recent years, maternal and child health professionals have been seeking approaches to integrating the Life Course Perspective and social determinants of health into their work. In this article, we describe how community input, staff feedback, and evidence from the field that the connection between wealth and health should be addressed compelled the Contra Costa Family, Maternal and Child Health (FMCH) Programs Life Course Initiative to launch Building Economic Security Today (BEST). BEST utilizes innovative strategies to reduce inequities in health outcomes for low-income Contra Costa families by improving their financial security and stability. FMCH Programs' Women, Infants, and Children Program (WIC) conducted BEST financial education classes, and its Medically Vulnerable Infant Program (MVIP) instituted BEST financial assessments during public health nurse home visits. Educational and referral resources were also developed and distributed to all clients. The classes at WIC increased clients' awareness of financial issues and confidence that they could improve their financial situations. WIC clients and staff also gained knowledge about financial resources in the community. MVIP's financial assessments offered clients a new and needed perspective on their financial situations, as well as support around the financial and psychological stresses of caring for a child with special health care needs. BEST offered FMCH Programs staff opportunities to engage in non-traditional, cross-sector partnerships, and gain new knowledge and skills to address a pressing social determinant of health. We learned the value of flexible timelines, maintaining a long view for creating change, and challenging the traditional paradigm of maternal and child health.

Generating Expectations: What Pediatric Rehabilitation Can Learn From Mental Health Literature.

PubMed

Smart, Eric; Nalder, Emily; Rigby, Patty; King, Gillian

2018-04-03

Family-Centered Care (FCC) represents the ideal service delivery approach in pediatric rehabilitation. Nonetheless, implementing FCC as intended in clinical settings continues to be hindered by knowledge gaps. One overlooked gap is our understanding of clients' therapy expectations. This perspective article synthesizes knowledge from the mental health services literature on strategies recommended to service providers for generating transparent and congruent therapy expectations with clients, and applies this knowledge to the pediatric rehabilitation literature, where this topic has been researched significantly less, for the purpose of improving FCC implementation. Dimensions of the Measure of Processes of Care, an assessment tool that measures clients' perceptions of the extent a service is family-centered, inform the organization of therapy expectation-generating strategies: (1) Providing Respectful and Supportive Care (assessing and validating clients' expectations); (2) General and Specific Information (foreshadowing therapy journeys, explaining treatment rationale, and conveying service provider qualifications); (3) Coordinated and Comprehensive Care (socializing clients to roles and reflecting on past socialization); and (4) Enabling and Partnership (applying a negotiation framework and fostering spaces safe to critique). Strategies can help pediatric rehabilitation service providers work with families to reframe unrealistic expectations, establish congruent beliefs supporting effective partnerships, and prevent possible disillusionment with therapy over time.

The use of touch to enhance nursing care of older person in long-term mental health care facilities.

PubMed

Gleeson, M; Timmins, F

2004-10-01

The self-care deficits experienced by older clients in long-term mental health settings, because of cognitive impairment, are likely to impact upon the clients' higher-order needs. The practice of nursing the elderly involves a lot of personal contact, during the delivery of fundamental physical care. While physiological and safety needs are crucial to clients in long-term settings, higher-order needs need also to be addressed. From the clients' perspective nurse's use of touch provides comfort, warmth and security, although there is a dearth of empirical evidence of these benefits. This paper explores the nurse's use of touch, the impact of touch and the experiences of touch on the older person in long-term settings. Because of the dearth of research in the use of touch with elderly clients in long-term care mental health facilities, a review of the literature was performed on the topic. This revealed that touch by nurses is frequently associated with routine tasks within nursing, and is less likely to be a caring touch intervention. Recommendations include further research on the topic and caution with widespread adoption of caring touch as an intervention.

A positive risk approach when clients choose to live at risk: a palliative case discussion.

PubMed

De Bono, Christopher E; Henry, Blair

2016-09-01

The article discusses recent approaches in the literature about clients who chose to live at risk in their homes. It argues for a positive risk-based approach and a tool to help manage risk in the home, and applies these to a hypothetical end-of-life scenario. Historically, safety plans to consider risk management involved a culture of risk aversion supported by sometimes paternalistic motives intended to protect vulnerable clients. New findings in the literature engage in a process that respects the ethical principles underlying harm reduction philosophies. The literature also argues for a perspective that moves away from viewing risk as only harmful, to one that supports a positive understanding of risk as part of a client's informed choice. A risk support management plan, based on a positive approach, can provide a way to both support a client's choice to live at risk, anticipate for expected complications, and inform the creation of a contingency plan to address concerns as they may arise. The added value of a structured approach like the one proposed here for risk support management plans is that it provides adequate due diligence and informed decision-making when planning for risk-taking in complex situations.

Exploring the potential of constructionist therapy: deaf clients, hearing therapists and a reflecting team.

PubMed

Munro, L; Knox, M; Lowe, R

2008-01-01

This article explores the use of constructionist therapy with a reflecting team of hearing therapists seeing deaf clients. Using findings from two in-depth interviews, postsession reflections and a review of the literature, we propose that this model has the potential to cater to the diversity of the lived experiences of deaf people and also to address issues of power and tensions between medical, social, and cultural models of deafness. The interviews found there was real value in sharing multiple perspectives between the reflecting team of hearing therapists and these deaf clients. In addition, the clients reported feeling safe and comfortable with this model of counseling. Other information that emerged from the interviews supports previous findings regarding consistency in interpreting and the importance of hearing therapists having an understanding of the distinctions between Deaf and hearing worlds. As the first investigation of its kind in Australia, this article provides a map for therapists to incorporate reflecting teams with interpreters, deaf clients, and hearing therapists. The value of this article also lies in providing a much needed platform for future research into counseling outcomes and the efficacy of this constructionist model of therapy.

Mentoring in Nursing: An Integrative Review of Commentaries, Editorials, and Perspectives Papers.

PubMed

Lin, Jian; Chew, Yi Rong; Toh, Ying Pin; Radha Krishna, Lalit Kumar

Although pivotal to mentoring success, scant data on mentoring relationships continue to hamper the application of mentoring programs in nursing education. To address this gap and circumnavigate mentoring's context-specific nature, this narrative review analyzes the perspectives and opinions of nurse mentors and mentees. The aim is to identify common themes in their mentoring experiences to better nurture effective mentoring relationships and programs in nursing.

"Treating adult survivors of childhood emotional abuse and neglect: A new framework": Correction to Grossman et al. (2017).

PubMed

2017-01-01

Reports an error in "Treating adult survivors of childhood emotional abuse and neglect: A new framework" by Frances K. Grossman, Joseph Spinazzola, Marla Zucker and Elizabeth Hopper ( American Journal of Orthopsychiatry , 2017, Vol 87[1], 86-93). In the article, in the second sentence of the third paragraph of the "The Empirical Base for CBP" section, "construction of a life narrative" should have read "construction of a trauma narrative." The full corrected sentence follows: "Therefore, the trauma treatment component traditionally focused upon construction of a trauma narrative must be expanded to address the effects of trauma on our clients' entire life narratives, including their development of a sense of self and social identity." (The following abstract of the original article appeared in record 2017-01147-002.) This article provides the outline of a new framework for treating adult survivors of childhood emotional abuse and neglect. Component-based psychotherapy (CBP) is an evidence-informed model that bridges, synthesizes, and expands upon several existing schools, or theories, of treatment for adult survivors of traumatic stress. These include approaches to therapy that stem from more classic traditions in psychology, such as psychoanalysis, to more modern approaches including those informed by feminist thought. Moreover, CBP places particular emphasis on integration of key concepts from evidence-based treatment models developed in the past few decades predicated upon thinking and research on the effects of traumatic stress and processes of recovery for survivors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Family Resemblances: Human Reproductive Cloning as an Example for Reconsidering the Mutual Relationships between Bioethics and Science Fiction.

PubMed

Hansen, Solveig L

2018-03-08

In the traditions of narrative ethics and casuistry, stories have a well-established role. Specifically, illness narratives provide insight into patients' perspectives and histories. However, because they tend to see fiction as an aesthetic endeavour, practitioners in these traditions often do not realize that fictional stories are valuable moral sources of their own. In this paper I employ two arguments to show the mutual relationship between bioethics and fiction, specifically, science fiction. First, both discourses use imagination to set a scene and determine a perspective. Second, bioethics and science fiction share the family resemblance of expressing moral beliefs. I then consider how understanding bioethics and science fiction as interrelated discourses can be the basis of a methodology for inquiry into relational autonomy in the context of biotechnologies and medicine. As an example of this methodology, I analyse Fay Weldon's novel The Cloning of Joanna May (1989).

Oral narratives: reconceptualising the turbulence between Indigenous perspectives and Eurocentric scientific views

NASA Astrophysics Data System (ADS)

Bechtel, R.

2016-06-01

Mitigating the borders that exist between scientific cultures can be a difficult task. The purpose of this paper is to look at the differences and similarities that occur in language use when two scientific cultures communicate in the same forum on a topic of mutual concern. The results provide an opportunity to share knowledge of an Indigenous culture that relies on barren ground caribou ( Rangifer tarandus) as a way of life in Northern Canada. Analysis of language use led to the identification of framework categories that can be used to increase awareness in different perspectives of science knowledge. Reconceptualization of the narratives presented can be used to calm the turbulence that exists between Indigenous People and other cultures and provides an opportunity for science educators to incorporate Indigenous ways of knowing into the classroom. It was found that autobiographical approaches in particular could provide an opening for cultural borders to be lessened.

Self-Reference Acts as a Golden Thread in Binding.

PubMed

Sui, Jie

2016-07-01

In a recent article in this journal, Glyn Humphreys and I proposed a model of how self-reference enhances binding in perception and cognition [1]. We showed that self-reference changes particular functional processes; notably, self-reference increases binding between the features of stimuli and between different stages of processing. Lane and colleagues [2] provide an interesting comment on our article that suggests our theory of self-reference is compatible with Dennett's philosophical perspective on the narrative nature of the self. Although the nature of the self has attracted the attention of both philosophers and scientists, the two disciplines have generated different perspectives on the functions of the self, largely due to their different methodologies. For example, Dennett argues that the self is constituted through human narration on experience [3]. By contrast, work from psychologists and cognitive neuroscientists focuses on the functional and neural mechanisms of self-reference. Copyright © 2016 Elsevier Ltd. All rights reserved.

Empathy beyond the head. Comment on "Music, empathy, and cultural understanding" by E. Clarke et al.

NASA Astrophysics Data System (ADS)

Krueger, Joel

2015-12-01

Can art build up our capacity for empathy? Some argue that film and narrative arts-by providing nuanced case studies of characters who act for reasons-serve as cognitive tools that scaffold our imaginative, perceptual, and affective capacities and expand our empathic skillset [1,2]. There is evidence that narrative may be an effective tool for at least modest improvements in children's theory of mind development [3]; other studies suggest reading literary fiction later in life can enhance empathy and perspective-taking [4-7].

Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga District Eastern Uganda, a qualitative study

PubMed Central

Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

2013-01-01

Introduction Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. Methods In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Results Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Conclusion Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC. PMID:24255723

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda.

PubMed

Bott, Sarah; Neuman, Melissa; Helleringer, Stephane; Desclaux, Alice; Asmar, Khalil El; Obermeyer, Carla Makhlouf

2015-10-01

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients' rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. This article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. It also explores health workers' fear of infection within the workplace and their reports on discrimination against HIV clients within health facilities. HIV care providers in Burkina Faso, Kenya and Uganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. They also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. Health workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with HIV, and also from difficult ethical dilemmas related to clients who do not disclose their HIV status to those around them, including partners. These findings suggest that providers of HIV testing and counselling need more resources and support, including better protections against HIV exposure in the workplace. The findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some unresolved ethical dilemmas related to confidentiality and non-disclosure, and translate those discussions into better guidance for health workers. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda

PubMed Central

Bott, Sarah; Neuman, Melissa; Helleringer, Stephane; Desclaux, Alice; Asmar, Khalil El; Obermeyer, Carla Makhlouf

2015-01-01

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients’ rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. This article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. It also explores health workers’ fear of infection within the workplace and their reports on discrimination against HIV clients within health facilities. HIV care providers in Burkina Faso, Kenya and Uganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. They also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. Health workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with HIV, and also from difficult ethical dilemmas related to clients who do not disclose their HIV status to those around them, including partners. These findings suggest that providers of HIV testing and counselling need more resources and support, including better protections against HIV exposure in the workplace. The findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some unresolved ethical dilemmas related to confidentiality and non-disclosure, and translate those discussions into better guidance for health workers. PMID:25237134

Listening with a narrative ear: Insights from a study of fall stories in older adults.

PubMed

Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara

2017-01-01

To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Qualitative study of interviews. A fall prevention clinic in Calgary, Alta. Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation. Copyright© the College of Family Physicians of Canada.

Listening with a narrative ear

PubMed Central

Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara

2017-01-01

Abstract Objective To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Design Qualitative study of interviews. Setting A fall prevention clinic in Calgary, Alta. Participants Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Methods Participants’ stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients’ additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. Main findings The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. Conclusion The addition of patient narratives to clinical assessments offers clinicians an understanding of patients’ perspectives, which can be used to better engage patients in rehabilitation. PMID:28115459

The implementation of psychiatric advance directives: experiences from a Dutch crisis card initiative.

PubMed

van der Ham, Alida J; Voskes, Yolande; van Kempen, Nel; Broerse, Jacqueline E W; Widdershoven, Guy A M

2013-06-01

The crisis card is a specific form of psychiatric advance directive, documenting mental clients' treatment preferences in advance of a potential psychiatric crisis. In this paper, we aim to provide insight into implementation issues surrounding the crisis card. A Dutch crisis-card project formed the scope of this study. Data were collected through interviews with 15 participants from six stakeholder groups. Identified implementation issues are: (a) The role of the crisis-card counselor, (b) lack of distribution and familiarity, (c) care professionals' routines, and (d) client readiness. The crisis-card counselor appears to play a key role in fostering benefits of the crisis card by supporting clients' perspectives. More structural integration of the crisis card in care processes may enhance its impact, but should be carefully explored. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Elizabeth Usher Memorial Lecture: Placing therapy in the context of the self and social connection.

PubMed

Douglas, Jacinta

2015-06-01

The concept of self influences the choice of goals and helps to make sense of lives. Essentially, self-concept is a dynamic internal representation of the individual. This representation shapes behaviour and how information about oneself is processed. The self-story is developed and validated through social interactions and shaped continuously through life experiences. The focus of this paper is the client's perspective of self and how one can actively use that perspective to plan therapy, particularly in the case of individuals with acquired brain injury (ABI). The paper draws upon the results of a number of research projects constructed around two primary aims: (1) to represent the perspectives of clients and their close others and (2) to maximize social connection through the delivery of effective communication intervention. A model of self, derived from in-depth qualitative exploration of the experiences of people with ABI, is presented as a framework to guide collaborative therapy. The model depicts the multidimensional and cyclical nature of self- conceptualization supported by factors that facilitate social connection. Communication is crucial to maintaining social ties and communication breakdown is a significant predictor of participation. A new intervention that effectively improves coping with communication breakdown is presented.

Exploring the relationship between client perspectives, clinical expertise and research evidence.

PubMed

Roulstone, Sue

2015-06-01

This paper examines the relationship between components of evidence-based practice (clinical expertise, patient perspective and research evidence). Findings are examined from two research programs: the Better Communication Research Program and Child Talk, including exploratory studies of the views of parents and children regarding speech-language pathology and studies of current practice by SLPs in England. Systematic reviews of the research literature were also undertaken. The paper analyses relationships between outcomes valued by children and parents and those reported in the literature and in practice, parents' perspectives regarding intervention in comparison with clinicians' reports of practice and the extent to which research evidence underpins current practice is examined. Parents and children value functional outcomes and positive experiences; these are not routinely measured in research or practice. Therapy is perceived positively by most parents; however, some are ambivalent and less clear about the rationale. Commonly used interventions are supported by evidence, but there are gaps regarding some critical therapy components. The paper discusses four challenges to evidence-based practice: the consistency and clarity of descriptions of interventions; consensus based models of practice; understanding of the mechanisms of change; and, finally, the operationalization of client preferences within an evidence-based practice framework.

Transforming Praxis in Science Through Dialogue Towards Inclusive Approaches

NASA Astrophysics Data System (ADS)

Brendel, Michelle; Siry, Christina; Haus, Jana Maria; Breedijk-Goedert, Fabienne

2017-08-01

This paper offers analyses from a project examining the construction of narrative assessments within elementary science investigations. We examined how positioning children to express understandings through narrative assessments created spaces for revealing children's perspectives on classroom experiences with their teachers and each other. Four findings emerged. First, transformation of practice requires a change of the teacher's role. Second, children's narrations provided a platform for elaborating their understandings. Third, our work illustrates the critical role of trust and time in working towards inclusive assessment practices. Lastly, dialogue around the children's products illustrates how they made decisions and challenges normative ideas of what children can or cannot do or know. Overall, we highlight how dialogue became a way for adults and children to cross boundaries of age and knowledge hierarchies in the construction of science assessments.

New roads paved on losses: photovoice perspectives about recovery from mental illness.

PubMed

Mizock, Lauren; Russinova, Zlatka; Shani, Roni

2014-11-01

People with serious mental illness face stigma that interferes with recovery. Photovoice is a method that integrates photography and writing, providing a valuable means for capturing the narratives of people with mental illness whose voices are often marginalized. The purpose of the present article is to explore the meaning of recovery for individuals with serious mental illness based on a qualitative analysis of a new photovoice-based intervention, Recovery Narrative Photovoice. This intervention focuses on promoting the process of recovery and sense of identity through the creation of empowering visual images and narratives of recovery for individuals with serious mental illness. In this article, we present iconographic and thematic analysis for the 23 photovoice works from two pilots of the Recovery Narrative Photovoice intervention. Results reveal several themes, including metaphors for mental illness, associated losses, recovery strategies, and recovery outcomes. A final theme pertains to recovery messages learned from the recovery process. © The Author(s) 2014.

Feelings and motives underlying Machiavellian behavioural strategies; narrative reports in a social dilemma situation.

PubMed

Czibor, Andrea; Vincze, Orsolya; Bereczkei, Tamas

2014-12-01

This study explored the reasons and motives underlying the decisions of individuals with strong Machiavellian attitudes (High Machs). One hundred and fifty undergraduate students completed the Mach-IV test, and their contributions to, financial success in and narrative reports of a public goods game were analysed. High Machs contributed less to the public good and gained more benefit than Low Machs. Analysis of the narrative reports showed that High Machs used significantly fewer verbs referring to emotional involvement and first person plural verb forms, than did Low Machs. This study confirmed previous findings that High Machs have a cool and rational character and a proself orientation and showed that their lack of group orientation may account for their low cooperation in social dilemmas. The results of narrative content analysis provide a new perspective on the motives and values behind High Machs' decisions and success in different fields of social life. © 2014 International Union of Psychological Science.

The Role of the Theory-of-Mind Cortical Network in the Comprehension of Narratives

PubMed Central

Mason, Robert A.; Just, Marcel Adam

2009-01-01

Narrative comprehension rests on the ability to understand the intentions and perceptions of various agents in a story who interact with respect to some goal or problem. Reasoning about the state of mind of another person, real or fictional, has been referred to as Theory of Mind processing. While Theory of Mind Processing was first postulated prior to the existence of neuroimaging research, fMRI studies make it possible to characterize this processing in some detail. We propose that narrative comprehension makes use of some of the neural substrate of Theory of Mind reasoning, evoking what is referred to as a protagonist perspective network. The main cortical components of this protagonist-based network are the dorsomedial prefrontal cortex and the right temporo-parietal junction. The article discusses how these two cortical centers interact in narrative comprehension but still play distinguishable roles, and how the interaction between the two centers is disrupted in individuals with autism. PMID:19809575

Producing patient-avatar identification in animation video information on spinal anesthesia by different narrative strategies.

PubMed

Høybye, Mette Terp; Vesterby, Martin; Jørgensen, Lene Bastrup

2016-06-01

Visual approaches to health information reduce complexity and may bridge challenges in health literacy. But the mechanisms and meanings of using animated video in communication with patients undergoing surgery are not well described. By comparing two versions of a two-dimensional animated video on spinal anesthesia, this study tested the patient-avatar identification within two different narrative models. To explore the perspectives of total hip arthroplasty, we employed qualitative methods of interviews and ethnographic observation. The animated presentation of the spinal anesthesia procedure was immediately recognized by all participants as reflecting their experience of the procedure independent of the narrative form. The avatar gender did not affect this identification. We found no preference for either narrative form. This study supports the potential of animation video in health informatics as a didactic model for qualifying patient behavior. Animation video creates a high degree of identification that may work to reduce pre-surgical anxiety. © The Author(s) 2014.

[Identity and narration: autobiographical quests].

PubMed

Arfuch, Leonor

2013-01-01

This paper aims to tackle the subtle relation between autobiographical narratives and identity construction, from a non essentialist conception of identity. In a perspective that articulates philosophy of language, psychoanalysis, semiotics and literary critique, we posit the concept of biographical space as an analytical instrument to make a critical update of the reconfiguration of identities and subjectivities in contemporary culture, marked by the predominance of the biographical, the private and a kind of "public intimacy". This look is more symptomatic than descriptive: it intends to account for the rise of auto/biographical narratives and life-stories, from canonic genres to their multiple derivations in the media, social networks and the most diverse artistic practices, a phenomenon that seems to reaffirm the notion of narrative identities by Ricoeur. Our analysis here, from an ethic, aesthetic and political point of view, will focus on two visual arts experiences that have recently taken place for the first time in Buenos Aires: Christian Boltanski's and Tracey Emin's, solo exhibitions, each of them with a different biographical approach.

Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation.

PubMed

Bonevski, Billie; Bryant, Jamie; Paul, Christine

2011-07-01

This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Individualised home-based rehabilitation after stroke in eastern Finland--the client's perspective.

PubMed

Reunanen, Merja A T; Järvikoski, Aila; Talvitie, Ulla; Pyöriä, Outi; Härkäpää, Kristiina

2016-01-01

Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning. © 2015 John Wiley & Sons Ltd.

Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia.

PubMed

Thomas, Kerry A; Rickwood, Debra J; Brown, Patricia M

2017-01-01

The aim of this study was to assess clients' and service providers' perspectives on changes in mental health after an admission to a residential recovery-focused, sub-acute service, in Australia. Clients were either step-up clients, entering the service directly from the community, or step-down clients who were transitioning from an inpatient unit to home. During the 30-month period of data collection (August 2011 to January 2014) all clients (N = 102) were invited to participate in the longitudinal study and 41 clients consented to be involved (38% response rate). At admission and exit, participants completed the Behaviour and Symptom Identification Scale (Basis-32) and service providers completed the Life Skills Profile-16 and Health of the Nations Outcome Scales. Follow-up data 3 months after exit were available for 12 clients, including the Basis-32 and a self-report measure of quality of life (Assessment of Quality of Life 8-dimension). Both client groups reported positive improvements between admission and exit in the areas of relation to self and others, psychosis, daily living and presence of depression or anxiety symptoms. Service providers reported gains for clients in the areas of self-care, level of symptoms and presence of social problems. At 3 months, clients generally reported positive quality of life, although there was no significant change in symptoms and functioning. This study demonstrates that after an admission to a sub-acute service, step-up clients experience an improvement in their symptoms and functioning, have avoided a hospital admission and are well enough to return home. Step-down clients also experience further improvements in their symptoms and functioning, indicating that the service has assisted them in their transition to independent living after a hospital admission. Sub-acute residential units provide a continuation of care for inpatients preparing to return home, and people with a mental health problem living in the community who experience an escalation in symptoms and prefer an alternative to hospital. © 2015 John Wiley & Sons Ltd.

Not the Color Purple: Black Feminist Lessons for Educational Caring.

ERIC Educational Resources Information Center

Thompson, Audrey

1998-01-01

Asserts that theories of caring in education have avoided issues of racial imbalance. Reinterprets these themes from a black feminist perspective: moral relevance, primacy of survival, significance of one's standpoint, and the moral power of narrative. (SK)

Case Management: Service or Symptom?

ERIC Educational Resources Information Center

Netting, F. Ellen

1992-01-01

Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

A Million Cancer Genome Warehouse

DTIC Science & Technology

2012-11-20

Software, Strawberry Canyon, 2012. 25 Units (GPUs) without any changes needed to the client applications. ● Service-level APIs are designed to... Strawberry Canyon, 2012. 62 Patterson, D. For better or worse, benchmarks shape a field: technical perspective, Communications of the ACM, v.55 n.7

Narrative Inquiry for Science Education: Teachers' repertoire-making in the case of environmental curriculum

NASA Astrophysics Data System (ADS)

Hwang, Seyoung

2011-04-01

This paper considers how the school science curriculum can be conceptualised in order to address the contingent and complex nature of environmental and sustainability-related knowledge and understanding. A special concern lies in the development of research perspectives and tools for investigating ways, in which teachers are faced with complex and various situations in the sense-making of science-related issues, and subsequent pedagogic issues. Based on an empirical examination of Korean teachers' sense-making of their curricular practice, the paper develops a narrative approach to teachers' perspectives and knowledge by considering the value of stories as sense-making tools for reflective questioning of what is worth teaching, how and why. By employing the idea of 'repertoire', the study regards teachers' stories about their environment-related personal and teaching experiences as offering angles with which to understand teachers' motivation and reflection in curricular development and implementation. Furthermore, three empirical cases present ways in which the nature of knowledge and understanding is recognised and potentially integrated into pedagogies through teachers' narratives. Finally, the paper argues for the need to reconsider the role of the science teacher in addressing environmental and sustainability-related issues, in ways that facilitate teachers' reflexive interpretation of meanings in cultural texts and the construction of pedagogic text.

Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives

PubMed Central

Kavanaugh, Megan L.; Frohwirth, Lori; Jerman, Jenna; Popkin, Ronna; Ethier, Kathleen

2013-01-01

Study objective To describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24). Methods Data collection occurred between June – December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At six of these sites, we conducted a total of six focus group discussions (FGDs) with facility staff and forty-eight in-depth interviews (IDIs) with facility clients ages 16-24. Results Staff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the “forgettable” nature of the methods and their duration were some of LARC’s most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients. Conclusion Incorporating young women’s perspectives on LARC methods into publicly funded family planning facilities’ efforts to provide these methods to a younger population may increase their use among young women. PMID:23287602

Recommendations for physical and occupational therapy practice from the perspective of clients undergoing therapy for breast cancer-related impairments.

PubMed

Lattanzi, Jill B; Giuliano, Susan; Meehan, Caitlin; Sander, Beth; Wootten, Rachel; Zimmerman, Amanda

2010-01-01

Evidence points to the efficacy of physical and occupational therapy intervention for the management of impairments and functional limitations related to the treatment of breast cancer. However, few studies give voice to the women participating in the physical rehabilitation programs intended to ameliorate their deficits. The purpose of this qualitative investigation was to explore the experience of physical rehabilitation as well as to identify recommendations for physical and occupational therapy practice from the perspective of the client undergoing therapy for breast cancer-related impairments. A phenomenological design was chosen and included a purposive sample of women (n = 10) undergoing physical rehabilitation for impairments related to breast cancer treatment. Data included semistructured interviews and artifact examination. Ten semistructured interviews were conducted at a setting of the participants' choice. Data collection continued until saturation was reached. Data analysis was cyclical and ongoing and involved all six researchers in analyzing and triangulating all pieces of data. Member checks and a peer review were conducted to confirm relevance and validity. Five themes emerged: 1) challenges with obtaining referrals, 2) challenges with patient education, 3) improvements in functional impairments, 4) emotional support, and 5) benefits of a specialized clinic environment. Consideration of the five themes led to four recommendations for physical and occupational therapist practice from the perspective of the client: 1) advocate for presurgical therapy consultations, 2) be competent in the management of all impairments and functional limitations associated with breast cancer treatment, 3) be aware of the emotional support the therapist has the capacity to provide or not provide, and 4) as much as possible, create an inviting, nonclinical environment.

Perspectives on Queer Music Therapy: A Qualitative Analysis of Music Therapists' Reactions to Radically Inclusive Practice.

PubMed

Boggan, Catherine E; Grzanka, Patrick R; Bain, Candice L

2018-01-13

The queer music therapy model was designed by Bain, Grzanka, and Crowe in 2016 as a novel therapeutic approach to affirm and empower LGBTQ+ identity through music. No data have been generated on how this model might actually be implemented, or the strengths and limitations of the model according to music therapy professionals. The purpose of this study was to build on Bain and colleagues' work by collecting music therapists' perspectives on queer music therapy and using these data to critically evaluate the model. Semi-structured qualitative interviews were conducted with twelve music therapists who identify as LGBTQ+ or have experience working with LGBTQ+ clients. Participants were prompted to discuss their music therapy backgrounds, experiences with LGBTQ+ clients, and reactions to the queer music therapy model. Interviews were analyzed using a critical discourse analysis approach. The qualitative findings revealed major strengths of the queer music therapy model and ways in which it could be improved by attending to: (a) the structural limitations of the music therapy discipline, including the demographic composition of the field and lack of critical perspectives in music therapy training; and (b) intersectional considerations of ageism and ableism within diverse LGBTQ+ populations. Queer music therapy has positive implications for future work with LGBTQ+ individuals, but it must more substantively integrate intersectionality theory to serve a diverse range of LGBTQ+ clients. Further, it must critically attend to the structural limitations of the music therapy discipline itself. © The Author(s) 2018. Published by Oxford University Press on behalf of American Music Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Life Themes and Interpersonal Motivational Systems in the Narrative Self-construction

PubMed Central

Veglia, Fabio; Di Fini, Giulia

2017-01-01

What makes unique and unrepeatable individuals is their ability to write their own story attributing meaning, sharing it through narration, giving coherence to the information related to the interpersonal motivational systems, and creating alternative hierarchies to those biologically provided by the genetic code. Through clinical narratives and narrative literature, we can observe the recurrence of specific topics, across time and different cultures. Hence, we wondered whether there are some evolutionary suggestions that guide us in the construction of the narrative-autobiographical contents. In this article we proposed a theoretical-clinical hypothesis about the existence of a biological disposition to identify as fundamental six Life Themes (LTs) that contribute to defining the image of the self and the world: Love, Personal Value, Power, Justice, Truth, and Freedom. Besides the innumerable narratives dependent upon context, there may be many ways of telling stories that, instead, would be reported to these few essential themes. A narrative review of the literature about these concepts follows the systematic explanation of the perspective about the LTs as attractors of meaning. The manuscript considers also the process of co-construction of meanings within the interpersonal relationships and the influences of these on the narratives. In particular, we focused on the importance of episodic and autobiographical memory related to the attachment and significant figures, in the construction of the personal story and the LTs. We also explained the possible clinical implications of the theoretical hypothesis of LTs. Within clinical conversations, the LTs could be expressed rigidly or, otherwise, in a confused way. The lack of narrative integration may lead to the dominance of chaos or rigidity that generates suffering. A better comprehension of the LTs in patients’ narrations could be useful to identify a narrative profile about the areas of greatest suffering related to the idea of self and the world, as well as to construct an adequate care plan. PMID:29163279

Identity Development and Future Orientation in Immigrant Adolescents and Young Adults: A Narrative View of Cultural Transitions From Ethiopia to Israel.

PubMed

Flum, Hanoch; Buzukashvili, Tamara

2018-06-01

This paper examines a major aspect of identity development in the context of cultural transition. Following Eriksonian psychosocial and sociocultural perspectives, it investigates self-continuity and identity integration in light of inherent discontinuity among young immigrants. More specifically, this examination draws on three distinct narrative studies, within the framework of Dynamic Narrative Approach, with first- and second-generation adolescents and young adult Ethiopian immigrants to Israel. Their negotiations of identity, with a focus on their narrative construction of past, present, and future across life domains (education, career, military service, family), are illustrated in this article in a variety of developmental paths. Dynamics of reciprocity between early life experiences and future orientation are revealed in the narratives. A capacity to connect cultural resources in the past with challenges in the new culture is identified as a key. By processing them and bringing them up-to-date, meaning becomes relevant to current experiences and developmental challenges. Across the three distinct studies, a variety of exploratory activities and relational qualities are found to facilitate or impede the reconstruction and integration of identity. © 2018 Wiley Periodicals, Inc.

Doctors' voices in patients' narratives: coping with emotions in storytelling.

PubMed

Lucius-Hoene, Gabriele; Thiele, Ulrike; Breuning, Martina; Haug, Stephanie

2012-09-01

To understand doctors' impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process. 394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure. Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes. Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor-patient relations by individualized emotional and biographical aspects of patients' perspective. Doctors should be trained to become aware of their impact in patients' coping processes.

Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.

PubMed

Lee, Windy W M; Choi, K C; Yum, Royce W Y; Yu, Doris S F; Chair, S Y

2016-01-01

Clinically, there is an increasing trend in using motivational interviewing as a counseling method to help clients with cardiovascular diseases to modify their unhealthy lifestyle in order to decrease the risk of disease occurrence. As motivational interviewing has gained increased attention, research has been conducted to examine its effectiveness. This review attempts to identify the best available evidence related to the effectiveness of motivational interviewing on lifestyle modification, physiological and psychological outcomes for clients at risk of developing or with established cardiovascular diseases. Systematic review of studies incorporating motivational interviewing in modifying lifestyles, improving physiological and psychological outcomes for clients at risk of or diagnosed with cardiovascular diseases. Major English and Chinese electronic databases were searched to identify citations that reported the effectiveness of motivational interviewing. The searched databases included MEDLINE, British Nursing Index, CINAHL Plus, PsycINFO, SCOPUS, CJN, CBM, HyRead, WanFang Data, Digital Dissertation Consortium, and so on. Two reviewers independently assessed the relevance of citations based on the inclusion criteria. Full texts of potential citations were retrieved for more detailed review. Critical appraisal was conducted by using the standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute - Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStaRI). After eligibility screening, 14 articles describing 9 studies satisfied the inclusion criteria and were included in the analysis. Only certain outcomes in certain studies were pooled for meta-analysis because of the large variability of the studies included, other findings were presented in narrative form. For lifestyle modification, the review showed that motivational interviewing could be more effective than usual care on altering smoking habits. For physiological outcomes, the review showed that motivational interviewing positively improved client's systolic and diastolic blood pressures but the result was not significant. For psychological outcomes, the review showed that motivational interviewing might have favorable effect on improving clients' depression. For other outcomes, the review showed that motivational interviewing did not differ from usual care or usual care was even more effective. The review showed that motivational interviewing might have favorable effects on changing clients' smoking habits, depression, and three SF-36 domains. For the other outcomes, most of the results were inconclusive. Further studies should be performed to identify the optimal format and frequency of motivational interviewing. Primary research on the effectiveness of motivational interviewing on increasing clients' motivation and their actual changes in healthy behavior is also recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of a Social Network Intervention for People with Mild to Borderline Intellectual Disabilities.

PubMed

van Asselt-Goverts, A E; Embregts, P J C M; Hendriks, A H C

2018-03-01

Little is known about the effectiveness of interventions aimed at enhancing the social networks of people with intellectual disabilities. This study explores the results of such an intervention. How did the clients with mild to borderline intellectual disabilities and their support workers evaluate the intervention? What did they learn from it? Were there any changes in network characteristics, satisfaction and wishes in relation to networks, participation, loneliness, self-determination or self-esteem? The evaluation of the intervention was explored from several perspectives (i.e. five clients, their six support workers and three trainers), using mixed methods (i.e. interviews and questionnaires). The intervention was positively evaluated by both clients and support workers. Moreover, the analysis revealed the vulnerability of clients and their networks but also the benefits experienced from the intervention, such as decreased loneliness, enhanced social networks, increased awareness, competence, autonomy and increased participation. The indicative level of evidence for the effectiveness of this intervention justifies a larger series of case studies or a larger control trial study. © 2016 John Wiley & Sons Ltd.

Substance use in young adults with schizophrenic disorders.

PubMed

Test, M A; Wallisch, L S; Allness, D J; Ripp, K

1989-01-01

Use of nonprescribed mood altering substances is pervasive and problematic in young adults with serious mental illnesses in community care. Fifty-eight percent of young adult clients with clearly defined schizophrenia or schizophrenia-related disorders participating in a long-term community treatment study were rated by staff or themselves as using alcohol, cannabis, or other street drugs several times a week or more. We interviewed in depth a random sample of these "significant users" to obtain their perspective on their frequencies, patterns, histories, contributing factors to, and effects of substance use and their related treatment experiences. Results revealed these clients' substance use to be of long duration and deeply entrenched, with current use often involving multiple substances including both street drugs and substances of "everyday life" (e.g., caffeine, nicotine). Clients reported compelling reasons for use including anxiety reduction, relief of boredom, and a means for social contact. Staff and clients clearly view substance use quite differently, with the latter focusing at least as much on consequences of symptom relief as symptom exacerbation. Treatment implications are discussed.

The Experiences and Insights of One Community College Foster Alum and One Community College Faculty Advocate

ERIC Educational Resources Information Center

Westland, Melinda A.; Totten, Volena

2018-01-01

Using personal narratives, in this chapter the authors weave together two distinct perspectives to illuminate the stark reality of many students' experiences as they transition from the foster care system to postsecondary education.

Contemporary Play Therapy: Theory, Research, and Practice

ERIC Educational Resources Information Center

Schaefer, Charles E., Ed.; Gerard Kaduson, Heidi, Ed.

2006-01-01

This highly practical book presents current developments in play therapy, including innovative applications for particular problems and populations. Contributors first discuss the latest ideas and techniques emerging from object-relations, experiential, dynamic, and narrative perspectives. Next, research evaluating the effectiveness of play…

Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?

PubMed

Greenstein, Caroline; Lowell, Anne; Thomas, David Piers

2016-06-01

To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.

What Happens to Therapists Who Work with Sex Offenders?

ERIC Educational Resources Information Center

Farrenkopf, Toni

1992-01-01

Surveyed 24 experienced therapists working with sex offenders regarding personal impact of work. Most reported shift in perspective, becoming discouraged about client change. Several adjustment phases were reported. One-quarter experienced burnout. Alternative to burnout was adaptation: lowering of expectations, objective detachment, acceptance of…

An Introduction to Multicultural Counseling.

ERIC Educational Resources Information Center

Lee, Wanda M. L.

When client and counselor are from different cultural backgrounds, they tend to view things from disparate perspectives. Though a background in multiculturalism is required for program accreditation, most existing texts limit coverage to ethnicity, without the emphasis of broad concepts such as discrimination and acculturation, or coverage of…

Evoking and Measuring Identification with Narrative Characters – A Linguistic Cues Framework

PubMed Central

van Krieken, Kobie; Hoeken, Hans; Sanders, José

2017-01-01

Current research on identification with narrative characters poses two problems. First, although identification is seen as a dynamic process of which the intensity varies during reading, it is usually measured by means of post-reading questionnaires containing self-report items. Second, it is not clear which linguistic characteristics evoke identification. The present paper proposes that an interdisciplinary framework allows for more precise manipulations and measurements of identification, which will ultimately advance our understanding of the antecedents and nature of this process. The central hypothesis of our Linguistic Cues Framework is that identification with a narrative character is a multidimensional experience for which different dimensions are evoked by different linguistic cues. The first part of the paper presents a literature review on identification, resulting in a renewed conceptualization of identification which distinguishes six dimensions: a spatiotemporal, a perceptual, a cognitive, a moral, an emotional, and an embodied dimension. The second part argues that each of these dimensions is influenced by specific linguistic cues which represent various aspects of the narrative character’s perspective. The proposed relations between linguistic cues and identification dimensions are specified in six propositions. The third part discusses what psychological and neurocognitive methods enable the measurement of the various identification dimensions in order to test the propositions. By establishing explicit connections between the linguistic characteristics of narratives and readers’ physical, psychological, and neurocognitive responses to narratives, this paper develops a research agenda for future empirical research on identification with narrative characters. PMID:28751875

Evoking and Measuring Identification with Narrative Characters - A Linguistic Cues Framework.

PubMed

van Krieken, Kobie; Hoeken, Hans; Sanders, José

2017-01-01

Current research on identification with narrative characters poses two problems. First, although identification is seen as a dynamic process of which the intensity varies during reading, it is usually measured by means of post-reading questionnaires containing self-report items. Second, it is not clear which linguistic characteristics evoke identification. The present paper proposes that an interdisciplinary framework allows for more precise manipulations and measurements of identification, which will ultimately advance our understanding of the antecedents and nature of this process. The central hypothesis of our Linguistic Cues Framework is that identification with a narrative character is a multidimensional experience for which different dimensions are evoked by different linguistic cues. The first part of the paper presents a literature review on identification, resulting in a renewed conceptualization of identification which distinguishes six dimensions: a spatiotemporal, a perceptual, a cognitive, a moral, an emotional, and an embodied dimension. The second part argues that each of these dimensions is influenced by specific linguistic cues which represent various aspects of the narrative character's perspective. The proposed relations between linguistic cues and identification dimensions are specified in six propositions. The third part discusses what psychological and neurocognitive methods enable the measurement of the various identification dimensions in order to test the propositions. By establishing explicit connections between the linguistic characteristics of narratives and readers' physical, psychological, and neurocognitive responses to narratives, this paper develops a research agenda for future empirical research on identification with narrative characters.

The optimal design of service level agreement in IAAS based on BDIM

NASA Astrophysics Data System (ADS)

Liu, Xiaochen; Zhan, Zhiqiang

2013-03-01

Cloud Computing has become more and more prevalent over the past few years, and we have seen the importance of Infrastructure-as-a-service (IaaS). This kind of service enables scaling of bandwidth, memory, computing power and storage. But the SLA in IaaS also faces complexity and variety. Users also consider the business of the service. To meet the most users requirements, a methodology for designing optimal SLA in IaaS from the business perspectives is proposed. This method is different from the conventional SLA design method, It not only focuses on service provider perspective, also from the customer to carry on the design. This methodology better captures the linkage between service provider and service client by considering minimizing the business loss originated from performance degradation and IT infrastructure failures and maximizing profits for service provider and clients. An optimal design in an IaaS model is provided and an example are analyzed to show this approach obtain higher profit.

An institutional analysis of HIV prevention efforts by the nation's outpatient drug abuse treatment units.

PubMed

D'Aunno, T; Vaughn, T E; McElroy, P

1999-06-01

Drawing from an institutional-theory perspective on innovations in organizations, this paper examines the use of human immunodeficiency virus (HIV) prevention practices by the nation's outpatient substance abuse treatment units during a critical period from 1988 to 1995. An institutional perspective argues that organizations adopt new practices not only for technical reasons, but also because external actors actively promote or model the use of particular practices. We examine the extent to which treatment units use several practices to prevent HIV infection among their clients and among drug-users not in treatment. Results from random-effects regression analyses of national survey data show that treatment units significantly increased their use of HIV prevention practices from 1988 to 1995. Further, the results show that treatment units' use of prevention practices was related to clients' risk for HIV infection, unit resources available to support these practices, and organizational support for the practices. Implications are discussed for an institutional view of organizational innovation as well as for research on HIV prevention.

Equine-Assisted Psychotherapy for adolescents experiencing depression and/or anxiety: A therapist's perspective.

PubMed

Wilson, Kaitlyn; Buultjens, Melissa; Monfries, Melissa; Karimi, Leila

2017-01-01

Animal-Assisted Interventions (AAIs) are thought to overcome some of the limitations of traditional therapies as they do not rely exclusively on language as a medium for change. One such Animal-Assisted Therapy (AAT) approach involves horses as a therapeutic medium. Equine-Assisted Psychotherapy (EAP) comprises a collaborative effort between a licensed therapist and a horse professional working with clients to address treatment goals. The purpose of the present Australian-based qualitative study was to examine EAP facilitators' perspectives on the biospychosocial benefits and therapeutic outcomes of EAP for adolescents experiencing depression and/or anxiety. The findings suggest a range of improvements within adolescent clients, including increases in confidence, self-esteem and assertiveness, as well as a decrease in undesirable behaviours. The effectiveness of the therapy was thought to be due to the experiential nature of involving horses in therapy. The lack of understanding in the wider community about EAP was seen as a barrier to recognition and acceptance of EAP as a valid therapeutic intervention.

The Character Strengths of Special Forces Personnel: Insights for Civilian Health Care Practitioners.

PubMed

Gayton, Scott D; Kehoe, E James

2016-09-01

Civilian employees, contractors, and private community clinicians are increasingly providing health treatment to currently serving and former military personnel. This study addresses recent calls for evidence-based information to assist civilian practitioners in understanding the perspectives of their military clients. To this end, the self-reported character strengths of military personnel were elicited as an operationalized expression of their underlying personal values that shape their perspectives and conduct as soldiers. Specifically, Australian Army Special Forces operators and support personnel (N = 337) were asked to rank themselves on 24 character strengths. The three character strengths of integrity, teamworker, and good judgment were ranked significantly above random assignment. Nearly all the respondents (84%) gave a top rank to at least one of these character strengths. Differences between the operators and support personnel were modest. Results are discussed with respect to establishing an effective relationship between military clients and civilian health care practitioners. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Embodied practice: claiming the body's experience, agency, and knowledge for social work.

PubMed

Tangenberg, Kathleen M; Kemp, Susan

2002-01-01

Although social work practice typically is concerned with physical conditions and experiences such as poverty, addiction, and violence, relatively little attention has been given to the body in professional literature. Emphasizing both physical and sociocultural dimensions of the body, this article argues for an invigorated, more complex understanding of the body in social work theory, practice, and research. Drawing from scholarship in the humanities, social sciences, and social work, a framework involving three dimensions of the body is proposed for integration with accepted ecological practice models. The nature and implications of three primary dimensions of the body for multiple domains of social work practice are explored, citing examples from narratives of mothers living with HIV disease: (1) the experiencing body, focused on the physicality of daily life; (2) the body of power, focused on the physicality of oppression and marginality, typically based on race or ethnicity, socioeconomic status, gender, sexual orientation, age, disability, physical appearance, and illness; and (3) the client body, reflecting the bodily experiences of those identified as clients who participate in relationships with social workers.

Contextualising eating problems in individual diet counselling.

PubMed

Kristensen, Søren T; Køster, Allan

2014-05-01

Health professionals consider diet to be a vital component in managing weight, chronic diseases and the overall promotion of health. This article takes the position that the complexity and contextual nature of individual eating problems needs to be addressed in a more systematic and nuanced way than is usually the case in diet counselling, motivational interviewing and health coaching. We suggest the use of narrative practice as a critical and context-sensitive counselling approach to eating problems. Principles of externalisation and co-researching are combined within a counselling framework that employs logistic, social and discursive eating problems as analytic categories. Using cases from a health clinic situated at the Metropolitan University College in Copenhagen, we show that even if the structural conditions associated with eating problems may not be solvable through individual counselling sessions, exploration of the complex structures of food and eating with the client can provide agency by helping them navigate within the context of the problem. We also exemplify why a reflexive and critical approach to the way health is perceived by clients should be an integrated part of diet counselling.

Making cross-racial therapy work: A phenomenological study of clients’ experiences of cross-racial therapy

PubMed Central

Chang, Doris F.; Berk, Alexandra

2010-01-01

A phenomenological/consensual qualitative study of clients’ lived experiences of cross-racial therapy was conducted to enhance our understanding of whether, how, and under what conditions race matters in the therapy relationship. The sample consisted of 16 racial/ethnic minority clients who received treatment from 16 White, European American therapists across a range of treatment settings. Participants who reported a satisfying experience of cross-racial therapy (n=8) were examined in relation to gender- and in most cases, race/ethnicity-matched controls (n=8) who reported an overall unsatisfying experience. Therapy satisfaction was assessed during the screening process and confirmed during the research interview. Therapy narratives were analyzed using consensual qualitative research to identify the client, therapist, and relational factors that distinguished satisfied from unsatisfied cases. Findings reveal substantial differences at the level of individual characteristics and relational processes, providing evidence of both universal (etic) as well as culture/context-specific (emic) aspects of healing relationships. Recommendations for facilitating positive alliance formation in cross-racial therapy are provided based on clients’ descriptions of facilitative conditions in the therapy relationship. PMID:20414342

Meanings of well-being from the perspectives of youth recently diagnosed with psychosis.

PubMed

Lal, Shalini; Ungar, Michael; Malla, Ashok; Frankish, Jim; Suto, Melinda

2014-02-01

The phenomenon of well-being has attracted a surge of attention in mental health policy, clinical practice and research internationally. Yet, the definitions of well-being remain elusive, and there is limited understanding on its meanings from the perspectives of youth mental health service users. This study explored the meanings of well-being from the perspectives of youth mental health service users diagnosed with psychosis in the past 3 years. Using a qualitative approach, we conducted semi-structured interviews and participant-photography elicited focus groups with 17 youth recruited from an early intervention program for psychoses and a mental health program specializing in the delivery of psychiatric services to street youth. Analysis combined the methods of constructivist grounded theory and narrative inquiry. The findings illustrate five key themes in participants' conceptualizations of well-being: multidimensionality; active oriented states; social environment; identity; and normality. Dimensions of well-being identified in participants' accounts include: psychological, physical, emotional, moral/virtuous, financial/material, spiritual, and social aspects. Our heuristic framework for conceptualizing well-being, grounded in the narrative accounts of youth participants, can inform the future planning and design of interventions, research, and outcome measures pertaining to the well-being of youth recently diagnosed with psychosis.

Shifting the Balance: Relationship as Power in Organizational Life.

PubMed

Davidson, Sandra J

2015-01-01

Power has traditionally been studied and experienced within organizations from a hierarchical and positivist perspective. However, organizational complexity has never been greater, and in our attempts to find new ways to live amid this complexity we seek alternative theoretical perspectives that may better represent and inform our experiences of organizational life. This article summarizes the positivist view of power within organizations and the limitations of attempting to study power from this perspective. Power is then reconceptualized and explored using the complex responsive process (CRP) analysis. This is an exemplar of how narrative inquiry guided by CRP may be used as a frame for reflexivity and reflection amid organizational power dynamics. The narrative description used in this paper was based on the author's experience and reflection upon a nursing faculty meeting in a large public university. By becoming aware of the power relations in which we engage, and by reflecting upon them using CRP, we may come to understand power relations in a different way. In the act of examining and reflecting on our habitual roles in power relations, we may open up the potential for personal and organizational transformation. © 2015 Wiley Periodicals, Inc.

A Decolonizing Methodology for Health Research on Female Genital Cutting.

PubMed

Werunga, Jane; Reimer-Kirkham, Sheryl; Ewashen, Carol

2016-01-01

In this article, critical perspectives including postcolonial feminism, African feminism, and intersectionality are presented as having decolonizing methodological potential whereby the Western narrative surrounding the practice of female genital cutting, particularly in the context of migration, is reexamined. In addition, multiple intersecting influences on affected women's realities are accounted for and a critical consciousness that serves to inform praxis, address social determinants of health, and promote health equity is encouraged. The inclusion of an African feminist perspective, a traditionally marginalized critical perspective, serves to further decolonize some long-held erroneous beliefs about the sexuality, subjectivity, and embodiment of the African woman.

Symbolic healing of early psychosis: psychoeducation and sociocultural processes of recovery.

PubMed

Larsen, John Aggergaard

2007-09-01

This article analyzes sociocultural processes of recovery in a Danish mental health service providing two years of integrated biopsychosocial treatment following first-episode psychosis. The study is based on ethnographic research in the service and person-centered involvement with 15 clients. The analysis applies Dow's [1986 American Anthropologist 88:56-69] model of universal components of symbolic healing to elucidate sociocultural aspects of therapeutic efficacy that are alternatively disregarded as placebo or nonspecific effects. It is demonstrated how staff engaged with clients to deliver "psychoeducation" that provided scientific and biomedical theories about mental illness, constituting a shared "mythic world" that was accepted as an experiential truth and used to explain clients' illness experiences. The analysis highlights the need to supplement attention in Dow's model to the healing procedure with consideration of variability in the healing process. Depending on individual responses to the intervention, the staff's professional backgrounds and staff-client relationships different recovery models were applied. One suggested "episodic psychosis" and full recovery, and the other suggested "chronic schizophrenia" and the necessity of comprehensive life adjustments to the mental illness. The recovery models influenced clients' perspectives on illness and self as they engaged in identity work, negotiating future plans and individual life projects by including also alternative systems of explanation from the wider cultural repertoire.

Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires.

PubMed

Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

2014-01-01

Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

Body Movement Synchrony in Psychotherapeutic Counseling: A Study Using the Video-Based Quantification Method

NASA Astrophysics Data System (ADS)

Nagaoka, Chika; Komori, Masashi

Body movement synchrony (i. e. rhythmic synchronization between the body movements of interacting partners) has been described by subjective impressions of skilled counselors and has been considered to reflect the depth of the client-counselor relationship. This study analyzed temporal changes in body movement synchrony through a video analysis of client-counselor dialogues in counseling sessions. Four 50-minute psychotherapeutic counseling sessions were analyzed, including two negatively evaluated sessions (low evaluation groups) and two positively evaluated sessions (high evaluation groups). In addition, two 50-minute ordinary advice sessions between two high school teachers and the clients in the high rating group were analyzed. All sessions represent role-playing. The intensity of the participants' body movement was measured using a video-based system. Temporal change of body movement synchrony was analyzed using moving correlations of the intensity between the two time series. The results revealed (1) A consistent temporal pattern among the four counseling cases, though the moving correlation coefficients were higher for the high evaluation group than the low evaluation group and (2) Different temporal patterns for the counseling and advice sessions even when the clients were the same. These results were discussed from the perspective of the quality of client-counselor relationship.

[Intercultural health care policy from the perspective of health care providers and Mapuche clients].

PubMed

Alarcón, Ana María; Astudillo, Paula; Barrios, Sara; Rivas, Edith

2004-09-01

Intercultural health is becoming an emergent topic in the design of health care programs for Mapuche people of Chile. This process faces important challenges such as the scarce theoretical support about the meaning of intercultural health and their practical consequences for providers and clients. To explore the perception in providers and Mapuche clients about intercultural health. A survey performed in 11 counties with the highest concentration of Mapuche people, of the IX region of Chile. The perception about the development of a new health policy specially designed for Mapuche patients was surveyed in 399 Mapuche patients and 64 providers of primary health care centers. Mapuche clients considered, as the main regional challenges, the indifference and discrimination of health care teams towards Mapuche patients, aggravated by the indifference of authorities. Providers considered that the main problem was a lack of knowledge about Mapuche culture and skills to deal with this ethnic group. Patients and providers agreed on the need to use Mapuche dialect in health care attentions, to coordinate actions with traditional healers and to accept ethnical therapeutic practices. There is scarce agreement between providers and Mapuche clients about the need for an special intercultural health policy, its contents, and the regional conditions for its implementation and development.