Therapists In Cases Research Articles

Goal-setting and personalization under the International Classification of Functioning, Disability, and Health framework: Community reintegration program for post-stroke patients.

Body functions and structures, activities, and participation are the core components in the International Classification of Functioning, Disability, and Health (ICF) to identify post-stroke patients' health conditions. The specification of health conditions enhances the outcomes of post-stroke rehabilitation. This study aimed to explore the extent and the processes in an ICF-based post-stroke rehabilitation program (ICF-PSRP) that could enhance patients' community reintegration level. Post-stroke patients who completed the ICF-PSRP participated in intake and pre-discharge individual face-to-face semi-structured interviews. In addition, case therapists were invited to a face-to-face semi-structured group interview. Clinician experts were invited to complete an interview with the same interview contents as case therapists but in an online format. All interview recordings were analyzed with the Framework analysis. Patients' treatment goals were mapped with the ICF Core Set for Stroke. Out of 37 invited post-stroke patients, thirty-three of them completed the interview. Three case therapists and five clinicians completed the interviews. The goals set by the patients and their caregivers showed a broadening of their scope over the course of the program. The changes in scope ranged from the activities to the participation and environmental components. Increases in patient-therapist interactions played an essential role in the goal-setting process, which were integral to personalizing the treatment content. These characteristics were perceived by all parties who contributed to the program outcomes. The application of ICF's principles and core components offers a useful framework for enhancing post-stroke patients' community reintegration level. Future studies should explore the way in which patient-therapist interaction, exposure to environmental factors, and personalized interventions maximize the benefits of applying this framework to the community integration of post-stroke patients.

Predicting Employment Outcomes for People with Chronic Psychiatric Illness

ABSTRACT This study investigates the factors that contribute to successful employment of people with chronic psychiatric illness in Hong Kong, and to develop a statistical model that can predict their employment outcomes. Sixty-two clients from three psychosocial rehabilitation programmes were rated by their case therapists on their psychiatric history, mental condition, independent living skills, work performance, and social performance. Employment outcome is measured as the change in employment status, and the total earning achieved within three months. The percentage of the clients who improved their employment status was 21.7%. Diagnosis and demographic variables were not associated with the change in employment status. Total earning has significant correlation with three variables; attendance to program, number of hospital admissions, and relating with authority. Multiple regression analysis identified a six-variables model that can explain 44% of the variance in total earning. Path analysis further illustrated that attendance, mental condition, and work motivation exert significant effects on total earning directly, and through their influence on the social performance variables.

Use of Figurative Language in Successful and Unsuccessful Cases of Psychotherapy: three Comparisons

The purpose of the present study was to extend the scant empirical literature on figurative language in psychotherapy by analyzing its use over time by clients and therapists in cases differing in outcome. Instances of figurative language related to major therapy themes were selected from all available and audible sessions (N = 95) of six cases of psychotherapy—one successful and one unsuccessful case from each of three therapists—gleaned from the Vanderbilt I Psychotherapy Project. Descriptive analyses revealed features of clients' figurative language that were more consistently present in the successful than in the unsuccessful cases, namely, the elaboration of major therapy themes via bursts of figurative language or development of a metaphor over time, the existence of a central metaphor(s) as evidenced by the use of several conceptually related figures that fit the metaphor(s), and the expression of some positive personal change in figurative language. The analyses also cast doubt on certain prevaili...

Clinical and legal issues in the family therapy record.

The authors present guidelines for writing family therapy records that are not only clinically meaningful but also not unnecessarily damaging to a member of the family or the therapist in case the records are subpoenaed. They suggest that when deciding what to include in the record, the therapist should remember that those in treatment are both individuals and members of the family. They also recommend that a patient's right to privacy be safeguarded by omitting potentially damaging or embarrassing material from the record.