Client Change Research Articles

Documenting the Impact of Infra Low Frequency Neurofeedback on Underserved Populations With Complex Clinical Presentations.

There is a crisis in mental health. The demand for services is huge; the efficacy of current services is lacking, and the traditional path to developing effective treatments is not working. This paper describes an approach based on implementing infra low frequency (ILF) neurofeedback in agencies that work with the underserved and collecting data on client’s concerns, behavior, quality of life and cognitive performance. We also track session-by-session changes in client concerns and their relation to ILF neurofeedback protocols. Results are reviewed for over 300 clients who have been seen in such agencies. Limitations and future directions are discussed for this model.

화상회의 플랫폼 기반 상담실습에 관한 탐색적 연구

This study aims to explore the experiences of the students who had participated as either counselor and client in a graduate counseling practicum via videoconferencing platform. A protocol to include procedures and guidelines appropriate for online counseling was developed from the existing in-person protocol and implemented. The online counseling practicum(OCP) was to be completed within one semester with each case meeting 6 sessions; nine counselors (graduate) and fifteen clients (undergraduate) were participated in this process. Upon termination, quantitative and qualitative data on OCP experiences of the 26 participants were collected and anlayzed with non-parametric statistics and the Consensual Qualitative Research(CQR) methods. The statistical analysis show that compared to counselors, clients scored higher in terms of counseling relationship and outcome; however, there were no significant differences overall between the two groups in terms of (dis)advantages of videoconferencing and compliance with ethical and other guidelines. The qualitative data analysis reveal that conveniences of no commute and conversing in a familiar space were mentioned the most by both groups. Although less frequently, lack of skills in tracking client changes, online session to facilitate memos and questions, and harmful effect on client of the sessions ceased due to internet instability were mentioned by the counselors. Implications for counseling education are suggested regarding ways to extend procedures and guidelines of in-person counseling practicum to OCP.

A dynamic incentive and reputation mechanism for energy-efficient federated learning in 6G

As 5G becomes commercial, researchers have turned attention toward the Sixth-Generation (6G) network with the vision of connecting intelligence in a green energy-efficient manner. Federated learning triggers an upsurge of green intelligent services such as resources orchestration of communication infrastructures while preserving privacy and increasing communication efficiency. However, designing effective incentives in federated learning is challenging due to the dynamic available clients and the correlation between clients' contributions during the learning process. In this paper, we propose a dynamic incentive and reputation mechanism to improve energy efficiency and training performance of federated learning. The proposed incentive based on the Stackelberg game can timely adjust optimal energy consumption with changes in available clients during federated learning. Meanwhile, clients’ contributions in reputation management are formulated based on the cooperative game to capture the correlation between tasks, which satisfies availability, fairness, and additivity. The simulation results show that the proposed scheme can significantly motivate high-performance clients to participate in federated learning and improve the accuracy and energy efficiency of the federated learning model.

FCR special issue on Covid-19 pandemic.

FCR special issue on Covid-19 pandemic.

Facilitating the client change: A perspective from the therapeutic zone of proximal development

<p id=C6>Therapeutic zone of proximal development (TZPD) is an extension of Vygotskys concept of the zone of proximal development in the field of psychotherapy. Based on the assimilation model, TZPD represents the space between the actual development level and the potential development level of clients within a developmental sequence. As a new concept to understand the change process of psychotherapy, it can enhance the understanding of setbacks in psychotherapy, provide an easy-to-operate theoretical framework for promoting the change of the client, and provide precise guidance for the therapist to choose supportive or challenging intervention strategies. In terms of research, TZPD theory is based on an unconventional methodology of Theory-Building Qualitative Research. TZPD theory is built upon accumulating observations in qualitative case studies in which TZPD helped the therapist understand and interpret the psychotherapy process. Under this methodology, researchers mainly use a therapeutic collaboration coding system (TCCS) as a research tool to analyze different case studies, understand the causes and characteristics of different counseling cases, and compare the effects of good and bad results based on TZPD, to describe the characteristics of the psychotherapy process. This kind of practice will provide a richer perspective for future research on the theoretical construction of psychological counseling and therapy and the understanding of psychological treatment mechanisms. In clinical practice, as the working area of psychotherapy, TZPD provides a new perspective for understanding the setback phenomenon in the psychotherapy process. Early researchers regarded setbacks as a hindrance in the psychotherapy process, but the TZPD suggests that setbacks may be therapists exploration of the clients TZPD boundaries and preparation for subsequent progress. The key point of therapists work is not to avoid setbacks, but to discover and differentiate the phenomenon of setbacks under the enlightenment of TZPD theory, and choose the appropriate intervention technique at the appropriate stage. The future of TZPD hinges on further exploration of the clinical wisdom of experienced therapists. Its also worthy of carrying out theoretical exploration from different approaches and perspectives, which might ultimately explain setbacks in the process of assimilation and lead to a better understanding of the dynamics of the psychotherapy process.

Therapeutic Collaboration in Career Construction Counseling: Case Studies of an Integrative Model.

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling (CCC), we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of career certainty, vocational identity, career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC.

Less Is More: Implementing the Minimal Intervention Needed for Change Approach to Increase Contextual Fit of Speech-Language Interventions.

Speech-language pathologists (SLPs) and researchers face difficulties in moving evidence-based practices from clinical research into widespread practice, in part due to a mismatch between the design of typical intervention research studies and the realities of clinical settings. SLPs must adapt interventions from the literature or established programs to fit the needs of specific clients and settings. Researchers must design studies that better reflect clinical practice. Here, we provide an overview of the Minimal Intervention Needed for Change (MINC) approach, a systematic approach to developing and adapting interventions that focuses on achieving meaningful outcomes within specific contexts. We outline the principles of MINC and illustrate this process through the use of a case study. MINC can support systematic development and adaptation of interventions in clinical and research settings, particularly settings with resource limitations. Researchers should work to align research intervention work with typical clinical settings. This involves both targeting outcomes that are functional and clinically significant and acknowledging resource limitations. SLPs should adapt evidence-based interventions systematically and carefully to meet the needs of clients and settings while retaining the core components of intervention that result in meaningful change for clients.

Working with radicalised individuals: insights from a secondary and tertiary prevention program

ABSTRACT Despite their widespread adoption, little is known about the content and implementation of case-managed programs targeting individuals at risk of radicalisation and known extremists. This study examined data on one state-based case-managed program implemented by police in Australia – referred to as Intervention 01. Drawing on case note information for a sample of clients and interviews with intervention staff and clients, data are presented on the radicalisation risk factors amongst program beneficiaries, client participation and intervention goals, forms of assistance, and family member involvement and support. Five client case studies are described outlining the experiences of program beneficiaries and lessons are highlighted relating to intervention delivery and the disengagement process. This study provides insights into the practical realities of delivering programs to counter violent extremism, focusing on factors that influence client change and facilitate and inhibit client progress. Implications for the implementation and evaluation of programs to assist radicalised individuals are considered.

Good fortune and its influence on B2B relationships: The case of the Mae Manee money solution campaign in Thailand

Drawing on advice response theory and superstitious beliefs, advertising and branding literature, we explore the Thai archetype of good fortune and how it affects business to business (B2B) relationships. With the use of the interpretive qualitative method of Multimodal Discourse-Mythological Approach (MDMA), we develop a holistic understanding of the exchanged meanings around the notions of good fortune within the B2B context. We chose the archetype of Mae Manee that represents good fortune, as it is being used in the money solution campaigns of a major Thai bank, in an effort to overcome business clients' resistance towards adopting a new payment system. Our findings identify the importance of the notion of good fortune in the successful development of B2B relationships in Thailand by showcasing how it is used to encourage behavioural change of business clients towards new product adoption, while building on established business relationships though co-branding initiatives. The study offers theoretical and practical implications on the impact of good fortune in B2B relationships in Thailand.

Professional coaching versus vocal coaching: similarities and differences.

This Brief Communication describes the professional coaching/coach counterpointed by the vocal coaching/coach. The aim is to introduce and explain these two coaching perspectives for a correct and specific use of the terms. Six undergraduate professors, speech language pathologists - SLP and/or professional coaches and/or vocal coaches met and shared their perceptions and experiences in professional or vocal coaching and in teaching coaching strategies to professionals working in the voice field. A chart was set encompassing the similarities and differences between the two attributions, both in terms of the intervention process and professional training. Six fundamental aspects were identified to characterize the two coaching presentations, both professional and vocal, namely: credentials, performance, process, basic knowledge, partnership for results, and professional title. Professional coaching involved a structured process that requires certified training with individuals accredited by qualified associations aiming to facilitate positive changes in clients' lives and improve for the understanding of how personal and professional skills are developed. Conversely, vocal coaching can be characterized as an unstructured function that does not require accredited training, executable by various health or vocal pedagogy professionals for improving voice and/or communicative performance of artistic or non-artistic individuals , sung or spoken voice users. Particularly regarding vocal coaching, it is suggested that the professional is identified throughout the academic training or basic professional performance, thus adding the term vocal coach as a qualifier.

Employment Stress and Couple Adjustment among Clients With Disorders of Gambling and Alcohol Use: Themes of Transfers in Congruence Couple Therapy.

Background:Individuals with problematic gambling, alcohol and substance use commonly report lower employment rates and more employment-related problems such as job loss, work conflicts and poor performance.Method:A thematic qualitative analysis was conducted to extract employment-related themes from 21 sets of addiction counselors’ case notes of couple therapy sessions (average 10 sessions per case) from a randomized controlled trial of Congruence Couple Therapy (CCT). Case notes were examined for the types of employment issues to answer the research question: What are the interconnections of employment, couple adjustment and addictive behaviors as revealed in the CCT counselors’ case notes?Results:Five key areas of employment-related stress were identified: (1) unemployment, (2) financial concerns, (3) history of crime, (4) overworking and workaholism, and (5) workplace conflict. These themes interacted negatively with couple adjustment and addictive behaviors. Using CCT as an intervention, clients gained skills in 4 areas transferred to employment: (1) awareness of self, other and family of origin, (2) congruent communication, (3) work-family balance, and (4) enlisting spousal support. These themes intersected with enhanced work functioning and reduced stress, alcohol use and gambling.Conclusion:Employment problems negatively impacted addictive behaviors, couple adjustment and well-being of partners and clients. Skills and awareness gained in CCT promoted changes in addicted clients’ employment functioning and coping with employment stress. The domains of work and couple adjustment are mutually influential in increasing or reducing stress with implications for addiction recovery. CCT as a viable intervention for enhancing employment function should be further studied.

The cloverleaf model of cognitive behaviour therapy as experiential learning: implications for case formulation, therapeutic practice and practitioner development

Abstract Cognitive behaviour therapy (CBT) is an evidence-based psychotherapy for a wide variety of psychological problems. While the exact working mechanisms of CBT remain unknown, its mode of action might usefully be conceptualised as facilitated experiential learning. An adapted ‘cloverleaf’ version of Borton’s ‘what, so what, now what’ learning model is presented to elaborate some of the potential benefits of taking an experiential learning perspective on CBT. These include conceptualising the maintenance of client problems as inhibited experiential learning and the CBT therapeutic process as the cultivation of more effective experiential learning. An experiential learning perspective might also provide an accessible way for trainee and early-career CBT therapists to understand more clearly the learning methodology that underlies CBT’s distinctive approach to psychotherapy. The model is also intended to create an overarching conceptual bridge between reflective practice, the therapist’s experiential learning in the client role, and the client’s experience of CBT as facilitated experiential learning. Key learning aims (1) To introduce a modified ‘cloverleaf’ experiential learning process model that can be applied to the conceptualisation of client difficulties, CBT therapeutic processes, and practitioner development. (2) To demonstrate how the model can be used to develop cross-sectional and descriptive maintenance formulations of client problems and client wellbeing. (3) To show how the model can be used as a conceptual and practical tool to help formulate both the therapeutic process and challenges and obstacles to that process. (4) To help practitioners make links between the process of personal and professional development and client change processes.

DIGITALIZATION AND GLOBALIZATION IN TAXATION IN THE CONTEXT OF MODERN PRACTICE OF INTRODUCTION OF BLOCKCHAIN TECHNOLOGIES

One of the essential features of the new economy (neo-economy) is the increasing use of information and communication technologies, which led to the emergence and spread of the concept of "digitalization" as a process of digitalization, which is gradually formed within the post-industrial period of economic development. technical progress and innovative management methods, intellectualization of human capital, the use of advanced technologies, accelerated development of knowledge-intensive industries, giving priority to the production of knowledge and services, the mentality of creative, efficient, rational business. The vision of changes in taxation regarding the inclusion of blockchain technologies in the sphere of tax policy and introduction of taxation of tax differences of their exchange rate, as well as digitalization of cryptocurrency detection and taxation processes in Ukraine, which are currently outside the Tax Code of Ukraine. The world has changed significantly over the last decade. We live in an era of accelerating pace due to the rapid development of high technology. Traditional working tools used for years are losing relevance or disappearing altogether. Digital transformation, as a global trend, is steadily penetrating all industries. It affects both the most innovative and completely conservative areas. First of all, the client changes, both internal and external, his expectations, preferences and requirements. It forms a new demand, which must symmetrically correspond to supply. In the conditions of modification of the external environment there is an urgent need to reorient to modern methods of doing business. Only those companies that immediately translate their services into a more convenient and capacious mobile format of interaction with the client, will win the competition. Online retail and Internet banking, booking tickets and tours with aggregators or calling a taxi through mobile applications have become a reality of everyday life. According to Hampleton Partners, an international consulting firm specializing in technology mergers and acquisitions, the annual volume of transactions for the use of blockchain technology alone will be $6 billion. Many classic business models are giving way to technological innovation. The main message for businesses: "Upgrade or disappear", to which the modern tax system must also be adapted.

Influence before and after Early Mobilization of Changes in Pain Levels in Post Orthopedic Surgery Patients at Royal Prima Medan Hospital in 2021

Orthopedic surgery is a surgical action associated with the correction of musculoskeletal system deformities and orthopedic problems that aim to improve function by restoring movement and stability and reducing pain and disabilities. Early mobilization is a prominent factor in speeding up postoperative recovery and may prevent postoperative complications. This study aims to find out the influence before and after early mobilization of changes in pain levels in orthopedic postoperative clients at RSU Royal Prima. This type of research uses a correlational descriptive research design, using the One Group Pretest-Postest approach. The location of this study was conducted at RSU Royal Prima Medan in March 2021. The population of all patients’ post-surgery orthopedic hospitalization amounted to 176 patients. The size of the sample uses the formula Structural Equation Modelling (SEM), then the number of samples is determined to be 100 people. Univariate analysis, bivariate with t-dependent test (paired t-test) with a meaningful limit of 0.05. The results of the study that there was a change in the level of pain Wilcoxon test results at the time of the pre-test the result of the mean value of 3.82, at the time of the post-test test the mean value was 2.34. So the result of Z = -5,358 then p-value as much as 0.004 &lt; 0.05 so that Ho is rejected and Ha accepts. The conclusion of the level of pain before early mobilization in the client post orthopedic surgery the majority feels even more pain and the minority experience severe pain. The level of pain after early mobilization in the majority of orthopedic postoperative clients was slightly more painful and the minority felt even more pain. There is an early mobilization effect on pain changes in orthopedic postoperative clients in patients in the hospital room of RSU Royal Prima in 2021.

Client–therapist closeness–distance dynamics as a pathway for understanding changes in the alliance during psychodynamic therapy

AbstractThis study examines how changes in clients’ and their therapists’ perceptions of the therapeutic distance relate to changes in their reported alliance. Alliance is commonly measured using self‐report questionnaires that provide information regarding the partners’ bond and collaboration, but do not reflect the interactions or events underlining them. We developed the Observer Version of the Therapeutic Distance Scale (TDS‐O; Egozi et al., 2020) to assess components of the therapeutic relationship, including closeness–distance dynamics, autonomy and engagement. Sixty‐seven clients and their 27 therapists completed the Working Alliance Inventory (WAI) and underwent Relationship Anecdote Paradigm (RAP) interviews in which they related narratives about their experiences with each other three times during psychodynamic therapy (after sessions 5, 15 and 28). The clients’ and their therapists’ narratives were rated on the TDS‐O. Clients’ and therapists’ decrease in their sense that the partner was too distant correlated with WAI increase, as did therapists’ decrease in their opinion that the client was too close. Increases in both partners’ engagement was also related to WAI increase. A clinical example of a successful case demonstrates these changes and highlights significant moments that might contribute to positive change. The study establishes the relationship between the alliance and therapeutic distance, and reveals discrepancies in the experiences of clients and therapists. Tracking therapeutic distance has the potential to refine therapists’ attunement to their clients’ emotional needs.

H-Container: Enabling Heterogeneous-ISA Container Migration in Edge Computing

Edge computing is a recent computing paradigm that brings cloud services closer to the client. Among other features, edge computing offers extremely low client/server latencies. To consistently provide such low latencies, services should run on edge nodes that are physically as close as possible to their clients. Thus, when the physical location of a client changes, a service should migrate between edge nodes to maintain proximity. Differently from cloud nodes, edge nodes integrate CPUs of different Instruction Set Architectures (ISAs), hence a program natively compiled for a given ISA cannot migrate to a server equipped with a CPU of a different ISA. This hinders migration to the closest node. We introduce H-Container, a system that migrates natively compiled containerized applications across compute nodes featuring CPUs of different ISAs. H-Container advances over existing heterogeneous-ISA migration systems by being (a) highly compatible – no user’s source-code nor compiler toolchain modifications are needed; (b) easily deployable – fully implemented in user space, thus without any OS or hypervisor dependency, and (c) largely Linux-compliant – it can migrate most Linux software, including server applications and dynamically linked binaries. H-Container targets Linux and its already-compiled executables, adopts LLVM, extends CRIU, and integrates with Docker. Experiments demonstrate that H-Container adds no overheads during program execution, while 10–100 ms are added during migration. Furthermore, we show the benefits of H-Container in real-world scenarios, demonstrating, for example, up to 94% increase in Redis throughput when client/server proximity is maintained through heterogeneous container migration.

An Exploration of Empathy and Personality in Preservice Counselors

Empathy allows individuals to care for the well-being of others and act with compassion. Research indicates that empathy is an essential ingredient for developing successful counseling relationships, leading to positive change for clients. Determining how empathy is related to personality provides counselors with valuable information for exploring the impact of personality on empathy in counselor trainees. To explore the relationship between empathy and personality among counselor trainees, the researchers compared scores on the MBTI® and the IRI. Results of this study suggest a clear relationship between personality and empathy and were similar to the findings of previous researchers. In addition, this study demonstrated that the MBTI® type preferences of extraversion, intuition, feeling and perceiving are significantly higher than introversion, sensing, thinking and judging on the various empathy scales, specifically in the areas of empathic concern, perspective taking, personal distress and fantasy. Implications were discussed for both counselor educators and practitioners.

Understanding the Symbolic Effects of Gender Representation: A Multi-Source Study in Education

Symbolic effects of bureaucratic representation assume that outcomes for citizen–clients change in response to the mere presence of bureaucrats with similar backgrounds. The social–psychological mechanisms in clients that may explain these changes are barely examined, though. Based on multi-source data on male and female high school students in the Netherlands, this study empirically tests a theoretical model that links student–teacher gender congruence to students’ performance in math and Dutch language through the mediating role of students’ gender-stereotypical beliefs and self-perceived abilities. The empirical analyses do not support the hypotheses. For student performance in math, no effects were found, while for Dutch language, a negative gender-representation effect was found for male students. In all, the results point at divergent relations between gender congruence, self-perceived abilities and performance for male and female students across subjects. The null results in this study suggest that symbolic effects of gender representation may be affected by national context and socio-economic status which should be considered as new frontiers for future research on representative bureaucracy.

The Evaluation of Case-managed Programs Targeting Individuals at Risk of Radicalisation

ABSTRACT There currently exists little evidence on the effectiveness of case-managed programs targeting radicalised individuals. This paper provides results from an evaluation of two case-managed interventions implemented by police in Australia, referred to as Intervention 1 and Intervention 2. Drawing on client case note data and interviews, the paper provides quantitative and qualitative results. It examines client change using a five-point metric and details two individual case studies. Results provide data on radicalised behaviours, intervention goals and services offered to clients. Individual client progress is explored, and the overall effectiveness of both programs examined. The results show a positive relationship between client change and different measures of engagement. Limitations of the evaluation methodology and data sources are acknowledged and addressed. Lessons are highlighted relating to the assessment of client change, program evaluation and the role of interventions in supporting disengagement.

Changes in home care clients\u2019 characteristics and home care in five European countries from 2001 to 2014: comparison based on InterRAI - Home Care data

BackgroundPolicymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required.MethodsThis descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods.ResultsIn most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low.ConclusionOlder people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.