Client Well-being Research Articles

The Couple Therapist-Supporting and Undermining Behavior Scale: An Exploratory Factor Analysis

Some therapist behaviors are more helpful than others. The current study is a report on an exploratory factor analysis (EFA) of a new instrument, The Couple Therapist-Supporting and Undermining Behavior Scale (CT-SUBS), designed to assess couple therapist behaviors that contribute to and detract from both the therapeutic relationship and client well-being in relationship-focused therapy. The EFA revealed four dimensions of therapist behaviors according to participant (n = 270) report: (1) Active and Hopeful Engagement, (2) Unsupportive, (3) Dismissive, and (4) Supporting Individuals. We discuss the potential uses of the instrument in relationship-oriented therapy and directions for future research and training.

The change process questionnaire (CPQ): A psychometric validation.

Tracking therapeutic processes and outcomes session to session, known as feedback-informed treatment (FIT), has shown many significant benefits for systemic family therapists. However, more clinically useful FIT measures are needed in our field. In response, we conceptualize core dimensions of the therapeutic change process and propose a measure-the Change Process Questionnaire (CPQ)-based on some of those dimensions to provide a clinically useful FIT measure. Developed as a 25-item measure, this study evaluated the measure's psychometric properties, resulting in a refined version with 18 items organized into four subscales (client relationships, client well-being, therapist regard, and therapeutic effect) that demonstrate some alignment with core dimensions of the change process. In this article, we provide a preliminary overview of the CPQ's psychometric validity and potential to contribute to the therapeutic change process and its accompanying scholarly literature.

Reflections on ethical challenges in green guidance

This article explores the ethical challenges of incorporating 'green guidance' into career counselling, a concept introduced by Peter Plant in 1996. Green guidance advocates for integrating environmental justice and sustainability into career decision-making. The article discusses diverse perspectives on the ethical implications, particularly the balance between impartiality and socio-political responsibilities. Despite some concerns about neutrality, the article argues that career guidance should evolve to prioritize environmental sustainability and client well-being. Practical approaches for integrating green issues into career counselling are suggested, drawing on insights from the 'Exploring Green Guidance' project in Europe. The article concludes that addressing climate change in career guidance is an ethical and practical necessity for future career development.

The Application of Self-Determination Theory in Psychological Counseling Process

Self Determination Theory (SDT) is an important theoretical framework used in psychological counseling to increase intrinsic motivation, strengthen psychological well-being and support behavioural changes. This study examines the applications and effects of SDT in psychological counseling in detail. Deci and Ryan SDT focuses on the needs for autonomy, competence and relatedness to increase the intrinsic motivation of individuals. Meeting these basic needs has positive effects on the psychological well-being of clients. SDT applications in psychological counseling stand out with their effectiveness in increasing client engagement and commitment to therapy. The autonomy-supportive approaches of SDT encourage clients to participate more actively in the therapy processes, which positively affects therapeutic outcomes. Research shows that SDT increases clients' intrinsic motivation and this motivation leads to high success rates in therapeutic processes. In the study, the application examples and case studies section shows how SDT is applied in various therapeutic contexts and what results it yields. The case studies illustrate how SDT supports clients' psychological well-being and is effective in behavioural change processes. Clinical research and meta-analyses provide important findings supporting the general validity and effectiveness of SDT. In conclusion, SDT is an effective approach in psychological counseling to increase clients' intrinsic motivation, strengthen their psychological well-being and support long-term changes.

Maintaining and Improving Virtual Call Centers for Public Health: The CUNY Recovery Corps Experience.

In the early stages of the COVID-19 pandemic in New York City, individuals who tested positive, exposed contacts, and their families faced significant challenges in accessing essential resources for successful quarantine and isolation. These resources included alternative housing, food access, grocery delivery, missed wage assistance, transportation for household members, medical care, and more. The City University of New York (CUNY) Recovery Corps emerged as an innovative virtual resource navigation service to connect New Yorkers to essential resources and later to vaccinations, treatment, and services for Long COVID. The program prioritized reaching people living in underserved and under-resourced neighborhoods. Over 3years, it made a substantial impact, reaching 374728 New Yorkers and connecting 135147 to crucial resources. Implementing a successful virtual navigation center amidst a global pandemic posed unique challenges. It required well-established systems to provide services, manage staff, build community, and both assure and improve service quality. Continuous quality assurance and process improvement efforts resulted in a nearly 10-point increase in successful client-resource connections program-wide, with individual navigators showing improvements of up to 20%. Staff-led initiatives, such as population-specific resource guides and incentive awards, boosted morale and cohesion. Providing continuous professional development opportunities and requested training including trauma-informed care, self-care, and strategies for managing grief contributed to staff retention and improved client interactions. The CUNY Recovery Corps provides a blueprint for setting up navigation services for emergency response and supporting health and social services. The current paper delves into the intensive quality improvement efforts, program management infrastructure, and staff support that made this program a success. By applying these lessons on establishing and maintaining a virtual call center prioritizing the client's well-being and staff strengths, policymakers and social service leaders can effectively address various health and social service needs proactively rather than rebuilding after each disaster.

Enhancing Evidence-Based Practice in Rural Social Work: Applying the Theory of Planned Behavior to Identify Key Determinants.

This study explores the application and extent of utilization of Evidence-Based Practice (EBP) among rural social workers, identifying key factors such as attitudes, social pressures, and perceived barriers that influence its use. Utilizing the Theory of Planned Behavior as a framework, this research involved a comprehensive survey targeting rural social workers. The survey assessed their attitudes toward EBP, the social pressures, and the barriers in implementing EBP. Data from 91 participants were analyzed using multiple regression to determine how these factors impact EBP utilization. The analysis indicated that while attitudes toward EBP did not significantly affect its use, perceived ease of use, social pressures, and practical barriers were significant predictors. Interestingly, the data showed that external factors like organizational support and resource availability played a larger role than personal attitudes in the adoption of EBP. The regression model successfully explained 39% of the variance in EBP usage among rural social workers. The findings underscore the importance of external over internal factors in the adoption of EBP within rural settings. The study suggests that improving access to EBP resources and enhancing organizational support could facilitate more effective use of EBP among rural social workers. Effective implementation of EBP in rural areas necessitates addressing both perceived and actual barriers. Developing strategies to enhance resource availability and organizational support is recommended to boost EBP adoption, ultimately aiming to improve service outcomes and client well-being.

Care quality and safety in long-term aged care settings: A systematic review and narrative analysis of missed care measurements.

To critically evaluate missed care measurement approaches and their application in long-term aged care (LTAC) settings. Systematic review using Tawfik's guideline. PubMed, Scopus, Web of Science, CINAHL and ProQuest were searched. Supplemental searching was from reference lists of retrieved records, first authors' ORCID homepages and Google advanced search for grey literature. Search limitations were English language, published between 1 January 2001 and 31 December 2022. COVIDENCE was utilized for screening, data extraction and quality appraisal. JBI Critical Appraisal Tools and COSMIN Risk of Bias Tool were used for quality appraisal. Data were summarized and synthesized using narrative analysis. Twenty-four publications across 11 regions were included, with two principal methods of missed care measurement: modified standard scales and tailored specific approaches. They were applied inconsistently and generated diverse measurement outcomes. There were challenges even with the most commonly used tool, the BERNCA-NH, including absence of high-quality verification through comparative analysis against an established 'gold standard', reliance on self-administration, incomplete assessment of constructs and inadequate exploration of psychometric properties. Globally, there are deficiencies in the effectiveness and comprehensiveness of the instruments measuring missed care in LTAC settings. Further research on theoretical and practical perspectives is required. Findings highlighted a critical need to establish a standardized, validated approach to measure missed care in LTAC settings. This review calls for collaborative efforts by researchers, clinical staff and policymakers to develop and implement evidence-based practices as a way of safeguarding the well-being of older clients living in LTAC settings. Measurements of missed care in LTAC settings rely on adapting acute care tools. There is a critical gap in measuring missed care in LTAC settings. Developing a new tool could improve care quality and safety in LTAC settings globally. Adhered to PRISMA guideline. No patient or public contribution.

Oral health status and oral health-related quality of life: a cross-sectional study of clients in an Australian opioid treatment program.

Background Individuals with opioid dependence often experience poor oral health, including dental decay, periodontal disease and mucosal infection, frequently exacerbated by factors such as smoking, alcohol consumption, inadequate oral hygiene and low utilisation of oral health services. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) among opioid-dependent individuals and explore their potential associations. Methods Participants enrolled in an opioid treatment program (OTP) at three Australian urban clinics were assessed using the validated Oral Health Assessment Tool (OHAT) and Oral Health Impact Profile (OHIP-14). Results The average age of the 75 participants was 44.7years, with 45% receiving opioid treatment for over 5years. Dental decay and inadequate oral hygiene were prevalent. Mean OHAT and OHIP-14 scores were 6.93 and 20.95 respectively, indicating moderate oral health severity and poor OHRQoL. Physical pain and psychological discomfort significantly impacted participants' quality of life, with the effects being particularly pronounced for those aged 30 and above. An exploratory analysis revealed a strong correlation between OHAT and OHIP-14 severity scores, with a one-point increase in OHAT associated with 1.85times higher odds of a lower OHRQoL (odds ratio=1.85, 95% confidence interval: 1.38-2.49, P = Conclusions These findings underscore the multifaceted impact of oral health on the well-being of OTP clients. Routine dental check-ups, education on oral hygiene practices and timely treatment for oral health problems are crucial recommendations based on this study. Such measures hold the potential to enhance the quality of life for individuals attending OTPs.

Exploring the influence of leadership styles on psychological well-being and satisfaction of Pilates classes clients

BackgroundThe recent trend of increased indoor activities has significantly influenced daily life, enhancing the popularity of exercises like Pilates. This study explores how Pilates instructors’ leadership styles affect class satisfaction and psychological well-being, addressing the research gap concerning the specific impact of leadership within the context of Pilates classes.MethodsThe study surveyed 388 participants from 39 Pilates studios across South Korea, utilizing a questionnaire to assess leadership styles (transformational, transactional, and servant leadership), class satisfaction, and psychological well-being. Using statistical analyses, leadership styles were assessed for their correlation with class satisfaction and psychological well-being.ResultsFindings revealed that transformational and transactional leadership styles were positively correlated with class satisfaction and psychological well-being. Specifically, transformational leadership significantly enhanced educational satisfaction and personal growth, while transactional leadership most strongly influenced social satisfaction and the sense of purpose in life. Servant leadership was notably effective in improving physical class satisfaction. The study also highlighted the critical role of class satisfaction in promoting psychological well-being among participants.ConclusionThis research underscores the importance of leadership styles in enhancing the Pilates class experience, suggesting that instructors’ leadership approaches can significantly impact participants’ satisfaction and psychological well-being. The study advocates developing training programs that equip Pilates instructors with the skills to adopt effective leadership styles, fostering a more positive and fulfilling class environment.

"It Made Me Feel Like a Person Again": Benefits of Meals on Wheels-Based Social Connection Programs.

Social isolation and loneliness are associated with negative health outcomes, and these outcomes are exacerbated among older adults who are homebound. To address this issue, Meals on Wheels programs increasingly provide social connection services to clients in addition to home-delivered meals. This descriptive qualitative study examines the impact of three types of social connection programs on the well-being of homebound older adult clients, as well as on the volunteers and staff members who deliver the programs. Thematic analysis of semi-structured interviews conducted with 117 clients, volunteers, and staff in six Meals on Wheels social connection programs across the United States indicated that program participation was associated with substantial benefits. Benefits included the development of supportive friendships, reduced feelings of loneliness, and an improved overall sense of well-being. Insights from this study may inform the development, expansion, and sustainability of social connection programs provided by community-based organizations.

Sound Baths, Trauma Talk, and the Wellness Paradox in the USA

ABSTRACT Yoga-informed sound bath providers orchestrate vibrations from singing bowls, chimes, gongs, and other simple instruments to promote client well-being – sometimes in ways that create a trauma trap. Drawing on immersive research with sound bath providers and receivers in California, USA, I explore how these ritual performances feed on and fuel narratives regarding trauma, stress, and dysregulation, diverting attention from structural and cultural factors creating said disharmony. Beyond thereby ensuring a market, they can perpetuate a trauma-informed self-identification and subjectivity that harmonizes with the American work ethic, diminishes nonproductive sensual enjoyment, promotes self-care over community care, undermines resilience, and amplifies suffering.

Impact of racial microaggressions in psychotherapy vignettes with african american clients: An experimental analogue design.

Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions-subtle, sometimes unintentional, racial slights-during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of waqf-based microfinance program on clients’ well-being during COVID-19 pandemic: empirical evidence from Indonesia

Purpose The purpose of this study was to evaluate the impact of a waqf-based microfinance program on clients’ well-being during the COVID-19 pandemic. Design/methodology/approach This study obtained primary data from a survey distributed to 282 respondents, consisting of 150 clients and 132 nonclients of the Bank Wakaf Mikro (BWM) Al Kausar in Indonesia. This study constructed a well-being index (WBI) and compared clients’ and nonclients’ WBI before and during the pandemic using the difference-in-differences (DID) method. DID measures the effect of a treatment in a “treatment group” versus a “control group” using data from two periods. Findings This study found that clients and nonclients alike experienced an increase in well-being throughout the pandemic, but the increase was greater for clients than for nonclients. This study argues that the waqf-based microfinance program run by Bank Waqf Mikro model can assist their clients – as more vulnerable groups in society – to maintain their well-being during the pandemic. Research limitations/implications To ensure the effectiveness of waqf-based microfinance programs in diverse settings, this study should include more respondents from different institutions. Practical implications This research has several practical recommendations, particularly for integrating Islamic charity for microfinance. The findings of this study suggest that the BWM model, which combines three institutions – the government, zakat groups and Islamic boarding schools (pesantrens) – can play a substantial role in enhancing the welfare of its members during the pandemic. Originality/value This study contributes to the body of knowledge on Islamic microfinance by providing empirical evidence of the importance of waqf-based microfinance in reducing the pandemic’s impact on clients well-being.

Family health assessment in Ifugao, Philippines: a baseline study for Health In-tervention Program

A study was conducted to assess the health status of families in selected communities in Ifugao, Philippines. Interviews were done using a guide questionnaire adopted from the Family Health Management Manual for Nursing Students by Lydia Capistrano-Viet. The findings showed that the majority of households are nuclear, consisting of 5–10 people, and have an average monthly family income of 5,000–10,000 Philippine peso. The majority of the families possessed their own lots and homes made of wood and concrete, with enough space for the entire family. The majority of them disposed of their trash by burning it or giving it to animals. Nearly majority of them feature closed drainage systems and flush toilets. The majority reported that their homes lacked bug and rodent breeding grounds and shared a water supply. Additionally, they felt that their families' health was good as they had only experienced colds and the common cold over the previous six months. As shown by the fact that all of the respondents visit doctors and the health center for their medical requirements, 80% of them have complete immunization records. More or less seventy percent of people said they also follow healthy habits. The findings also demonstrate the availability of transportation, communication, and health resources in the neighborhood. A health intervention program aimed at enhancing the health and well-being of family clients in the community will be developed based on the study's findings.

Preserving the Integrity of Psychotherapy: Let’s Not Throw It Under the Bus

This paper delves into the evolving landscape of psychotherapy and counselling in Australia. Using personal experiences in the field, the author addresses concerns surrounding the conflation of these two disciplines and discusses shifts in training approaches, the influence of practitioners lacking proper psychotherapy training, and the dilution of both professions within health care settings due to a lack of national standards. Through the lens of psychosynthesis, the paper delineates the distinctions between psychotherapy and counselling and emphasises the importance of depth work in addressing complex psychological concerns and severe psychopathology. Additionally, it highlights the role of the therapeutic relationship and the nuances of transference in psychotherapeutic practice. The paper concludes with a call to uphold standards that safeguard client wellbeing, advocating for clarity in terminology and a future in which individuals receive support from rigorously trained psychotherapists.

96-week retention in treatment with extended-release subcutaneous buprenorphine depot injections among people with opioid dependence: Extended follow-up after a single-arm trial

BackgroundThe most recent formulation of buprenorphine treatment is extended-release depot injections (BUP-XR) that are administered subcutaneously by health care professionals. This study aimed to observe treatment outcomes of BUP-XR delivered in standard practice during a 96-week follow-up period in a community setting. MethodsThis study is an extension of the CoLAB study, a prospective single-arm, multicentre, open label trial (N=100, 7 sites in Australia) among people with opioid dependence who received monthly injections of BUP-XR to evaluate the retention in treatment. Participants were followed for 96 weeks, comprising 48 weeks of the CoLAB study followed by a 48-week extension. ResultsOf 100 participants at baseline, 47 were retained on BUP-XR at 96 weeks. The median time retained on monthly depot was 90 weeks. Heroin use (adjusted OR=0.19, P=0.012) in the month prior to baseline was associated with lower odds of retention on BUP-XR. Older age at first opioid use (adjusted OR= 1.08, P=0.009) and longer duration in OAT at baseline (adjusted OR= 1.12, P=0.001) were associated with increased retention. Prevalence of past four-weeks opioid use was estimated at 4% at 96 weeks of treatment (prevalence 0.04, 95%CI: 0.00-0.11) compared to 15% at baseline. Quality of life and medication treatment satisfaction improved over time for those retained in treatment. ConclusionThis is one of the few studies to describe long term (96 week) retention in treatment with BUP-XR in a community setting. It displayed retention rates with 47% of participants completing 96 weeks of treatment with BUP-XR. Patient reported outcomes suggest improvements in client wellbeing. FundingIndivior

Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being.

Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes. We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care (n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice-Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes. While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated (p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms. The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home.

Social welfare professionals’ views on addressing environmental issues in social work in Finland

ABSTRACT Global environmental challenges such as climate change, biodiversity loss, and overconsumption of natural resources require urgent action. Environmental crises have social consequences; hence, social work should participate in recognizing and mitigating these . This study investigated social welfare professionals’ perceptions on the relation of their work to environmental issues in Finland and the factors that influence these views. The research questions were: 1) How important do social welfare professionals perceive addressing environmental issues to be in their work? 2) What kinds of environmental issues do they perceive as having the most influence on social work clients’ wellbeing in Finland? 3) What background factors are associated with the perceived importance of addressing environmental issues in social work? A survey (N = 542) conducted among Finnish social welfare professionals in November 2020 showed that most respondents perceived addressing environmental issues in social work as important. Increasing concentrations of the population in certain areas, anxiety related to environmental problems, and desolated rural areas were the three most important environment-related issues marked as impairing client wellbeing. Social welfare professionals who emphasized the importance of addressing environmental issues in their personal life and those working in private or third sector organizations were more likely than public sector counterparts to value addressing environmental issues in social work. The findings suggest that social welfare professionals recognize that environment-related issues affect client wellbeing; hence, these issues should be incorporated into social work training and practice.

Marriage and Family Therapists Relationship Commitment During the COVID-19 Pandemic

Marriage and family therapists (MFTs) are tasked with managing the wellbeing of various clients. These tasks have become difficult during the global pandemic caused by COVID-19. This study aimed to understand the influence of the global pandemic on the lives of MFTs. A sample of 72 practicing MFTs in committed relationships were surveyed. A hierarchical linear regression showed that conflict at step one and stress at step two predicted greater relationship commitment. Our findings have clinical implications for MFT’s regarding commitment difficulties and conflict resolution. Tools for relationship management of conflict along with future directions in research are discussed.

Food provision to support improved nutrition and well-being of people experiencing disadvantage - perspectives of service providers.

Diet quality is significantly impacted by social and environmental factors. People experiencing socio-economic disadvantage face inequitable barriers to accessing nutritious foods and health services, resulting in significant health disparities. This study aimed to explore the barriers faced by organisations that provide food support to people experiencing disadvantage as well as to identify potential strategies to enhance this support for improved well-being of clients. Semi-structured interviews using an exploratory approach and inductive thematic analysis. Australia. Individuals from organisations involved in the provision of food support for people experiencing disadvantage aged ≥16 years. Two major themes were identified from thirteen interviews. 'Dignity and respect for clients' serves as a guiding principle for food-related services across all organisations, while 'food' was a point of connection and a potential gateway to additional support pathways. Five additional subthemes included 'food as a platform to reduce social isolation, foster connection and promote participation', challenges with 'servicing clients with diverse experiences and needs', 'dependence on staff and volunteers with varying knowledge and skillsets', ensuring 'adequate access to services, resources and facilities' and 'necessity of community collaboration'. This study highlights the unique position of organisations involved in food support to identify client-specific needs and implement broader holistic health support. Future interventions should prioritise dignity, respect and social connection in design. Organisations require an adequately trained, sustainable workforce, with shared or enhanced services, resources and facilities, and greater community coordination with other services to maximise effectiveness.