Clients In Clinical Settings Research Articles

Opening Up: Clients' Inner Struggles in the Initial Phase of Therapy.

ObjectiveTo explore how clients in clinical settings experience the process of opening up and sharing their inner experiences in the initial phase of therapy.MethodsTwo psychotherapy sessions of clients (N = 11) were videotaped and followed by interviews. Interpersonal process recall was used to obtain in-depth descriptions of clients’ immediate experiences in session. A follow-up interview was conducted 3 months later. The interviews were analyzed using thematic analysis.ResultsThe data revealed how and why clients distanced themselves from inner experiences in the initial phase of therapy. The overarching theme was “Holding back and struggling to open up,” which included four subthemes: (a) fearing the intensity and consequences of negative emotions; (b) experiences of being incapable and bodily stuck; (c) being insecure about one’s worthiness and right to share inner experiences with the therapist; and (d) struggling with feeling disloyal to loved ones.ConclusionThe participants held back because they feared different consequences of opening up. A range of concerns led participants to distance themselves from their inner experiences and/or to refrain from openly talking about them to the therapist. Concerns related to appropriate interpersonal conduct as client were especially important. This knowledge is highly relevant to clinicians when building safety for psychotherapeutic work.

Asexual-identified clients in clinical settings: Implications for culturally competent practice.

Asexual-identified clients in clinical settings: Implications for culturally competent practice.

Gender Comparisons of Self-Identified Strengths and Coping Strategies: A Study of Adolescents in an Acute Psychiatric Facility

This study examined gender comparisons of adolescents in psychiatric acute care who responded to an intervention designed to help youth self-identify strengths and coping strategies. A cross-sectional survey design and a random, census-based sampling approach were employed to obtain data from 281 adolescents. During the study period, a small group method was used to deliver a solution-focused, brief-therapy intervention to these adolescents. These data revealed that 38.2% identified an “arts-based” strength, 26.7% of the sample utilized a “relational” strategy and 26.1% reported a variety of sports and physical activity as a means of coping with crises. Controlling for psychiatric diagnosis, we found gender differences and similarities in the types of strengths identified by adolescents in this study. One application of these results is that they support the continued practice of engaging young clients in clinical settings using strength-based perspectives.

Nursing students' use of language in communicating with isiZulu speaking clients in clinical settings in KwaZulu-Natal

Language provides an important means by which humans communicate with one another, and communication plays a pivotal role in the health professions in developing trust and co-operation between the carer and the one being cared for. Little has been written about the importance of language barriers in nursing, although much has been written about the importance of cultural sensitivity in communication in nursing (Bischoff et al., 2003). A qualitative research methodology was implemented to explore and describe the experiences of senior undergraduate nursing students in communicating with isiZulu speaking clients in clinical practice settings. Permission to undertake the study was obtained from the relevant authorities. Data were collected by means of narratives and a focus group discussion and were analysed using Tesch's method of analysis to identify categories. The category ‘language of colour’ emerged from the descriptions where language was used to illustrate colour or race differences. The category ‘translation and interpretation' emerged from the students’ direct experiences of having to act as a translator or interpreter. The category ‘walls of language’ emerged from data that described how language can be used to access a group and the privileges of that group. The language that an individual uses can either include or exclude a person from a group—much like walls can create physical boundaries.

Social anxiety in stuttering: measuring negative social expectancies

Much research has suggested that those who stutter are likely to be anxious. However, to date, little research on this topic has addressed the role of expectancies of harm in anxiety, which is a central construct of anxiety in modern clinical psychology. There are good reasons to believe that the anxiety of those who stutter is related to expectancies of social harm. Therefore, in the present study, 34 stuttering and 34 control participants completed the Fear of Negative Evaluation (FNE) Scale and the Endler Multidimensional Anxiety Scales-Trait (EMAS-T). The FNE data showed a significant difference between the stuttering and control participants, with a large effect size. Results suggested that, as a group, a clinical population of people who stutter has anxiety that is restricted to the social domain. For the EMAS-T, significant differences between groups were obtained for the two subtests that refer specifically to people and social interactions in which social evaluation might occur (Social Evaluation and New/Strange Situations) but not for the subtests that contained no specific reference to people and social interactions (Physical Danger and Daily Routines). These results were taken to suggest that those who stutter differ from control subjects in their expectation of negative social evaluation, and that the effect sizes are clinically significant. The findings also suggest that the FNE and the EMAS-T are appropriate psychological tests of anxiety to use with stuttering clients in clinical settings. The clinical and research implications of these findings are discussed, in terms of whether social anxiety mediates stuttering or is a simple by-product of stuttering. Possible laboratory explorations of this issue are suggested, and potential Cognitive Behavior Therapy packages for stuttering clients who might need them are discussed. Educational objectives: The reader will be able to: (1) explain why expectancy of social threat or harm may be associated with stuttering; (2) name and describe two psychological tests that are suitable for assessment of the social threat or harm that may be associated with stuttering; and (3) explain how findings for the EMAS-T test in the present results suggest that expectancy of social threat or harm, but not other kinds of negative expectancy, are associated with stuttering.

Myers-Briggs Type Indicator Correlations with Enneatype-6 Alcohol or Other Drug Clients in Clinical Settings in Southeastern Wisconsin

ABSTRACT Research indicates that type six from the typology system of the Enneagram overrepresents the population of drug and alcohol abusers. Type six drug and alcohol abusers are correlated with the Myers-Briggs Type Indicator in a clinical setting in Wisconsin to reveal a “universal” nature of type six. Susceptibility toward addiction and depression are also revealed by the MBTI within this characterological structure.

Nutrition videotapes reach low-income WIC audiences

Although some research exists on the effectiveness of using videotapes to deliver nutrition education to middle-income clients in clinical settings, little has been reported on the effectiveness of this approach in public health environments. This preliminary study evaluated the success of “For Goodness Sake!”, a video series teaching nutrition education to low-income participants in the Women, Infants and Children's (WIC) program. Participants reported significant increases in their consumption of broccoli and rice 3 to 4 weeks after viewing the videos.

Social Comparison Theory and the Universality of Experience

Social comparison theory (1) predicts that clients in clinical settings will compare their own thoughts, experiences, and behaviors to those of because what other people do is considered normal. Schachter (4) further predicts that people who are anxious and unsure about themselves will seek out who are in similar situations and that the information they obtain through social comparison will increase their self-esteem. Group psychotherapy makes use of these dynamics through the therapeutic power of the universality of experience (2 ) . Psychological education ( 5 ) may increase self-esteem rhrough classroom interventions. This article reports the use of peer tutors to facilitate social comparison. All students registering in a course designed to students gain better understanding and acceptance of themselves and others met in small groups for 45 min. twice per week. They also attended a 45-min. lecture on issues in adjustment each week and were assigned readings and given tests. The small groups were led by peer tutors who had completed the class satisfactorily the previous quarter. The small groups' task was to discuss personal concerns and how members dealt with them. The Janis-Field Feelings of Inadequacy Scale (3) was administered to the students on the first and last days of class. Self-esteem significantly increased from pre- to postrests (t = 5.71, p = .001). Answers to items on the post-treatment questionnaire indicate that this increase was based on receipt of information through social comparison. For example, self-esteem increased for those students who found the group activities worthwhile (r = 32, j~ = .037), those saying such classes should provide information through social comparison (r = .48, p = .003), and those saying they got such information from the group (r = .61, p = .001). These results provide convergent evidence that obtaining information through social comparison increased self-esteem. This occurred after group discussions led by peer tutors whose only role was to facilitate social comparison. Practitioners and researchers may look to social comparison theory as the theoretical basis for interventions which stress the universality of experience and help change perceptions associated with feeling alone, deviant, or abnormal.