Client's Life Research Articles

Neuro-Occupation: The Nonlinear Dynamics of Intention, Meaning and Perception

This paper suggests revisiting and re-exploring the concepts of intention, meaning and perception through neuro-occupation, which theoretically operationalises nonlinear brain dynamics and occupation. A review of theory and research suggests that intention, meaning and perception are instrumental in understanding the client's unfolding life experiences through a self-organised process.In describing the organisation of the nonlinear dynamics of brain activity, it becomes apparent how intention, meaning and perception are the fundamental components of how human beings create meaning by engaging in self-directed and self-determined actions; hence, occupations. Through a fresh point of view and an improved understanding of the concepts of intention, meaning and perception, occupational therapy and occupational science may find common ground to integrate many diverse approaches into a more unified field.

Identifying Comparable Therapeutic Foundations between “Musical Re-play” and Improvisation

Philosophical perspectives, clinical experiences, and research findings grounded in cancer care, offer clarification of therapeutic components of “musical re–play”, that is, a client and music therapist relationship that is focused on playing with known music from the client's life. Addis' (1999) theory of mind and music and Winnicott's (1971) theory of “playing” as a means to attain growth and health are included, to inform the perspective that musical re–play can provide a multisensorial “human musical mirror” able to penetrate one's entire consciousness, including consciousness states that do not involve language. Consequently, it is the author's belief that when cancer patients are involved in musical re–play they may powerfully experience identity affirmation, creative self–discoveries, and a heightened sense of feeling and experiencing one's “real” and “alive” self. While it has been proposed that prior association with known, precomposed music thwarts creative awareness development (Aigen, 1991; Pavlicevic, 1997), consideration is given to the idea that playing with known music is a foundation for offering opportunities for creative responses and therapeutic change: changes which are evident and comparable in improvisational as well as re–played music therapy methods.

A multidimensional conceptual framework for understanding HIV/AIDS as a chronic long-term illness.

New treatment advances have radically altered the course of HIV illness and created new challenges for HIV-affected individuals, families, and communities. This article provides a conceptual framework for understanding HIV in the multiple contexts of the client's culture, strengths, life course, and biomedical progression. The article concludes with a discussion of HIV prevention and treatment adherence as key focal points for social workers and their clients.

Sacred changes: Spiritual conversion and transformation.

We use Pargament's (1997) definition of religion-"the search for significance in ways related to the sacred"-as a framework to understand spiritual conversion. Like other life-changing transformations, spiritual conversion alters the destinations that clients perceive to be of greatest importance in life (significance) and the pathways by which clients discover what is most significant in life (search). Unlike other transformative experiences, however, spiritual conversion incorporates the third element of religion, "the sacred," into the content of change. To illustrate these points, we discuss two theological models of spiritual conversion rooted in Christianity: a traditional model based on classic western theology and an alternative model based on feminist theology. We then compare processes of spiritual conversion to nonreligious models of transformation. We also highlight the importance for clinical work of the fit between the context of a client's life and the type of spiritual conversion experienced.

FINDING BOUNDARIES INSIDE PRISON WALLS: CASE STUDY OF A TERMINALLY ILL INMATE

The number of terminally ill prison inmates rises each year. Mental health professionals are uniquely prepared to provide therapy during the end-of-life process with their assessment, training, empathy, and communication skills. This case study examines the six-month therapy of one terminally ill inmate, using a client-centered approach. Drawing from existential therapy, the review of meaningful life events in the client's life clarifies current goals and the value of the current final stage of life. Ethical issues that arose are discussed, including pain management and compassionate release. Creative solutions to these ethical dilemmas were implemented through consideration of the overt and underlying goals of the inmate, the necessary rules and protocols of the prison, and in conjunction with professional codes of ethics.

From misery to mission: forensic social workers on multidisciplinary mitigation teams.

Social workers are well-equipped by experience and education to play a pivotal role in death penalty mitigation teams. They offer expertise in researching complete social histories, providing for people under threat of execution, and helping those individuals cope with that threat. The social worker's primary role is to develop the client's story through an extensive empirical inquiry into the person's life. An equally important role for social workers is to work with the multidisciplinary defense team to ensure that the client's life story becomes a part of the defense. This article, through a case example of a condemned prisoner, examines the mitigation team concept, focusing on the social work role.

In Search of “Ivan the Terrible”: John Demjanjuk and the Judicial Use of Ironic Argumentation

This essay analyzes the role that irony plays in legal argumentation. The author argues that the case of John Demjanjuk illustrates how both defendants and prosecutors in popular trials can take advantage of some of the inconsistencies and contradictions that exist in legal debates. In the Demjanjuk affair, defense attorneys were able to save their client's life in 1988 by arguing that he may be been at Sobibor instead of Treblinka, but this position would ultimately be appropriated by other prosecutors in denaturalization proceedings. Ironically, some of the same evidence that was used to “free” Demjanjuk from the characterization of “Ivan the Terrible” was used by those who still considered him to be a “Wachmann” and war criminal.

Narratiewe terapie aan die seksueel mishandelde kliënt : gevalstudie ter illustrasie van die herskryf van die verhaal van 'n kliënt met 'n 'ander seksuele versteuring'

Narrative therapy as a discourse for dealing with sexual abuse: rewriting the own story. Sexual abuse changes the victim's life. All forms of sexual abuse leave a scar, regardless of race or gender. It does not impact in the same way on the lives of all people, but victims are able to report extensively on exactly how such an event has changed their lives; how the incident has caused problems in various facets of their lives. When the question is turned around and the victims are asked to explain how they have handled these problems, what influence they exercise over the problems, the storytelling often ends just there - revealing their inability to cope. When problems are articulated, the possibility arises that victims may be helped. The aim is to re-establish victims as persons with integrity and to enable them to resume control of their lives after the traumatic event. They are en couraged to write an alternative life story based on their newly found inner strength and on what they desire for their lives. The current research, in which a client who presented with Sexual disorder not otherwise specified was helped to create an alternative story, suggests that it is possible to substitute 'unwanted' parts of such a client's life story with a rewritten narrative with which he / she can identify. South African Journal of Education Vol.23(4) 2003: 297-306

Encountering the Sacred in Psychotherapy: How to Talk With People About Their Spiritual Lives

Back to table of contents Previous article Next article Book ReviewsFull AccessEncountering the Sacred in Psychotherapy: How to Talk With People About Their Spiritual LivesRoger D. Fallot, Ph.D.Roger D. FallotSearch for more papers by this author, Ph.D.Published Online:1 Sep 2002https://doi.org/10.1176/appi.ps.53.9.1187AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Spirituality has become a hot topic in recent years, even in the historically skeptical arena of mental health practice. James L. Griffith and Melissa Elliott Griffith have written a thoughtful, balanced, and often creative work describing not only how to talk about spirituality but also, perhaps more importantly, how to think about and listen to the spiritual dimension of people's lives.Drawing on a wide range of case studies, clustered mostly in psychiatric consultations and in individual and family psychotherapy, they outline a conceptually and technically eclectic approach to spiritual and religious experiences. Unlike works based in the literature of the psychology of religion or of spirituality and health, this book draws on narrative and solution-oriented models within a framework informed by cultural anthropology and postmodern philosophy. While the authors are not apologists for a specific religion or for religion in general, they are acutely attuned to the possibilities for human life that are uniquely expressed in the spiritual realm. Their goals are to describe helpful modes of engagement with people in exploring spirituality and to offer corresponding guidelines for therapists.Throughout the book, the authors recommend addressing spiritual issues from a stance of curiosity, attentive listening, and gentle responsiveness. They do not urge the adoption of a unique set of interventions related to spirituality. Rather, they seek to foster openness to the possibility of change through collaborative and empathic dialogue about clients' spiritual lives. Notably, the authors avoid premature judgments about the meaning and implications of spiritual or religious language in therapy. The detailed conversations they report offer models for how to listen carefully, to question sensitively, and to respond helpfully even when the therapist's knowledge of a client's religious or spiritual background is minimal.The book is organized around genres of spiritual expression that the authors have found most relevant in therapy—metaphor, narrative, conversation, rituals and practices, and community, among others. In each chapter, they examine a particular genre, present case studies illustrating its potential importance in therapy, and discuss change processes related to that mode of spiritual expression. Especially valuable are pragmatic sets of questions the authors pose. Some invite the therapist to think more clearly about the place or function of spirituality in a client's life; others invite the client to do the same. The conceptual material about the various genres is in many places less focused and compelling than the clinical conversations, and it is sometimes difficult to make connections between the many theoretical constructs and their therapeutic expressions. Yet the authors' carefully probing voices are clear throughout, emphasizing the primacy of shared understanding in therapy relationships.The authors clearly acknowledge many ways that spirituality and religion may become destructive, at both individual and systemic levels. But their emphasis on spirituality's capacity to sustain such values as hope, joy, community, and gratitude in the midst of their polar opposites is a reminder of why spirituality is often so central to the experience of people suffering with mental or physical illnesses and why therapists do well to take seriously spirituality's importance.Dr. Fallot is codirector of Community Connections in Washington, D.C., and an adjunct faculty member in pastoral counseling at Loyola College in Maryland in Baltimore.by James L. Griffith and Melissa Elliott Griffith; New York, Guilford Press, 2002, 320 pages, $35 FiguresReferencesCited byDetailsCited ByNone Volume 53Issue 9 September 2002Pages 1187-1188 Metrics History Published online 1 September 2002 Published in print 1 September 2002

Reinventing Justice: The American Drug Court Movement

Drug courts offer radically new ways to deal with the legal and social problems presented by repeat drug offenders, often dismissing criminal charges as an incentive for participation in therapeutic programs. Since the first drug court opened in 1989 in Florida, close to 600 have been established throughout the United States. Although some observers have questioned their efficacy, no one until now has constructed an overall picture of the drug court phenomenon and its place in an American history of the social control of drugs. Here James Nolan examines not only how therapeutic strategies deviate from traditional judiciary proceedings, but also how these differences reflect changes afoot in American culture and conceptions of justice. Nolan draws upon extensive fieldwork to analyze a new type of courtroom drama in which the judge engages directly and regularly with the defendant-turned-client, lawyers play a reduced and less adversarial role, and treatment providers exert unprecedented influence in determining judicially imposed sanctions. The author considers the intended as well as unexpected consequences of therapeutic jurisprudence: for example, behavior undergoes a pathological reinterpretation, guilt is discredited, and the client's life story and ability to convince the judge of his or her willingness to change take on a new importance. Nolan finds that, fueled in part by the strength of therapeutic sensibilities in American culture, the drug court movement continues to expand and advances with it new understandings of the meaning and practice of justice.

BROKEN NARRATIVES: TRAUMA, METACONSTRUCTIVE GAPS, AND THE AUDIENCE OF PSYCHOTHERAPY

A constructivist model of posttraumatic psychotherapy is presented with particular attention to the metaphors of "narrative" and "audience." Metaconstruction, implicit construing, and narrative continuity are explored to conceptualize how persons story their experiences, and how some experiences (e.g., traumas) disrupt the storying process. Then the elements of posttraumatic psychotherapy are discussed with case examples illustrating how the therapist, as audience member and conarrator, facilitates the reconstruction and renarration of the client's life story.

Aesthetic knowing: understanding the experience of chronic illness.

Aesthetic knowing can help students gain a deeper understanding of a client's life with chronic illness. Simply asking clients to describe what their illness means is not enough. Having clients express themselves through a form such as a drawing, poetry, song, pictures, letters, or any form comfortable to the clients often reveals critical information that can change the direction of planned nursing care. This article presents the process and outcomes of asking nursing students to do an aesthetic project with one of their clients whose case they managed in the community during the semester.

Reinventing justice: the American drug court movement

Drug courts offer radically new ways to deal with the legal and social problems presented by repeat drug offenders, often dismissing criminal charges as an incentive for participation in therapeutic programs. Since the first drug court opened in 1989 in Florida, close to 600 have been established throughout the United States. Although some observers have questioned their efficacy, no one until now has constructed an overall picture of the drug court phenomenon and its place in an American history of the social control of drugs. Here James Nolan examines not only how therapeutic strategies deviate from traditional judiciary proceedings, but also how these differences reflect changes afoot in American culture and conceptions of justice. Nolan draws upon extensive fieldwork to analyze a new type of courtroom drama in which the judge engages directly and regularly with the defendant-turned-client, lawyers play a reduced and less adversarial role, and treatment providers exert unprecedented influence in determining judicially imposed sanctions. The author considers the intended as well as unexpected consequences of therapeutic jurisprudence: for example, behavior undergoes a pathological reinterpretation, guilt is discredited, and the client's life story and ability to convince the judge of his or her willingness to change take on a new importance. Nolan finds that, fueled in part by the strength of therapeutic sensibilities in American culture, the drug court movement continues to expand and advances with it new understandings of the meaning and practice of justice.

A Study of the Gender Role Orientations of Beginning Counselors

Counseling literature and the Council for Accreditation of Counseling and Related Educational Programs' (1994) accreditation standards advocate gender‐sensitive counseling practices. However, the effects of socialization processes on counselor education students concerning gender role orientation may interfere with that mandate. This study explored the gender role orientation of future counselors and implications for development as professional counselors.

The Storied Approach: A Postmodern Perspective for Career Counseling

The author discusses the storied approach as a constructivist perspective on career counseling. The storied approach explores the client's world through story development as the client and counselor collaboratively co‐construct, deconstruct, and construct life stories. Story development encompasses the client's past, present, and future life experiences that are related to life roles (i.e., family, student, worker, leisure, community). Assessment consists of both quantitative and qualitative data that are woven into the client's story as the symbols or meanings that call for further exploration.

Review of Career counseling: A narrative approach.

LARRY COCHRAN Career Counseling: A Narrative Approach Thousand Oaks, CA: Sage Publications, 2000, x + 166 pages (ISBN 0-7619-0442-5, us$35, Softcover) Reviewed by ANNE MARSHALL This book introduces narrative approach to career counselling. The author specifically makes the distinction that this is counselling approach, not career development theory. A narrative approach invites counsellors to make their career interventions with clients more personal. In contrast to the traditional objective emphasis in career counselling, this is subjective approach that emphasizes meaning and meaning-making. Cochran characterizes the central task of career counselling as emplotment rather than matching. Emplotment involves casting the individual as the main character in career narrative that is meaningful, productive, and fulfilling. Cochran's approach makes use of literary models and constructivist methods. He draws upon the personal construct approach of George Kelly (1955), as well as the writings of more recent authors such as Robert Neimeyer (1987) and Mark Savickas (1993). Specific client examples are used to illustrate the concepts and techniques presented. Canadian readers will appreciate an approach that does not rely on the American content that is so prominent in books focused on career. In Chapter 1, Cochran argues that narratives constitute our primary way of making meaning in the world. A narrative provides temporal organization in our lives, integrating beginning, middle, and an end into whole. Career counselling is concerned with narratives that empasize the future. The individual must identify with the narrative envisioned. In adopting career narrative, person tries to match an ideal vision with the possibilities offered by available options. This is continuous, dialectic process in which the individual is actively constructing meaning. These personal meanings are then expanded, refined, tested, and revised over the life course, resulting in unique career narrative. Cochran maintains that career counselling must focus on a person's capacity for future decisions and actions, what has been termed practical wisdom and sense of agency (p. 31). The standards for judging an ideal narrative include wholeness, harmony, agency, and fruitfulness. To help clients explore and emplot or implement their career narratives, Cochran proposes seven (rather than steps): Elaborating Career Problem, Composing Life History, Founding Future Narrative, Constructing Reality, Changing Life Structure, Enacting Role, and Crystallizing Decision. These episodes are intended to enhance deciding and acting, practical wisdom, and sense of agency. They are not meant to be followed in rigid fashion: different clients require different episodes, or different coordination and ordering of the episodes. Also, the arrangement of episodes might change as the course of counselling evolves. Elaborating career problem (Chapter 2) is critical first step. A problem is gap between client's actual state of affairs and his or her desired state. Counsellor and client must form working alliance, which includes agreement on purpose, agreement on means, and bond of relationship. The techniques of elaboration might include vocational card sort, construct laddering, drawing, testing, and the exploration of stories or anecdotes. Chapter 3 covers the next episode, the composition of the client's life history. This includes assessment as well as active intervention on the part of the counsellor. A counsellor intervenes to correct distortion, improve coherence, enhance agency, consolidate identity, and to prepare the client for other episodes concerned with founding future narrative. Several interview techniques to empower clients' narration are described: Life Line, Life Chapters, Success Experiences, Family Constellation, Role Models, and Early Recollections (pp. …

Applying the Visions of Reality to a Case of Brief Therapy

The “visions of reality” refer to assumptions about the nature and content of human reality and have been used to describe different genres of literature as well as psychoanalytic, behavioral, and humanistic modes of therapy. In this paper, four visions—the tragic, romantic, comic, and ironic—are applied to a single case, spelling out the way in which each can direct the focus of a therapist's attention to different aspects of a client's problems. Each vision can also influence the process of therapy and its goals. Keeping the several visions in mind can broaden both the therapist's and the client's view of the client's life situation and problems, thereby opening up possibilities for integrative work. The paper also spells out the shift in visions of reality that is necessary when conducting brief versus long-term therapy.

Social networks for women with serious mental illness.

Assessment of ways to work with situations as they exist, and capitalizing on positive factors or strengths within the client's life context, may enhance the nurse-client relationship, and the likelihood of positive outcomes. It is important to identify "natural helpers" and "natural community resources," such as churches and adult centers within the community and to assess the actual and potential contributions and needs of these resources.

Psychological distance, stated values and values in use: An approach to considering interactions for counselling within organizations

The work of Argyris (Reasoning, Learning and Action: Individual and Organisational: San Francisco Jossey-Bass, 1982) demonstrated the gaps that we tend tio have between our stated values and those that we actually use in practice. That of Micholt (Transactional Analysis Journal, 22, 228–233, 1992) illustrated the concept of psychological distance as applied tio facilitating groups in an organizational setting. These are both important works which can be very useful in conceptualizing the organizational context of counselling and also the client's problem situation. By combining these two approaches, it is possible to demonstrate a more detailed picture of the psychological distance and some of the potential problems inherent in interactions among three (or more) parties. For counselling, the combined approach emphasizes the importance of the counsellor remaining aware that the client's story is likely to reveal their stated values and that only by gaining a values-in-action perspective (i. e. behaviour) about the client's life can the counsellor adequately assess the client's situation. The examples given in this paper relate to counselling in an organisational context, but the approach may be applied tio facilitation, geneal management or consltancy.

Toward an Existential Model of Panic and Anxiety

SUMMARY This theoretical article demonstrates that panic and anxiety are often due to existential conflicts in the client's life. Pointing out that current cognitive behavioral and biological models do not pay sufficient attention to the existential dimension of panic and anxiety, the article presents a comprehensive, integrated clinical model for understanding and addressing these problems from an existential perspective. The article takes the position that panic and anxiety often serve as opportunities or “calls” for clients to examine the existential issues of their lives and to create a deeper, more authentic existence.