Client Response Research Articles

Spiritual Healing: Ragam Bahasa Balian Sebagai Salah Satu Pelestarian Tradisi Lokal di Bali

This research aims to identify the language varieties of Balian and the factors that influence these language varieties. This research is descriptive qualitative with a linguistic and pragmatic theory approach used by Balian. Data collection was done by in-depth interviews with Balians in the hotel. The collected data were then transcribed and thematically coded to identify patterns in language use, such as the use of language, the use of metaphorical language styles, and the sentence structure used. The results found that the balian language variety when communicating with clients is the use of affirmative language, the use of spiritual metaphor style, and the use of imperative sentence structure to direct the client's experience and emotional response during the healing process. Meanwhile, the factors that influence balian language varieties are cultural, spiritual, social, economic, and personal factors. An understanding of these factors helps explain how balians navigate between local traditions and the needs of their clients, as well as how they integrate different elements of language to create effective and meaningful healing experiences. Future studies go more in-depth into analyzing balian language use when viewed pragmatically and therapeutically.

Collaboration with clients to create journal notes: A mixed methods evaluation of a pilot intervention study in a municipality mental health services team

AbstractIntroductionThe purpose of this study was to evaluate an intervention designed to encourage therapists in a municipality mental health services team to collaborate with their clients when writing journal notes. The team was part of a low‐threshold mental health service for children, adolescents and their parents. The therapists offered individual therapeutic sessions with children, adolescents and parents, as well as family sessions. The therapists documented their encounters in the clients' electronic health records.MethodsThe study used a convergent mixed methods design. First, the quality and quantity of documented therapist–client interactions were measured before and after the intervention using the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI). Cross‐tabulation and logistic regression analyses were used to examine potential differences in the recording of therapists' approaches before and after intervention. Second, we explored the therapists' experiences of participating in this project by conducting individual in‐depth interviews. Qualitative interviews were analysed by systematic text condensation. Finally, the quantitative results from assessing the journal notes were contextualised with the qualitative results from the interviews.ResultsThe number of journal notes describing therapist approach and client response increased by 25% points after the intervention. In the interviews, the therapists acknowledged the intervention's relevance to their practice. However, they invited only a limited number of clients to co‐create journal notes. The clients welcomed the invitation.ConclusionCollaborative documentation challenges established journal documentation practices and may strengthen the client's voice. This study provides suggestions for strengthening the intervention in the future full‐scale studies.

Translating 'proportionate universal healthcare' into meaningful system design to optimize equity in child and family services.

To conduct a child and family health nursing service redesign to improve pathways of access, response and outcomes for all families with children aged 0-5 years. The study was conducted as an iterative, mixed-method study of the process and impact of the service redesign, informed by a participatory action research paradigm and the NSW Agency for Clinical Innovation process for developing a model of care. Diagnostic, solution design, implementation and sustainability phases were undertaken. Quantitative analyses were undertaken of administrative data, and child and family health nurse and client surveys. Qualitative analyses were undertaken of design workshops. The administrative data demonstrated that prior to the redesign service provision was the same for all clients regardless of levels of risk. The design solution, developed through a series of diagnostic and visioning workshops, included multiple new client response pathways. Implementation included development of tools and training. Sustainability of the redistribution of resources to the new pathways was assessed though an evaluation demonstrating a positive impact for families with adversity, with no deleterious effects for families receiving a universal response, and improvements in the emotional labour undertaken by nurses. Despite this, nurse burnout increased post-redesign. The shift from equal services (everyone receives the same) to equitable proportionate universal provision in response to need can be achieved and has positive impacts for nurses and families. This study shows the value of undertaking a systematic and participatory approach to service redesign. A proportionate universalism approach can ensure that early childhood nursing services are available to all in relation to needs. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) check-list was used to guide reporting. No patient or public contribution.

Production of sounds by squirrelfish during symbiotic relationships with cleaner wrasses

Examples of symbiotic relationships often include cleaning mutualisms, typically involving interactions between cleaner fish and other fish, called the clients. While these cleaners can cooperate by removing ectoparasites from their clients, they can also deceive by feeding on client mucus, a behavior usually referred to as “cheating behavior” that often leads to a discernible jolt from the client fish. Despite extensive studies of these interactions, most research has focused on the visual aspects of the communication. In this study, we aimed to explore the role of acoustic communication in the mutualistic relationship between cleaner fishes and nine holocentrid client species across four regions of the Indo-Pacific Ocean: French Polynesia, Guam, Seychelles, and the Philippines. Video cameras coupled with hydrophones were positioned at various locations on reefs housing Holocentridae fish to observe their acoustic behaviors during interactions. Our results indicate that all nine species of holocentrids can use acoustic signals to communicate to cleaner fish their refusal of the symbiotic interaction or their desire to terminate the cooperation. These sounds were predominantly observed during agonistic behavior and seem to support visual cues from the client. This study provides a novel example of acoustic communication during a symbiotic relationship in teleosts. Interestingly, these vocalizations often lacked a distinct pattern or structure. This contrasts with numerous other interspecific communication systems where clear and distinguishable signals are essential. This absence of a clear acoustic pattern may be because they are used in interspecific interactions to support visual behavior with no selective pressure for developing specific calls required in conspecific recognition. The different sound types produced could also be correlated with the severity of the client response. There is a need for further research into the effects of acoustic behaviors on the quality and dynamics of these mutualistic interactions.

In the Driver's Seat: Narrative-Based Counseling in Aphasia

Purpose: People with aphasia have been shown to experience higher rates of depression and mental health issues than stroke survivors without aphasia. Narrative-based counseling approaches to therapy in communication disorders have shown promise in several areas, such as stuttering. Little is known regarding how these approaches can be implemented with individuals with aphasia. This study sought to uncover what therapeutic processes could be utilized to overcome barriers to utilizing this approach with people with aphasia. Method: A qualitative case study design was utilized. The primary data source included audio-recorded intervention sessions of a narrative-based counseling approach. Secondary data sources included reflection journals produced by the clinician and artifacts created by the client, including letter written as a part of the therapeutic process and other documents co-constructed by the clinician and client that detailed the client's journey. Data were analyzed inductively, in which transcripts were coded by the researchers and compared across the data set until patterns were apparent in the data that were later defined as themes. Results: Analysis of data suggests that adapting narrative counseling techniques for success with people with aphasia consists of allowing adequate time for client response, building a therapeutic alliance, reiteration and saturation of solution-focused language and narratives, and maintaining a topic of conversation centered around aphasia. Conclusion: This study argues for further consideration of how narrative-based counseling techniques can be adapted and flexibly used in aphasia intervention.

"Now once again this idea of yours (…) how does it sound when I say that?" - Changing the perspective: how coach's questioning practices elicit self-reflecting processes in clients.

Drawing upon the transformative power of questions, the paper investigates questioning sequences from authentic coaching data to examine the systematic use of a particular succession of formulation and question and its impact on inviting self-reflection processes in the client and eliciting change. The object of investigation in this paper are therefore questioning sequences in which a coach asks a question immediately after a rephrasing or relocating action, prompting the client to respond in an explicit or implicit way. The coach hereby shifts the focus to a hypothetical scenario, prompting the client to change her perspective on the matter and reflect on her own statements, ideas and attitudes from an outside perspective. The paper aims to contribute to closing the research gap of the change potential of reflection-stimulating action techniques used by coaches, by investigating one of many ways of how questions can be powerful tools to invite a change of perspective for the client. The study focuses on one coaching process consisting of three sessions between a female coach and a female client, utilizing a single case study approach. The data collection was part of the interdisciplinary project "Questioning Sequences in Coaching", comprising 14 authentic coaching processes. The analysis follows Peräkylä's Transformative Sequences model, examining the first position including the formulation and the subsequent question, the client's response, and the coach's reaction to the response. On a practical level, the main purpose of this paper is not to contribute to the many ways practical literature recommends coaches how to do their work and how to ask questions, but rather to show in what ways the elicitation of self-reflection processes in clients has been achieved by other coaches in authentic coaching sessions.

Research on Tourism English Translation System Based on Fuzzy Clustering Algorithm

The emergence of economic globalization and the Internet have precipitated extensive and profound international exchanges and collaborations. Language barriers have surfaced as the primary impediment to effective international communication and cooperation. This study is dedicated to the development of a tourism English translation system utilizing the fuzzy clustering algorithm. The system's functionalities undergo testing and validation through black box testing. Key performance indicators like response time and throughput are scrutinized to evaluate the system's effectiveness. The performance evaluation involves monitoring specific checkpoints in test cases to ascertain whether the system aligns with the essential performance criteria. The system's response time and throughput take the forefront in this educational system assessment. Use-cases are categorized based on the number of online users, with the client's response time being assessed in each scenario. Successful completion of the criteria deems a use case qualified; conversely, failure designates it as unqualified, with any system deficiencies recorded within the testing framework. Data analysis reveals that the integration of the enhanced PCM algorithm elevates C-FCA's clustering data accuracy to 95%. Consequently, the findings signify that the fuzzy clustering algorithm significantly amplifies the precision of the tourism English translation system.

Defining and empirically testing a two-stage build-maintain model of cognitive behavioural therapy for insomnia

Cognitive Behavioural Therapy for Insomnia is the front-line intervention for Insomnia Disorder. However, few studies have reported data on how CBT-I implementation evolves over the course of therapy or the time course of client response. This is due, in part, to no formal framework for defining stages of CBT-I. Here, we follow Spielman's original conceptualisation of Sleep Restriction Therapy (SRT) to report a two-stage model for defining stages of CBT-I, based on progression through the phases of SRT. Using data from a prior randomized clinical trial, we show the model helps identify patterns of treatment progression, which are in turn associated with baseline insomnia severity. The reported model is parsimonious and easy to implement and it holds potential for further examining and understanding a variety of CBT-I processes currently not fully understood, such as adherence and the optimal order of various CBT-I treatment components.

Clinician motivational interviewing skills in 'simulated' and 'real-life' consultations differ and show predictive validity for 'real life' client change talk under differing integrity thresholds.

Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language. This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package. Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk (p < 0.001), Partnership (p < 0.001) and Empathy (p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping ('moderate') in both SI (p = 0.01) and RL (p = 0.02) compared to untrained veterinarians in each respective context. Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts.

Nursing Care for Clients Suffering from Non-Hemorrhagic Stroke with Impaired Physical Mobility in the Neurology Room, 6th Floor, Block B Koja Regional Hospital, North Jakarta

Non-Hemorrhagic Stroke is a blockage of blood vessels which causes blood flow to the brain to partially or completely stop, causing Non-Hemorrhagic Stroke sufferers to experience muscle weakness in some parts of their body. Based on the number of non-hemorrhagic strokes that occurred at Koja District Hospital from January to July 2017, there were 52 patients. The actions taken by nurses to reduce muscle tone weakness are Range of Motion (ROM) exercises which aim to increase muscle tone strength. In this study the author carried out a case study research design method by comparing 2 clients who experienced Non-Hemorrhagic Stroke with impaired physical mobility. To overcome this physical mobility disorder, the author provided Range of Motion (ROM) nursing actions to 2 clients for 6 days. After carrying out nursing actions for 6 days, the author compared the two clients to determine the client's response to Range Of Motion (ROM) nursing actions. In carrying out data analysis, the author collected data from interviews, observations, physical assessments, supporting data, medical records, nursing actions for 2 clients who would receive nursing care who experienced Non-Hemorrhagic Stroke with impaired physical mobility. The research results obtained were that there was an increase in muscle tone strength in client 1 (Mr. S) because Mr. S has high motivation, there is support from the family, sufficient knowledge, and the family's willingness to train ROM independently. Meanwhile, there was no change in increasing muscle strength in client 2 (Mrs. T) due to the client's low motivation to recover, lack of support from the family, lack of knowledge, and lack of family willingness to train ROM independently. Suggestions for nurses, especially Koja Regional Hospital nurses, are expected to be able to provide ROM exercises to Stroke clients.

The Impact of Client Response Time and Message Processing Fluency on Staff Auditor Judgment

SUMMARY Staff auditors frequently email clients to conduct evidence inquiry. However, little research has examined how characteristics of email communication impact auditors’ assessments of evidence. We experimentally investigate whether two characteristics of email communication, client response time and message processing fluency, influence auditors’ judgments. We find that auditor skepticism is reduced when the client provides a more fluent email response compared with a less fluent response in a moderate response time. In addition, auditor skepticism is reduced when the client provides a more fluent email response in a moderate response time versus in an immediate response time. Our results suggest that if client management takes their time to respond to an auditor’s email, then this may reduce auditor skepticism, especially if the client composes a fluent response. These findings have audit quality implications because the same client information provided via email can be perceived differently depending on other client communication characteristics.

A Qualitative Analysis of Clinician Perspectives of Ultrasound Biofeedback for Speech Sound Disorders.

Ultrasound biofeedback therapy (UBT) is a relatively new type of technology-assisted speech-language therapy and has shown promise in remediating speech sound disorders. However, there is a current lack of understanding of the barriers and benefits that may influence the usage behavior and clinical decision making for the implementation of UBT from a clinician perspective. In this qualitative study, we explore the perspectives of speech-language pathologists (SLPs) who have used ultrasound biofeedback in programs of speech sound therapy using the unified theory of acceptance and use of technology (UTAUT) model. Seven SLPs who had clinical experience treating speech sound disorders with UBT participated. Semistructured in-depth interviews were conducted and video-recorded. Two coders coded and categorized the transcribed data, with consensus established with a third coder. Using thematic analysis, the data were exploratorily grouped into themes along components of the UTAUT model. The highest number of codes was sorted into the "effort expectancy" theme, followed by "performance expectancy," "social influence," and "facilitating conditions" themes of the UTAUT model. Clinicians identified multiple perceived barriers and benefits to the use of ultrasound technology. The top identified barrier was limited accessibility, and the top benefit was the ability to visualize a client's articulatory response to cues on a display. Clinicians prioritized "effort expectancy" and "performance expectancy" when reflecting on the use of ultrasound biofeedback for speech sound disorders. Clinicians spoke favorably about using UBT for speech sound disorder treatment but acknowledged institutional barriers and limitations at organizational and social levels.

Banter in psychotherapy: Relationship to treatment type, therapeutic alliance, and therapy outcome.

The use of humor in psychotherapy is widely considered to improve therapy outcomes and typically depends on context, patient sensitivity, and the therapist's humor style. Different types of humor may impact treatment type, therapeutic alliance, and therapy outcome; however, evidence from psychotherapy sessions on the role of banter has been sparse to date. Therefore, the study aims to examine banter in a secondary analysis of psychotherapy sessions. The sample consisted of 68 depressed outpatients treated with one of three treatment types: psychoanalytic therapy (PA), psychodynamic therapy (PD), and cognitive-behavioral therapy (CBT). Banter and therapeutic alliance were rated for therapy sessions taken from the middle phase of treatment, outcome was assessed at the end of treatment. The main findings were (1) clinical examples of banter in psychotherapy were found in 62 from 68 sessions, (2) significantly more bantering in the main bantering category of facilitation for CBT sessions as compared to other treatment types, (3) facilitative banter as a significant predictor for the positive introject, (4) a significant correlation between bantering and bond between therapist and client. Furthermore, based on these results, psychometric properties of the Klagenfurt Bantering Instrument (KBI) are reported. From a bantering perspective, this study emphasizes the need to consider session context, client response, and sarcastic markers when categorizing negative banter using the KBI.

Comparing People’s Experience of Therapy for Complex Trauma Across Three Modalities: Face-to-Face, Mixed, and Online

To compare client response to a 3-stage phased intervention for complex trauma, comparing (1) those who received face-to-face intervention with (2) those who received a hybrid of face-to-face moving mid-therapy to online intervention with (3) those who received online only. Comparing quantitative and qualitative outcome data from 3 consecutive groups (N=22) who participated in a 3-stage phased intervention for complex trauma (1) face-to-face intervention (n=7); (2) a mix of face-to-face and online intervention (n=6); (3) online only (n=9). Analysis of quantitative data indicated a reduction in trauma symptoms across all modes of delivery. Reliable change indices suggested that face-to-face intervention facilitated the greatest change. In response to questions, participants spoke about (1) having a positive experience of the intervention, (2) advice to future group members, (3) constructive feedback, and (4) the experience of engaging online. Responses indicated that the experience of all groups were broadly similar. Participants reported strong group connections and an increased understanding of trauma. Minor differences, specific to the practicalities of each group, were found in the constructive feedback offered. Comments regarding the online experience highlighted the accessibility of the modality and indicated a sense of diminished group cohesion. Overall, participants reported a preference for face-to-face engagement. The majority of participants benefitted from the intervention regardless of modality. However, there is tentative evidence that the online format was the delivery mode associated with poorer-performing clients. In the future, online engagement and client preference should be considered carefully.

Vibrational Music Therapy with D/deaf clients

D/deaf clients perceive music through their bodies. The music therapist needs various methods to appreciate these sensations. It is necessary to examine the instruments from a vibrational perspective. Also, listening to the client is more important than speaking. This article focuses on how non-verbal methods are more appropriate when working with clients who have a hearing loss. Vibrosensoric approach to music combined with touch-based communication methods (social-haptic communication) enhances a positive client response. As a deafblind music therapist, musical vibrations play an important role for me as well as for the client during a therapy process. Background noise and spoken language can sometimes mask the perception of musical tones from different types of instruments. Speech with music within GIM sessions renders the client unable to follow either music or storyline. This distorts the sounds in hearing aid devices. Therefore, the instrument selection within the therapy session needs to be considered from a vibratory aspect. Musical tones from the instruments can be felt in different parts of the body. In this case, the focus is not on how an instrument sounds but more on the vibrational sensations it produces.

The role of the relational context and therapists' technical behaviors in brief motivational interviewing sessions for heavy alcohol consumption: Findings from a sample of Latinx adults

IntroductionMotivational interviewing (MI) theory and process research highlights the role of therapist technical and relational behaviors in predicting client in-session statements for or against behavior change (i.e., change and sustain talk, respectively). These client statements, in turn, have been shown to predict intervention outcomes. The current study examines sequential associations between therapist behaviors and client change and sustain talk in a sample of Latinx individuals who engage in heavy alcohol consumption. DataData are from a completed randomized clinical trial of a culturally adapted (CAMI) versus unadapted MI targeting alcohol use and consequences among Latinx individuals. MethodThe study collected observational coding data with the Motivational Interviewing Skill Code (MISC 2.5, i.e., therapist behaviors and global ratings) and the Client Language Assessment – Proximal/Distal (CLA-PD, i.e., client language). Frequentist and Bayesian sequential analyses examined the relationship among nine different categories of therapist behaviors and three different categories of client language (i.e., change talk, sustain talk, neutral). We examined odds ratios and conditional probabilities for the direction, magnitude, and significance of the association between the use of MI technical behaviors and subsequent client statements about change. The study compared these same transitional associations between low/average (i.e., <4) and high (i.e., ≥4) MI Spirit sessions. ResultsThe pattern of results was replicated across both analytic frameworks. Questions and reflections about change talk versus sustain talk versus neutral statements showed greater odds of predicting the intended client response (i.e., change talk, sustain talk, neutral, respectively) compared to other possible client responses. Conditional probabilities for these transitions were high, ranging from 0.55 to.88. The magnitude of certain technical transitions significantly differed between low/average and high MI Spirit sessions. ConclusionsAnalyses supported the hypothesized associations between therapist use of technical MI behaviors and client change language within this Latinx sample. Analyses of MI Spirit as a moderator of these transitions showed partial support.

Description of Nursing Implementation with Main Nursing Problem on Child Diarrhea of The Regional Hospital in Besuki Residency

Diarrhea are one of the diseases that causes the death of children number two in 2016 and has the main causative factors, namely groups of viruses, bacteria and parasites. The purpose of this study was to find out a description of nursing implementation in diarrhea children aged 0-18 years in the area of Besuki residency which is famous for its agro-cultural with high mortality problems in children. This research method was descriptive with a retrospective approach and use a purposive sampling technique. The sample in the study was 199 diarrhea children aged 0-18 years of the regional hospital in the area of Besuki residency. Data collection tools in this study is using checklist sheets. The result of the study showed diarrhea nursing problems that often arise with observational nursing action, namely pulse strength monitoring, number of frequencies, monitoring a number of respiratory. Observation has influence which is high enough to detect changes in life support systems. Vital signs are a statistical measure, especially for clients who are medically unstable, can know the baseline data to determine the stress response of physiology or psychology, concerning factors related to the existing disease and to assess the client's response to the conversion given by health workers. Observation is a basic method of assessment and assessment for clients to find out clinical signs in establishing a diagnosis of disease and for planning appropriate medical therapy.

Review of Challenges and Solutions in Web Based Vehicle Breakdown Assistance System

Abstract: At this point individuals prefer own vehicle for travelling to stay off from trouble. But just in case of any disruption during travelling, it’s very strenuous to go looking mechanic in anonymous location. Therefore, to work out this trouble we come up with an online based assistance system. During this system car and bike mechanics are ready to record yourself with their assistance information. The website will trace client’s live location automatically when he’s online. Based on client’s live location, system will develop a listing of the closest mechanics. When the client look for the mechanics then the list are going to be visible, so if user’s vehicle breakdown, then he is going to be ready to view the closest mechanics. This website is employed to seek out the closest mechanics while we instantaneously stuck on the rural area because of vehicle breakdown. It’s an adequate solution for the client who hunt for help within the rural areas. Here, only verified mechanics are entered in this website. As well, mechanics are examined by the admin for not asking unspecified top off charge against the client. This probably observed through the tech team over the client response supported their assistance. The certified client can attain this website. This website will assist to chop down client time to detect an accurate mechanic. This website will acknowledge client to pay the bill for a vehicle fixing in an appropriate charge. Keywords: Live Location, Client, Mechanic, Vehicle Disruption/Breakdown, Issue.

Experiences of Aggressive Behavior Patient after Physical Restraint in Mental Hospital, A Qualitative Study

Aims. The prevalence of Violence in nurses and patients is an important issue today. One of the handlings of violent patients in mental hospitals is restraint. Restraint becomes a difficult choice for nurses in mental hospitals. This choice is still made with ethical considerations to prevent a worse risk. Restraints can violate patient rights. But if not done can threaten the environment. After physical restraint the patient has special experiences that need to be evaluated by the mental health nurse. Purpose. The purpose of this study was to describe the experience of patients with physical violence after restraint at the Mental Hospital, West Java. Methods. The informant selection technique used in this study was purposive sampling. The number of informants in this study was six patients. Patients were selected based on two inclusion criteria, first; have ever done physical violence, secondly, have experienced physical restraint. Patients have been selected by the head of the ward and approved by the nursing ethics board. Data was collected through focus group discussions (FGD). Data was recorded using an audiovisual camera. The discussion was conducted over three sessions, in three days, each for 60 minutes. The collected data is typed verbatim. The thematic analysis used in this study refer to six steps qualitative analysis. Result. There are six themes that arise in the client's response to violent behavior during physical restraint. It includes ignoring the patient's basic needs, Feelings of anger and irritation, thinking that there is no perceived positive influence, controlling his behavior for fear of the next physical restraint, Surrender to the conditions experienced, Feelings of relief and joy after not undergoing physical restraint, there is a feeling of revenge and want to take revenge. Conclusion. The patient's experience with physical violence after the act of restraint reveals the occurrence of neglect of basic human needs, the emergence of feelings of anger and irritation and thinking that restraint is of no benefit. After going through the angry phase, there is a sense of resignation to the patient and the informant's efforts to control his behavior for fear of getting physical restraint again. However, there is also a feeling of resentment that is triggered by the experience of being treated inhumanely.

Therapist challenges and client responses in psychodynamic psychotherapy: An empirically supported case study.

In this case study of an adult female client working with a doctoral student female therapist in 85 sessions of individual psychodynamic psychotherapy, we analyzed the antecedents, challenges, and consequences for 53 challenges in the intake and first five sessions, the middle three sessions, and the final three sessions. Within the context of a strong therapeutic relationship and when the client was balanced in being defended as well as open/reflective, the therapist's challenges that were of high quality (deep, clear, empathic, and moderately forceful) were associated with the client becoming more open/reflective. In contrast, when the client was defended (but not open/reflective), the therapist's challenges were of lower quality and were associated with the client becoming more defended and closed off. Thus, both the antecedent client state and the quality of the therapist challenges were associated with the consequences of challenges in terms of the client's response. (PsycInfo Database Record (c) 2022 APA, all rights reserved).