Experience Of Therapeutic Relationship Research Articles

Correction to: Music Therapists’ Experiences of Therapeutic Relationships with Clients with Marginalized Gender Identities and Sexual Orientations

Correction to: Music Therapists’ Experiences of Therapeutic Relationships with Clients with Marginalized Gender Identities and Sexual Orientations

Music Therapists’ Experiences of Therapeutic Relationships with Clients with Marginalized Gender Identities and Sexual Orientations

Abstract This phenomenological inquiry investigated the ways in which music therapists perceive and discuss their music therapy relationships (MTRs) with people with marginalized gender identities and sexual orientations. Five participants completed semi-structured interviews that were transcribed and analyzed with reflexive emphasis on member checking and data triangulation. First-level analysis utilized values coding and second-level analysis refined values themes to distill individual participant essences (Saldaña, 2016). The coding manual for qualitative researchers. SAGE). Subsequent horizontalization across participants was then used to discern collective participant essences (Saldaña, 2016). The coding manual for qualitative researchers. SAGE). Critical feminist, queer, disability, anti-oppressive, and humanist theory lenses shaped the foundation and perception of the project with particular attention to intersectionality, intersubjectivity, and power dynamics in relationships. Findings included commentary on MT/client identities and balance in relationships; contextual influences on MT processes; necessity of cultural humility (CH) and cultural sustainability (CS) and respect for identity complexity; and the role of implicit/explicit communication in MTRs. Crucially, participants and the researcher endorse a non-clinical view of people with marginalized gender identities and sexual orientations, and the researcher urges introspection regarding identity, supervision, and the space that MTs and clients occupy within the MTR construct. Discussion, recommendations for future research and applications to MT theory, research, and practice are provided.

“I’ve made that little bit of difference to this child”: Therapeutic parent’s experiences of trials and triumphs in therapeutic children’s homes

The workforce caring for children in residential homes are central to the outcomes for the UK’s most vulnerable children, although are often overlooked in research. The working practices, skills training, and wellbeing of these practitioners are directly linked to service delivery and the recovery outcomes for the children (e.g., ability to form positive relationships, self-regulate and become stable). This study uses a phenomenological approach to explore practitioners’ perspectives and experiences of working in a trauma-informed residential children’s service, with the aim of informing and improving working practices. Importantly, this study highlights the risk and protective factors that impact practitioner wellbeing and consequently, service outcomes for staff and children. This qualitative study gathered in-depth ideographic data through twelve individual interviews with practitioners working in Therapeutic Children’s Homes, which was then inductively analysed using thematic analysis. Two themes developed from the data: “Reciprocal Restorative Relationships” and “The Self within the System.” These themes explore the experiences of therapeutic relationships with the children and the collegiate network; as well as the essential role of supervision, training and emotional support to facilitate positive working practices and practitioner wellbeing. Additionally, a cyclical relationship between service outcomes, practitioner wellbeing and the perceived efficacy of the service emerged. Recommendations for service development and future research are discussed.

Consensual Qualitative Research on the Music Therapists’ Experiences of Therapeutic Relationships with Children on the Autism Spectrum Disorder

Consensual Qualitative Research on the Music Therapists’ Experiences of Therapeutic Relationships with Children on the Autism Spectrum Disorder

Adolescents’ experiences of therapeutic relationships at high and low levels of risk and resilience

Engaging adolescents in treatment requires professionals to negotiate relationship boundaries in ways that young people experience as therapeutic. For this study, we used qualitative data from a mixed methods investigation of 85 young people ages 12-19 who were either clients of two or more human services (n=61) or selected from a convenience sample of young people attending school in the same communities as the service users (n=24). By sorting participants into four groups based on their risk and resilience scores calculated during the quantitative phase of the research, patterns emerged in the quality of the relationships young people reported as the most therapeutic. Findings show that youth at higher levels of risk exposure preferred looser professional boundaries (a real relationship) in their interactions with their workers while those with higher resilience scores described positive relationships with professionals that included more structure, greater expectations and firmer boundaries. Findings suggest that the quality of adolescent client-professional relationships should vary depending on the risk and resilience profiles of the youth.

Communication skills training for mental health professionals working with people with severe mental illness.

Research evidence suggests that both mental health professionals and people with severe mental health illness such as schizophrenia or schizoaffective disorder find it difficult to communicate with each other effectively about symptoms, treatments and their side effects so that they reach a shared understanding about diagnosis, prognosis and treatment. Effective use of communication skills in mental health interactions could be associated with increased patient satisfaction and adherence to treatment. To review the effectiveness of communication skills training for mental health professionals who work with people with severe mental illness. We searched the Cochrane Schizophrenia Trials Register (latest search 17 February, 2016) which is compiled by systematic searches of major resources (including AMED, BIOSIS, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings. There are no language, date, document type, or publication status limitations for inclusion of records into the register. All relevant randomised clinical trials (RCTs) that focused on communication skills training (CST) for mental health professionals who work with people with severe mental illness compared with those who received standard or no training. We sought a number of primary (patient adherence to treatment and attendance at scheduled appointments as well as mental health professionals' satisfaction with the training programme) and secondary outcomes (patients' global state, service use, mental state, patient satisfaction, social functioning, quality of life). RCTs where the unit of randomisation was by cluster (e.g. healthcare facility) were also eligible for inclusion. We included one trial that met our inclusion criteria and reported useable data. We independently selected studies, quality assessed them and extracted data. For binary outcomes, we planned to calculate standard estimates of the risk ratio (RR) and their 95% confidence intervals (CI) using a fixed-effect model. For continuous outcomes, we planned to estimate the mean difference (MD) between groups, or obtain the adjusted mean difference (aMD) where available for cluster-randomised trials. If heterogeneity had been identified, we would have explored this using a random-effects model. We used GRADE to create a 'Summary of findings' table and we assessed risk of bias for the one included study. We included one pilot cluster-RCT that recruited a total of 21 psychiatrists and 97 patients. The psychiatrists were randomised to a training programme in communication skills, compared to a no specific training (NST) programme. The trial provided useable data for only one of our prestated outcomes of interest, patient satisfaction. The trial did not report global state but did report mental state and, as global state data were not available, we included these mental state data in the 'Summary of findings' table. There was high risk of bias from attrition because of substantial losses to follow-up and incomplete outcome data.Patient satisfaction was measured as satisfaction with treatment and 'experience of therapeutic relationship' at medium term (five months). Satisfaction with treatment was similar between the CST and NST group using the Client Satisfaction Questionnaire (CSQ-8) (1 RCT, n = 66/97*, aMD 1.77 95% CI - 0.13 to 3.68, low-quality evidence). When comparing patient experience of the therapeutic relationship using the STAR-P scale, participants in the CST group rated the therapeutic relationship more positively than participants in the NST group (1 RCT, n = 63/97, aMD 0.21 95% CI 0.01 to 0.41, low-quality evidence).Mental state scores on the Positive and Negative Syndrome Scale (PANSS) were similar between treatment groups for general symptoms (1 RCT, n = 59/97, aMD 4.48 95% CI -2.10 to 11.06, low-quality evidence), positive symptoms (1 RCT, n = 59/97, aMD -0.23, 95% CI -2.91 to 2.45, low-quality evidence) and negative symptoms (1 RCT, n = 59/97, aMD 3.42, 95%C CI -0.24 to 7.09, low-quality evidence).No data were available for adherence to treatment, service use or quality of life.* Of the total of 97 randomised participants, 66 provided data. The evidence available is from one pilot cluster-randomised controlled trial, it is not adequate enough to draw any robust conclusions. There were relatively few good quality data and the trial is too small to highlight differences in most outcome measures. Adding a CST programme appears to have a modest positive effect on patients' experiences of the therapeutic relationship. More high-quality research is needed in this area.

Experiences of therapeutic relationships on hospital wards, dissociation, and making connections

ABSTRACTAn interpretive phenomenological analysis sought to explore how people reporting moderate to high levels of dissociation experienced relationships with multidisciplinary hospital ward staff. Three superordinate themes were developed. First, the theme “multiple me and multiple them” explores the instability experienced by the participants as they managed their dissociative experiences alongside many inconsistencies. Second, “recognizing, meeting, or neglecting interpersonal and care needs” reflects on participants’ needs within therapeutic relationships. Third, “between the needs of the internal system: navigating between ‘better on my own’ and ‘someone to talk to’” discusses the confusion and understanding around dissociation and the importance of working with parts, not around them. Findings suggested that the current culture of some hospital wards directly influenced participants’ distress, which could lead to further dissociation as a means of coping with perceived threats. Reflections on relational complexities and developing ward-based treatment are discussed.

Counselor empathy or “Having a heart to help”? An ethnographic investigation of Chinese clients' experience of counseling.

Current understanding of counselor empathy is almost entirely based on Western culture. Clients'; perceptions of counselor empathy are scarcely investigated within any non-Western group. Using ethnographic interviews, this study explored the concept of counselor empathy from Chinese counseling clients'; perspectives by exploring their experiences of therapeutic relationships. Although informants did not commonly and explicitly consider counselor empathy as a priority in counseling, preliminary results suggest that they may perceive it in Chinese counseling relationships as a different phenomenon linguistically and conceptually.

Novice Counselors’ Conceptualizations and Experiences of Therapeutic Relationships

This qualitative study investigated three novice counselors’ experiences and characterizations of therapeutic relationships. Thematic analyses of interviews and diaries revealed six common themes: (a) the centrality of supervision and training experiences to navigating interpersonal experiences with clients; (b) anxiety about counselors’ roles in therapeutic relationships; (c) the perception of the therapeutic relationship as less directive than outside (lay) helping relationships; (d) experimentation with different interpersonal styles; (e) awareness of countertransference; and, (f) impact of therapeutic relationships on outside relationships. Findings expand upon the therapeutic relationship as a focal point for the training and supervision of novice counselors.