Professional Therapists Research Articles

The Development of Communication Skills, Interpersonal Skills, and a Professional Identity Within a Community of Practice

Background and Purpose. The development of professional behaviors, including communication and interpersonal skills, has become an issue of great concern in the physical therapist profession. Yet little has been written about how these behaviors are learned, particularly from the perspectives of students and newly graduated physical therapists (PTs). This study sought to understand how PT students and new PT graduates learn professional communication and interpersonal skills. Subjects. The author interviewed 13 PT students and 6 new graduates. Their most recent clinical instructors (CIs) and clinical supervisors (CSs) were interviewed as well. Three hundred forty-four of their classmates submitted critical incidents for analysis. Finally, 5 additional PT students, 2 additional new graduates, and 5 additional clinicians participated in 2 separate summative focus groups. Methods. One-on-one semistructured interviews were used to explore the experiences of the students and new graduates. Similar questions were asked of their most recent CIs and CSs. Critical incidents were used to obtain the perspective of the participants' classmates. Once data were analyzed, 2 summative focus group interviews were completed to confirm, refute, and/or extend the findings. Qualitative methods were used to analyze the data. Triangulation of methods and subjects, use of “devil's advocates,” member checks, and search for negative cases ensured trustworthiness. Results. A model of learning within the community of physical therapist practice has emerged. This model depicts a process of learning that incorporates the following: access to the clinic and all of its challenges; strategies to make personal meaning of the clinical experience; dialogue as a mechanism to negotiate shared meaning; and outcomes, which include identification and assimilation of the values, beliefs, and attitudes of the profession. Discussion and Conclusion. Application of this process of learning will enable students, clinicians, and academicians to design and engage in clinical experiences that optimize learning of communication, interpersonal skills, and the development of a professional identity for both the learner and the clinical community.

Evaluating the Performance of the Academic Coordinator of Clinical Education in Physical Therapist Education: Determining Appropriate Criteria and Assessors

Background and Purpose. The role of the academic coordinator of clinical education (ACCE)/director of clinical education (DCE) in physical therapist education programs is evolving as physical therapy moves to a doctoring profession. Faculty evaluation of the ACCE on traditional academic criteria does not capture all of the responsibilities of the ACCE. Teaching occurs in individualized instructional sessions, making it difficult to obtain student feedback of teaching performance on course evaluations that assume a more typical classroom format of teaching. Administrative activities are not represented on course evaluation forms. The purpose of this study was to determine relevant criteria and identify appropriate individuals to contribute to the faculty evaluation of the ACCE. Subjects. The ACCEs and DCEs from all accredited physical therapist education programs in the United States were surveyed. Methods. An anonymous questionnaire was developed using institutional promotion criteria, traditional course evaluation forms, and published roles of the ACCE. Content validity was established. The percent responses were rank ordered to determine the importance of items in the categories of administration, teaching, scholarship, and service. Data obtained regarding individuals qualified to contribute input on performance were reported. Results. The response rate was 63%. The items rated the most valuable were in the category of teaching, followed by administration, service, and scholarship. Academic administrators, faculty, center coordinators of clinical education, clinical instructors, and students were identified as qualified to provide input on various items in evaluation of the ACCE. Discussion and Conclusion. Results are valuable in designing a comprehensive faculty evaluation of the ACCE for the purposes of promotion, tenure, and career satisfaction. The information will be useful in designing appropriate evaluation criteria for formative and substantive feedback to ACCEs. Key Words: Faculty evaluation, Academic coordinator of clinical education, Physical therapist education, Promotion and tenure. BACKGROUND AND PURPOSE Accredited professional (entry-level) physical therapist education programs in the United States include both academic and clinical coursework. Clinical education coursework occurs at health care facilities, schools, and wellness programs providing physical therapist (PT) students opportunities to apply learned academic knowledge with the supervision and guidance of a licensed physical therapist. Specific objectives for the experiences are set and collaboratively monitored by the clinical instructors (CIs) and the academic program. These experiences are required by the Commission on Accreditation in Physical Therapy Education (CAPTE)1 and are defined in A Normative Model of Physical Therapist Professional Education: Version 2004(2) as an integral component of the entire curriculum to prepare students to enter the profession of physical therapy. These courses provide students opportunities to apply theory and didactic information learned in the classroom and laboratory to patient care and are facilitated, coordinated, and monitored by the academic coordinator of clinical education (ACCE) or director of clinical education (DCE) employed by the academic program. For simplicity purposes in this paper the term ACCE will be used to be inclusive of the DCE terminology. In its Model Description Position for ACCEs/DCEs, revised in 2002,3 the American Physical Therapy Association (APTA) defines the position as follows: The ACCE/DCE holds a faculty (academic or clinical) appointment and has administrative, academic, service, and scholarship responsibilities consistent with the mission and philosophy of the academic program. This individual demonstrates competence in clinical education, teaching, and curriculum development. In addition, the ACCE's/ DCE's primary responsibilities are to plan, coordinate, facilitate, administer, and monitor activities on behalf of the academic program and in coordination with academic and clinical faculty. …

Beyond Disclosure: Seeking Forgiveness

In a Boston hospital delivery unit, a series of small mistakes—compounded by everyday stressors, personality conflicts, and the harried schedules familiar to every health care professional—culminated in the loss of a newborn and the serious compromise of the mother's health. Sachs, who tells this extraordinary story in JAMA ,1 should be commended for his discussion of mistakes in health care, the costs to everyone involved, and this particular medical team's generative approach to improving their practices. But what makes the article extraordinary is its focus on offering an apology. In doing so, the involved health care professionals moved into a position of seeking forgiveness . Forgiveness themes have surfaced, albeit infrequently, in the health care literature. One notable example is a widely read study—written by medical sociologist Charles Bosk and published in the book titled Forgive and Remember: Managing Medical Failures 2—documenting surgical error in the 1970s. The term “forgiveness” might be stumbled upon, rarely if at all, in professional ethics texts, especially those few that are virtue-based in approach or written within the context of particular religious ethics approaches. The concept of forgiveness is glaringly absent, however, in the medical and nursing literature and in the curricular materials of those professional education programs. But the medical and nursing professions are not unique. Apology and forgiveness themes are seldom, if ever, the focus of ethics cases in professional physical therapist education or plenary sessions at APTA meetings. Apology just isn't in the clinical vocabulary or, for that matter, in the clinician's line of vision. Why is the idea of apologizing absent from the health care professions at a time when taking precautions to prevent mistakes, being reflective, and being accountable are increasing in the literature and guidelines about professionalism? I believe that apology is largely absent from the …

Calling, Recalling, and Restoring the Signal Function of Emotions

Among the huge accumulation of psychological books offered in libraries and book stores, a relative few volumes stand out in an otherwise deluge of self-help exhortations, and discuss the psychotherapeutic process itself. Of that small portion, most consist of self-congratulatory case histories from professional therapists. Few volumes come from patients. The author, a long-term psychotherapy patient, briefly summarizes lessons gained in one of the most difficult processes a human can endure. The essay criticizes the current emphasis on psychotropic medication and equates anesthetizing unpleasant emotions, particulary depression, to shooting the messenger. Unpleasant emotions, like physiological pain, act as the body’s signals that something needs attention. Drugging them into insensitivity in the belief that they stem from unbalanced chemistry cures nothing. The argument offers an admittedly more difficult alternative that preserves the natural signal functions of depression, anxiety, and fear.

Correlates of Clients’ emotional and Behavioral Responses to Treatment Termination

This study investigates the associations between clients’ emotional and behavioral responses to treatment termination and eight sets of indepentent variables, covering the source of termination (client, therapist, external source); the termination process (speed, centrality, control, choice, and desire), and the perceived outcome (failure, goal achievement) of the therapy. Subjects were 92 student therapists and 40 professional therapists, who reported on their clients’ perceptions, experiences, and responses. All the variables examined were associated with one or another client response. The findings support the view of treatment termination not only as a loss experience but also as a transition. They highlight the need for therapists to pay careful attention to both the source and the process of treatment termination.

Interventions for Child and Adolescent Depression: Do Professional Therapists Produce Better Results?

We reviewed and analyzed child and adolescent depression treatment studies (1980–2001) through a comprehensive literature search. The outcome data from 19 studies (31 treatments) were extracted and weighted standard mean effect sizes were computed. Outcomes were compared across two levels of therapist training: professional and graduate student. Moreover, age was examined to test for differential effects on treatment outcome. Overall, professionals and graduate student therapists produced impressive yet commensurate outcomes when treating depressed youth. There were no significant differences found when treating children versus adolescents. The implications and limitations are reviewed, as are the suggestions for future research.

Borczon, R. (2004). Music therapy: A field work primer. Gilsum, NH: Barcelona. 149 pages. ISBN 1-891278-21-5. $21.00

Borczon, R. (2004). Music therapy: A field work primer. Gilsum, NH: Barcelona. 149 pages. ISBN 1-891278-21-5. $21.00 Ronald Borczon, MT-BC, has published Music therapy: A fieldwork primer, a text designed for students who are training in therapy fieldwork experiences and internships. The author has an admirable reputation as a clinician and educator: nearly 25 years as a professional therapist as noted in this book. He has to his credit a previous text, also published by Barcelona, titled Music therapy: Group vignettes (1997), which is used widely in English speaking undergraduate and graduate training programs around world. A stated focus for current handbook is to assist students in . . process of developing helping skills (p. xiii). Toward this aim Borczon provides supportive advice, brief clinical scenarios with various intervention suggestions, descriptions of a group of verbal techniques with examples of usage, an explanation of documentation procedures, and encouragement for students to embrace supervision opportunities. Cursory descriptions of musical techniques and methodological procedures are found, but these are few and are admittedly not intention of book. A final chapter is devoted to quotes from experienced therapists that were provided in to author's request for helpful thoughts to share with less experienced therapists. In very beginning of text (second page) I was struck by Borczon's acknowledgement of the two most influential therapy educators in my life, Ken Bruscia and Jayne Standley (p. x). Personally, I found it difficult to envision two more noteworthy yet distinctive professionals after whom one might model oneself as a therapist. Bruscia is known world-wide as a therapist steeped in psychodynamic traditions. His important work in clinical improvisation, Guided Imagery and Music (GIM), and qualitative research methodologies is quite dissimilar to that of Standley, whose equally renowned pioneering work in medical and school-based settings has its foundations firmly in behaviorism. And while Bruscia's academic success may be traced to training of students in a diversity of clinical orientations, Standley's academic program has been similarly well-regarded and attended for its unwavering ethos of behaviorism. Consequently, my curiosity was instantly piqued for what rest of this fieldwork primer held. From which clinical orientation will guiding notions be drawn? Will in therapy process be conceived as a reinforcer for client behaviors or will students be encouraged to hear clients' in an interpretive fashion from which insights to unconscious motivations may be gained? Will students read that client responses must be evaluated through quantifiable means or will recognition be afforded to value of qualitative and subjective observations? And what value will be ascribed to process of developing therapeutic relationships and relative therapeutic importance thereof? Although above observations and curiosities may initially appear peripheral to intent and content of this text, reader is well advised to hold notion of clinical polarities in mind while absorbing Borczon's recommendations for successfully facilitating therapy. The book has a principal slant toward behaviorism, particularly where clinical technique is concerned. Behavioral therapy terms such as contingency, reinforcement, and incompatible response abound as does notion that treatment is most successfully evaluated through quantifying client responses. In a chapter titled Intervention Strategies for Difficult Client, a preponderance of behaviorally grounded suggestions is put forth for 'managing client behaviors/ Conversely, Borczon advises students in their first clinical encounter Io Think of client as a piece of that is constantly flowing and changing in time. Your role is to help this symphonic outline embodied in human form discover meaning and health through their music (p. …

Preliminary Remarks Toward A Constructive Encounter Between St. Thomas and Clinical Psychology

This article address the ways in which contemporary psychologists might usefully engage in a dialogue with Catholic philosophers and theologians influenced by the thought of St. Thomas Aquinas. The specific point of common agreement and vision between these diverse approaches lies in the general notion that human action is directed toward an end which the individual judges to be good in some sense. Despite the considerable differences in foundational issues, both the clinical psychologist and Thomist are perhaps able to come to a constructive, common vision around the notion that all human action is directed toward the achievement of some good. The drama of human suffering and the desire to address such need through the efforts of clinical therapy mark a constant feature of contemporary life. Americans, Catholics included, are far more likely to turn to the rhetoric of psychology than theology for solutions to the problems of modern living. The church remains always at the service of humanity, yet it appears in many ways that humanity turns elsewhere, to its secular priests, the professional therapists, for guidance and advice on life’s most vexing problems. The accomplishments of the profession of psychology, especially within the counseling milieu, are in so many ways without question positive and compelling. There remains, nonetheless, the need to explore more fully how the profession might draw upon the theological wisdom of Catholicism and the moral tradition of St. Thomas Aquinas. It is the aim of this paper to outline in a preliminary way some of the directions for a positive exchange between the contemporary aspects of clinical therapy and the moral tradition of Thomism. The task is as daunting as it is urgent for any exchange of ideas among Catholic philosophers or theologians and contemporary clinical psychologists will have to confront at the beginning a number of difficulties. Perhaps first among them is the difference in the meaning of terms.

Early response in psychotherapy: Further evidence for the importance of common factors rather than “placebo effects”

Evidence is presented demonstrating that placebo control groups benefit more from psychotherapy than no-treatment control groups but less than patients who receive theory-driven treatments. Through a brief review of the results of comparative outcome studies, studies which compare patient outcomes for those seen by trainees or paraprofessionals versus professional therapists and those which show an early response of a sizable portion of patients, a case is made for the powerful effects of common factors in psychotherapy. The early response phenomenon has proposed another challenge to the unique effects of specific psychotherapies and to the wisdom of emphasizing the causative effects of specific techniques in the treatment of specific disorders.

Clinical Instructorsʼ Descriptions of Physical Therapist Student Professional Behaviors

Background and Purpose. Clinical instructors (CIs) have significant influence and responsibility guiding students toward professional competence through evaluation of clinical performance. CIs evaluate the professional behaviors of students in all three domains of learning: cognitive, psychomotor, and affective. The purposes of this study were to identify the behaviors that CIs expect, to describe appropriate and inappropriate behaviors, and to compare these behaviors to those cited in the literature. Subjects. Eleven physical therapists from variety of clinical settings, with an average of 8.9 years of experience as CIs, were interviewed. Methods. Subjects agreed to one-time, audiotaped, individual interview. A pre-interview form and methodological journal maintained by the researcher were also used to gather data for this study. Open-ended interview questions were used to identify the expected appropriate and observed inappropriate professional behaviors of students. The interviews were then transcribed. Interview transcripts were analyzed using qualitative methods for emergent themes and concepts. Results. Twenty-four students demonstrating inappropriate behaviors were discussed during the course of the CI interviews. CIs supervised range of one to six students with inappropriate behavior. These behaviors were divided into four concepts: An Attitude, Lack of Interest, Poor Communication, and Being Unprofessional. behaviors were divided into concepts: Accepts Responsibility for Learning, Communication Skills, Empathy, and Professionalism. Discussion and Conclusion. The appropriate behaviors identified by these clinical instructors are similar to what has been reported in the physical therapy literature, with the exception of the expectation for empathy. The concepts of and behaviors related to inappropriate behaviors have not been cited in the physical therapy literature. Descriptions of these inappropriate behaviors or Inabilities may be useful to academic faculty, CIs, and students, when examining and evaluating behaviors of students during clinical education experiences. Key Words: Student professional behavior, Generic Abilities, Inappropriate behaviors. INTRODUCTION Professional behaviors are skills that are expected of graduates of physical therapist education programs. Professional behaviors include all three domains of learning: cognitive, psychomotor, and affective. Inappropriate behavior in any domain can potentially affect patient care and outcomes1 and, therefore, all domains are important in clinical settings. Research and commentary in the literature of the health professions identifies professional behaviors as difficult to assess and evaluate,1-11 particularly behaviors that are affective in nature. Appropriate attitudes, values, beliefs and behaviors of the affective domain are more elusive to identify, develop and emulate than cognitive or skill behaviors.3(pi578) Professionalism is described as a repertoire of behaviors, in addition to core of knowledge and psychomotor skills (necessary) to be successful as physical therapist. 12(pviii) The physical therapy profession's Code of Ethics and Guide for Professional Conduct published by the American Physical Therapy Association (APTA)13 identifies the rudiments of expected practice and behavior for physical therapists. Respect for individuals, responsibility to the public and profession, criteria for remuneration, and maintenance of high standards in all areas of practice, are expectations in physical therapist practice as well as in other professions.14'16 A Normative Model of Physical Therapist Professional Education17 reflects the physical therapist profession's consensus on the purpose, scope, and content of professional education. It is comprehensive document detailing the expectations held by academic and clinical facilities for the preparation of professional physical therapists.17 The Normative Model includes detailed information about the expectations for professional behavior. …

PROTOCOL: Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10–17

PROTOCOL: Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10–17

European Perspective Interview Series 2

This second set of interviews follows on from the previous issue. It focuses on further exploring some aspects of music therapy in the UK and in other countries that were raised in the last interview. In this case, we are concentrating on Finland, the host country for the 2004 European Congress. Two Finnish music therapists are interviewed: Jaakko Erkkilä and Esa Ala-Ruona. Jaakko runs the music therapy masters training course at the University of Jyväskylä and he is Vice President of the European Confederation of Music Therapy. Esa trains music therapists and also works within the area of psychiatry as a clinician, supervisor and researcher. He is the chairperson of the Finnish Society for Music Therapy. The UK perspective is given by Judith Nockolds, the Chair of the Association of Professional Music Therapists. Judith works as a clinician with children, young people and adults with a wide range of needs. She is also involved in training and has a private supervision practice.

Social Work Students' Treatment Termination as a Temporary Role Exit

The end-of-year treatment terminations of social work student trainees are usually discussed as forced terminations, similar to those of professional therapists. This paper discusses them from the perspective of Ebaugh's (1988) role exit theory, which defines role exit as the departure from any role that is central to one's self-identity. This paper argues that in addition to being forced terminations, the end-of-year treatment terminations of student trainees are also temporary role exits. As such, they undermine the trainees' as yet undeveloped sense of professional identity and leave them susceptive to a “vacuum experience,” in which, suspended between a past role that they no longer possess and a future that is still unknown, they feel fear, anxiety, and a sense of being neither here nor there. This article offers suggestions for reducing the detrimental impact of the temporary role exit.

A Conceptual Toolkit for Intensive Early Behavioral Intervention Teachers

Intensive early behavioral intervention (IEBI) for children with autism requires effective team work involving professional therapists, parents, teachers and others. It is important for all team members to employ a common conceptual and procedural vocabulary so that communication among them is clear, unambiguous, and effective. This article outlines the rationale of a small and practical vocabulary or conceptual toolkit that we have found useful in working with teachers and families in designing, implementing, and analyzing the details of behavioral programs to help autistic children learn to speak and understand language. Special attention is given to a heuristic device called the language matrix. Illustrative data describing the course of generative language acquisition by a child with autism taught according to the language matrix approach are included.

Three Perspectives on Physical Therapist Managerial Work

The nature of managerial work in the commercial sector has not been studied since the 1970s, and little is known about the work of managers in the health care sector. In this study, the perceived importance of managerial role and skill categories among 3 groups of physical therapists were studied to better understand the work priorities of physical therapist managers. Two groups of subjects were physical therapist managers in hospitals or private practices. A third group consisted of faculty members in professional physical therapist education programs. Respondents (n=343) rated the importance of 75 managerial activities. Responses related to 16 predetermined work categories were placed in rank order by group. A multivariate analysis of variance (MANOVA) was used to identify differences among groups. All groups identified communication, financial control, entrepreneur, resource allocator, and leader as the 5 most important categories and rated technical expert and figurehead as least important. The MANOVA showed differences between faculty members and private practice managers in 15 work categories, between hospital-based managers and private practice managers in 9 categories, and between faculty members and hospital-based managers in 8 categories. Work setting appears to have an impact on level of importance placed on managerial work categories. The strongest candidates for "universal" physical therapist managerial work categories were communication, financial control, and resource allocator.

Cancer Group Therapy Adds To Well-Being, Not Longevity

Cancer Group Therapy Adds To Well-Being, Not Longevity

Interdisciplinary Health Assessment of the Older Individual: A Conceptual Framework for Curricular Integration

Background and Purpose. Evidence indicates that interdisciplinary health assessment of the older adult improves identification of needs and referral to appropriate services, as well as improving quality of life. Objectives. The objectives of this article are: (1) to dif ferentiate between and summarize evidence in support of a multidisciplinary and interdisciplinary approach to health assessment of the older adult, (2) to provide a conceptual framework for fostering interdisciplinary geriatric education, and (3) to describe challenges encountered in implementing interdisciplinary educational strategies for the professional (entry-level) physical therapist student. Framework. Three broad curricular elements are proposed as the foundation for progressing the physical therapist student toward multidisciplinary and interdisciplinary health care practice for the older adult: (1) the student must develop into a competent practitioner, with a scientific understanding of the varied motor control changes potentially encountered by the older adult, (2) the student must understand the indications for a multidisciplinary or interdisciplinary health care assessment and respect the roles of other professionals in the health care assessment of the complex older adult, and (3) the student must gain a practical understanding of the dynamics involved in team decision making and prioritization of treatment approaches. Approaches to addressing these curricular goals within one curriculum are described and critiqued. Betty Smith is a 78-year-old woman who arrives at the doctor's office with chief complaints of knee pain and difficulty doing her grocery shopping. She has lost 5 lb in the last year, and radiology reports reveal midstage degenerative joint disease in both knees. The physician prescribes anti-inflammatory medication, an analgesic, and a referral to a physical therapist for gait training with an assistive device. The physical therapist discovers that Betty also has problems with balance and fatigue and learns that her fear of falling has resulted in increased avoidance of activities outside the home. After examination and treatment, the physical therapist discharges Betty as independent with an assistive device on level surfaces and on stairs with rails. Betty does not take her anti-inflammatory medication because it causes digestive problems. Betty continues to have pain, balance problems, fear of falling, and fear of going outside, resulting in the continued decline in her functional abilities and inability to shop adequately for her groceries. Loretta Sizemore is an 80-year-old woman whose complaints and diagnoses are similar to Betty's. Loretta attends an interdisciplinary geriatric clinic and receives services as follows: (1) the pharmacist recommends an analgesic that does not interfere with balance, (2) the physical therapist recommends physical therapy for gait training with an assistive device, exercises to improve strength and balance, an evaluation for assistive equipment at home, and education to develop strategies to confront her fear of falling, (3) the social worker connects Loretta to appropriate community meal programs to help her obtain better nutrition, counseling services to address her depressive symptoms, and church and community resources for socialization and spiritual guidance, and (4) the physician makes a referral for a nutritional assessment to educate Loretta about her dietary needs. Betty and Loretta typify patients whose pathology (osteoarthritis) neither explains nor predicts the functional limitations and overall decrease in quality of life experienced by these individuals. It may not be reasonable to assume that one health care professional can effectively assess all of the factors that need to be addressed in clinical management of the person with complex and chronic health problems. A coordinated team representing multiple disciplines can provide a cohesive and thorough assessment and treatment plan for the person with multiple needs. …

Alternative Medicine on the Internet

If you go to a bookstore to look for information on a particular health problem you will have a choice between the "medicine" corner with scientific manuals for professionals and the "health" corner with all kinds of books about acupuncture, ayurveda, natural healing, homeopathy, nutrition, massage, and so on! How is it on the Net? Even a short tour will bring you a lot of "medical" information, but when you look for alternative approaches in the "health" corner you will be rather disappointed. Interesting sites are rare and the amount of information very sparse. In many cases the lists of therapists are seriously incomplete; professional therapists with long experience do not appear in them. Recommendations for alternative treatments are superficial and encourage the user to buy some specialties or some book. Many sites are inflated by just quoting other sites so that, in the end, the basic information is rather poor.As we know, "health" information is becoming increasingly important since patients want to take more responsibility for themselves. They look for alternative methods. Doctors too, as 46% of Swiss doctors use alternative methods in one way or another (Médecine et Hygiène, 1996). That is why we should not leave this part of the Internet in the hands of unqualified people. To some doctors, alternative medicine may seem a chaotic maelstrom of superstition and odd techniques. That is not so. Nearly every alternative therapy has a long tradition with its own rules and principles. All reliable therapists have undergone years of training and expect the same from their colleagues. Why should this search for quality not be present online?What is needed? Good quality information. The identity of the author must be clear (education, tradition, professional experience, training). As many schools claim to be "the only one", the user should be informed about the differences and conflicts between all the approaches. Ethical behavior must be encouraged: respect the right to be different, show respect and tolerance, act correctly regarding copyright. More good authors should put their articles on the Net to increase the amount of basic data available online (theory, case reports, FAQ etc.). The need to create a specific (virtual) team in order to establish quality criteria, screen, control and grade the online information about alternative medicine seems obvious. This team must include professional experts with specific knowledge and experience. A homeopath should evaluate homeopathy, an acupuncturist should evaluate acupuncture. Serious thought has to be given to creating a central data bank on alternative medicine, to provide quality information to different portals and websites, as well as to patients, doctors, educators and journalists.

A Study of Burnout and Multidisciplinary Team-Working amongst Professional Music Therapists

This paper reports the findings of a survey of 151 members of the British Association of Professional Music Therapists, conducted in January 1998, to investigate burnout and job satisfaction in relation to multidisciplinary team membership. Information on personal profile and employment characteristics was also sought, as music therapists are such a widely diverse group. Three aspects of burnout (emotional exhaustion, depersonalisation and personal accomplishment) were measured with the Maslach Burnout Inventory (Maslach & Jackson 1981). Factors influencing reward and dissatisfaction in the job were also assessed in relation to multidisciplinary team membership. Personal and team role clarity and team and professional identification were assessed in therapists who were members of multidisciplinary teams. Therapists who were members of multidisciplinary teams were found to have higher levels of personal accomplishment and similar levels of emotional exhaustion and depersonalisation in comparison to those working independently. These results are discussed in relation to previous surveys of other health and social care professionals. Sources of pressure and reward differed between multidisciplinary team members and non-members. Music therapists who were members of multidisciplinary teams were found to have a moderate level of personal role clarity within their team and identified with their profession more than with their multidisciplinary team.

Retrospective Self-Reports of Changes in Homosexual Orientation: A Consumer Survey of Conversion Therapy Clients

We present the results of a survey of 882 dissatisfied homosexual people whom we queried about their beliefs regarding conversion therapy and the possibility of change in sexual orientation. There were 70 closed-ended questions on the survey and 5 open-ended ones. Of the 882 participants, 726 of them reported that they had received conversion therapy from a professional therapist or a pastoral counselor. Of the participants 779 or 89.7% viewed themselves as “more homosexual than heterosexual,” “almost exclusively homosexual,” or “exclusively homosexual” in their orientation before receiving conversion therapy or making self-help efforts to change. After receiving therapy or engaging in self-help, 305 (35.1%) of the participants continued to view their orientation in this manner. As a group, the participants reported large and statistically significant reductions in the frequency of their homosexual thoughts and fantasies that they attributed to conversion therapy or-self-help. They also reported large improvements in their psychological, interpersonal, and spiritual well-being. These responses cannot, for several reasons, be generalized beyond the present sample, but the attitudes and ideas are useful in developing testable hypotheses for further research.