Client Ratings Research Articles

Should we feel the same? Mutual recognition and congruence between therapist and client regarding ruptures and repairs.

The pattern of rupture and repair within therapeutic alliances has been associated with improved outcome. The present study adds to this body of research by examining rupture and repair from a dyadic perspective. First, we examined the relationship between mutual recognition of ruptures, rupture intensity, and client ratings of session helpfulness. We then examined client-therapist congruence regarding rupture and repair characteristics and their relation to client ratings of session helpfulness. Data were collected from 90 client-therapist dyads (providing two subsamples of 61 and 45 dyads) during 16 sessions of short-term psychodynamic therapy. Clients and therapists rated the occurrence of ruptures, rupture characteristics, and rupture repair following each session. Clients also rated session helpfulness following each session. We found a significant negative interaction effect, indicating that when clients rated ruptures as more intense, therapist rupture recognition was related to lower client ratings of session helpfulness. Client-therapist congruence in the perception of rupture intensity was positively related to client perceptions of the extent to which ruptures were discussed. Finally, we found a significant positive relationship between client-therapist congruence in their perception of rupture repair and client ratings of session helpfulness. This study demonstrates the significance of the dyadic view of the rupture/repair process. Therapist recognition of ruptures may not be enough to facilitate repair, specifically in ruptures with a high level of intensity. Nevertheless, congruence in intensity is valuable for addressing the rupture within the session, and congruence in repair is valuable for session helpfulness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Investigating the existence of ethnic bias in professional services

The underrepresentation of ethnic minorities persists in professional service organizations because some are reluctant to hire minority employees owing to fear of negative customer evaluations. I apply expectancy violation theory to challenge the assumptions behind such hiring practice and predict that in unambiguous service encounters between majority customers and minority professional service providers (PSP) detrimental consequences are less salient. In four scenario-based studies in two contexts (lawyer, physician), I manipulate PSP ethnicity status and find that clients rate minority (vs. majority) PSPs more favorably in terms of competence, satisfaction, and rapport; rapport also mediates the relationship between PSP ethnicity status and clients’ compliance with their advice. This relationship is moderated by social dominance orientation too. A fifth study shows that the predicted relationships largely hold for positively and negatively valenced encounters. These results suggest an absence of bias effects in professional service settings and have implications for research and practice.

Scoring Aided Federated Learning on Long-Tailed Data for Wireless IoMT Based Healthcare System.

In this article, we propose a novel federated learning (FL) framework for wireless Internet of Medical Things (IoMT) based healthcare systems, where multiple mobile clients and one edge server (ES) collaboratively train a shared model on long-tail data through wireless channels. However, the presence of long-tailed data in this system may introduce a biased global model which fails to handle the tail classes. Additionally, the occurrence of severe fading in wireless channels may prevent mobile clients from successfully uploading local models to the ES, thereby excluding them from participating in the model aggregation. These situations adversely affect the performance of FL. To overcome these challenges, we propose a novel scoring aided FL framework that uses a scoring-based sampling strategy to select mobile clients with more tailed data and better transmission conditions to upload their local models. Specifically, we leverage the logits to explore the data distribution among local clients and propose a logits based scoring client selection method to alleviate the impact of long-tailed data. Moreover, we address the impact of severe fading by incorporating the channel state information (CSI) and data rate of clients into the logits based scoring and proposing a novel logits and model upload rate based client selection method. Experimental results demonstrate the effectiveness of our proposed framework. In particular, compared to the conventional FedAvg, the proposed framework can achieve accuracy gains ranging from 4.44% to 28.36% on the CIFAR-10-LT dataset with an imbalance factor (IF) of 50.

Health care provider and client experiences of counselling on depot medroxyprogesterone acetate subcutaneous (DMPA-SC) for self-injection in Malawi.

Since the introduction of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in 2018, Malawi has achieved national coverage of trained providers in the public sector and steady increases in uptake of DMPA-SC. However, the rate of clients opting to self-inject DMPA-SC has remained lower than early acceptability studies suggested. Providers play an instrumental role in building client confidence to self-inject through counselling/training. This cross-sectional qualitative study explored the perspectives of providers and injectable clients on the integration of self-injection into contraceptive counselling, to identify best practices and potential gaps. The study was conducted at public sector sites in three districts (Nkhotakota, Mzimba South, Zomba) in Malawi. In-depth interviews were conducted with provider-administered injectable clients, self-injecting clients, and DMPA-SC trained providers. All providers interviewed reported successfully integrating self-injection into their approach. During group health education sessions, some providers reported focusing on benefits of self-injection to spark interest in the method, and then follow that up with more in-depth information during individual counselling. Due to time pressures, a minority of providers reported replacing individual counselling with small-group counselling and limited use of elements such as visualizations and demonstrations. Most providers skipped client practice on inanimate objects, feeling this was either not necessary or inappropriate given stock constraints. Self-injection clients tended to credit their decision to take up SI to receiving lengthy, comprehensive counselling/training, often inclusive of reassuring messages, visualizations, demonstrations and sometimes repeated trainings over time. Provider-administered clients tended to credit their lack of uptake of self-injection to fear and lack of confidence, often blaming themselves instead of the quality of their counselling/training-even while many felt their counselling/training had been rushed or incomplete. Providers should be supported to overcome time- and resource-pressures to invest in counselling/training best practices, to ensure sufficient support is provided to clients interested in self-injection.

Prevalence of Cervical Cancer and Clinical Management of Women Screened positive using visual inspection with acetic acid and Cervicography in selected public sector health facilities of Manicaland and Midlands provinces of Zimbabwe, 2021.

Zimbabwe has high cervical cancer (CC) burden of 19% and mortality rate of 64%. Zimbabwe uses Visual Inspection with Acetic Acid and Cervicography (VIAC) for CC screening. Manicaland and Midlands provinces recorded low VIAC positivity of 3% (target 5-25%) and treatment coverage of 78% (target = 90%) between October 2020 and September 2021. We explored VIAC positivity rate and clinical management of clients screening positive in Manicaland and Midlands provinces. We conducted a retrospective cross-sectional study using routine VIAC and CC management data for period October 2020 to September 2021. Two samples were used, 1) a sample drawn from 48,000 women VIAC screened to measure positivity rate, and 2) a sample of 1,763 VIAC positive women to assess clinical management. Kobo-based tool was used to abstract data from facility registers, and data were analyzed using STATA 15. We analyzed data for 2,454 out of 48,000 women screened through VIAC. About 82% (2,007/2,454) were HIV positive, median ages were 40 and 38 years for HIV positives and negatives respectively. Most (64% and 77%) of HIV positive and negative clients respectively were married. VIAC positivity was 5.9% and 3.4% among HIV positive and negative women screened for the first time, and 3.2% and 5.6% for repeat visits respectively. Overall, 89.1% (1,571/1,763) of VIAC positive women received treatment. Most (41%) of those treated received thermocoagulation. Overall, 43.1% of clients received treatment on VIAC day, and 77.4% within 30 days. Six-month post-treatment coverage was 3.8%. VIAC positivity among HIV positive women screening for the first time was 5.9%, within the expected 5-25%. Treatment coverage was high, and turnaround time from diagnosis to treatment met national standards. Post-treatment coverage was suboptimal. We recommend continued implementation of quality improvement initiatives, capacity building of clinicians, and optimization of post-treatment review of clients.

Personalizing the user experience in Salesforce using AI technologies

Artificial intelligence (AI) technology has transformed the interactive marketing experience of clients. Despite a large number of studies investigating the use of AI in interactive marketing, customization as a significant concept remains unexplored in marketing using AI research and practice. authors investigate appropriate research as well as insights on Salesforce interactive advertising. The authors highlight practice challenges at various points of the customer experience and give critical managerial advice as a solution to such problems. Personalization may help your business in a variety of ways. For starters, it may enhance customer loyalty and engagement by making consumers feel appreciated and understood. Second, it may aid your company's revenue growth by encouraging clients to make more purchases based on personalized suggestions. Third, it can boost retention rates of clients by increasing trust and decreasing the possibility that consumers would migrate to a rival. Fourth, it may enhance overall consumer satisfaction through rendering it more easy, efficient, and pleasurable. Your company is well-positioned to provide uniquely customised experience to customers at scale by embracing AI-powered customization technology. AI can aid in the discovery of important consumer data, the generation of forecasts about consumer habits and preferences, and the optimization of content and product suggestions. One can guarantee that AI-driven personalisation is successful and satisfies your customers' expectations by doing so.

Completion of four or more ANC visits among women of reproductive age in Iganga district in Uganda: a quantitative study on the role of service-level factors

BackgroundEvidence indicates that antenatal care (ANC) has both indirect and direct effects on maternal and perinatal morbidity and mortality reduction. In Uganda, the ANC attendance rate stands at 97.3% for one visit, but 59.9% for four or more visits. Given the imminent shift to the eight-contact ANC model in Uganda, combined with a lack of universal coverage for completion of four ANC visits, there is need for research that provides information on the factors that differentiate completers of recommended ANC attendances from non-completers. The aim of this quantitative study was to assess service- level factors affecting completion of ANC attendance defined by completion of four or more visits among women of reproductive age in Iganga district in Uganda.MethodsFacility assessment scores on the service-level factors of interest for health facilities were obtained using a service level index tool. The relationship between the ANC completion rates of clients sampled from records at the health facilities and facility scores on service-level factors of interest were analyzed. Regression was conducted to determine the predictive relationship between ANC service availability, ANC service content, and ANC service organization, and completion of ANC attendance.ResultsThe model was statistically significant, χ2 (6) = 26.118, p ˂ 0.05, and accounted for approximately 17.3% of the variance of ANC attendance completion (R2 = .173). Completion of ANC attendance was primarily predicted by better timing of provision of ANC services, and to a lesser extent by higher levels of availability of medicines and medical supplies.ConclusionsThis study demonstrated that service-level factors have a predictive value for completion of ANC attendance. The findings can be used to improve availability, content, and organization of ANC services with the aim of enhancing positive experiences for clients and motivating them to complete the recommended number of ANC visits.

Retraction of Kivlighan et al. (2017).

Reports the retraction of "Congruence and discrepancy between working alliance and real relationship: Variance decomposition and response surface analyses" by Dennis M. Kivlighan Jr., Kathryn Kline, Charles J. Gelso and Clara E. Hill (Journal of Counseling Psychology, 2017[Jul], Vol 64[4], 394-409). The following article (https://doi.org/10.1037/cou0000216) is being retracted. This retraction is at the request of coauthors Kivlighan, Hill, and Gelso after the results of an investigation by the University of Maryland Institutional Review Board (IRB). The IRB found that the study included data from between one and four therapy clients of the Maryland Psychotherapy Clinic and Research Laboratory (MPCRL) who either had not been asked to provide consent or had withdrawn consent for their data to be included in the research. Kline was not responsible for obtaining and verifying participant consent but agreed to the retraction of this article. (The following abstract of the original article appeared in record 2017-15328-001.) We examined how congruence and discrepancy in clients' and therapists' ratings of the working alliance (WA) and real relationship (RR) were related to client-rated session quality (SES; Session Evaluation Scale). Ratings for 2517 sessions of 144 clients and 23 therapists were partitioned into therapist-level, client-level, and session-level components and then analyzed using multilevel, polynomial regression and response surface analysis. For both clients and therapists, at all levels of analysis (except the therapist level for therapist ratings), SES was highest when combined WA and RR ratings were high, and lowest when combined ratings were low. For client ratings, discrepancy between WA and RR, at the client and session levels, was associated with greater session quality. Some clients perceived greater session quality when, across all sessions, WA was stronger than RR and other clients perceived greater session quality when RR was stronger than WA. Within clients, session quality was highest when some sessions had a stronger WA than RR whereas other sessions had a stronger RR than WA. These findings are compatible with a responsiveness framework, therapists varied the balance of WA and RR to suit situational demands or needs of different clients. When therapists rated WA and RR the opposite pattern of results emerged; clients perceived greater session quality when therapists' WA and RR ratings, for a session were high and consistent (i.e., no discrepancy between WA and RR). In addition, across all sessions, clients perceived greater session quality when WA and RR ratings were high and consistent. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Conversation Analysis of Clients' Active Resistance to Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada.

The impact of nutrition on animal health requires effective diet-related treatment recommendations in veterinary medicine. Despite low reported rates of veterinary clients' adherence with dietary recommendations, little is known about how clients' resistance to nutritional proposals is managed in the talk of veterinary consultations. This conversation-analytic study investigated clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients' accounts suggested the proposals themselves or nutritional modifications were unnecessary, inappropriate, or unfeasible, most often based on patients' food preferences, multi-pet feeding issues, current use of equivalent strategies, or current enactment of the proposed changes. Resistance arose when veterinarians constructed proposals without first gathering relevant diet- and patient-related information, soliciting clients' perspectives, or educating them about the benefits of recommended changes. Veterinarians subsequently accommodated clients' concerns more often when resistance involved patient- or client-related issues rather than clients' lack of medical knowledge. The design of subsequent proposals accepted by clients frequently replaced dietary changes in the initial proposals with nutritional or non-nutritional alternatives and oriented to uncertainty about adherence. This study provides evidence-based findings for developing effective communication training and practice guidelines in nutritional assessment and shared decision-making.

Therapist and client perceptions of empathy in simulated teletherapy sessions

ABSTRACT Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of ‘therapist’ or ‘client’, forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy.

Quality of the therapeutic working alliance as a factor in intensive residential treatment of obsessive-compulsive disorder

Objective: Intensive residential treatment (IRT) for obsessive-compulsive disorder (OCD) includes frequent meetings with a cognitive–behavioral therapist. We examined whether this therapeutic working alliance relates to IRT outcomes. Method: Data came from a naturalistic sample of patients with OCD (n = 124) who received IRT at a specialty OCD clinic. Patients completed measures of OCD severity and well-being at admission and discharge. Both the patient and treating psychologist completed the Working Alliance Inventory-Short Form (WAI-SF). Alliance ratings were tested as predictors in models predicting outcomes (discharge scores adjusting for baseline and treatment duration) as well as logistic regression predicting treatment response (≥35% symptom reduction in OCD symptoms). Results: Patient and clinician ratings of the quality of the alliance were weakly yet significantly correlated. Patient ratings of the alliance predicted outcomes, while therapist ratings did not. Moreover, greater discrepancy between patient and client ratings predicted worse outcomes. Patient ratings of the task dimension of the alliance uniquely related to responder status. Conclusions: Patient perceptions of the working alliance, particularly as pertaining to agreement on therapeutic tasks, related to success with IRT for OCD. Further study is needed test interventions to improve task alliance as a strategy to enhance treatment.

The Impact of SARS-CoV-2 (COVID-19) on the Acuity of Mental Health-Related Diagnosis at Admission for Young Adults in New York City and Washington, DC: Observational Study.

BackgroundThe COVID-19 pandemic has required restrictive measures to mitigate transmission of the virus. Evidence has demonstrated increased generalized anxiety and depression among young adults due to the COVID-19 pandemic. However, minimal research has examined the longitudinal effect of COVID-19 over the course of time and its impact on anxiety and depression. Additionally, age and gender have been found to play a significant role on individuals’ mental health, with young adults and women particularly at risk.ObjectiveThe aim of this study was to examine the impact of the COVID-19 pandemic on anxiety and depression upon admissions to treatment.MethodsThis was an observational study that was completed longitudinally in which the grouping variable split the time interval into five equal groups for assessments over each period of time. A total of 112 young adults (aged 18-25 years) were recruited for the study. Participants completed assessments online through a Qualtrics link.ResultsPsychometric properties of the admission assessments were uniformly highly statistically significant. There was a significant difference in generalized anxiety between the group-1 and group-3 time intervals. No significant difference was found across the time intervals for depression. Differences in predicting the impact of the psychometrics scores were found with respect to gender. Only the ability to participate and the quality-of-life subfactor of the Functional Assessment of Chronic Illness Therapy (FACIT) assessment were significant.ConclusionsThis study sought to understand the impact that COVID-19 has had on young adults seeking mental health services during the pandemic. Gender emerged as a clear significant factor contributing to increased anxiety in young adults seeking mental health services during the pandemic. These findings have critical importance to ensuring the potential treatment success rate of clients, while providing an overarching understanding of the impact of the pandemic and establishing clinical recommendations for the treatment of individuals who are seeking out treatment.

Client-rated facilitators and barriers to long-term youth anxiety disorder recovery.

This study examined client ratings of 26 facilitators and barriers to anxiety improvement approximately 6 years after randomization to treatment for anxiety. 319 youth (average 17.12 years old; 82.1% Caucasian; 58.6% female) participated in the longitudinal follow-up study to child and adolescent anxiety multimodal study (CAMS), a randomized controlled trial of medication, cognitive-behavioral therapy (CBT), combination, and placebo. Correcting for multiple comparisons, CBT components (i.e., problem solving, changing unhelpful thoughts, relaxation skills) were rated significantly more helpful among youth without, versus with, an anxiety disorder at follow-up. Barriers that differentiated youth with and without an anxiety disorder included being bullied and difficulty applying therapy content to new situations. Comparisons between youth with different anxiety disorder trajectories (e.g., stable remission, relapsed, or chronically ill) also revealed several differences. Findings suggest that client-rated facilitators and barriers covary with anxiety disorder recovery and may serve as useful tools when evaluating long-term treatment efficacy.

Outcomes in clients transitioning from in‐person counselling to telehealth counselling with trainees

AbstractThe onset of the 2020 COVID‐19 pandemic necessitated a rapid transition of mental health services from in‐person to telehealth counselling. Despite the far‐reaching impact of this transition, we know little about the impact of this transition on outcomes for clients working with counsellor trainees. The present study utilised longitudinal data collected from a counselling training centre at a major U.S. university to compare client ratings of depression, anxiety and working alliance across 1) in‐person services delivered (i.e. pre‐pandemic) and 2) telehealth services delivered after the pandemic began (i.e. intra‐pandemic) among the same group of clients. Results support our hypothesis that changes in clients' self‐reports would be generally equivalent across in‐person and telehealth services. Depression and anxiety symptoms decreased, and working alliance tended to increase during both in‐person and telehealth care; however, these trends were only statistically significant during telehealth services. Limitations related to sample size (N = 15 clients; up to 17 sessions per client) and low statistical power are discussed. Nonetheless, this study supports the growing body of literature supporting the efficacy of telehealth counselling services. We provide suggestions for future telehealth research and discuss implications for counsellor training.

Marketing Strategy of Byju’s during Covid-19

Background/Purpose: Byju’s e-learning App is one amongst the foremost used on-line learning mobile applications in India. Byju’s app operations began in 2011. it's launched by 2 business entrepreneurs Byju Raveendran and Divya Gokulnath. The Company' head workplace is in Bengaluru, India. The app shibboleth is "Fall enamored with learning.” Byju' app brings new and innovative trends in education, specifically in online education. within the beginning, the Byju e-Learning app consists of all types of students, all state boards in India, particularly from grades 1st to 12th. Furthermore, the app provides distinctive services to graduates trying attempt} to pass competitive tests like GATE, JEE, NEET, UPSC, and Bank Exams. The application' main phase is to produce an electronic learning platform with various examples to improve students' concentration. it's Indian' quickest physics app, centered solely on learning the thought by various ways and thru various animated videos, a lot of simple and effective, wherever to urge the most effective outcome in learning arithmetic and science subjects. Objective: during this paper, we have a tendency to analyze Byju' app' influence on students throughout the COVID19 pandemic, and to understand whether or not its subscription exaggerated or not in the Covid nineteen outbreak. This paper conjointly analyzes however e-learning apps will specialise in enhancing the expertise of scholars and serving to to boost client focusing and subscription rate. Design/Methodology/Approach: A survey is conducted in an exceedingly semi-urban space to investigate totally different aspects concerning on-line education through Byju’s app throughout COVID 19 pandemic. In addition, analyze the data collected from the survey and from numerous critical articles and by mistreatment the SWOT analysis framework. Findings/Results: throughout the COVID-19 pandemic, for online education, Byju' app stands as a number one online education brand, with 85% of oldsters signed to the current mobile application for his or her child' education. So, coronavirus crisis helped Byju’s app to become a frontrunner in on-line education suppliers in India. Conclusion: From the conducted survey-increased subscription rate of the app was seen and detected that customers are loyal to Byju’s App. Also, it's found that the majority of the scholars within the semi-urban space use Byju' app for their studies throughout the Covid nineteen pandemic. By SWOT analysis, we've got given some suggestions that may be accessorial to Byju' Learning App as a business strategy. Paper Type: Case study-based analysis Analysis Keywords: on-line Education, on-line learning, Byju’s App, personalised learning

Serial mediation analysis of treatment-specific processes in two contrasting alcohol treatments

IntroductionThis study explored whether treatment-specific processes linking therapist behaviors, post-session client ratings, and 3-month proximal outcomes (i.e., end of treatment) can explain 12-month outcomes for two contrasting alcohol treatment conditions with equivalent overall outcomes. MethodsThis study is a secondary analysis of the UK Alcohol Treatment Trial (UKATT), a multi-center randomized controlled trial of treatment for alcohol problems comparing 3-session motivational enhancement therapy (MET) to 8-session social behaviour and network therapy (SBNT). Among 742 adult clients included in UKATT, 351 had one treatment session recorded and coded and were followed-up 3 and 12 months after baseline. The study team conducted serial mediation analyses to test whether the frequency and quality of MET and SBNT skills were related to 12-month alcohol outcomes (drinks per drinking day) through postsession client ratings of treatment progress (Processes of Change Questionnaire, PCQ), readiness to change (RTC) and social support for drinking after 3-months. ResultsHigher quality of MET skills was related to higher PCQ scores, which were in turn related to greater post-treatment RTC, and subsequently to better alcohol outcomes. Total indirect effect was consistently significant. In contrast, only PCQ was predictive of treatment outcome in the SBNT portion of the model. ConclusionsThis study provides evidence from a large pragmatic trial that the quality of MET skills positively influences alcohol outcomes in part through improvements in motivation during treatment and actively trying to change when treatment ends. Research should explore the ways in which SBNT secured outcomes that were equivalent to MET.

Community-based and HIV integrated testing for hepatitis B and C among key populations in Vietnam.

Community-based and HIV integrated testing for hepatitis B and C among key populations in Vietnam.

Health and Work Outcomes of Brief Counseling From an EAP in Vermont: Follow-Up Survey Results, Client Satisfaction, and Estimated Cost Savings

The purpose of this applied naturalistic study was to determine the effectiveness of brief counseling, estimate the potential cost savings associated with select outcomes, and explore the client ratings and comments evaluating their experience. Follow-up survey data from 830 employee users of counseling services from a statewide employee assistance program (EAP) were analyzed. Paired tests examined changes in anxiety, depression, health status, life satisfaction, and work productivity. At the start, more of the EAP cases were above the threshold for at-risk status on each outcome than healthy employees in normative data. Significant reductions in risk were achieved for all outcomes after counseling. Improvements in health were correlated with improvements in work productivity. Most of the cases (82%) considered their experience to be positive and helpful. Results were used to estimate an ROI of $4.26:$1 for the EAP from avoided overall health care treatment costs for depression ($611/case) and avoided lost work productivity ($1,433/case).

The educational needs of Canadian homeless shelter workers related to traumatic brain injury.

Traumatic brain injury (TBI) has a higher prevalence in the homeless population. Caregivers to individuals who have TBIs may require better education surrounding screening, diagnosis and management of this disease to tailor interventions to their clients' needs. To assess the insight and educational needs of homeless care providers in recognizing and dealing with clients who had experienced a TBI. A survey assessing the point of views of homeless care providers across Canada regarding their level of confidence in identifying and managing symptoms of TBI. Eight-eight completed surveys were included. Overall, frontline workers expressed a moderate level of confidence in identifying and managing TBI, stating that educational initiatives in this context would be of high value to themselves and their clients. Frontline workers to homeless clients rate their educational needs on the identification and management of TBI to be high such that educational initiatives for shelter workers across Canada may be beneficial to increase their knowledge in identifying and managing the TBI-related symptoms. Improved education would not only benefit frontline workers but may also have a positive effect on health outcomes for their clients.

How therapists' emotion recognition relates to therapy process and outcome.

Empathy is an essential characteristic for therapists that explained 9% of the variance in treatment outcomes. Many measures of empathy are based on self-report questionnaires. Therefore, they reflect how a person perceives his empathic abilities, which can be biased from his true abilities. The ability to recognize emotions has been found to be related to empathy and serves as a measure for the use of empathic abilities. In this study, we examined therapists' empathic abilities, using a novel task for recognizing emotions, and looked at how they related to the therapy process and outcomes. The study included 33 patient-therapist dyads. Therapist empathy was assessed with an emotion detection task, the JeFEE. Clients filled questionnaires after each session regarding therapy progress and their symptoms. We found that emotion recognition moderated the change in (a) client secure attachment to therapist, (b) client avoidant attachment to therapist, (c) client working alliance, (d) client rate of tense or upset they felt during the session, (e) client lack of emotional clarity of emotions, (f) client non-acceptance of emotional responses, (g) client overall emotion regulation and (h) client main target complaint. Implication for therapy and therapists' selection and training are discussed.