Therapeutic Use Of Self Research Articles

Therapeutic Use of Self and Fieldwork Experience: An Exploration of the Art and Science of Occupational Therapy

Therapeutic Use of Self and Fieldwork Experience: An Exploration of the Art and Science of Occupational Therapy

Spiritual care interventions in nursing: an integrative literature review.

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

Evaluating Students' Use of Therapeutic Communication in Entry-Level Education: The Observer Version of the Clinical Assessment of Modes (CAM-Observer).

The Intentional Relationship Model (IRM) guides learning about therapeutic use of self. The observer version of the Clinical Assessment of Modes (CAM-Observer) may be used to evaluate students' therapeutic communication as the process is defined in the IRM. To assess the structural validity of the CAM-Observer. Cross-sectional, psychometric study. Master's in occupational therapy program. One hundred thirty-four entry-level students. The overall CAM-Observer and the individual subscales (Advocating, Collaborating, Empathizing, Encouraging, Instructing, Problem-Solving) were used to assess students' communication from the instructor's perspective. The overall CAM-Observer and six subscales demonstrated appropriate rating scale functioning and dimensionality. The Advocating subscale demonstrated poor item fit, floor effects, and low person separation. One Collaborating item demonstrated poor fit to the overall CAM-Observer and the Collaborating subscale, requiring revision. Instructing and Encouraging items were most likely to be endorsed by the instructor-observers, resulting in a ceiling effect for the Instructing and Encouraging subscales. The Advocating and Problem-Solving items were least likely to be endorsed by the instructor-observers. Except for the Problem-Solving subscale, the overall CAM-Observer and the individual subscales could reliably separate items according to difficulty. Except for the Advocating subscale, the overall CAM-Observer and the individual subscales could reliably separate people into high- and low-performance groups. The CAM-Observer offers a structurally valid and theoretically grounded assessment of students' therapeutic communication as the process is defined in the IRM. The CAM-Observer can be integrated into occupational therapy education to guide students' critical reflection on their interpersonal communication. The CAM-Observer offers a means of evaluating students' therapeutic use of self.

Empathy in Action in Healthcare (EACH): A mixed methods study of nurses' and therapists’ empathy

BackgroundDespite a plethora of research on empathy and its associated constructs, there is little evidence exploring clinicians’ perceptions of their empathy and its impact on service level outcomes. MethodsThe aim of this single centre mixed methods study was to investigate nurses' and therapists’ empathy levels and explore their views regarding its impact on clinical decision making at a national specialist orthopaedic centre. Data were collected from 126 respondents using an online validated empathy scale (Jefferson scale) supplemented by interviews with a convenience sample of 20 respondents. Questionnaire data were analysed using descriptive and inferential statistics. Qualitative interview data were subjected to a standard process of inductive thematic analysis prior to seeking relationships between the two datasets. ResultsThere was a statistically significant difference in empathy levels between nurses and therapists (p = 0.031), with nurses scoring lower than therapists. Interview findings identified four key themes; displaying empathy, therapeutic use of self, influences and impacts, and learning. Differences between empathy scores and participants’ subjective accounts of empathy were apparent. ConclusionEmpathy is an important construct built upon personal and professional experiences. Previous research reports empathy as a positive tool, however, our data suggest that its inappropriate use might also have a negative impact on service delivery and health outcomes.

Evaluation of a financial skills training programme for vulnerable young people at risk of homelessness

Introduction A financial skills training programme (Cash Pointers) for young people at risk of homelessness had an unexpectedly positive impact on their wellbeing. A qualitative inquiry examined this phenomenon. Method Interviews with six trainees explored their experiences of the programme. A focus group comprising four programme workers added a service provider perspective. Findings Cash Pointers addressed trainees’ basic living and health needs. Additionally, trusting relationships with programme workers enabled trainees to feel safe, develop skills, pursue goals, manage health problems, improve relationships and engage in life roles. Trainees said Cash Pointers was accessible and responsive, offering advocacy, inter-agency liaison and hope. Programme workers said they balanced the need for quick results with patient relationship-building, were a well-supported team with a high degree of casework autonomy and felt skilled in the therapeutic use of self. Conclusion Cash Pointers created a psychologically informed environment within which trainees stabilised, acquired skills and progressed towards greater life satisfaction and inclusion. Improving financial skills can be profoundly transformative and an acceptable intervention for this population. Aspects of occupational therapy’s knowledge-base (dynamic systems thinking) and skillset (person-centred goal-setting, therapeutic use of self, creating enabling environments) can support this.

Occupational Therapy Students’ Self-Efficacy for Therapeutic Use of Self: Development and Associated Factors

Creative Commons License: Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Correlation Between Therapeutic Use of Self and Clients’ Participation in Rehabilitation

Abstract Date Presented 4/20/2018 The Model of Human Occupation Screening Tool (MOHOST) and the Clinical Assessment of Modes were used to evaluate clients’ participation and paired therapists’ use of mode. Correlation analyses were conducted. The results show that the empathizing mode was significantly correlated to five subdomains of the MOHOST. Primary Author and Speaker: Chia-Wei Fan Additional Authors and Speakers: Renee Taylor

Hearing Voices: The Experience of Associate Degree Nursing Students to an Auditory Hallucinations Simulation

Background: Associate degree nursing students (ADNS) have limited exposure to persons experiencing the full range of alterations in cognition of psychiatric illness during their psychiatric mental health nursing rotation. Objective: This qualitative study examines the experience reported by second semester ADNS after completing an auditory hallucinations simulation in the nursing skills and simulation lab at a community college in the mid-Atlantic. Design: The study was reviewed and approved by the college Institutional Review Board. Guided by Grounded Theory, investigators analyzed the data from written reflective debriefing reports of the simulation in which students, working in pairs, one as the patient wearing headphones while listening to a streaming of auditory hallucinations, and the other as the nurse conducting a psychiatric nursing assessment of the patient. Students consented to have their written reports included in the study. Responses were reviewed for conceptual and thematic content using the constant comparative analysis method of Corbin and Strauss. Results: Concepts identified included fear, distraction, frustration, empathy, patience, and understanding. Themes included attitude changes from skepticism about auditory hallucinations to acceptance of symptoms, therapeutic use of self, and keeping patient safe. Conclusions: The auditory hallucinations assignment gives nursing students the opportunity to learn from a brief simulation experience about psychotic symptoms and assists in attaining knowledge, skills, and attitudes (KSAs) necessary for planning and providing care to patients with serious mental illness.

Short-term changes in occupational therapy students’ self-efficacy for therapeutic use of self

Introduction Self-efficacy concerned with the therapeutic use of self is important for occupational therapists, and students need to develop the skills and the self-efficacy required to meet interpersonal challenges in practice. This study examined short-term changes in occupational therapy students’ self-efficacy for using therapeutic modes, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events. Factors associated with such changes were also examined. Method A sample of 89 Norwegian occupational therapy students from two universities was used, and the students completed three questionnaires 2–3 weeks after a workshop and at 3 months’ follow-up. Changes on the outcome measures were analyzed with t-tests for dependent samples, and factors associated with the outcome changes were analyzed with linear regression analyses. Results During the follow-up period, the students improved their self-efficacy scores on all three outcome measures. Higher age was associated with more improvement on two of the outcome measures. Conclusion The occupational therapy students improved their self-efficacy for therapeutic use of self during the brief follow-up period. Thus, the time in education, either university-based or practice-based, seems to add to students’ self-efficacy for clinical skills in this area. Higher age appears to be a resource for gaining more self-efficacy from attending educational courses.

The Course of Self-Efficacy for Therapeutic Use of Self in Norwegian Occupational Therapy Students: A 10-Month Follow-Up Study.

Background Occupational therapy students need to develop self-efficacy for managing the therapeutic relationship in practice. This study examined the 10-month trajectories of Norwegian students' self-efficacy for use of self. Methods Eighty-nine students completed self-efficacy questionnaires related to the use of self after a workshop and at 3- and 10-month follow-up. Changes on the three outcome measures (self-efficacy for therapeutic mode use, for recognizing clients' interpersonal characteristics, and for managing interpersonal events) were analyzed with repeated measures ANOVA. Results Across the follow-up period, the students improved their self-efficacy for therapeutic mode use (partial η2 = 0.44, p < 0.001), for recognizing clients' interpersonal characteristics (partial η2 = 0.81, p < 0.001), and for managing interpersonal events (partial η2 = 0.32, p < 0.001). Conclusion The increased self-efficacy for use of self that was found at 3-month follow-up was maintained at 10-month follow-up. The results indicate that students may experience a boost in self-efficacy for therapeutic use of self after a brief workshop and that these changes can be sustained over time.

A Survey on Awareness and Experience on Therapeutic Relationship and Therapeutic Use of Self for the Occupational Therapists

A Survey on Awareness and Experience on Therapeutic Relationship and Therapeutic Use of Self for the Occupational Therapists

Making Magic With Interprofessional Education: A 3-Year Experience

BACKGROUND: In the past 5 years, the American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists have urged collaborative practice and the development of interprofessional education (IPE) teams. Many barriers exist in establishing true interdisciplinary teams in training. METHODS: Over 3 years, all OB/GYN interns completed a rotation with the faculty CNM practice 1 day per week. The rotation included didactics, simulation, and clinical teaching with an emphasis on normal birth as well as an introduction to midwifery scope of practice and philosophy of care. Interns completed a validated attitude survey before and after the rotation, formative feedback evaluations after each shift, and a clinical reflection. RESULTS: Of all participating interns (n=30), 50% had never previously worked with a midwife. Topics rated most helpful included: nonpharmacologic pain control, normal labor and birth, and birth positions. Based on the attitude survey (4-point Likert scale), the most significant changes in perception at completion included: scope of care (Δ 0.5), nonmedical approach to obstetrics (Δ 0.6), and understanding credentials in midwifery (Δ 0.7). Review of the reflections revealed three main qualitative themes learned during the rotation: therapeutic use of self, birth experience, and relationship with midwives. DISCUSSION: An interprofessional education with faculty CNMs provided interns with an introduction to midwifery care and an opportunity to establish positive relationships with future collaborators.

Emotional Intelligence: An Opportunity for Occupational Therapy

ABSTRACTEmotional intelligence theory developed within the psychology and business fields and is described as an ability to monitor emotions and to use the information to guide thinking and problem solving. Emotional intelligence skills are needed by occupational therapy practitioners to support therapeutic use of self, promote client-centered care, and foster communication skills within the workplace. A scenario illustrates how emotional intelligence supports the therapeutic use of self during a clinical interaction. The Mayer Salovey Caruso Emotional Intelligence Test is introduced as a resource for occupational therapy practitioners to measure and develop therapeutic relationship skills based upon emotional intelligence research.

Meaningful Occupations Impacted by Burn Injuries

Abstract Date Presented 3/31/2017 Burn injuries can significantly impact an individual’s ability to return to meaningful occupations and identity in society; every burn has a story. Occupational therapists can contribute to recovery through the use of therapeutic use of self and a holistic approach. Primary Author and Speaker: Hayley Mata Contributing Authors: Ruth Humphry, Shelley Sehorn, Heather S. Dodd, Sydney J. Thornton, Mark Prochazka, Bruce A. Cairns

Nurses experiences of delivering care in acute inpatient mental health settings: A narrative synthesis of the literature.

Inpatient psychiatric care requires a balance between working with consumers' priorities and goals, managing expectations of the community, legal, professional and service responsibilities. In order to improve service delivery within acute mental health units, it is important to understand the constraints and facilitating factors for good care. We conducted a systematic narrative synthesis, where findings of qualitative studies are synthesised to generate new insights. 21 articles were identified. Our results show that personal qualities, professional skills as well as environmental factors all influence the ability to provide recovery focused care. Three overarching themes which either facilitated or hindered were identified. These included: (i) Complexity of the nursing role (clinical care; practical and emotional support: advocacy and education; enforcing aspects of the Mental Health Act. and, maintaining ward safety); (ii) Constraining factors (operational barriers; change in patient characteristic; and competing understandings of care); and (iii) Facilitating factors (ward factors; nursing tools; nurse characteristics; approach to people; approach to work and ability to self-care). We suggest that the therapeutic use of self is central to the provision of recovery oriented care. However person-centred practice can be fragile and fluid and a compassionate system of support is needed to enable an understanding of context and self. It is critical to have a work environment which fosters hope and optimism and is supportive of autonomy, ensures workload balance, and is safe.

Adapting to a Challenging Fieldwork: Understanding the Ingredients

Two occupational therapy students were assigned to an inpatient psychiatric unit for their first Level 1 fieldwork. With limited on-site supervision provided, they looked to each other for peer support and collaboration in assisting one patient with severe depression who was considered the “sickest patient on the unit.” The students were able to work together and make a positive intervention with this patient despite their novice status. Understanding what each of them brought personally to this experience as well as the nature of their working relationship and their use of concepts taught in the classroom has important implications for occupational therapy education. One of the profession’s goals in acute psychiatric settings is to engage clients in meaningful occupations to facilitate rehabilitation and the recovery process. The two students skillfully employed the concepts of emotional intelligence, cultural competence, and therapeutic use of self and demonstrated their comfort with technology and spirituality to facilitate his occupational reengagement. By examining this case report through the lens of the literature on emotional intelligence, cultural competence, and therapeutic use of self, the ingredients of their clinical reasoning becomes more transparent and available to other occupational therapy educational programs.

Therapeutic implications of counselling psychologists’ responses to client trauma: An interpretative phenomenological analysis

The past two decades have seen a surge of interest in the impact of working with trauma survivors on therapists’ psychological well-being. Existing literature assumes that therapists’ strong subjective responses to traumatic material adversely influence the therapeutic process. However, this has not yet been directly researched. Nine counselling psychologists were interviewed regarding the clinical impact of their responses to the disclosure of traumatic material. Interpretative Phenomenological Analysis showed that significant challenges are experienced in the use of self in therapy with trauma survivors, including making sense of horrific human actions, negotiating complex interpersonal dynamics and responding to ethical dilemmas in therapy. Results emphasised the importance that therapists attached to the development of their therapeutic use of self in therapy with trauma survivors, the value of learning from others and reaching a place of acceptance and hope when working with trauma survivors. Finally, specific training and development implications are proposed.

Patients and Nurses' Opinion about uses of physical restraint for psychiatric patients in Mental Health Hospital

Physical restraint is any manual method or mechanical device attached to the patient's body that restricts freedom of movement and cannot be easily removed. Despite extensive literature on the potential complications of using physical restraint, it is still considered as a permanent and effective intervention in the management of unpleasant behaviors. This study aimed to assess patients' and nurses' opinion about uses of physical restraint on psychiatric patients in Mental Health Hospital. Study was conducted in Tanta Mental Health Hospital which is affiliated to Ministry of Health. The study subjects include 49 psychiatric patient and all nurses working in Tanta Mental Health Hospital (80 nurses). Two tools were developed by the researcher to collect the necessary data. Tool (1) was Patient Structured Interview questionnaire, and Tool (2) was nurses structured Interview questionnaire. The main results revealed that a round one third of studied patients had negative opinions about use of physical restraint, and nearly half of them were average. In another hand more than half of studied nurses had positive opinion and nearly to one third were average regarding to using of physical restraints, so it was recommended that nurses should be involved in educational program about; therapeutic use of self and effective communication skills to improve their interaction with patient and encourage them to express gradually about their strong feeling, and educated about aggressive behaviors, it's dynamic and predisposing factors, and how applied physical restraints effectively with patients and debriefing following these procedure to minimize a negative effects on patients.

Occupational therapy and the therapeutic use of self

The therapeutic use of self is a term used to encapsulate the therapist’s role in working consciously with the interpersonal side of the therapeutic relationship to facilitate an optimal experience and outcome for the client. In occupational therapy, although the literature is replete in references to the topic, there is a paucity of current debate and it remains an elusive aspect of practice. This raises an intriguing point: if the therapeutic use of self is as central to the profession as the rhetoric suggests, why does a lack of clarity in its practice remain? The purpose of this opinion piece is to explore these issues, and consider the potential for refocusing on this aspect of our skills set to meet the challenges of contemporary practice.

Consenting recently bereaved adults for post mortem research: An evaluation of ethical considerations

Abstract Aim To present an evaluation of ethical considerations, which have been identified whist working as a trial consenter, undertaking prospective telephone consenting for post-mortem CT research and associated minimally invasive procedures. Methods The Local ethics committee, research and development office, and local HM coroners gave their permission for the families of the deceased, in cases where a 'routine' coroner's autopsy had been authorised, to be approached for their consent to PMCT research and associated minimally invasive procedures being investigated before and during autopsy examination. The trial consenter telephones the next of kin, discusses the nature of the study aiming to obtain verbal informed consent for research procedures. The concepts of 'the consenter as the consenting tool' and 'therapeutic use of self' are drawn on to gain consent using a flexible interview style. Working in this way with recently bereaved relatives raises ethical considerations. These are evaluated. Conclusions This review shows that prospective consenting for HM coroners' cases to be used for post mortem research is ethically appropriate given that ethical guidelines and principles are considered and upheld.