Ability Of Therapists Research Articles

Exploring perspectives on how to improve psychological treatment for women from minoritised ethnic communities: A qualitative study with service users.

Women are disproportionately impacted by depression and anxiety disorders and in particular, women from minoritised ethnic communities experience inequalities in access to outcomes of psychological treatment for these disorders. Better understanding from the views of service users about the factors that impact their access to, and experiences of care could help to optimise treatment for these groups. This study explored experiences of treatment and gathered suggestions about treatment improvement, from the perspectives of women currently using psychological therapy services. Semi-structured interviews were conducted with 12 female NHS Talking Therapies for anxiety and depression (NHSTTad) service users from minoritised ethnic communities. Data were analysed using thematic analysis. Four high-order themes were identified: (1) cultural identity and experiences of mental health and treatment, (2) challenges associated with treatment, (3) facilitators of good treatment experiences and outcomes and (4) improvements for women from minoritised ethnic communities. Findings showed that cultural sensitivity and awareness are important to minoritised ethnic women receiving therapy. Challenges included access difficulties and limitations of treatment options offered, alongside personal challenges of engaging in therapy. Facilitators of good treatment experiences and outcomes included flexibility on the part of the service, as well as therapist-related factors such as identity characteristics (age, gender and culture of therapist), a good therapeutic relationship and the therapist's ability to deliver person-centred care. Improvements included ensuring care is culturally sensitive, reducing waiting times or providing better support for people on waiting lists, providing a flexible service that takes individual needs into account, increasing workforce diversity and reaching out to underserved communities. Many of the suggested improvements are generalisable to underserved minoritised ethnic groups, regardless of gender and could be applied to other psychological therapies services other than NHSTTad.

Improving the Managerial Ability of Dental and Oral Therapists in Adolescent Health Services through the Posyandu Management Information System (SIMYANDU)

Dental and oral therapists provide health services to adolescents in the Soppeng Regency area in the implementation of planning management, especially in posyandu, which is still manual and has not been implemented properly. The Posyandu Management Information System (SIMYANDU) is an information system that can overcome problems and improve the managerial skills of dental and oral therapists. This study uses the Research and Development (R&D) method, model testing using the pre-experimental design method. The data from the model test results were tested using Aiken's V and Intraclass Correlation Coefficient (ICC). The results of the expert validation test on SIMYANDU obtained an average feasibility score of 100% which means it is feasible as a posyandu management information system based on expert validation (v=0.68), ICC value (p=0.940). Assessment of the managerial ability of dental and oral therapists after treatment is meaningful. The results of the effect size test on the aspects of problem identification (p=0.001), problem priority (p=0.001), cause of problem (p=0.003), alternative solution to the problem (p=0.001), planning (p=0.001) means that the web-based SIMYANDU model to improve the managerial ability of dental and oral therapists is very effective in adolescent health services in the Soppeng Regency area. This study shows that the application of the web-based SIMYANDU model is feasible and its application is effective in improving the managerial ability of dental and oral therapists in health services for adolescents in the Soppeng Regency area.

Awareness, Knowledge and Attitude About Virtual Reality and Augmented Reality in Physiotherapy Practice among Physiotherapists

Abstract Background: The rationale for the use of Virtual Reality an Augmented Reality in rehabilitation is based on a number of unique attributes of this technology like opportunity for experiential, active learning that encourages and motivates the participant, ability of therapists to objectively measure behavior in challenging but safe and ecologically valid environments, while maintaining strict experimental control over delivery of the stimulus. A promising future requires the continued development and use of new, innovative technologies like Virtual Reality and Augmented Reality that will transform existing practices. To ensure the long- term use of such systems, it is imperative to understand the perspectives of healthcare providers in the implementation of Virtual Reality and Augmented Reality technologies. Method: An observational cross- sectional study was done. A total of 102 physiotherapists from various fields and of different age groups and experience were included. A self- made questionnaire of 3 sections was administered to the physiotherapists using google forms. Results: it was found that 82.4% physiotherapists knew that virtual reality and augmented reality have applications in healthcare whereas only 46.1% knew about its applications in complex musculoskeletal disorders. 90.2% think that virtual reality and augmented reality should be widely applied in clinical practice. Conclusion: In conclusion, many of the participants were not aware about extent of Virtual Reality, Augmented Reality rehabilitation in different fields across physical therapy. Most of the participants knew about its application in the neuro physiotherapy field. More awareness needs to be spread on the widespread implementations of these technologies in the field of rehabilitation. Most of the participants have a positive attitude towards application of Virtual Reality and Augmented Reality clinically.

Consequences of Stress on the Workability of Physical Therapists

Assertive stressors are legitimate within all occupations. Elements similar to varying employee slots, underprivileged administration, increasing payables, lack of scheduled employee development, insufficient figures of workers, moreover disputes in the office might be frequent job-related irritants. Work efficiency is based on the equilibrium between job requirements and individual resources. Objective: To evaluate the consequences of stress on the ability of physical therapists to work. Methods: A cross-sectional study was conducted in which data were collected from 100 Physical therapists by using a non-probability convenient sampling technique from multiple hospitals in Karachi. The duration of the study was 6 months from January 2023 to June 2023. Data were evaluated by two validated questionnaires: The Work Ability Index Questionnaire (WAI) and the Perceived Stress Scale (PSS). Statistical analysis was done through SPSS version 23.0. Results: Our study results show there is a weak relationship between stress with the different systems of the body in most of the research participants but it physically affects the performance of work in 27 % of participants with symptoms while 4% were unable to complete their task due to stress. Among the participants, 42% were taking leave due to sickness and work burden. Conclusions: There is a significant effect of stress on the workability of a physical therapist.

What is Effective in Massage Therapy? Well, "It Depends…": a Qualitative Study of Experienced Orthopaedic Massage Therapists.

Massage has been used as a treatment for musculoskeletal pain throughout history and across cultures, and yet most meta-analyses have only shown weak support for the efficacy of massage. There is a recognised need for more research in foundational questions including: how massage treatments are constructed; what therapists actually do within a treatment, including their clinical reasoning; and what role therapists play in determining the effectiveness of a massage treatment. The aim of this study was to explore what experienced orthopaedic massage therapists consider to be the aspects of their work that contribute to effectiveness. Semi-structured interviews were conducted via Zoom with six experienced orthopaedic massage therapists in Australia. The interviews were analysed using inductive thematic analysis, seeking insights that might be practically applied, rather than theory-driven interpretations. The participants focused on the underlying differences between clients, between therapists, and between treatments, and clearly indicated that this concept of "difference" was foundational to their view of their work and was the underlying context for the comments they made. Within that frame of "difference", three key themes were interpreted from the data: (1) "Everyone is different so every treatment is different": how they individualised treatment based on these differences; (2) "How therapists cope with difference": how they managed the challenges of working in this context; and (3) "What makes a difference": the problem-solving processes they used to target each treatment to meeting the client's needs. Participants did not identify specific techniques or modalities as "effective" or not. Rather, a therapist's ability to provide effective treatment was based on an iterative process of treatment and assessment that allowed them to focus on the individual needs of the client. In this case "effectiveness" could be considered a process rather than a specific massage technique.

Push and Pull: Role of Therapist Mentalizing in Navigating Therapeutic Distance.

In the relational playground of psychotherapy, negotiating therapeutic distance is crucial for the process as well as the outcome of treatment. The challenge of navigating this closeness and distance may be accentuated during emotionally charged interactions in therapy. Therapist and client may get locked in complementary, rigid positions, leading to either submission or resistance to the others' demands. The therapist's ability to respond appropriately to these pushes and pulls is supported by their ability to mentalize, which is their ability to attend to and understand their own states of mind while being aware of others' states of mind. Therapists are expected to maintain a mentalizing stance throughout and despite the relevance and impact of therapist mentalization, there is relatively less research, training, or practice-related guidance on how to maintain this balance. We use case illustrations to demonstrate therapeutic interactions that can trigger non-mentalizing for the therapist and reflect on ways of recognizing and addressing these patterns related to closeness and distance. We also share recommendations for reflective practice and supervision, training as well as research on therapist mentalization.

Experiences of Working‐Age Adults with Depression of Psychodynamic Couple Therapy: A Thematic analysis using a Phenomenological Approach

The current study draws on interviews with service users about their experiences to inform the practice of psychodynamic couple therapy for depression. Five participants, who had received at least six months of psychodynamic couple therapy in London (UK) for the treatment of severe distress and depression, completed a semi‐structured interview. They were recruited using a purposive sampling technique. Data was analysed using a phenomenological approach to thematic analysis. Six themes were identified in relation to participants' experiences of couple therapy. Key aspects highlighted by participants include: the therapist, described as a ‘third person’, became a referee and mediated the communication within the couple, providing a different perspective, enabling a safe environment for reciprocal listening; the process of making links with the past enabled participants to understand their current behaviour as individual and dysfunctional areas as a couple; the therapist's ability to understand the couple as individuals rather than as a unified entity was key; therapist neutrality and capacity to empathise with the couple was valued by participants. The study highlighted the intertwined dynamic between relationship difficulties and depression. Participants were not able to make a clear distinction between these two experiences, and this microcosm may reflect the difficulties that clients face in accessing public services, which have historically held a more individualistic perspective of distress.

The effect of a dermoscopy training programme on diagnostic accuracy and management decisions regarding pigmented skin lesions: a comparison between dermal therapists and general practitioners.

Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30-90) for GPs and 63% (range 27-80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor > 100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.

Measuring Critical Thinking Ability of Respiratory Therapists Working in Critical Areas in King Abdullah Specialized Children’s Hospital, King Abdulaziz City, Riyadh, Saudi Arabia

Aim: The aim of this study was to assess the critical thinking ability of respiratory therapists working in critical care areas from King Abdullah Specialized Children Hospital (KASCH), Riyadh, Kingdom of Saudi Arabia.
 Methods: The study's design was cross-sectional. Prior to the start of the research, the protocol was reviewed and given the approval by King Abdullah International Medical Research Center in Saudi Arabia. The study was conducted in Riyadh, Saudi Arabia, at the King Abdullah Specialized Children's Hospital (KASCH). The research included all the 45 respiratory therapy ICU staff members. The critical thinking skills of the respiratory therapy staff were evaluated using the Watson Glaser Critical Thinking Appraisal (WGCTA) short form. The evaluation consisted of a total of 40 questions broken down into five distinct categories: assumptions, arguments, deductions, inferences, and information interpretation. Excel was used to enter the acquired data before it was exported to the Statistical Package for Social Sciences (SPSS) (version 22).
 Results: The results showed that most RTs (77.42%) were male and (22.58%) were female. Regarding educational level, it shows that (87.09%) had bachelor's degree. Additionally, it shows that majority (58.06%) had 3-6 years of experience. Nearly two thirds (64.52%) of RTs aged between 26 to 30 years. The critical thinking skills level among respiratory therapists in the screened hospital was average.
 Conclusion: This study revealed no correlation between respiratory therapists' critical thinking abilities and age, gender, experience, or education.
 Recommendations: ICU respiratory therapists should continuously improve their critical thinking skills. This research will help managers and supervisors understand respiratory therapists' critical thinking and build programs to improve staff skills and prepare them to manage ICU situations. The study also recommends conducting further studies to accurately measure the staff's critical thinking skills. These recommendations aim to foster a culture of critical thinking and contribute to informed decision-making within the organization.

Art Therapy during COVID-19 with a Deaf Client Diagnosed with Schizophrenia: A Case Report

This case report explores the shifts in therapeutic power relations during the COVID-19 pandemic between an art therapist and her Deaf client diagnosed with schizophrenia. A therapeutic journey of two and a half years is described, accompanied by examples of the client's artwork. This case report demonstrates how a shared reality in times of global crisis enabled the rethinking of therapeutic power relations and the way art was used to shift these dynamics. The art therapist's ability to use her shared reality experience to reposition herself to facilitate the therapeutic relationship is discussed.

Training Community Therapists in Core Elements of CBT and Family Therapy for Adolescent Externalizing Problems

ABSTRACT Objective This pilot study tested pragmatic methods for training therapists in core techniques of two evidence-based interventions (EBIs) for adolescent externalizing problems: cognitive-behavioral therapy (CBT) or family therapy (FT). Training methods were designed to help therapists accurately self-monitor their use of EBIs and increase delivery of EBIs with current clients. The study compared coder training only versus coder training plus fidelity-focused consultation. Method Therapists (N = 42) from seven behavioral health clinics reported on 65 youth clients; four clinics elected to train in CBT and three in FT. Therapists were randomized to either coder training only, consisting of a 25-week observational coder training course (didactic instruction and mock session coding exercises in core EBI techniques); or coder training plus fidelity-focused consultation, consisting of direct-to-therapist fidelity measurement feedback along with fidelity-focused expert consultation. During the 25 weeks of training, therapists submitted self-report data on EBI use along with companion session audiotapes subsequently coded by observational raters. Results Compared to coder training only, coder training plus fidelity-focused consultation produced superior effects in therapist ability to judge the extensiveness of EBI techniques in online coding sessions, as well as therapist ability to self-rate use of EBI techniques with their own cases. In both conditions, therapists who trained in CBT showed a significant, though modest, increase in real-world delivery of core CBT techniques; this did not occur for FT. Conclusions Pragmatic training and consultation methods show promise as viable and effective options for enhancing EBI fidelity monitoring and, for CBT, increasing EBI delivery.

Diagnostic Imaging for Distal Extremity Injuries in Direct Access Physical Therapy: An Observational Study.

Military physical therapists practicing direct-access routinely utilize diagnostic imaging and numerous published case reports demonstrate the ability of physical therapists to diagnose and appropriately disposition patients with foot/ankle and wrist/hand fractures. However, no larger cohort studies have explored the utilization of diagnostic imaging by physical therapists to detect fractures. To describe the utilization of diagnostic imaging in foot/ankle and wrist/hand injuries by physical therapists in a direct-access sports physical therapy clinic. Retrospective cohort study. The Agfa Impax Client 6 image viewing software (IMPAX) was searched from 2014 to 2018 for patients with diagnostic imaging ordered for foot/ankle and wrist/hand injuries. The Armed Forces Health Longitudinal Technology Application (AHLTA) electronic medical record was independently reviewed by the principal and co-investigator physical therapists. Data extracted were demographics and elements from the patient history and physical examination. In foot/ankle injuries, physical therapists diagnosed a fracture in 16% of the 177 cases and waited for an average of 3.9 days and 1.3 visits before ordering imaging. In wrist/hand injuries, physical therapists diagnosed a fracture in 24% of the 178 cases and waited for an average of 3.7 days and 1.2 visits before ordering imaging. The time to definitive care from the initial physical therapy evaluation was significantly different (p = 0.04) for foot/ankle fractures (0.6 days) compared to wrist/hand fractures (5.0 days). The Ottawa Ankle Rules demonstrated a negative likelihood ratio (-LR) of 0.11 (0.02, 0.72) and a positive likelihood ratio (+LR) of 1.99 (1.62, 2.44) for the diagnosis of foot/ankle fracture. Physical therapists utilizing diagnostic imaging in a direct-access sports physical therapy clinic diagnosed fractures in similar proportions for foot/ankle and wrist/hand injuries and quickly dispositioned patients to definitive care for those fractures. The diagnostic accuracy of the Ottawa Ankle Rules was similar to previously reported values. Level 3.

"Where have you been in this world?" a qualitative study of clients' curiosity about their psychotherapists.

Curiosity is widely seen as a basic human drive, important to the development of relationships as well as to the process of change in psychotherapy. Less attention, however, has been directed toward examining curiosity in the client-therapist relationship. In particular, we lack a comprehensive understanding of what occurs for clients when they become curious about their therapists. As a result, we aimed to explore clients' experiences of curiosity about their therapists. Using a consensual qualitative research approach, we analyzed data from ten current and former adult psychotherapy clients. Results were organized in six domains that captured different facets of participants' experiences of curiosity about their therapists: the content of the curiosity, motivation(s) for the curiosity, triggers of the curiosity, expressions of curiosity, influences on the curiosity, and consequences of the curiosity. More specifically, results revealed participants experienced curiosity that (a) concerned the therapist's professional and personal life, (b) was motivated by concerns over the therapist's ability to understand or relate, and (c) was triggered by therapist behavior (e.g., disclosures). For some participants, having a positive therapeutic relationship led to greater curiosity; by the same token, participants' desire for professional boundaries at times quelled this curiosity. Moreover, although some participants described positive relational outcomes, others disclosed feelings of shame or discomfort resulting from their curiosity. Several cultural factors were also found to influence participants' curiosity. Implications for research and practice are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Mediating Effects of Self-reflection in the Influence of Supervsion Experiences on Countertransference Manangement Ability of Play Therapists

The purpose of this study is to verify the mediating effects of self-reflection in the influence of supervision experiences on countertransference management ability of play therapists. For this purpose, The Supervision Experience Questionnaire, Counselor Self-Reflection Scale, and Countertransference Factors Inventory(CFI) were used. The subjects of this study are 138 play therapists who have received the individual supervision at least three times. The results of this study can be summarized as follows. First, play therapists’ supervision experiences, the total score of Self-reflection and its sub-factors (self-understanding of counselor, counselor-client interaction), countertransference management ability had a positive correlation. Second, the total score of Self-reflection and its sub-factors (self-understanding of counselor, counselor-client interaction) had significant mediating effects on the relationships between play therapists’ supervision experiences and countertransference management ability. In conclusion, this study confirmed the mediating effects of self-reflection in the influence of supervision experiences on countertransference management ability of play therapists. Through this, the importance of the self reflection training in the play therapists’ supervision scene can be suggested.

Depression Detection Model in Social Network Content

Social media (SM) is a platform that generates a massive quantity of data every day and allows individuals to engage with one another. For many people, social media has evolved into a way of life and the fifth component of daily living. Among the most popular social media platforms are Facebook, Instagram, Twitter, WhatsApp, and Snapchat. Depression is a frequent and dangerous medical condition that has a negative impact on how you feel, think, and act. A therapist's ability to swiftly detect depression in persons is limited since they cannot observe a person's mood throughout the day. Researchers can assess a person's sentiments via social media by looking at the user's posts and comments to discover if he or she has a mental issue. This survey study mirrors prior research on detecting depression using user-generated material from social media platforms, which introduce different techniques and compare between it to obtain accuracy.

Proposal of the SAIL Model and Its Application in Humanistic Care of Rehabilitation Therapy

Correct rehabilitation treatment has universality, and not limited to the scope of the hospital, which can be in the community development. Customer expectations for rehabilitation results are often higher, so it is necessary for therapists to master communication skills with clients, on the basis of professional ability strong enough, and improve the humanistic care ability to client, and treat respect and equality as a fundamental requirement. Based on the current requirements of humanistic care ability for rehabilitation therapists, the author proposes a new model to analyze the effect of communication between rehabilitation therapists and clients, and to evaluate the humanistic care ability of rehabilitation therapists for clients. That is, the SAIL model.

The Resistance Vignette Task: Validating a rapid measure of therapist skill at managing resistance.

Therapist appropriate responsivity to client ambivalence and resistance is considered an important interpersonal skill to avoid disengagement and ensure a continued collaborative, productive process. The present study examined the predictive validity of the newly developed Resistance Vignette Task (RVT), a 10-item rapidly administered measure of therapist ability to appropriately respond to various presentations of client resistance. Following a resistance management workshop, the concurrent and prospective predictive capacity of RVT scores were examined through test interviews with ambivalent simulators and volunteers. Prospectively, in test interviews with ambivalent interviewees, higher RVT scores immediately postworkshop were associated with significantly greater responsivity (appropriate responsivity and fewer responsivity errors) at 4-month follow-up. RVT scores at the 4-month follow-up point were also concurrently associated with significantly greater therapist responsivity and lower levels of interviewee resistance. These findings provide further validation for the RVT as a measure of therapist responsivity in vivo, in actual interviews by predicting and being concurrently associated with therapist performance in response to client resistance. Thus, the RVT holds promise in advancing therapist training, as well as research on resistance as it represents an efficient measure of this key therapist skill.

How can psychotherapists improve their practice with service users from minoritised ethnicities? An application of the Declarative-Procedural-Reflective (DPR) model of clinical skill development

Abstract Many white psychotherapists may lack the skills required to work effectively with service users from minoritised ethnicities. This article proposes that the nature of this skills deficit can be understood through applying the Declarative-Procedural-Reflective (DPR) model of therapist skill development. The DPR model has been used in a range of psychotherapeutic contexts, and it provides a systematic account of how therapists from all modalities develop and can improve their skills. Adapting this model to white therapists’ skills in working with service users from minoritised ethnicities allows the identification of specific areas of skills deficit, and therefore clear recommendations as to how to address those deficits. The application of the DPR model to this context suggests that there are clear areas of skills deficit in terms of knowledge base, the practical skills of carrying out therapy, and the ability of therapists to reflect on their work with service users from minoritised ethnicities. I conclude by making a number of suggestions as to how those deficits could be addressed, both by individual therapists and at a systemic level. Key learning aims (1) To explore why some white psychotherapists find it more difficult to work effectively with service users from minoritised ethnicities. (2) To conceptualise difficulties in working with service users from minoritised ethnicities as an issue of clinical skill, knowledge and attitude development, where therapists’ skills can be improved if specific deficits are appropriately addressed. (3) To use the structure of the DPR model to better understand how deficits in therapists’ skills, knowledge and reflective ability may have an impact on their work with service users from minoritised ethnicities. This allows the identification of specific areas of deficit, and therefore clear recommendations as to how to address those deficits. (4) This is primarily addressed at CBT therapists, but the points raised in this article apply to all schools of therapy.

Mental capacity legislation and communication disability: A cross-sectional survey exploring the impact of the COVID-19 pandemic on the provision of specialist decision-making support by UK SLTs.

Mental capacity legislation in the UK is designed to safeguard the rights of people who may need support, or may be unable, to make autonomous decisions. Very limited evidence has been published about the impact of the COVID-19 pandemic on the application of mental capacity legislation and, to our knowledge, none on the ability of speech and language therapists (SLTs) to support people with communication disabilities to engage in decision-making. To describe how UK SLTs supported people with communication disabilities to make decisions and participate in mental capacity assessments, best interests decision-making and advance care planning during the COVID-19 pandemic. This descriptive, cross-sectional study used an online survey to collect quantitative and qualitative data about SLTs' practice experiences between August and November 2020. SLTs working with a range of adult clinical populations in different care settings were sampled purposively from all UK jurisdictions. Participants were recruited through professional networks and social media. Quantitative data were summarized using descriptive statistics. Qualitative data were analysed thematically. Data were collected from 107 SLTs working in a range of settings across all four UK nations. The sample included SLTs working with people with neurological conditions, learning disabilities, mental health conditions and acute confusion. The need for SLT support appeared to increase during the pandemic. Most respondents were still able to offer support; however, the amount and nature of support varied. Quality of support was impacted by adjustments associated with social distancing and infection control restrictions. Personal protective equipment (PPE) was identified as a barrier to communication. Indirect working methods (e.g., telehealth) were inaccessible to some people with communication disabilities. Most respondents felt confident that legal requirements were upheld, but suggested this group was less able to engage in decision-making and had reduced access to support to manage their own health conditions. Some SLT services were limited in their ability to meet the decision-making support needs of people with communication disabilities during the COVID-19 pandemic due to structural and systemic barriers. This suggests that existing inequities in the provision of care for people with communication disabilities in the UK were amplified during the pandemic. What is already known on the subject People with communication disabilities may require support from healthcare professionals, including SLTs, to make decisions and communicate their wishes and preferences about their care, in line with mental capacity legislation. There is a lack of published evidence relating to how changes in staff deployment and resource during the COVID-19 pandemic may have impacted on the ability of SLTs to provide this support. What this paper adds to existing knowledge This study provides novel evidence about the ways in which UK SLTs supported people with communication disabilities to engage in mental capacity assessments, best interests decision-making and advance care planning during the COVID-19 pandemic. In some cases, the amount and quality of decision-making support available was affected negatively due to changes in healthcare delivery and resource management and SLT working practices. What are the potential or actual clinical implications of this work? This study suggests that some people with communication disabilities experienced greater barriers to receiving professional support to maximize their autonomy and manage their health conditions during the COVID-19 pandemic. Speech and language therapy services and healthcare commissioners should consider how best to ensure equitable service delivery to this population in resource-limited situations.

Therapeutic Communication Theraphy to Improving Social Interaction of Autism Children (Case Study in SLB Negeri Autis Medan)

The purpose of this study was to analyze the application of therapeutic communication therapists in increasing social interaction of children with autism in SLB Negeri Autis Medan. The research method used is a case study method with a qualitative approach. The research subjects were 3 (three) therapists at SLB Negeri Autis Medan and 2 (two) triangulation informants, they are parents of autistic children who school in SLB Negeri Autis Medan and one as psychologist. Data collection techniques using in-depth interviews and the theory used as a reference in this research is the theory of relationship building in therapeutic communication which is derived from interpersonal communication theories. The research findings after the data is saturated and fulfiiled show that the application of therapeutic communication therapy in increasing social interaction of children with autism is by using the ABA method and through the stages of assessment, observation, self-introduction and environment and classical class. The findings also indicate that there are supporting factors as well as inhibiting factors for the application of therapeutic communication therapy, namely acceptance and parental participation, therapeutic methods, therapeutic media, the ability of therapists, the severity of children with autism and dietary food. The researcher concluded that the application of therapeutic communication therapy in increasing the social interaction of children with autism in SLB Negeri Autis Medan using the ABA method and through four (4) stages was appropriate in increasing social interaction and communication of children with autism in the school environment.