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Ethical practice and professional decision-making
Published in Michael Weir, Law and Ethics in Complementary Medicine, 2023
Clear and honest communication is fundamental to the healing process. A practitioner needs to establish an environment where clients are prepared to reveal and discuss the physical and emotional aspects of their health. Without a good level of communication and trust, the quality of the therapeutic relationship may be prejudiced.
Establishing and Maintaining a Therapeutic Relationship
Published in Danielle L. Terry, Michelle E. Mlinac, Pamela L. Steadman-Wood, Providing Home Care for Older Adults, 2020
Janet Yang, Marc Parker, Carlos Santell
When coming into a patient’s home, a wealth of information is available regarding their personal issues and practical needs. In Mrs. Johns’ case, the MH provider became aware that she tended to stay in her pajamas, which would likely not be evident in the clinic. As a provider becomes aware of practical needs, he or she needs to decide what response is likely to be most clinically helpful. It may be that helping a patient with a practical need is a useful method of developing rapport. For example, if the patient is clearly unable to cook, establishing dietary assistance (like Meals on Wheels) could both improve the patient’s wellbeing and enhance rapport. Or, if the provider notices the patient’s home is in significant disrepair, referral to a low-cost home repair agency could help develop the therapeutic relationship. A wise MH provider will assess for, and consider helping with, practical needs, while not moving too quickly, which may undermine independence. Helping the patient and the developing rapport should be considered in the context of enhancing patients’ personal empowerment rather than enabling dependency. This will be discussed further below.
Integrating mindfulness into therapy with people who stammer
Published in Trudy Stewart, Stammering Resources for Adults and Teenagers, 2020
Studies since the 1990s have revealed that the strongest predictors of therapy outcome in the psychotherapy field are rooted in the qualities of the therapist and the resulting therapeutic relationship. “It might almost be said that the relationship is the treatment” (Duncan and Miller 2000) (See also chapter 1 Stewart and Leahy). The qualities patients attribute to a positive therapeutic relationship include empathy, warmth, understanding and acceptance (Lambert and Barley 2001). Thus, the challenge to be a more effective therapist is, to a large degree, the challenge of finding ways to help cultivate the qualities shared by excellent therapists. Whilst an SLT working with a PWS is not practising psychotherapy her client who stammers is, nevertheless, being offered a relationship where challenging thoughts, feelings and experiences can be explored and worked with. Bien (2006) comments that the mindful therapist considers diagnosis broadly and sees the person as a whole, looking beyond any label he may come with. A therapist working with a PWS should know the need to look beyond the label, stammering, and the need to understand each unique PWS.
An Examination of the Treatment Utility of the MMPI-2-RF: Prediction of Post-Treatment Depressive Symptoms and Increased Understanding of the Therapeutic Alliance in an Inpatient Mood Disorder Treatment
Published in Journal of Personality Assessment, 2023
Taylor R. Rodriguez, Katrina A. Rufino, Michelle A. Patriquin, Joye C. Anestis
Mental health treatment aims to maximize patients’ outcomes while minimizing barriers that may interfere with progress or decrease the quality of care. Such barriers may include difficulties building trust in a therapeutic relationship (i.e., alliance). Researchers have worked to understand therapeutic processes and outcomes by examining ways in which providers can anticipate these potential difficulties for patients. Incorporating psychological assessments, such as the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) (Ben-Porath & Tellegen, 2008/2011), into treatment is one avenue that has implications for enhanced quality of care (Harkness & Lilienfeld, 1997) and furthering our understanding of treatment (e.g., Anestis et al., 2015a). While personality, psychopathology, therapeutic alliance, and other treatment factors have been examined broadly, there is limited research on the MMPI-2-RF that intersects all of these concepts. Such literature that does exist (e.g., Anestis et al., 2015b; Arbisi et al., 2022; Mattson et al., 2012; Sellbom et al., 2008; Tarescavage et al., 2015) has been limited by a lack of attention to alliance, an overreliance on attendance-related outcomes, and a lack of data in inpatient settings. Thus, the current study aims to examine the associations between MMPI-2-RF substantive scales and post-treatment depressive symptoms, a novel indicator of treatment outcome, and to investigate the influence of therapeutic alliance on these relationships in a sample of psychiatric inpatients with mood disorders.
Participants’ unspoken thoughts and feelings negatively influence the therapeutic alliance; a qualitative study in a multidisciplinary pain rehabilitation setting
Published in Disability and Rehabilitation, 2022
Davy Paap, Leonie A. Krops, Henrica R. Schiphorst Preuper, Jan H. B. Geertzen, Pieter U. Dijkstra, Grieteke Pool
This study has several important implications. First, it was found that many participants did not experience a strong therapeutic alliance. Participants were insufficiently aware of the position they held in the alliance and the tasks they could perform therein. Furthermore, they did not feel engaged in the agreement on goals and tasks set forth in the treatment plan. Other studies have shown that a strong therapeutic alliance can contribute considerably to treatment effects [29,30]. This implies that a stronger focus on the therapeutic alliance is needed to improve the effects of pain rehabilitation programs. Healthcare professionals should effectively explore unspoken thoughts, feelings, and dilemmas of participants regarding the therapeutic relationship in combination with the diagnosis and treatment plan. In this way a reciprocal and negotiable relationship with agreement on goals and in tasks can be reached.
Guidance for clinicians when working with refugees and asylum seekers
Published in International Review of Psychiatry, 2022
Rachel Tribe, Farkhondeh Farsimadan
Ensure joined-up service delivery and avoid duplication by knowing what other agencies are or could be providing. If there are agencies that can support your client’s practical needs (e.g. courses, in the new language, befriending schemes, community groups), signpost your client to them. For example, the Red Cross/Crescent/and a range of other non-governmental and community organisations may be providing services, which are similar or complementary to those, offered by mainstream services. Otherwise, your service user may look to you as a general resource for—e.g. inadequate housing, translating legal letters. Although, assisting the service user with their basic needs, can assist building the therapeutic relationship, you should be mindful of the boundaries and if this becomes problematic you need to discuss this with them sensitively to minimise distress and ensure they understand your rationale.