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Results for “Therapist variable”

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PubMed1980

Role of stereotypes in selecting patients for psychotherapy.

This investigation addressed the question of what implicit notions on the suitability for psychotherapy are operative in the therapist and how they affect his perception of the real patient in the first interview. Study 1 compared 13 psychotherapist's ratings of ideal, implicit notions of suitability for a variety of psychotherapies to their ratings of 20 videotaped patients. A significant correlation was found for analytical indication stereotypes only. Clinical person perception in this task seems to be focused on desirable patient variables, leading to paradoxes. In study 2, a Swiss sample of 67 therapists was able to differentiate only two indication stereotypes, an analytical one versus a nonanalytical one. Results suggest that goal variables of psychoanalytical therapies must be present in the ideally suited patient at the onset of therapy.

Adolescent↗
PubMedDate not supplied

Team collaborative practices between teachers and occupational therapists.

OBJECTIVE: A descriptive, correlational study using a survey instrument and record review was designed to describe collaboration practices between teachers and occupational therapists in public schools and to explore relationships of these practices to individual education plan (IEP) objectives and teachers' perceptions of occupational therapy contributions to student skill development. METHOD: Forty teachers of students who receive occupational therapy comprised the sample. Descriptive statistics and Spearman rank order correlations were used to describe the practices and to determine associations among the variables. RESULTS AND CONCLUSIONS: The findings indicated that teachers and occupational therapists were using collaborative team practices, such as jointly developing goals and objectives, collaboration within the classrooms, jointly monitoring interventions, and jointly reviewing student progress. However, scheduling team meetings was difficult. The majority of respondents stated that occupational therapy contributed to student skill development, and as collaboration practices increased, the teachers' perceptions of occupational therapy contribution to student skill development increased. A significant negative correlation was found between the percentage of IEP objectives met variable and three collaborative variables--team meetings, reviewing progress, and develop goals and objectives. This finding indicated that as the frequency of these team processes increased, fewer objectives were met.

Adolescent↗
PubMed1994

Participation in and outcome of treatment for major depression among low income Asian-Americans.

This study examined the relationship of four aspects of psychiatric treatment (use of medication, client-therapist ethnic match, treatment in an Asian-specific clinic, and professional therapist) to participation in treatment and outcome of treatment in low income Asian-American clients (n = 273) of the Los Angeles County mental health system who were diagnosed with major depression. Based on cultural responsiveness theory, the study tested the hypothesis that use of medication in treatment would have the greatest effect on participation and outcome followed, in order, by client-therapist ethnic match, treatment in an Asian-specific clinic, and treatment by a professional therapist. The hypotheses were largely supported: treatment with medication had a significant relationship to total number of treatment sessions (participation) and improvement in the admission-discharge Global Assessment Scale (GAS) score (outcome). Treatment by a therapist of the same ethnicity as the client and treatment in an agency designated to provide services to Asian clients both had significant relationships to the number of treatment sessions but not to GAS score improvement. Four covariates included in the analysis and treatment by a professional therapist had no relationship to either of the dependent variables.

Adolescent↗
PubMed2005

Risk assessment of sexual offenders in German forensic institutions.

BACKGROUND: The assessment of recidivism in sexual offenders is an urgent topic for forensic psychiatry in Germany. The call for useful predictive measures is therefore getting louder. AIMS: The present study analyses which criteria are employed by therapists in forensic hospitals to assess the dangerousness of sexual offenders. Of particular interest is whether the criteria listed in presently known prediction scores as decisive are actually used in decision-making in current forensic psychiatric practice. METHOD: Data are collected in a prospective prediction study funded by the German Research Association. RESULTS: The results reveal that therapists employ mainly clinical and less historical criteria, thus indicating substantial differences from currently known prediction scores and results of other studies. CONCLUSIONS: That therapists base their prediction of dangerousness primarily on clinical variables reveals a substantial error that has to be remedied. Further research on the extent of relevance of clinical variables is needed.

Adult↗
PubMed1998

Comparison of the characteristics and features of pressure garments used in the management of burn scars.

Two companies provide custom-made pressure garments to clients with burn scars at Westmead Hospital. This prospective study was completed in order to make objective decisions about which garments were most appropriate and cost effective to provide to clients. Issues such as cost, durability, fit and client preferences were investigated. Data were collected from 43 clients; at the time of initial fitting, at a follow-up appointment 4-6 weeks later, and at the time one of the garments required replacement. One Second Skin and one Jobst garment were provided to each client and the garments were compared using therapists' evaluation and clients' perspectives on a number of variables. Second Skin garments had significantly more favourable results on the variables of time for delivery, fit at follow-up, garment design, quality of fabric and seams, overall satisfaction and garment preference for ongoing wear. On all other variables there was no significant difference between the garments. Second Skin provided the most optimal and appropriate option for pressure garments in the management of burn scars for our clients.

Adolescent↗
PubMed1993

Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain.

In this study, three types of treatments for chronic musculoskeletal pain were compared. Fifty-seven patients who suffered from chronic back pain and 21 patients who suffered from temporomandibular pain and dysfunction were randomly assigned to either electromyographic (EMG) biofeedback, cognitive-behavioral therapy, or conservative medical treatment. At posttreatment, improvements were noted in all three treatment groups, with the biofeedback group displaying the most substantial change. At the 6- and 24-month follow-up, only the biofeedback group maintained significant reductions in pain severity, interference, affective distress, pain-related use of the health care system, stress-related reactivity of the affected muscles, and an increase in active coping self-statements. Treatment outcome was predicted by chronicity and treatment-specific variables. Analysis of attrition showed a significant effect for therapist and extent of somatic pathology. Results suggest that pain patients who suffer from musculoskeletal pain problems and display few physical disabilities may profit the most from short-term EMG biofeedback treatment.

Adult↗
PubMed1995

Graduate training in psychotherapy: are therapy outcomes enhanced?

Several sources of indirect evidence supporting the value of graduate training in psychotherapy are reviewed here. Training protocols that are known to enhance trainees' skills are briefly discussed, as are conclusions of meta-analytic reviews examining relationships between therapist experience and training, and therapy outcome. An updated meta-analysis of therapy outcome studies involving within-study comparisons of psychotherapists of different levels of training and experience is summarized. It is concluded that a variety of outcome sources are associated with modest effect sizes favoring more trained therapists. In many outpatient settings, therapists with more training tend to suffer fewer therapy dropouts than less trained therapists. Shortcomings of available research and speculations about possible variables influencing outcomes are discussed.

Curriculum↗
PubMed1975

The need for intervention: a further delineation.

Clinical material from experimental tape sessions is used further to delineate a crucial variable in psychotherapy research: the degree to which the therapist meets the patient's need for intervention. Several discrete needs for intervention are identified, how they were (later) met by a therapist is observed, and the outcome of each is assessed.

Alcoholism↗
PubMed1985

Self-destructive dermatoses.

It appears certain that the causes of self-destructive dermatoses are many and complex. The disorder spans diagnostic categories and varies from unconscious picking at the skin to severe self-destructive actions. Although not limited to any one diagnosis, skin disorders appear to be more prevalent in depression. This association may involve activation of the hypothalamic-pituitary-adrenal axis commonly found in depression. Two specific types of commonly occurring dermatoses-neurotic excoriations and dermatitis artefacta-are reviewed in this article. The major distinction of these disorders centers on whether the patient can admit to self-mutilation. Because of the difficulties in dermatitis artefacta with insight and body-image, it has been compared with anorexia nervosa. Often, dermatitis artefacta coexists with anorexia nervosa. In both disorders, neurotic excoriations and dermatitis artefacta, the personality style tends to be introverted with emotional immaturity. These patients have difficulty when they are under stress; the problem is compounded because of poor communication skills. Pharmacotherapy is of limited usefulness, and psychotherapy is often times hindered by strong resistance to exploring long-standing emotional issues. Once an alliance is established with the therapist, however, these issues may be examined. Prognosis is variable but does seem to directly correlate with the duration of the illness. Young individuals may experience alleviation of symptoms after one session of psychotherapy, whereas older patients may never have resolution. Dermatologic abuse involving psychosis has many presentations; one of the most common involves infestation. Organic causes must always be excluded as part of the differential diagnosis. In schizophrenia, this presentation has one of the highest incidences of suicide.(ABSTRACT TRUNCATED AT 250 WORDS)

Conflict, Psychological↗
PubMed1993

Therapist individuality in the diagnosis and treatment of depression.

The influence of physician variables on the diagnosis and treatment of depression was analysed by presenting a trained pseudo-patient to four physicians each with different professional backgrounds. Although all physicians had earlier given their informed consent to the study design, they thought that they were treating a real patient during regular practice hours. All physicians assessed the acute psychopathology almost completely except for suicidal thoughts. Despite similar information about the case, four different diagnoses/pathogenetic concepts and four different treatments were chosen. Medical decision processes and their results can be related to the professional background and personal attitudes of physicians.

Adult↗
PubMed1983

Effect of compatibility on goal achievement in patient-physical therapist dyads.

The purpose of this study was to test two hypotheses related to the effect of interpersonal compatibility in patient-physical therapist dyads on goal achievement in a rehabilitation setting. Seventeen patients with spinal cord injuries and the physical therapists primarily responsible for their treatment were asked to participate. The Fundamental Interpersonal Relations Orientation Behavior scale, which includes three interpersonal dimensions--Inclusion, Control, and Affection--was used to assess patient-physical therapist compatibility. Patient performance on four quantitatively measurable functional goals was used as the dependent variable. The results of this study did not support the hypothesis that goal achievement would be greater for patients in compatible patient-physical therapist dyads. Further, compatibility in the dimension of affection was found to be strongly related to a lack of rehabilitation goal achievement.

Achievement↗
PubMed1999

The Effect of Therapist and Activity Characteristics on the Purposeful Responses of Probable Alzheimer's Disease Participants.

The purpose of this study was to examine the efficacy of individual therapist sessions on the purposeful responses of probable Alzheimer's disease (AD) participants (hereby designated as "dementia participants". Three music therapists and one occupational therapist individually presented a combined total of 29 sing-along and exercise sessions to a group of seven participants, six having a diagnosis of probable Alzheimer's disease (moderate to severe cognitive decline), and one nondementia "control" participant, at an adult day care center specializing in dementia. Informed consent procedures were given to all study participants and their families. Sixteen sing-along sessions of 25-45 minutes duration consisted of live guitar playing and singing by individual music therapists. Thirteen exercises sessions of 20 minutes in length consisted of individual therapist (music or occupational) leading of exercises to a music tape ("Everyone Can Move" by Farnan & Johnson, 1988). Independent variables and their response definitions included: activity type (Sing-along, exercise); session content (music intervals, nonmusic intervals); therapist type (music, occupational); and therapist styles (singing, guitar playing). Participant dependent measures included singing/humming to songs, and movement/exercise to a therapist model (purposeful responses). All sessions were videotaped. Results indicated that the six dementia participants as a group purposefully responded significantly more during exercise than during sing-along sessions, but one of the six participants had extremely low exercise participation scores. That one participant's scores in sing-along sessions were in the range of the majority (4 of 5) of the other dementia participants' singing scores. Further analysis to help explain the discrepancy in this participant's purposeful responding indicated no significant difference in responding to individual music or occupational therapists during exercise activities, but a significant difference in individual responding to 3 different music therapists during the sing-along activities. Addi6onal analyses of the sing-along activities revealed significant differences in the total percentage of singing and guitar playing by the individual music therapists. Implications of the results for music therapy programming with dementia clients are discussed.

Journal Article↗
PubMedDate not supplied

In-hand manipulation in young children: rotation of an object in the fingers.

OBJECTIVE: The purpose of this study was to look at the development of two in-hand skills of rotation. Three questions were asked: (a) Do boys' and girls' performance differ significantly? (b) Does performance improve with age? and (c) Can periods of rapid improvement with age be seen on the tasks presented? METHOD: The in-hand manipulation skill of rotation was measured in 154 right-handed children between the ages of 3-0 years and 6-11 years as well as in 13 adults. The participants were videotaped as they either turned over small pegs in a pegboard or rotated a peg in their fingertips. The number of pegs dropped when turning and placing them back in the board, the number of times a peg could be rotated in the fingertips, the time it took to complete each task, and the methods participate used to accomplish the two tasks were recorded from the videotapes. RESULTS: The results indicated no differences between the performance of boys and girls on any of the variables studied, but performance did change with age, and periods of rapid change were identified. Further, when compared on methods used, the children did not achieve the same speed or consistency as the adult participants. CONCLUSION: The development of in-hand manipulation skills of rotation involves improvement in the dimension of speed, method, and consistency. Observation of these skills in a child can add to a therapist's understanding of the child's fine motor abilities. The variability in children's performance needs to be considered in both evaluation and treatment planning.

Adult↗
PubMed2004

The role of health promotion in physical therapy in California, New York, and Tennessee.

BACKGROUND AND PURPOSE: As health care providers, physical therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. The purposes of this study were: (1) to investigate perceptions of practice patterns in 4 focus areas of Healthy People 2010 (disability and secondary conditions by assessing psychological well-being, nutrition and overweight, physical activity and fitness, and tobacco use) and (2) to identify related self-efficacy and outcome expectations in California, New York, and Tennessee. SUBJECTS: A instrument was pilot tested and distributed in 2 waves to 3,500 randomly selected, licensed physical therapists from 3 states: California, New York, and Tennessee. METHODS: Interviews were randomly conducted via telephone with 23 physical therapists in all 3 states until similar responses were identified in order to create the qualitative instrument, which was then pilot tested with 20 physical therapists in California. The total number of qualitative instruments used in the data analyses was 417 (145 from California, 127 from New York, and 145 from Tennessee) or 11.9%. RESULTS: The health promotion behavior most commonly thought to be practiced by physical therapists was assisting patients to increase physical activity (54%), followed by psychological well-being (41%), nutrition and overweight issues (19%), and smoking cessation (17%). Self-efficacy predicted all 4 behaviors beyond the control variables. Minimal state-to-state differences were noted. DISCUSSION AND CONCLUSION: Physical therapists believe they are addressing health promotion topics with patients, although in varying degrees and in lower than desirable percentages based on Healthy People 2010 goals. This study demonstrated that a physical therapist's confidence in being able to perform a behavior (self-efficacy) was the best predictor of perceptions of practice patterns and is an area to target in future interventions.

Adult↗
PubMed1993

Male or female therapists for eating-disordered adolescents: guidelines suggested by research and practice.

The question of whether male or female therapists are best for female patients has sparked controversy for decades. This paper explores which therapist-patient gender matches facilitate the most patient growth and avoid detriment to female patients. There is little research on this subject related to eating-disordered female adolescents. Thus, an attempt was made here to distill relevant variables from the literature on eating disorders, adolescence, transference and countertransference, and psychotherapy, as well as the author's own practice, to suggest guidelines for effective matches. Although no consistent evidence pointed to a particular match as being most effective in this population, situations are noted in which assignment of one gender offers the chance of better therapeutic alliance. Therapist and patient preferences, the patient's traumatic experiences, enmeshed versus disengaged patient relationships, patient resistance, and therapists' comfort with both their male and female sides are variables related to preferred assignment. Advantages and disadvantages for male and female therapists are discussed, and suggestions made for variables to be used in future studies.

Adolescent↗
PubMedDate not supplied

Persistent vegetative state: which sensory-motor variables should the physiotherapist measure?

This study used a modified Delphi technique to establish a list of core items which should be included in the measurement, by the physical therapist, of sensory-motor capacities of persons in a persistent vegetative state. Twenty-eight physical therapists with a mean of 5.9 years of experience working with this clientele participated in the study and identified 105 items as being important in the evaluation of the PVS patient (Round I). The study planning committee reduced these to 20 categories and asked the therapists to rate each category of items (a 5-point scale) as to it's importance (Round II). Physiotherapists identified 14 variables as being 'extremely' or 'very important' to include in such an evaluation. These included: tonus, voluntary movement on request, postural reactions, passive range of motion, tolerance to verticalization and postural status. These results are being used to develop a quantitative assessment instrument to be used by the physical therapist working with the PVS patient.

Arousal↗
PubMed1984

The effect of note-taking on a simulated clinical interview.

This study investigated the effect of note-taking in a simulated therapeutic session on the ratings of therapist's effectiveness, client's perception of the session, and total therapeutic impact. Half of 34 social work graduate students were shown a videotaped dramatization of a therapy session with the interviewer taking notes, the other half an identical session but without note-taking. The latter was rated as significantly higher than the session with notes. Similarly, the ratings of the therapist's effectiveness and of the client's perceptions of the therapy session were significantly higher for the session without notes. Neither the raters' age, clinical experience, nor stated theoretical orientation significantly influenced the ratings of the therapy sessions. The results indicate that note-taking is viewed by clinicians as a distracting and detrimental variable in a clinical interview. The generalizability of these results, the need for studies utilizing client instead of therapist ratings, and the role of videotaped control of variables are discussed.

Adult↗
PubMed2002

Characterization of neonatal personnel time inputs and prediction from clinical variables--a time and motion study.

OBJECTIVE: To characterize and predict personnel time inputs to neonatal intensive care using infant characteristics from chart review. STUDY DESIGN: For 12 hours each day, observers timed all direct care, charting, discussions, and procedures for 154 infants. Time inputs were correlated with 40 infant characteristics and resource markers, as well as the Score for Neonatal Acute Physiology (SNAP) for that day of care. RESULTS: Nurses accounted for 76%, respiratory therapists 8%, fellows 5%, nurse practitioners 7% and attendings 5% of total time invested in patient care. Nurses and respiratory therapists spent proportionately more time in direct patient care. In regression models, a limited number of variables explained 36% of the variance in time input per patient for respiratory therapists (p<0.0001), 42% for nurses (p<0.0001), and 23% for physicians and nurse practitioners (p<0.0001). CONCLUSIONS: Total labor inputs can be accurately predicted through the use of a limited number of clinical characteristics. This technique should be routinely employed to improve the accuracy of economic evaluations. Nursing accounts for the majority of time invested in neonatal care. Improved efficiency in neonatology is thus most likely to be generated by interventions that reduce direct nursing time.

Health Personnel↗