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The purpose of this paper is to examine how the skills involved in building therapeutic relationships, especially the therapeutic use of self, in clinical work can…
The purpose of this paper is to examine how the skills involved in building therapeutic relationships, especially the therapeutic use of self, in clinical work can transfer in to teaching, making reference to the supporting education theory.
A review of relevant education and health literature was undertaken.
Mental health practitioners’ skills transfer with good effect to the classroom, therefore clinicians who deliver teaching to mental health colleagues can be seen to be highly effective in promoting excellent learning environments. The teacher, and their teaching, needs to be student focused in the same way that the clinician needs to be patient centred to build the best possible relationships to support development and change.
The therapeutic relationship is a fundamental element of mental health work and similarly, the relationships that the teachers develop with students are essential to the promotion of learning environments. However, what creates the teacher-student relationship has been little examined in the literature and this paper suggests that the core elements of the therapeutic relationship, especially therapeutic use of self, transfer to the teaching relationship to impact on learning for mental health staff.
The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as…
The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good nurse’ characteristics (Smith & Godfrey, 2002). Forensic nurses perform unique, multifaceted roles; they are viewed by patients as ‘a source of treatment, comfort and advice’, but also as ‘part of the system that deprives them of their liberty’ (United Kingdom Central Council for Nursing, Midwifery and Health Visiting & University of Central Lancashire (UKCC & UCLAN), 1999: 42). This is problematic both for nurses and patients. Although appearing as opposites, security and therapeutic characteristics of nurses can and do co‐exist in forensic nursing (Peternelji‐Taylor & Johnson, 1996). Through critical analysis of dialogue from interviews and focus groups, this paper depicts forensic practice with people with a learning disability through a study that explores apparent ‘truths’ about such people detained in forensic settings (here referred to as ‘the men’) and the staff who work with them. Beliefs about nursing characteristics were exposed through discourses present in dialogue between the men and the staff. General research questions included: (1) What are the discourses related to learning disability and forensic practice? (2) What ideologies underpin and justify forensic practice? (3) What in particular are the positive discourses? Related discussion is primarily concerned with the way that staff and men share relationships and with characteristics of the nursing staff. Findings generally suggest that the staff may be viewed as prison wardens, leading to relationships of mistrust. Paradoxically, there are also positive discourses identifying warm and therapeutic relationships and good nurse characteristics of the staff. This may have practice implications, such as enabling staff to hear positive views expressed by the men and begin to develop metrics of ‘good’ forensic nurse characteristics that may positively affect treatment.
In a companion paper, we have argued that therapeutic work with interpreters has been viewed more negatively than is warranted, and that the inherent advantages of this…
In a companion paper, we have argued that therapeutic work with interpreters has been viewed more negatively than is warranted, and that the inherent advantages of this way of engaging with the non English speaking client have been minimised or ignored. This paper seeks to explore the aspects that may underlie the reluctance of clinicians to engage with therapeutic work with interpreters. Difficulties often appear to be centred on the anxieties provoked by working in the three‐way therapeutic relationship rather than in the traditional therapeutic dyad. It is also possible that the highly traumatised nature of some clients, who may be refugees or asylum seekers fleeing from political violence, also complicates such work. The intention in this paper is to consider both the dynamics of the three‐way relationship and the impact of traumatic experience, when relevant, on therapeutic work with interpreters, and to suggest how the pulls inherent in such work might be managed. It is hoped that by exploring these problematic areas, some light can be shed on the difficulties that all clinicians can experience but can equally overcome.
This article explores the meanings of societal marketing in the context of AIDS community‐based organizations (CBOs). Studies have investigated the practice of relationship…
This article explores the meanings of societal marketing in the context of AIDS community‐based organizations (CBOs). Studies have investigated the practice of relationship marketing in for‐profit businesses, but we have yet to understand fully the practice of relationship marketing in the vast and socially important not‐for‐profit or philanthropic sectors that practise societal marketing. Four ways in which therapeutic or “revivalist” discourse is cultivated and appropriated by clients are elaborated: reproduction of community, the use of metaphor, encouraging reflexive self‐development, and tangibilizing grief. Implications for customer intimacy and relationship marketing in the societal marketing sector are elaborated.
It has been suggested that over the last decade interest in and delivery of psychological therapy for people with learning disabilities have increased (Beail et al, 2005)…
It has been suggested that over the last decade interest in and delivery of psychological therapy for people with learning disabilities have increased (Beail et al, 2005). While the literature continues to highlight the need for further evidence of its effectiveness (Willner, 2005) there is a general ‘swell of opinion’ that psychological therapy for individuals with learning disabilities is helpful (Mason, 2007). A component of psychological therapy that is generally considered to be universally important is the quality of the relationship between therapist and client (Clarkson, 2003). However, in the relatively new field of psychological therapies for people with learning disabilities, there remains a poor empirical and theoretical understanding of the role and potential complexities of the therapeutic relationship. The paper explores some of the existing literature in this field. It highlights the limited empirical evidence before exploring some of the common themes outlined so far in the clinical literature. The paper concludes with some suggestions for future research in this area.
This paper reviews the literature on therapeutic process specific to sexual offender treatment. The general clinical literature emphasises the importance of therapist…
This paper reviews the literature on therapeutic process specific to sexual offender treatment. The general clinical literature emphasises the importance of therapist style, the client's perceptions, the therapeutic alliance and cohesiveness. We highlight the importance of therapist characteristics, group cohesion and emotion in effective treatment of sexual offenders. Implications for programming and research are emphasised.
While there is general agreement in the literature regarding the importance of the therapeutic alliance (TA) in psychological interventions with people, the forensic…
While there is general agreement in the literature regarding the importance of the therapeutic alliance (TA) in psychological interventions with people, the forensic context raises some unique challenges. The purpose of this paper is to discuss how these challenges are managed within a therapeutic context.
This paper consists of a literature review examining the following: the significance of the TA in interventions with forensic clients, especially men who have committed a sexual offence and the impact on treatment efficacy and change; therapist characteristics as well as some of the obstacles and challenges present in a correctional setting, which can impact on the TA and; the role of transference and countertransference in relation to these forensic clients.
Through the literature review, there is a discussion regarding how some of the common obstacles within correctional settings can be overcome, and how certain therapist qualities should be interpreted.
This paper will discuss some of the practical applications of certain recommended therapeutic factors within a correctional setting, challenging some of the common misconceptions and limitations. Furthermore, transference and countertransference, topics which are seldom discussed, will be considered in this paper.
Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage with adolescents. The majority of disturbed…
Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage with adolescents. The majority of disturbed adolescents do not receive professional mental health care and of those who do fewer still will fully engage with the therapeutic process (Offer et al. 1991; US Surgeon General 1999). Personal Investigator (PI) is a 3D computer game specifically designed to help adolescents overcome mental health problems such as depression and help them engage more easily with professional mental health care services. PI is an implementation of a new computer mediated model for how therapists and adolescents can engage. The model has its theoretical foundations in play therapy and therapeutic storytelling and applies current research on the educational use of computer gaming and interactive narrative systems to these foundations. Previously demonstrated benefits of computer games and interactive narrative systems in education include increased motivation, increased self‐esteem, improved problem solving and discussion skills and improved storytelling skills (Bruckman 1997; Bers 2001; Robertson 2001; Robertson and Oberlander 2002; Bers et al. 2003; Squire 2003). PI aims to take advantage of these benefits in a mental health care setting. PI incorporates a goal‐oriented, strengths based model of psychotherapy called Solution Focused Therapy (SFT). By engaging adolescents, in a client‐centred way, it aims to build stronger therapeutic relationships between therapists and adolescents. PI is the first game to integrate this established psychotherapy approach into an engaging online 3D game. Results of trials of PI with four adolescents, referred to clinics for issues including anxiety and behaviour problems, attempted suicide, and social skills difficulties, are presented.
This chapter focusses on the contribution of health professionals' communication competences to patients. We propose a model of communication to be used in the therapeutic…
This chapter focusses on the contribution of health professionals' communication competences to patients. We propose a model of communication to be used in the therapeutic relationship, supported by a literature review. The methodology is qualitative. Four focus groups (FGs) composed of Portuguese health professionals (N = 25), such as medical doctors, nurses and professors in health fields, were conducted during 2017 and 2018. All the participants of FGs validated a three-factor aggregated and interdependent model, which is composed of assertiveness, clear language and positivity (ACP model). The factors reinforce the therapeutic relationship and improve health literacy, thus reinforcing the patient's health and well-being. The argument is that health is wealth, so if the communication can improve health, then this has positive social implications. The study is a response to the lack of consensus in the literature on what specific and operative communication competences the health professional should perform in clinical encounters with the patients, and how these competences can improve, in the final instance, their health and well-being.
This paper explores the central role a language interpreter can play in the process of the therapeutic relationship. Although others have described the changes to the…
This paper explores the central role a language interpreter can play in the process of the therapeutic relationship. Although others have described the changes to the therapeutic dyad that the presence of a third party (an interpreter) brings, little attention has been paid to the advantages and additional opportunities of this altered therapeutic situation. This paper details these gains and further argues that clinicians who are willing to gain experience of working with interpreters will find that benefits accrue at the micro and macro levels: at the micro level, through enhancement of their work with individual non English speaking clients, and at the macro level through learning about different cultural perspectives, idioms of distress and the role of language in the therapeutic endeavour. This is in addition to developing skills to fulfil legal and professional requirements relating to equity of service provision. Some ideas are offered to explain the negative slant than runs throughout the literature in this area and tends to colour the overall discussion of therapeutic work with interpreters and, before the final section, makes some specific suggestions which may help maximise the gains possible in such work while reducing difficulties.