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This paper seeks to focus on the reflections of therapists who were working professionally in Chile during the time of human right violations in an attempt to inform and to develop ways of working professionally in similar circumstances around the world.

The paper draws on the experiences of therapists who were working in Chile at the time and extrapolates from these experiences to provide suggestions and guidance for other therapists who find themselves in similar circumstances.

After Dr Salvador Allende was overthrown, Chile was governed by a military dictatorship that engaged in massive human rights violations. From the reflections of therapists 30 years later, this paper summarizes some of the psychological consequences of the traumas that therapists faced when dealing with clients who were directly affected by the same trauma. This included feelings of terror following state treachery, amnesia, fear of political resistance and guilt.

Therapists in these countries are encouraged to seek the protection of international organizations who deal with human rights violations, work in professional groups rather than isolation, and when challenging human rights violations by conducting therapy, to work similarly to a resistance movement.

Therapists in countries where there is no repression should form professional alliances with their colleagues in these repressive countries to help protect them and provide support for their ongoing work.

This paper highlights the extreme danger that ensues for therapists who simply continue with their work during state sanctioned repression, and how this may be perceived as political statements against the repressive regime. Ways of dealing with this professionally are discussed.

There is little consensus regarding what constitutes an effective therapist when working with adults with intellectual disabilities (ID) who have a mental health problem. This study aims to explore whether clusters of clinical psychologists (CPs) could be differentiated with regards to beliefs as to what defines an effective therapist for adults with ID experiencing psychological distress and seeking treatment.

Four interviews with CPs and an associated thematic analysis created the 49-item Q-set. These items were then sorted into a forced quasi-normal distribution by N = 27 CPs via an online Q-sorting task.

Three participant clusters were identified in the principal components analysis that accounted for 49% of the variance. These clusters were labelled the creative collaborator, the reflective expert and the system integrator.

Differences exist regarding beliefs as to what the psychotherapeutic approaches effective therapists working with ID and comorbid mental health problems should take. These differences approximated to preferred psychological therapy models. This study is critiqued to enable future research on this topic to progress.

To the best of the authors’ knowledge, this is the first study to explore what constitutes an effective psychological therapist for people who have ID.

The purpose of this study is to investigate how physical therapists make meaning of their professional role identity when transitioning from clinician to leadership positions. Despite the importance of professional role identity in the transition from health-care provider to health-care leader, research on this topic in physical therapy remains almost nonexistent.

A qualitative, phenomenological research approach was used in this study. Data was collected through a three-part, semistructured interview process. An open coding to focused coding process was used to analyze data and develop themes which answered the research question.

Physical therapists in this study engaged in identity work, making meaning of their professional role identity by referencing a professional role identity focused on more than clinical skills, accepting the role of discomfort, focusing on relationships, exercising agency over the construction of their leader identity, recognizing consistency between clinical and leader roles and establishing a professional role identity informed but no longer bound by their physical therapist identity.

To the best of the author’s knowledge, this study is the first to investigate how physical therapists make meaning of their professional role identity when transitioning into leadership positions. The findings of this study highlight uniquities in the physical therapy professional role identity and the manner in which physical therapists navigate this work role transition.

Sex‐role attitudes in therapy are examined, focusing on the therapist's attitudes. The sexism that all therapists possess is investigated and whether this sexism influences the skills therapists use to the detriment of both male and female clients. It is likely that the therapist's experiences and ways of perceiving men and women will produce particular kinds of blocks in therapy which may vary for each therapist. A summary of the dialogue in interviews and therapy sessions for one male therapist is given.

Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational therapists experience and describe their roles in municipalities after the implementation of a health reform (the Coordination Act) in Norway.

This qualitative study was designed within the perspectives of social constructivism. Data was collected through focus group interviews with 10 community-working occupational therapists. A thematic framework analysis was used to examine the participants’ experiences.

The following four themes emerged: external factors that framed and shaped the occupational therapists’ roles in municipalities; the strengths and dilemmas of the generalist; the problematic generic position and the strengths; and dilemmas of the specialist.

The study suggests that occupational therapy practitioners should identify new opportunities and adapt to health reform changes. They also need to renegotiate their roles as the health reforms require more specialized competences. Greater emphasis must be placed on the core knowledge and competences of occupational therapists to strengthen their professional identity in the municipalities.

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.

Occupational therapists are increasingly working in organisations outside of the public sector. UK government policy over the past decade has promoted health and social care provision by social enterprises. The purpose of this paper is to examine the compatibility of occupational therapy practice and a social enterprise environment, within the UK and questions if this approach may enhance experiences of social inclusion for people who use these services.

Case study methodology was used with eight social enterprises in the UK. Data were collected through: semi-structured interviews, formal organisational documents, and field visits and observations. Interviews were conducted with 26 participants who were occupational therapists, service users and social entrepreneurs/managers. The interviews were recorded, transcribed and analysed using thematic analysis.

Occupational therapists experienced job satisfaction, professional autonomy and were able to practise according to their professional philosophy. Service users valued support with: employment, routine, social relationships, and developing a sense of identity, particularly outside of a medical model definition. To a degree therefore, people using these services claimed socially inclusive benefits. Challenges with funding social enterprises, however, impacted occupational therapy delivery in some cases.

The majority of social enterprise research is drawn from case study methodology; however, this was the most appropriate research design to gain greatest insight into a small but developing phenomenon. Further research into occupational therapy practice within social enterprises is required, particularly on the effectiveness of returning to work and social inclusion.

Social enterprises can provide therapeutic environments to promote recovery and social inclusion which is also compatible with occupational therapy practice.

This is the first known national research into occupational therapy provision in social enterprises within the UK, which evidences a compatibility within occupational therapy practice within a social enterprise environment and the benefits of this.

The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with personality disorders, the authors have used video calls but not all clients could work in this way. The authors decided to meet patients outside and walked with them while adhering to government guidelines. This study aims to present the authors’ experience with one client who was interviewed afterwards about the experience.

A total of 10 walking therapy sessions of 60-min duration were conducted with the patient. After the sessions, both the patient and therapist were interviewed about their experience. The resulting interviews with both patient and therapist were thematically analysed independently by both authors.

There were common themes to both the client and therapist’s account following thematic analysis. These were: modelling and normalising in the real world, replacing what COVID-19 had taken away from the TC experience, changes at home, therapist disclosure, outcomes and good endings and being outside of the clinical environment.

The authors have presented a single case of the patient and therapist experience of outdoor therapy sessions in a TC context response to the COVID-19 pandemic. The findings are not generalisable and can only provide a suggestion at the positive potential for working in this way. The authors hope that the positive effects of outdoor therapy noted here may inspire other clinicians to consider similar novel approaches in their work.

This study describes a novel way that a TC has adapted to the COVID-19 pandemic.

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland.

This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys.

In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial.

A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally.

This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

The purpose of this paper is to demonstrate how a change management perspective contributes new understandings about music therapy implementation processes.

Narrative inquiry, ethnography, and arts-based research methods were used to explore the experiences of 12 music therapists who developed new services in healthcare settings. These experiences were interpreted using insights from the field of change management.

A change management perspective helps to explain music therapists' experiences of resistance and struggle when introducing their services to established health care teams. Organisational change theories and models highlight possible strategies for implementing music therapy services successfully, such as organisational assessment, communication and collaboration with other workers, and the appointment of a service development steering group.

This paper offers exciting possibilities for developing understanding of music therapists' experiences and for supporting the growth of this burgeoning profession.

There is an important need for professional supervision for music therapists in the service development phase, to support them in coping with resistance and setbacks. Healthcare managers and workers are encouraged to consider ways in which they can support the development of a new music therapy service, such as observing music therapy work and sharing organisational priorities and cultures with a new music therapist.

Previous accounts of music therapy service development have indicated that music therapists encounter complex interprofessional issues when they join an established health care team. A change management perspective offers a new lens through which music therapists' experiences can be further understood.