Storying Ruptures as Educational Practice

Studies in Philosophy and Education -     

Transformations in Therapeutic Practice

In her training of therapists, Virginia Satir sought to change the way her trainees perceived themselves, their clients, and the therapeutic endeavor. The change she sought was a movement from hierarchical models of therapy where clients were diagnosed in terms of paradigms of how they ought to be to an organic model where the therapist attempts to understand the client by entering the client's internal context. Contemporary training in the Satir model attempts to bring about the same change. Research indicates that the trainers are succeeding.     

The Therapeutic Alliance in Multicultural Practice

Abstract

The therapeutic relationship rests on both an emotional bond with the therapist and a rational, “working” connection. Both dimensions of the alliance have relevance for multicultural clinical work. There have been many contributions to multicultural practice that emphasize either cognitive or emotional levels of the alliance. This paper uses both empirical studies and clinical papers to synthesize both the emotional and the rational perspectives on the multicultural alliance. Examples are drawn from literature, published case examples, and the author's own clinical practice.     

Embodied Experience in Educational Practice and Research

The intention of this article is to make an educational analysis of Merleau-Ponty??s theory of experience in order to see what it implicates for educational practice as well as educational research. In this way, we can attain an understanding what embodied experience might mean both in schools and other educational settings and in researching educational activities. The analysis will take its point of departure in Merleau-Ponty??s analysis and criticism of empiricist and neokantian theories of experience. This will be followed up by an introduction of some central concepts in Merleau-Ponty??s own understanding of experience with emphasis on their relevance for educational analysis. This way of presenting the theory of embodied experience has the advantage of being able to indicate the difference it makes in the field of theories of experience.     

A Cross-Contextual Construction of Clients' Therapeutic Practice

This study demonstrates how gathering data from a different context can significantly change how an object of study may be viewed. Data from a qualitative diary study of psychotherapeutic practice were used to construct a cross-contextual view of psychotherapy. Data about clients’ everyday lives as well as psychotherapy sessions were analyzed. Examples of how extra-therapeutic factors are significant to client change are presented. Six types of extra-therapeutic information sources that clients use to develop their personal stances while in therapy were identified. The case of one client's abundant use of extra-therapeutic sources of information offers a different construction of how psychotherapy works, emphasizing client activities outside sessions. The implications of the study for psychotherapy research are addressed.     

128例重型颅脑损伤患者的临床治疗体会

探讨重型颅脑损伤的治疗方法与经验。观察128例重型颅脑损伤患者的脑部受伤情况,合并伤以及受伤到入院期间的病情变化。临床治愈113例,其中能生活自理者87例,留有后遗症者26例,死亡15例,病死率为11.72%。重型颅脑损伤病死率高,入院后重点合理的检查,积极有效的救治以及规范的康复护理是降低病死率、提高临床治愈率的关键。     

128例重型颅脑损伤患者的临床治疗体会

探讨重型颅脑损伤的治疗方法与经验.观察128例重型颅脑损伤患者的脑部受伤情况,合并伤以及受伤到入院期间的病情变化.临床治愈113例,其中能生活自理者87例,留有后遗症者26例,死亡15例,病死率为11.72%.重型颅脑损伤病死率高,入院后重点合理的检查,积极有效的救治以及规范的康复护理是降低病死率、提高临床治愈率的关键.     

Maintaining Therapeutic boundaries: The Motive Is Therapeutic Effectiveness,not defensive Practice

In his article "How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness," Lazarus asserts that many clinicians are adhering to strict therapeutic boundaries and ethics in a fear-driven effort to avoid unwarranted malpractice claims. Although I agree that maintenance of conventional therapeutic boundaries is apt to minimize malpractice claims in most cases, I believe that is because such boundaries are critical to protect patients' welfare and thereby promote effective treatment. My reasoning, discussed next, revolves around the following premises: 1. For many, if not most, types of patient problems and patient populations, boundaries and the personal meaning of the therapeutic boundaries are an arena in which critical emotional issues are manifested and worked through. 2. Clear, consistent boundaries provide a structure and safety for many patients that is a curative factor in itself. 3. Patients' reactions to alterations in usual therapeutic boundaries are often unpredictable ahead of time (even if requested by the patient) and typically complex, ambivalent, and heavily colored by transferential meaning. 4. Because alterations in therapeutic boundaries typically add a new therapist role or activity that involves potential gratification of personal needs of the therapist, objectivity in evaluating such a change may be compromised by the inherent self-interest. 5. Consistent, clear boundaries need have no impact on therapist warmth and empathy.     

Religious Experience as an Observational Epistemic Practice

William Alston proposed an understanding of religious experience modeled after the triadic structure of sense perception. However, a perceptual model falters because of the unobservability of God as the object of religious experience. To reshape Alston’s model of religious experience as an observational practice we utilize Dudley Shapere’s distinction between the philosophical use of ‘observe’ in terms of sensory perception and scientists’ epistemic use of ‘observe’ as being evidential by providing information or justification leading to knowledge. This distinction helps us to understand how religious experience of an unobservable God can be an epistemic practice that satisfies our epistemic obligations and justifies religious belief.     

Group-Based Psychotherapy Integration in Theory and Practice: Therapeutic Community Revisited

A group-based theoretical integration model presented in this journal (F. Knobloch, 1996) is elaborated in practice. The core aspects of the group-based system are described and illustrated with clinical examples as they apply to a modified therapeutic community: (a) the creation of the therapeutic world to represent real life and its multiple realities; (b) the group schema model as a context for problem identification and exploration; (c) the collaboration between therapists and group members; (d) the exploration and experimentation of problems through individual and group tasks; and (e) the transfer of new behaviors to real life situations and (f) the systematic application of major psychotherapy theories and techniques.     

Occupational Therapy Students' Development of Therapeutic Communication Skills During a Service-Learning Experience

This qualitative study examined the effect community-based service-learning experiences had upon occupational therapy students' therapeutic communication skills and their application of theoretical concepts. After their semester-long course was completed, six students de-identified and voluntarily submitted their weekly reflective journals for retrospective analysis in accordance with Giorgi's strategies (1985 Giorgi , A. ( 1985 ). Phenomenology and psychological research . Pittsburgh , PA : Duquesne University Press . [Google Scholar], 1997 Giorgi , A. ( 1997 ). The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure . Journal of Phenomenological Psychology , 28 , 235 – 261 .[Crossref] , [Google Scholar]). Two analysts identified eight themes: developing trust, establishing boundaries, communication, client-centered care, breakdown of preconceptions, increased self-awareness, power of pride, and power of occupation. Educators are urged to use service-learning experiences to facilitate student interpersonal skill development and integration of theoretical knowledge.     

The Embodied Experience of Microaggressions: Implications for Clinical Practice

Ongoing scholarship in multicultural counseling practice has established the significance of microaggressions in the lived experience of clients and in the client–counselor dyad. Grounded in new research into the embodied experience of oppression, this article reviews key concepts in nonverbal communication and traumatology to illustrate how the body is implicated in the transmission of microaggressions and how counselors can become more attentive, informed, and responsive to how social power differences manifest in the body. Las investigaciones actuales sobre la práctica de la consejería multicultural han establecido la importancia de las microagresiones en la experiencia vital de los clientes y en la díada cliente–consejero. Fundamentado en nuevas investigaciones sobre la experiencia corporal de la opresión, este artículo revisa conceptos clave de la comunicación no verbal y la traumatología para ilustrar cómo el cuerpo está involucrado en la transmisión de microagresiones y cómo los consejeros pueden tornarse más atentos, informados y sensibles a cómo las diferencias de poder social se manifiestan en el cuerpo.     

Storying endometriosis: Examining relationships between narrative identity,mental health,and pain

We examined whether narratives related to mental health and pain in 120 women with endometriosis. Participants wrote narratives about endometriosis, rated the narratives on centrality to identity and positive and negative self-change, and completed measures of depressive symptoms, life-satisfaction, pain intensity and pain symptoms. Narratives were content-coded for themes of agency and communion. Higher centrality to identity, more negative self-change, and lower agency and communion were related to poorer mental health. Higher centrality to identity was associated with more pain symptoms. Narrative measures predicted mental health beyond pain intensity, pain symptoms, and neuroticism. The results indicate that how women with endometriosis narrate their illness is connected to mental health.