Client-Centered and Family-Centered Care: Refinement of the Concepts

Occupational therapy has emphasized the relationship between the therapist and the client. The occupational therapy guidelines for client-centered practice produced in the 1980s by the Canadian Department of National Health and Welfare and the Canadian Association of Occupational Therapists (Task Force on Guidelines for the Practice of Occupational Therapy, 1983) has had variable use over the years. While occupational therapists believe in the principles of client-centered care, the philosophical concepts have been difficult to fully implement and also seem narrow in light of all the external forces and challenges posed by today's clients and their rights, and the ethics of medicine. Other concepts need to be in place to facilitate the true constructs of client-centered care. A historical overview of the medical perspective and the occupational therapy perspectives on client-centered and family-centered care are reviewed. Lessons learned from the various iterations of client-centered and family-centered care are posed for consideration of a newer more inclusive relationship-centered concept for occupational therapy.     

Family Resilience: Israeli Mothers' Perspectives

This qualitative study reveals the components underlying the concept "family resilience" based on the perception of Israeli women in families who underwent a crisis in the past year. The study is based on the analysis of 15 semi-structured interviews using grounded theory methods. Five main components were identified as family resilience was perceived in terms of (a) interpersonal relations; (b) the ability to share painful feelings, (c) flexibility among family members; (d) connectedness; and (e) family's values. These components have practical implications for professionals working with families that are encountering stressful life situations.     

Reducing infant immunization distress through distraction.

Infant procedural distress is largely understudied, and there is a dearth of empirically supported interventions in the child health psychology literature. This study examined nurse-directed distraction for reducing infant immunization distress. Ninety infants and their parents were randomly assigned to a distraction condition (i.e., nurses used stimuli to divert infants' attention) or a typical care condition. Outcome measures were an observational scale, parent and nurse ratings, and infant heart rate. Results indicated that infants engaged in distraction and that distraction reduced their behavioral distress; however, ratings and heart rate were inconclusive. Analyses of procedural phases indicated that infants exhibited elevated distress immediately prior to and during an injection, but this distress was fleeting.     

Nonsuicidal Self‐Injury in College Students: The Role of Perfectionism and Rumination

A paucity of research exists examining personality and cognitive characteristics that may contribute to nonsuicidal self‐injury (NSSI). The purpose of the current study was to clarify the contribution of perfectionism and rumination, along with depression and anxiety, to NSSI within a sample of 170 college students. Group comparisons revealed that participants with a history of NSSI endorsed significantly more rumination and depressive and anxious symptoms then non‐NSSI controls. Results regarding perfectionism were mixed, with NSSI participants differing from controls on select aspects of perfectionism. Results suggest higher levels of depression and anxiety and a ruminative cognitive style may increase vulnerability for NSSI; however, further research is needed to clarify the contribution of perfectionism.     

Our Immigration and Human Rights Work Group in Action: Psychoanalysts Evaluating Asylum Seekers,Trauma and Family Devastation

ABSTRACT

This paper presents the story of a family of four refugees from Central America seeking asylum in the United States, and of the experience of a group of psychoanalysts, members of the New York University Postdoctoral Program Immigration and Human Rights Work Group, who evaluated each member of the family and wrote affidavits in support of their applications for asylum. The work described provides an example of how clinicians can apply their skills and understandings outside the consulting room to address the dire needs of refugees who have fled from their homes. We discuss the process of refugees seeking asylum and the role of a psychological evaluation in the asylum process. We elaborate on the content and process of the evaluations of each member of the family with a focus on the trauma suffered and its sequelae on two school-aged children, their adolescent aunt, and their courageous and protective mother. We also address the analysts’ experience of doing psychological evaluations and writing affidavits for asylum seekers who have experienced trauma.     

Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer.

The authors report a 3-year follow-up of the effects of 8-week support group interventions on the quality of life of women with early stage breast cancer. Shortly after diagnosis, women were randomly assigned to 1 of 4 conditions: control, education, peer discussion, and education plus peer discussion. The education group intervention focused on providing information to enhance control over the illness experience, whereas the peer discussion group intervention focused on providing emotional support through the expression of feelings. Consistent with the results that emerged 6 months after the interventions (V. S. Helgeson, S. Cohen, R. Schulz, & J. Yasko, 1999), the authors found that the benefits of the education intervention were maintained over a 3-year period (N=252), although effects dissipated with time. The authors continued to find no benefits of the peer discussion intervention, either alone or in combination with education.