Mental Health and Adverse Childhood Experiences

The theoretical basis of occupational therapy interventions was investigated in two mental health facilities in the Midwestern United States. Using retrospective cohort and grounded theory designs, 121 medical records were reviewed and five occupational therapy practitioners were interviewed. Theoretical reasoning was not explicitly documented, but according to analysis, the behavioral/cognitive-behavioral model, client-centered models, and the model of human occupation were the most frequently used theories to guide interventions. Lack of documentation of theory use has significant implications for the value accorded to occupational therapy skills in health care. A larger study is recommended to increase external generalizability of the findings.     

Three Views of Artful Practice in Psychosocial Occupational Therapy

This qualitative study explored artfulness in the psychosocial practice of three occupational therapists through in-depth observation and interviews. Analysis focused on the therapist-client relationship, activity use, self-reflection, and the change process. Each therapist established an interpersonal connection while offering meaningful, engaging activities. In addition, each brought a distinct and unique personal view to treatment. Findings suggest that the art of practice in occupational therapy is constructed by the therapist's integrated balance of substance, form, and vision to achieve a coherent whole, which positively influences the personal views of substance, form, and vision in clients.     

Beyond Hopelessness

Abstract

The researchers conducted a needs assessment survey of practicing school-based occupational therapists to determine the incidence of grief within existing caseloads, current awareness of the issue, related concerns, and willingness or resistance to address grief in the intervention environment. The survey was administered to a representative sample of 150 school-based therapists throughout the state of Ohio. Fifty-six therapists responded with usable data.

The results suggest that the students who are currently on occupational therapy (OT) caseloads face a large number of grief issues. Although a majority of therapists reported addressing grief issues, only a small percentage typically do so for a variety of reasons. The school therapists offered a number of explanations for the limited follow-through on this issue. These findings support the profession's recent efforts to further establish occupational therapy as a well-recognized and respected provider of interventions to address the mental health and psychosocial needs of children in school settings.     

Being ordinary in extraordinary places: Reflective practice of the total situation in a total institution

This paper examines a ‘Foulkesian type’ Balint group for psychiatry trainees set in a high secure forensic hospital. Within a Balint group, group processes and dynamics are not examined. Deviation from this format is construed as resistance, and destructively getting in the way of the primary task.

This paper reports on a case‐based reflective practice group operating on a more Foulkesian group analytic model and argues that the revised principles of method proposed here – paying attention to context; group processes; and creating an atmosphere where group curative factors are in play – can help trainees to sustain an emotional reservoir for their patients. Further, these principles do not get in the way of the primary task but can add to an understanding of the individual transference and counter‐transference issues, and can place these in context within the organization and society. This is particularly important in total institutions such as forensic units.

Clinical material from this group is used to support this claim.     

Critical Issues in Causation and Treatment of Autism: Why Fads Continue to Flourish

The increasing incidence of autism and the lack of specific answers regarding causation have given rise to unproven educational interventions and medical treatments. Parents of a newly diagnosed child can easily fall prey to interventions that promise cures. These interventions may be harmful and, thus, pose one of the critical issues in special education today. This article will discuss some of the suspect interventions that have been popularized through the media (i.e., celebrities, journalists, and professional organizations). The authors argue that using the scientific method is clearly the antidote for pseudoscience; the need for accurate research-based decision making is apparent.     

Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.     

Conceptualizations of Social Class in Afrtican American Women:

This article addresses the multiple definitions of social class in African American people and how the therapist's understanding of these definitions is important in therapeutic interventions with African American women. The article discusses: (a) the traditional ways in which social class has been defined in social science and the limits of these conceptualizations; (b) the multiple definitions of class within the African American community; and (c) treatment concerns for African American women based on class issues. Clinicians working with African American and other women who vary by class should be able to assess how class variables influence their therapeutic interventions with these women.     

Fostering Feminist Principles in Our Community

SUMMARY

In a recent focus group discussion at the Feminist Therapy Institute conference participants outlined a vision for a future community based on feminist principles. It is built on five critical ideals, including more equitable distribution of resources, genuine respect for human diversity and varying world views, caring and compassionate members, increased connections and collaborations, and political/personal empowerment. While the challenges inherent to such vision must be acknowledged, greater attention will be placed on ways in which we can begin to foster environments and micro communities that are conducive to feminist practice and ideology.     

Mandatory personal therapy: does the evidence justify the practice? In debate

ABSTRACT

The article addresses the question of whether the practice of mandatory personal therapy, followed by several training organisations, is justified by existing research and evidence. In doing so, it discusses some implications of this training requirement from an ethical and ideological standpoint, raising questions of import for training organisations and highlighting avenues for further research.     

Women's views about intimate examinations and sexually inappropriate practices by their general practitioners

Abstract

The aim of this survey of 472 adult women was to assess women patients' feelings about intimate examinations and their perceptions and experiences of sexually inappropriate medical practice. Two-thirds of women preferred a women doctor for intimate examinations. Slightly more than two-thirds found intimate examinations embarrassing and stressful, and strongly expressed the need for information and on-task, health-related comments during these examinations. General personal comments or non-medical touching were not particularly welcomed, even for the purpose of comforting the patient. There was a range of views about patients' personal relationships with doctors, with the lines between acceptable and unacceptable behaviour somewhat ambiguous. A small but significant number of women perceived that they had been sexually harassed (5%) or abused (3%) by a doctor, with this experience more common for non-English speaking women. Results were discussed in terms of implications for improved doctor practice, particularly during intimate examinations and with vulnerable patients.