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1.
A therapy research team interviewed a therapist in the presence of a couple. Following each of six consecutive sessions with a couple, an interviewer posed questions to the therapist and couple. While one question was standard to each interview, other questions were generated by team members who tracked the entire process via live observation. These questions were directed first at the therapist, then at the couple, and then focused on therapeutic process and outcome. Findings of this process for the therapy system included decreasing the hierarchy within the client/therapist relationship; increasing the client ownership and energy in the therapy process; discovering the presence of parallel processes between the systems; and informing the direction of future therapy sessions. Practical, clinical implications are discussed for a variety of therapy settings.  相似文献   
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Research has failed to consistently show that therapists facilitate better client outcomes as they gain more experience. The present study was designed to examine changes in early client retention over the course of extended periods of time among 2591 therapists in private practice. Naturalistic data collected between 2018 and 2022 was extracted from a technology-enabled practice-research group (PRG). Therapists displayed an increase in client dropout rates as they gained more experience on the PRG. Additionally, larger caseloads on the PRG were associated with lower increases in client dropout over time. Finally, therapists working with clients paying higher out-of-pocket fees (e.g., co-pays) had higher increases in client dropout over time. These findings provide additional evidence supporting the distinction between clinical experience and expertise.  相似文献   
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Although creativity is an important aspect of occupational therapy theory and practice, there have been few studies that would explore this concept in the context of the occupational therapy process. This was the first qualitative study of creativity in occupational therapy in Slovenia. It was conducted as part of a larger mixed-methods study and included 22 experienced occupational therapists who participated in four focus groups. The focus of the study was on the exploration of different factors that could contribute to creativity and creative strategies in occupational therapy, in either a positive or a negative way. Since occupational therapy promotes a client-centered therapy approach, the role of the client as the motivating factor was of particular interest to our study. Six factors that can influence the creativity of occupational therapists emerged from the qualitative analysis (Strauss & Corbin, 1990). While the client was identified as the key factor, the potential of other factors was also recognized. This qualitative study increased the understanding of the concept of creativity and creative behavior in occupational therapy, and also provided empirical material that formed the basis for the development of a questionnaire on creativity in occupational therapy.  相似文献   
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The purpose of this study was to investigate how symptom distress, social role, interpersonal relationships, gender, age, number of supports, and education level predict client attrition in a community sample. Using binary logistic regression and cross-sectional data, the authors examined the predictive impact of 8 variables on adult client attrition in a university-based community counseling clinic. Results indicated that education level, interpersonal relationships, and number of supports significantly predicted attrition. In this sample, gender, age, symptom distress, social role, and race did not significantly predict attrition. Implications for clinical assessment and counseling practice are discussed.  相似文献   
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ABSTRACT

Demotion has received little attention from scholars and practitioners alike. The purpose of this study was to assess empirically the reaction to, and outcomes of, both involuntary and voluntary demotion. Drawing on 49 semi-structured in-depth interviews with 28 involuntarily demoted workers and 21 voluntarily demoted workers, we develop a conceptual model using organizational justice theory and person-job fit of the reaction to and outcomes of demotion. We show that involuntarily demoted individuals might react by expressing turnover intentions and lower motivation and commitment, indicating that the demotee’s reaction is related to perceptions of fairness. Voluntary demotion is related to a better work-life balance, greater satisfaction, less stress and burnout and is perceived to be a viable phased retirement option by older workers. In addition, the findings highlight the role of demotion-related stigma, status loss, identity threat, and age in the way employees react to the experience of demotion.  相似文献   
6.
    
Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.  相似文献   
7.
In virtually every kind of psychotherapy, therapist and client attend mainly to one another throughout almost the entire session. If each experiential session is to be successful in enabling the person to become the whole new person that the person can become, and to become free of the painful feeling in the painful situation, the radical alternative is for the experiential teacher–therapist and the person to attend mainly to the third thing that is the important center of attention for the person. An even more radical glimpse into the future includes the person having one's own sessions by oneself, complemented by skill-development sessions with the experiential teacher.  相似文献   
8.
Genetic counseling and the many roles a genetic counselor must assume to provide quality genetic health care are becoming increasingly complex, especially when the genetic condition is rare, and DNA testing is costly and not yet routinely used. A case study of a couple with a family history of retinoblastoma and their pursuit of DNA testing for prenatal diagnosis is presented. The case study illustrates the instrumental role of the genetic counselor in advocating for clients for genetic services such as DNA testing and in educating insurance companies in the nature and importance of such services to achieve improved client health care outcomes.  相似文献   
9.
The present paper explores elements of traumatic separation associated with involuntary migration by individuals and groups. Loss of home, one's sense of security, familiarity, and historical continuity—without physical threat or actual injury—is examined within a cultural and historical context. The author addresses the complex implications of traumatic separation by conscious human choice, rather than natural processes, such as the poisoning of nostalgia, the process by which normal mourning of loss is undermined by a potentially transgenerationally enduring sense of betrayal of trust.  相似文献   
10.
Burnout represents a potential risk for counsellors and psychotherapists in their work with distressed clients. In the research reported here, the relationship between spiritual well-being and burnout was explored, with attention paid to clinicians’ perceptions of trauma. Eighty-nine Australian counsellors and psychotherapists (71 females and 18 males) completed a demographic survey, the Maslach Burnout Inventory, and Spiritual Well-Being Scale. It was found that existential well-being accounted for some of the variance in MBI subscale scores, and buffered the effect of trauma on emotional exhaustion. In addition, clinicians who reported high levels of existential well-being reported being better able to avoid emotional exhaustion when working with severely traumatised clients.  相似文献   
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