Scholars since the 19th century have focused on the provision of care in group homes and have demonstrated that structure (that is, the staff, facilities, and equipment), is critical in the delivery of care. The researchers, however, advocate doing for, rather than doing with the clients the activities that address the clients' welfare. The purpose of this study is to investigate how a client-centered approach would affect the quality of care delivered to the mentally challenged individuals (MCIs) in a group home. The study employed the quality-care framework in which the emphasis is on structure (skills), process (efficiency), and outcome (results). The research questions examined operational values underpinning company sanctioned work processes, how personal values underpin work processes of the direct caregivers, configuration of personal values the caregivers believe should be supported in the group home context, and how critical incidents shaped the value set of direct caregivers in regard to care processes. Using structured questionnaires and observing staff as they delivered care to their clients, data were collected from participants who were direct caregivers (n = 7), a facility administrator, and a nurse. The data were coded, categorized, and analyzed for emergent themes. The results of the analysis indicated that there was discord between staff and the organizational leadership. This discord could be improved through increased interaction between the mentioned stakeholders. The results further depicted that client-centered care may have a positive impact on the health of the MCIs that would enable the MCIs to make notable contributions to social change.

This study was concerned with determining the effectiveness of play therapy as measured by behavioral changes in interpersonal relationships, mature behavior patterns, and more adequate use of intellectual capacities. Client-centered play therapy appears to have grown out of the concept that it is the relationship between the therapist and the child that brings about change and growth. Rather than diagnostic or as preliminary to therapy, the relationship itself is seen as therapy. Problems are seen not in terms of their historical past, but rather as they exist in the immediate present and in terms of the child's own means of expression. The relationship offers to the child the opportunity to experience growth under the most favorable conditions. Like its adult counterpart, client-centered counseling, client-centered play therapy is based upon the hypotheses that the individual has within himself the capacity for growth and self-direction, and that these growth impulses are released within the therapeutic relationship established between the therapist and the child. This study was conducted to investigate changes in behavior which occur as a result of play therapy and to determine that such changes do not occur in the absence of play therapy. It was a direct outgrowth of an ongoing program developed at the Pupil Appraisal Center of North Texas.

This qualitative study aimed to investigate psychotherapy clients’ phenomenological experience of positive regard. Though positive regard is broadly accepted as a useful and effective clinical tool across orientations, it has been under-researched and overlooked in favor of more clearly conceptualized variables, such as empathy and working alliance. Designed as a follow-up to a quantitative study that yielded a tentative factor structure and inventory for measuring positive regard (Psychotherapist Expressions of Positive Regard, PEPR), the study also aimed to elucidate the extent to which those findings could be replicated in a qualitative format. Following Consensual Qualitative Research (CQR) methodology, 15 psychotherapy clients, primarily white women, participated in semi-structured interviews eliciting the factors that contribute to their experience of positive regard in therapy, the absence of positive regard in therapy, and the impact of positive regard on the course of psychotherapy. Nine domains and several key findings emerged from the analysis. While clients named a wide range of therapist behaviors and actions that served as markers of positive regard in the relationship, three constituent attitudes appeared repeatedly throughout the CQR categories, suggesting an underlying tripartite structure of positive regard – warm authenticity, flexible responsiveness, and empathic understanding. Clients viewed positive regard as a crucial ingredient of therapy, suggesting that it facilitates self-disclosure, risk-taking, personal growth, and rupture resolution. In relationships where positive regard was lacking, clients became disengaged from treatment, and terminating without explanation was not uncommon. Clinical implications and recommendations for optimizing the experience of positive regard are offered. The substantial overlap and interdependence of positive regard with the other Rogerian facilitative conditions of congruence and empathy is discussed. Convergence and divergence between the PEPR factor structure and the results of the current study are also highlighted, with future directions proposed.

An extensive body of literature supports the clinical utility and feasibility of client-centric goal-setting techniques in neurorehabilitation. However, such techniques are seldom used and difficult to adopt in mainstream clinical practice. Two primary barriers that limit uptake and adoption of individualized goal-setting techniques into routine practice include: (1) lack of an operationalized framework susceptible to variations in the characteristics of the user and constraints of a medical setting and (2) limited knowledge on the part of clinicians and clients to confidently engage in goal-setting conversations. The eGAS app was designed to address the need for a semi-structured client-centric goal-setting framework for clinicians engaged in neurorehabilitation. This study used a single-subject design to investigate the effects of using eGAS in an outpatient hospital setting on clinician behavior and client responsiveness. A nonconcurrent, multiple-baseline design was used across three clinicians to determine if use of eGAS would result in functional changes in collaborative interviewing behaviors, validity of generated goal scales, and reliability of the process. Results revealed that using eGAS had strong functional effects on collaborative interviewing behaviors and validity of goal scales, and a weak effect on reliability. Another noteworthy finding was that eGAS could be implemented with relatively high fidelity within the constraints of a clinical context despite variations in the characteristics of the end-user, i.e. clients and clinicians. I discuss support for ecological validity of eGAS in terms of implementation barriers and facilitators that affected outcomes, methodological limitations, and future steps to improve design validity and implementation integrity.

Thesis (M.A.)--York University, 2001. Graduate Programme in Psychology. / Typescript. Title from certificate page: Both sides of the coin : comparative analyses of narrative process patterns in poor and good outcome dyads engaged in brief experiential psychotherapy for depression. Includes bibliographical references (leaves 182-193). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ66392.

Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references (leaves 59-70). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references (leaves 59-70). Also available on the Internet.

Thesis (M.A.)--University of Texas at El Paso, 2009. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1970. / Vita. Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

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