Abstract The term aftercare is largelyexplained by means of the contextual and ideological conditions for treatmentwhich are to be found in juvenile care facilities. The development of the livesof young people who have been placed in care facilities is dependent ontherapeutic relationships, professional separations, continuing follow-ups andan even transition from control to autonomy. The aim of this study was toexamine the steering mechanisms behind the execution and planning of aftercareat a youth facility for care or residence. The aim was further defined throughthe specification of the following questions: 1. How are the concepts ofresocialisation and aftercare define and delimit? 2. What criteria, standpointsand underlying reasons form the basis for the development of resocialisationand aftercare? 3. What characterises the work of the staff during the treatmentprocess? 4. What implications and specific needs are highlighted in the work ofresocialisation and aftercare?  The studyis based on a qualitative methodology where five semi-structured in-depthinterviews were carried out. The result shows that the organisation itselfdefines the concepts of resocialisation and aftercare through an integratedtreatment process. The core of the process consists of relational andstructurally close therapeutic work which forms the basis of a developmentalprocess in which the young person moves towards an independent life. It ishowever clear that the therapists experience the separation between therapistand young person as being problematic. Further, there is an expressed demandfor clearer time frames for finishing the process, more even transitionsbetween the treatment and structures and demands of the aftercare, and fordevelopmental work with the young persons’ networks and socialisation tocontinue. In the final discussion an integrated and investigatory clarificationof the implications of the aftercare process is suggested.    Key words: aftercare, youth, treatment,facilities, separation, therapeutic relationships / Sammanfattning Begreppeteftervård förklaras i hög grad via de kontextuella och behandlingsideologiskavillkor som råder på de ungdomsvårdande institutionerna. Institutionsplaceradeungdomars livsutveckling är beroende av terapeutiska relationer, professionellaseparationer, återkommande uppföljningar och en jämn övergång från kontrolltill autonomi. Denna studie syftar till att undersöka styrande drivkrafter iutförandet och planerandet av arbetet med eftervård vid ett hem för vård ochboende för ungdomar. Syftet konkretiseras genom frågeställningarna: 1. Hurdefinieras och avgränsas begreppen utsluss och eftervård? 2. Vilka kriterier,ställningstaganden och bevekelsegrunder utgör grunden för utformandet av utslussoch eftervård? 3. Vad kännetecknar personalens arbete underbehandlingsprocessen? 4. Vilka implikationer och specifika behov uppmärksammasi arbetet med utsluss och eftervård? Studien bygger på en kvalitativmetodansats där fem halvstrukturerade djupintervjuer genomfördes. Resultatetvisar att verksamheten definierar begreppen utsluss och eftervård genom enintegrerad behandlingsprocess. Processens kärna består av ett relations- ochstrukturnära terapeutiskt arbete som blir utgångspunkten för en förändringsprocessdär ungdomen utvecklas mot ett självständigt liv. Det framgår emellertid attterapeuterna upplever separationen mellan terapeut och ungdom somproblematiska. Vidare efterfrågas tydligare tidsramar för avslut, jämnareövergångar mellan behandlingen och eftervårdens strukturer och krav samt attett fortsatt utvecklingsarbete med den unges nätverk och socialiseringfortskrider. I slutdiskussionen föreslås ett integrerat och utredande synsättav eftervårdsprocessens implikationer.   Nyckelord: eftervård, ungdomar,behandling, institutioner, separation, terapeutisk relation

Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.

The purpose of this study was to determine if sensitivity training encouraged significantly more members to form mutually therapeutic relationships than did traditional group counseling, and to determine, if the members who formed the largest numbers of mutually therapeutic relationships increased both in self-awareness and self-actualization significantly more through sensitivity training than through the traditional form of group counseling. This study concluded from its findings that the sensitivity group members' relationships were more transitory or short-lived that were the relationships formed by the members of the traditional group. The formation of mutually therapeutic relationships, built on empathy, congruence, and positive regard, appeared to increase self-awareness, and a traditional form of group counseling may be better at achieving this than a sensitivity-training group. The sensitivity-training group appeared to deal best with material in the present, or "here-and-now," while the traditional group was more effective in dealing with intrinsic material outside the group and in the past.

Homelessness is a pressing social and health concern that affects Māori disproportionately. This research explores the provision of mental health services to Māori who are homeless. The thesis has two primary aims. First, to document the experiences of Māori homeless people who live with mental health concerns and their relationships with mental health professionals. Second, to document the experiences of mental health professionals and how they interact with, provide care for, and build relationships with Māori Homeless. The skills of, and the difficulties faced by these professionals in provisions of quality of care are also considered. Three male and three female homeless participants were recruited from the Waikato and Auckland regions. All participants had received care from Non Governmental Organisations (NGOs) and/or District Health Board services (DHB). Participating mental health professionals included one female and five males. Mental health professionals included counsellors, therapists, psychologists, social workers, crisis team coordinator, and a cultural advisor. All participants took part in individual semi-structured interviews conducted in an open and conversational manner. Key themes for homeless participants included their general life histories of mental illness, mental health service use, relationship with professionals, cultural issues, and concerns that Māori homeless wanted to discuss. Key themes for mental health professionals included their approaches when working with homeless people, relationship building, barriers to working with this group and possible solutions, linking with other professionals or organisations, and issues mental health professionals wanted to discuss. Findings highlight the importance of strong therapeutic relationships between homeless clients and mental health professionals, the need for more joined up (multi-level agency) approach to service delivery, and the importance of Māori ideology in restoring wellbeing and dignity. Findings suggest that the effectiveness of mental health service delivery relies in part on information provided by stakeholders. Information provided by homeless people and mental health professionals informs both service delivery and the ways in which practitioners can best support the needs of homeless people.

No description available.

This study used narrative inquiry to answer the question “What are the stories of older adults who choose not to share information with health care professionals?” The study explored the experiences of older adults who did not share information with health care professionals (HCPs), who they defined as doctors. A thematic analysis of five participants’ stories revealed three themes: Illusions of Care, describing the participants’ experiences with doctors before they chose not to share information; The Last Straw, revealing the final incident that caused participants to choose not to share information; and The Mask of the Non-sharing Older Adult, describing how participants interacted with their doctors after they decided not to share information. Relationship development between older adults and their doctors, sensitive topics, issues and perceptions of ageing, and structure of the health care system contribute to the complex issue of older adults not sharing information. The decision not to share information with health care professionals may adversely affect the health and health care of older adults.

This study used narrative inquiry to answer the question “What are the stories of older adults who choose not to share information with health care professionals?” The study explored the experiences of older adults who did not share information with health care professionals (HCPs), who they defined as doctors. A thematic analysis of five participants’ stories revealed three themes: Illusions of Care, describing the participants’ experiences with doctors before they chose not to share information; The Last Straw, revealing the final incident that caused participants to choose not to share information; and The Mask of the Non-sharing Older Adult, describing how participants interacted with their doctors after they decided not to share information. Relationship development between older adults and their doctors, sensitive topics, issues and perceptions of ageing, and structure of the health care system contribute to the complex issue of older adults not sharing information. The decision not to share information with health care professionals may adversely affect the health and health care of older adults.