This study was designed to collect information about the working relationship of otolaryngologists with speech pathologists who provide service to voice disordered clients.

Background: In Sweden, approximately 25 000–30 000 people suffer from a stroke every year. About a third of these get aphasia. Previous studies show communication problems between physical therapists and stroke patients with aphasia, which leads to difficulties in giving patients the opportunity to participate in their rehabilitation. There are few studies on how aphasia after stroke affects physiotherapeutic rehabilitation.  Objectives: To investigate a group of physical therapists' experiences of how aphasia affects the physiotherapeutic rehabilitation process after stroke, and how they feel that these patients have opportunity to participate in the rehabilitation.  Method: A qualitative design was used with a semi-structured interview guide followed by a qualitative content analysis. Six physical therapists in stroke care in three different regions, in inpatient and outpatient care were interviewed.  Results: Six main categories emerged from the interviews: Aphasia makes it more difficult to communicate, strategies for better communication with aphasia patients, teamwork is important in the rehabilitation process of aphasia patients - especially with speech and language therapists, how aphasia affects physiotherapists' examination and treatment measures, aphasia contributes to poorer patient participation and requires strategies for increased participation, and emotions in meetings with aphasia patients.  Conclusion: Aphasia is perceived to make it more difficult to communicate, which leads to difficulties in getting patients involved, even though the physical therapists together with the team use different strategies to improve communication and participation. Physiotherapeutic examinations are perceived as more difficult to carry out, but the exercise is not significantly affected by aphasia. / Bakgrund: I Sverige drabbas varje år cirka 25 000–30 000 personer av stroke. Ungefär en tredjedel av dessa får afasi. Tidigare studier visar på kommunikationsproblem mellan fysioterapeuter och strokepatienter med afasi vilket leder till svårigheter att ge patienterna möjlighet till delaktighet i rehabiliteringen. Det finns dock få studier kring hur afasi efter stroke påverkar den fysioterapeutiska rehabiliteringen.   Syfte: Att undersöka en grupp fysioterapeuters erfarenheter och upplevelser av hur afasi påverkar den fysioterapeutiska rehabiliteringsprocessen efter stroke, samt hur de upplever att dessa patienter har möjlighet att vara delaktiga i rehabiliteringen.  Metod: En kvalitativ design användes med en semistrukturerad intervjuguide följt av en kvalitativ innehållsanalys. Sex fysioterapeuter inom strokevård i tre olika regioner, inom såväl slutenvård som öppenvård intervjuades.   Resultat: Av intervjuerna framkom sex huvudkategorier: Afasi gör det svårare att kommunicera, strategier för bättre kommunikation med afasipatienter, teamarbete viktigt i rehabiliteringsprocessen av afasipatienter - särskilt med logopederna, hur afasi påverkar fysioterapeuternas undersöknings- och behandlingsåtgärder, afasin bidrar till sämre delaktighet för patienterna och kräver strategier för ökad delaktighet, samt känslor vid möten med afasipatienter.   Konklusion: Afasin upplevs göra det svårare att kommunicera vilket leder till svårigheter med att få patienterna delaktiga trots att fysioterapeuterna tillsammans med teamet använder olika strategier för att förbättra kommunikation och delaktighet. Fysioterapeutiska undersökningarna upplevs som svårare att genomföra, men träningen påverkas inte anmärkningsvärt av afasin utan de flesta patienter kan träna det som de behöver.

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This study investigated the impact of counselor smoking behavior upon nonsmoking clients' perceptions of therapists both during and at the conclusion of treatment. Clients' impressions when counselor smoking behavior was consistent across sessions and when counselors smoked in only the first or only the second interview were examined. In addition, the effect of therapists' smoking behavior on the outcome of counseling was assessed in two ways: changes in clients' career decisiveness and counselors' ability to influence client behavior. Eighty-two female undergraduates met with a vocational counselor for two sessions during which the counselor either smoked or refrained from smoking. Prior to the first interview, subjects completed the Behavioral Indecision Scale. Subjects then met and discussed their vocational concerns with a counselor. Following the interview, subjects completed the Counselor Rating Form and the California Occupational Preference System. The latter instrument, an interest inventory, was interpreted by the counselor during the second interview. The Counselor Rating Form and the Behavioral Indecision Scale were again administered following the conclusion of treatment. Data were analyzed by 2 (counselors) X 2 (conditions) X 2 (interviews) multivariate analyses with repeated measures on the third factor. No significant differences emerged for clients' perceptions when the counselors' indulgence in or restraining from smoking was constant from the first to the second sessions. Similarly, clients' impressions did not differ in relation to the inconsistency of counselors' smoking behavior from the first to the second interviews. In addition, subjects' compliance to a counselor initiated behavioral task and reported certainty of career choice were not differentially affected by counselors' smoking behavior. In conclusion, this study suggests that it makes no difference in nonsmoking clients' impressions of therapists and in counseling outcome if the latter smoke during treatment. Suggested variables to further explore include the effects of counselors' smoking in brief and extended psychotherapy, the impact of therapists' smoking implements other than cigarettes, and smoking clients' perceptions of smoking therapists.

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This mixed-methods study sought to examine the impact of learning the Internal Family Systems (IFS) model on novice therapists' self-of-the-therapist work. Criterion sampling was used to recruit participants enrolled in an IFS graduate course in Virginia Tech's Marriage and Family Therapy (MFT) Program. Participants completed three sets of questionnaires (Self-Compassion Scale, Five Facet Mindfulness Questionnaire, and Professional Quality of Life Scale V. 5) both before and after completing the course. Twelve of the 23 participants volunteered to contribute to the qualitative portion of this study in semi-structured focus groups or individual interviews. The qualitative data were analyzed using grounded theory to assist in building theory for whether and how IFS can build awareness of internal process and increased self-compassion in novice therapists, therefore contributing to their self-of-the-therapist work. The quantitative data reported an increase in Self-Kindness, Common Humanity, Mindfulness, ability to Describe one's experience, ability to Act with Awareness, and the ability to be Nonjudgmental and Nonreactive of one's experience after participants completed the IFS course. The quantitative data reported a decrease in participants' Self-Judgment, Over-identification, and Secondary Traumatic Stress after completing the IFS course. The qualitative data supported these findings. The themes that emerged for the qualitative data were an increase in Self-Leadership, Improved Relationships, and an increase in Self-Compassion. Overall, participants reported gaining greater awareness of their internal process and increasing their ability to be self-compassionate, which they report impacted and contributed to their self-of-the-therapist work. Limitations, clinical and training implications, and future directions for research are discussed. / Master of Science

The purpose of this study was to analyze how senior instructors in physical therapist educational programs in northern California define and seek to impart to students information about professional behavior. Towards this end a qualitative investigation was conducted using case study methodologies. The researcher conducted interviews with 8 instructors teaching in 4 physical therapist educational programs in northern California. Each interview was analyzed as an individual case study, followed by a cross case analysis to identify common themes. From this analysis nine common themes emerged: (1) instructors found it difficult to broadly define professional behavior. (2) instructors expect students to be on time. (3) instructors expect students to speak and act with courtesy and respect. (4) instructors expect students to communicate appropriately. (5) instructors expect students to dress appropriately. (6) instructors expect students to participate in class. (7) instructors consciously model professional behavior as a way to communicate their expectations. (8) Instructors give instructions and provide students with feedback about professional behavior. (9) instructors do not attach a specific grade to professional behavior. Instructor perceptions that professional behavior was difficult to define was consistent with existing literature, as was their reluctance to grade professional behavior. Behavioral expectations that emerged as themes in this study fit within existing descriptions of professional behavior for physical therapists, specifically the core values adopted by the American Physical Therapy Association. This relationship suggests that the core values document may be used as a framework through which classroom professional behavior can be viewed. Instructor perceptions of strategies for conveying information about professional behavior to students were consistent with existing literature on modeling and explicit teaching. Based on the results of this study, a five-step process is proposed to facilitate appropriate professional behaviors by students in the classroom: (1) define program expectations for professional behavior. (2) move from theory to practice. (3) intentionally and consistently model desired behavior. (4) provide immediate feedback and incremental consequences. (5) consciously plan for faculty interaction.

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