This study explored how psychodynamically oriented therapists understand and work with negative racial sentiments arising in traumatized clients. One of the aims of the study was to highlight and examine the technical, countertransferencial and ethical dilemmas faced when a patient brings ‘politically difficult’ material infused with negative racial sentiment to therapy. It was hoped that information gleaned would contribute to theoretical and technical understanding of this phenomenon and assist in working with such negative racial sentiments. In order to investigate the research questions eight therapists who identified themselves as ‘psychodynamically-oriented’ participated in semi-structured interviews on the topic of negative racial sentiment (NRS) in therapy. The study was located in the qualitative research tradition, and interview transcripts were subject to a critical thematic content analysis. The main themes were identified and presented under three sections, namely: how therapists understand, work with and respond to the phenomenon of NRS in traumatized clients. Understandings included the formation of NRS as inter alia reflecting the use of defenses such as splitting, projection, projective identification, the triumph of the bad object and a breakdown in the capacity to symbolize. Tensions in understanding the phenomenon of NRS post-trauma and related latent themes were also identified. Therapists’ approaches to working with NRS included the use of a range of implicit assessment criteria such as, whether, for example, the patient’s response was experienced as ego-dystonic or ego-syntonic. Technical strategies for intervention included adherence to a working model, interpretive interventions and cognitive strategies. The participating therapists’ countertransferential responses to negative racial sentiment were categorized, taking the form of: negative feeling towards or disidentification from the patient; negative feeling towards the perpetrator or identification with the patient and therapeutic impasse. Some guidelines proposed by the participating therapists for managing NRS, as it occurs in psychotherapy with traumatized clients, are presented.

A research report presented to the Department of Speech Pathology and Audiology, Faculty of Arts, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirement for the degree Master of Arts in Speech- Language Pathology by Coursework / Health care professionals are expected to apply ethical principles such as nonmaleficence, beneficence, autonomy and justice in their teaching of students and treatment of clients. Speech Pathologists and Audiologists (SPAs) in South Africa are responsible not only for educating members of their profession, but are often also involved in the training of Community Rehabilitation Workers (CRWs). Hence the aim of the present study was to explore the experiences, opinions and attitudes of a group of SPAs and CRW co-ordinators with particular reference to ethical issues related to CRW training. In order to investigate this aim. an interview schedule followed by a questionnaire were administered to SPA and CRW co-ordinators who had been involved in CRW training at The Wits/Tinstwalo CRW Training Programme in Gazankulu and at The Institute Of Urban Primary Health Care in Alexandra Township. Data elicited from the interview were analysed using content analysis and responses categorized according to respondents' background in ethics and knowledge regarding ethical principles. Results are discussed in terms of their implications for SPA and CRW co-ordinators. / Andrew Chakane 2018

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Child welfare agencies are responsible for the overall care and custody of children removed from their caregivers due to substantiated child abuse allegations. After the children are removed it is standard department procedure to offer court mandated reunification services. The only exception of this is when parent’s rights are terminated. Both the parents and children are ordered services based on the needs of the family. These services include but are not limited to parenting classes, drug treatment, and therapeutic services. The purpose of this study is to examine whether families in different geographic areas, who are referred to different therapeutic providers, experience different reunification rates. The agency that provided the data for this study presumed that families in more affluent zip codes are more likely to be served by licensed therapists, while families in less affluent zip codes are more likely to be served by interns or unlicensed professionals, and that this difference in providers would lead to greater reunification rates in the more affluent zip code. The study used data collected from client case files at a local child welfare agency. This data included clients from two distinct zip codes - one more affluent and one less affluent - as well as basic demographic and outcome information on the client’s case. After data was gathered a chi square test was utilized to compare the outcomes for clients in the two zip codes. It was initially presumed that families in lower socioeconomic areas were referred to non-licensed therapeutic providers such as interns and this may have impacted their reunification. However, the analysis revealed that families in the less affluent area were more likely to reunify than families in the more affluent area. These results were statistically significant and support the first part of the agency’s hypothesis, that families in different zip codes experience different reunification rates. However, these findings do not support the agency’s hypothesis that families in more affluent zip codes have higher reunification rates. Rather this study found the opposite: that families in the less affluent zip code had higher reunification rates. Implications for social work practice and research are discussed.

The purpose of this study was to explore perceptions of adolescent's motivation to change in therapy, specifically while residing in a residential treatment center (RTC) and participating in family therapy. Motivation for change was examined in three contexts. The first context for examining the adolescent's motivation for change was in re lat ion to their stage of therapy. The second and third contexts for examining the adolescent 's motivation for change was in relation to perceptions the adolescent's therapi st and parent had of their motivation to change. In addition, the study explored whether there was a relationship between the congruence of perceptions of motivation to change between adolescent and therapist, and adolescent and his or her parent with the adolescent's progress in therapy. A sample of I 0 adolescent clients in a RTC completed the University of Rhode Island Change Assessment (U RICA). The sample also included the adolescents' I 0 parents and four therapists. Parents and therapists completed revised lr versions of the URICA developed to obtain therapists' and parents' perceptions of adolescents' motivation to change. The findings indicated that most adolescents reported scores suggesting that their level of motivation would be classified as in the preparation stage of change. Data from the study also suggested that therapists and parents perceived adolescents as higher on the pre contemplation sub scale ofURICA than the adolescents perceived themselves. No support was found for the theoretical relationship between congruence in perceptions of motivation and progress in therapy, but future research needs to determine if a relationship exists given the inability to examine this relationship statistically due to limitations of the study. Considerations for future research are given along with implications for marriage and family therapy.

Physiotherapists in New Zealand are increasingly learning and practicing Western acupuncture. Western acupuncture as a new and different tool is enhancing and yet challenging physiotherapists practice. This study explores the meaning behind Western acupuncture practice to further understand the implications of its development and possible future direction.Hermeneutic methodology was used because it facilitates the exploration between that which is familiar and that which is unfamiliar. Seven New Zealand physiotherapists qualified to practise Western acupuncture were interviewed about their practice experiences. The data in relation to the phenomenon of inquiry was analysed thematically.The findings revealed a complex array of tensions within physiotherapy because of the differences Western acupuncture brings to physiotherapists' practice. Western acupuncture is a new and useful tool in the physiotherapists 'toolbox'. It is congruent with other physiotherapy practices in that it shares the same scientific neurophysiological foundation. However, the association of Western acupuncture with traditional Chinese acupuncture causes it to be viewed as a complementary medical practice and thus, not completely legitimate as a part of physiotherapy. These tensions are further confounded because the technical rationalist paradigm, upon which physiotherapy is based, values evidence-based practices. The best evidence is perceived to be that gained from the randomised controlled trial. I argue that the randomised controlled trial is poorly suited to the evaluation of complex practices such as Western acupuncture. Such insights also challenge physiotherapy, as a whole, because the available 'evidence' does not acknowledge the complexities of practice involving individual practitioners, their colleagues, the profession, other healthcare professions, patients and the public.The tensions encountered in physiotherapy and Western acupuncture practice have led to a number of recommendations in education, practice, research and legislation. Overall, they suggest a need to develop a more inclusive model of practice development. Western acupuncture is a potentially valuable tool. In order to maximise use of this tool physiotherapy practice understandings need to be extended. This in turn, will assist development of the profession as a whole.

Thesis (Ed. D.)--Illinois State University, 2006. / Title from title page screen, viewed on April 27, 2007. Dissertation Committee: Kenneth Jerich (chair), Adel AL-Bataineh, Fabiola Ehlers-Zavala, Heidi Harbers. Includes bibliographical references (leaves 93-98) and abstract. Also available in print.

Nowadays, thanks to medical advances, the wounded mortality reduces, make patients tide over the crucial moment of life and extend the lifespan, and inability in the work or life. Because the pressure and interpersonal relationships are estranged, the numbers of people who suffer from psychological disease are rising continuously as well as accompanied by the failing of the physical and psychological function and social adaptive capacity. In addition, children¡¦s obstacles of body movement, the development of mind, life, study, interpersonal relationships and behavior will influence their development and learning ability. Those who have obstacles of physical and psychological and social function must rely on the treatment of occupational therapists to get back to normal and independent life. The education of the occupational therapists is the same, but the work performances of the different occupational therapists let the patients, relatives, and colleagues feel differently. Why is the evaluation of the different occupational therapists received so different? According to human resource management, this kind of difference may come from different occupational therapists possess different competence. This research adopts the critical incident method and distinguishes the differences of the occupational therapists who perform excellently and others who perform generally. It compares two groups the difference of occupational therapists, and then learn what the competence that outstanding occupational therapists possess. The result of study finds the specialties of outstanding occupational therapists most tally with the specialties that the literature mentions. The occupational therapists have deeper involved in treating, including attention of the motive of the function rebuild, paying attention to the construction of treating atmosphere, the acumen of the case problem and dealing with voluntarily, considering the most greatly of case interests, cordial participation of daily life and social experiences. The following are conclusions of the research. To improve the performance of the general occupational therapists can refer to the performance of the outstanding occupational therapists. The differences of the occupational therapists in different fields are supposed to be the differences of the cases and the expectation of the relatives. In addition, occupational therapists and relatives of the case are the teacher and friend's relationship; it has a delicate change in different field categories even more.

Thesis (Ph. D., Education)--University of Idaho, April 2009. / Major professor: Jerry McMurtry. Includes bibliographical references (leaves 160-174). Also available online (PDF file) by subscription or by purchasing the individual file.

Little research has explored the dilemmas of practice experienced by practitioners working with rehabilitation clients who are assimilating disabilities, resulting from injury or chronic conditions, into their lives. Consequently, there is limited literature to support educational initiatives or clinicians' decision-making in these settings. Accordingly, this qualitative study was designed to explore 'expert' physical therapists' perceptions of dilemmas of practice in rehabilitation settings. Using an ethnographic design, multiple interviews were conducted over a period of six months with each of ten participants. The researcher's theoretical background and 'insider' role were thoroughly explicated. Interpretive analysis was grounded in three overarching themes that emerged from the participants' accounts and compared with relevant theoretical constructs and research in physical therapy and other health professions. In the first theme the 'authority' of the concept of evidence-based practice as it is currently promoted within physical therapy was questioned. A need was identified to develop rigorous alternative sources of 'evidence' to support current practice that are more congruent with the multifactorial and client-centred nature of rehabilitation service provision. A second theme explored situations interpreted as causing moral distress in which the participants found themselves prevented from acting effectively on behalf of the clients, as a result of admission and discharge decisions and perceived misuse of rehabilitation resources within the organization and health system. The third theme related to the advantages and disadvantages of being involved with the interdisciplinary team. A lack of understanding of different professional philosophies of practice was perceived as a contributing factor to conflict and miscommunication. These themes are related to issues of professional accountability and suggest that physical therapy needs to develop a clearly articulated philosophy and conceptual models, including the concept of client-centred practice, that would reflect practice, serve to guide research and promote interdisciplinary collaboration. Alternative sources of 'best' evidence need to be developed that more realistically reflect complex 'practice' knowledge. In addition, the profession needs to commit to developing a comprehensive ethics curriculum offered in education programs and through interdisciplinary learning opportunities, by which physical therapists will be better prepared for the moral deliberations inherent in their professional role.