The diversity of ethnic and cultural groups and the effects of language in the therapeutic relationship are timely professional issues of concern to occupational therapy practitioners. The tri-ethnic, tri-cultural South Florida area offers a natural environment where one can study how patient-therapist interactions are influenced by language barriers in a diverse society. This study examines the effects of language on the adequacy of occupational therapy services, specifically how language affects the length of the treatment program. The nature of diagnosis therapists' ethnicity, and how they impact treatment outcomes are also addressed. A sample was drawn from the occupational therapy outpatient department of a large county hospital. Data taken from patients' charts examined race, sex, age, diagnosis, and language. Number of treatment sessions and length of treatment were viewed as proxy measures for adequacy. Findings indicate that the effect of language cannot be understood aside from ethnicity. Implications for occupational therapy practice are discussed.

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<p> This dissertation focused on the impact of aphasia on social inclusion in LTC facilities. Data were gathered and examined using a qualitative research methodology. This research design used several data collection procedures including participant observation, ethnographic interviews, videotaped conversations, and artifact analysis. These procedures preserved the authenticity of the data and allowed for thick description of social interaction as it unfolded in real-time. The results of these data were examined using categorization of the context and culture of each environment, community-based strategies used during social interactions, and the linguistic and interactive devices used during conversational interactions. The views, reactions, and affective reactions of IWA were also explored and discussed. Patterns emerged from the data that revealed the types of strategies that IWA employed to overcome contextual barriers within the nursing home environment. This study uncovered the importance of considering the contextual makeup of nursing homes when examining IWA and the value in exploring the on-line behaviors and strategies that are implemented by IWA as they negotiate social action within these contexts. This study has important implications regarding the value of qualitative research paradigms in investigating social access and inclusion in IWA in LTC settings and exploring the complex interdependent and synergistic relationship of language and its situated context.</p>

Shame in the Therapy Hour: Recognizing, Managing, and Transforming Our Darkest Emotion / June Tangney, Ph.D. / George Mason University / Saturday, March 26, 2016, 10:00 a.m. - 12:00 p.m. / Location: Kiva Theater, University of Arizona Student Union / Although clinicians often use the terms “shame” and “guilt” interchangeably, ample research indicates that these are distinct emotions with very different implications for motivation and behavior (Tangney, et al., 2007). This workshop summarizes research on the phenomenology of shame and guilt (Wicker, et al., 1983; Tangney, et al., 1996), as well as clinically relevant empirical work demonstrating a link between shame and denial, defensiveness, and aggression (e.g., Stuewig, et al., 2010). Although ubiquitous in clinical settings, shame is a silent emotion. Clients rarely announce that they feel shame. Participants will become familiar with empirically validated verbal and non-verbal markers of shame (Keltner, 1995). Strategies for responding to, managing, and transforming or resolving client shame will be discussed, drawing on a handful of explicitly shame-focused therapies with empirical support (Gilbert, 2014; Rizvi & Linehan, 2005), augmented by observations of “master clinicians” presented in a recent edited volume on Shame in the Therapy Hour (Dearing & Tangney, 2011). The workshop will close with a consideration of therapists’ shame, as well as shame in supervisor-supervisee relationships.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Physical Therapy.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy [Physical Therapy].

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy [Physical Therapy].

Purpose: To investigate the incidence of urinary incontinence (UI) and relationship between UI and health related quality of life (HRQOL) of postpartum Bangladeshi women. Problem Statement: There are no studies comparing HRQOL with incidence and impact of UI amongst Bangladeshi women who have had cesarean section (CS) and those with normal vaginal delivery (NVD). Methods: Prospective, cross sectional, correlational design (n=94) of postpartum Bangladeshi women, ages 18-44, with history of one or more obstetrical deliveries within the last three years. Implemented at the Center for Rehabilitation of the Paralyzed (CRP) in Bangladesh. Subjects completed the Bengali version of the SF-36 and IIQ-7. Results: Six subjects were eliminated from the study because of co-morbidity exclusion factors. Eight subjects were excluded secondary to "mixed birth mode" (MBM). UI incidence was reported at 45% (n=39/86) total, 44% CS (n=18/41), and 47% (n=21/45) for NVD. IIQ-7 scores and UI presence showed strong correlations in both CS (rho=.729, 84, p<.001) and NVD (rho=.874, 84, p<.001). The highest impact of UI was reported in the CS group. One sample t-test reported significant differences for the sample when compared with the age equivalent norms for the SF-36 domain and component scores (p =.05-.001). Women in the 35-44 age group reported higher UI incidence and decreased HRQOL scores on the SF-36 and IIQ-7. Significant differences in HRQOL were reported for women with "pelvic/abdominal pain" and "UI" compared to those without "pain" or without "UI" and strong inverse correlations (rho=.597-.853) were reported for subjects with "pain" on the SF-36 domains (p=.001). The MBD group (n=8) reported UI incidence at 74% (n= 6/8), and pelvic/abdominal pain at 63% (n=5/8). Conclusion: No significant difference between birth modes was found in UI and HRQOL measures. A significant decrease in HRQOL for women during the postpartum period compared to age related norm scores was reported. Report of abdominal/pelvic pain and presence of UI were directly related to HRQOL in this study. Future research in this population should address pelvic and abdominal pain and "mixed birth mode" impact on QOL and UI in a larger sample using a longitudinal design.