The purpose of this Delphi study was to explore and identify a panel of experts' opinions of essential elements for successful multi-family group therapy (MFGT) and to propose the identified elements as guidelines for future MFGT theoretical and program development. Multi-family group therapy continues to be implemented while there is little empirical research to support how it is effective and with what populations and presenting problems it is best employed. A panel of MFGT experts identified 35 essential elements for successful MFGT. Many of the identified elements coincided with elements identified in the relevant literature. However, elements specific to MFGT were distinguished. The essential elements are presented as guidelines for MFGT theoretical and program development. The implications of this study for theory, research, and practice are discussed. / Ph. D.

Made available in DSpace on 2016-07-27T14:22:23Z (GMT). No. of bitstreams: 1 RAFAELA LUIZA SILVA SILVESTRE.pdf: 222530 bytes, checksum: c719d836bdab29eaef86fc96da2fc124 (MD5) Previous issue date: 2009-11-19 / The feelings of the therapist play a remarkable role in present-day models of psychotherapy. Going along with this tendency, the present study sets out to describe the experience of positive emotions by therapists in the interpersonal relationship with the client, during psychotherapy sessions. Contemporary models of emotion emphasize the complexity and plasticity of emotional responses. Positive psychology has shown that positive emotions offer a range of benefic effects including coping with negative experiences, restoration of wellbeing and personal growth. These issues are addressed empirically in this study through the concrete experience of a specific subgroup of health professionals, notably the psychotherapists. The aim of this study was to describe the experience of positive emotions by the therapist in the interpersonal relationship with the client, during sessions. Participants of this study were 20 psychotherapists, of which 19 female and one male; with in medium 13,9 years of professional experience. They were interviewed about their feelings during psychotherapy sessions. The data were analyzed according to the inductive precepts of Grounded Theory. A model was constructed in which treatment outcome, treatment process, therapist-client alliance, professional progress and the client are experienced as sources of positive emotions. The types of positive emotions experienced by the therapists are: happiness and joy, security, satisfaction and well-being. Experiencing these emotions positively influences the therapeutic relationship, professional development, therapist resilience and professional motivation. / Os sentimentos do terapeuta têm um papel de destaque em modelos de psicoterapia atuais. Com a intenção de contribuir com esta temática, o presente trabalho busca descrever a vivência das emoções positivas pelos terapeutas no relacionamento interpessoal com o cliente, durante o trabalho psicoterapêutico. Os modelos atuais de emoção destacam a complexidade e maleabilidade das respostas emocionais. A psicologia positiva aponta como as emoções positivas oferecem um leque de efeitos benéficos quanto à coping com vivencias negativas, restauração do bem-estar e crescimento pessoal. Tais assuntos são abordados de forma empírica neste estudo por meio da vivência concreta de um grupo específico de profissionais da saúde, a saber, os psicoterapeutas. O objetivo da presente pesquisa é de descrever a vivência de emoções positivas do terapeuta no relacionamento interpessoal com o cliente, durante o processo psicoterapêutico. Participaram do estudo 20 psicoterapeutas, dentre eles, 19 eram do sexo feminino e um do sexo masculino; com 13,9 anos em média de experiência profissional. Foram entrevistados sobre os seus sentimentos no decorrer das sessões. Os dados foram analisados a partir do método indutivo da Grounded Theory. Os resultados encontrados mostraram que as fontes de emoções positivas são os resultados, o processo, o vínculo, sucesso profissional e o cliente. Os tipos de emoções positivas vivenciadas pelos terapeutas são: felicidade e alegria, segurança, satisfação e bem-estar. Os efeitos provocados pela vivência de emoções positivas foram relativos ao aprimoramento profissional, ao crescimento pessoal, à promoção de resiliência, às melhoras no relacionamento terapêutico e à motivação profissional. Emoções negativas e seus efeitos também foram lembrados pelos participantes. Nota-se que o terapeuta pode se beneficiar com a vivência dessas emoções. Tais benefícios abrangem a vida dos terapeutas como profissionais, assim como pessoas.

The presented diploma thesis focuses on the definition of the terms of Art Therapy and Artphiletics. The history of these subjects describes the different approaches within these fields via several charts. The fundamental area of the thesis is the creativity and the process of creation, which are considered to be a concurrent realm of Art Therapy and Artphiletics. The thesis presents the primary reasons for the use of Art Therapy and Artphiletics in leisure time activities by specifying the positive effects of the creativity and the process of creation. The aim of the thesis is to map the importance of the process of creation, which is the "core" of Art Therapy and Artphiletics and due to it, draws the attention to the legitimacy of the use of these subjects within the realm of art-related leisure time activities.

Background: Kawa is a client-centered and culturally sensitive occupational therapy model. Discussion has aroused if Kawa would be a suitable model for the clientele, which is culturally more diverse than before. Aim: To investigate how occupational therapists have applied Kawa for the occupational therapy process. Material and Methods: This qualitative study involved 15 occupational therapists, who had applied Kawa to their clients. They got selected on social media by ‘snowball sampling’. Data was collected using an electronic questionnaire. Directed content analysis was conducted, guided by The Occupational Therapy Intervention Process Model. Results: Kawa was considered a client-centered model enhancing therapeutic relationships. By using Kawa, therapists gained relevant information through the client’s subjective self-report. However, observation of the client’s occupational performance omitted. Kawa did not provide sufficient tools, and therapists had to apply knowledge from other models. Conclusions: Kawa provided a strong starting point for the occupational therapy process by enhancing the therapeutic relationships and the client’s subjective self-report, but it did not guide the therapist to complete the whole occupational therapy process. Significance: This study proved that Kawa is a useful model for developing therapeutic rapport and gaining information through self-report. The study suggests that Kawa should be developed further or combined with occupation-based models.

Psychotherapist multicultural competence has been given increasing attention in the field of psychology since the 1970s. However, individuals and communities who are Black, Indigenous, or People of Color are still less likely to attend psychotherapy and often drop out earlier than White clients. These trends highlight the importance of the ongoing research on therapist multicultural competence. There are many multicultural competencies, however, the current study focuses on therapist cultural humility. Specifically, we systematically searched all the current research on the association between cultural humility and client experiences and outcomes in therapy. Our literature search yielded eight studies that met our search criteria. Next, we synthesized the data by conducting a meta-analysis using the metric of Pearson's r as the effect size. In addition, we aggregated average item-level therapist scores and the reliability coefficient of the Cultural Humility Scale (CHS; Hook et al., 2013). We found a moderate positive correlation between client perceptions of therapist cultural humility and client experiences and outcomes in therapy of r = .39 (p < .05). Furthermore, we found the average item-level score to be 3.86 out of a maximum score of 5 (SE =.086), which corresponds with the rating of "mildly agree," indicating that clients typically perceive therapists to demonstrate cultural humility. Finally, we found CHS to be reliable across studies, with an average alpha coefficient of .91. These finding suggest that cultural humility is an important aspect of the psychotherapeutic relationship. Furthermore, they suggest that the CHS is a reliable measure and should continue to be used in future studies. Finally, because our review yielded only eight studies, more research on this relationship is needed.

This study was aimed at exploring and describing the role of music as a medium in the Gestalt play therapy process with children who experience emotional distress and therefore suffer loss of healthy contact. The case study method was used as research strategy. A literature study of the Gestalt approach and Gestalt play therapy was carried out as well as a study of the child in middle childhood, the child experiencing emotional distress in the form of loss, and music as a medium. In implementing of this research study three case studies were described. The sampling method was based on a non-probability purposive sampling technique. The criteria for inclusion in this study were children who experience emotional distress in the form of loss and who, subsequently, do not make effective contact. Between seven and eight therapeutic sessions per child were conducted. The role of music was evident in all three cases. / SOCIAL WORK / MDIAC (PLAY THERAPY)

This study was aimed at exploring and describing the role of music as a medium in the Gestalt play therapy process with children who experience emotional distress and therefore suffer loss of healthy contact. The case study method was used as research strategy. A literature study of the Gestalt approach and Gestalt play therapy was carried out as well as a study of the child in middle childhood, the child experiencing emotional distress in the form of loss, and music as a medium. In implementing of this research study three case studies were described. The sampling method was based on a non-probability purposive sampling technique. The criteria for inclusion in this study were children who experience emotional distress in the form of loss and who, subsequently, do not make effective contact. Between seven and eight therapeutic sessions per child were conducted. The role of music was evident in all three cases. / SOCIAL WORK / MDIAC (PLAY THERAPY)

Text in Afrikaans / In this study the researcher explored and described the use of Gestalt play therapy with specific focus on self-support with the child in middle childhood years. A literature study was undertaken to examine the concepts of child, Gestalt play therapy, self-support and the play therapy process. This literature study forms the theoretical frame in which this study was done. After the completion of the literature study, the empirical study was conducted. The researcher made use of unstructured interviews within a intrinsic single case study in order to compile research data. During the empirical study ten therapy sessions were conducted with the participant which was explored within the framework of qualitative research methodology. The researcher was able to use ample Gestalt play therapy concepts and principles during the description of the case study in order to explore self-support within the child during middle childhood. These concepts and principles will be discussed in depth within this study. / Social Work / M.Diac. (Spelterapie-rigting)

Ziel: Nach einem Jahr dialektisch-behavioral orientierter Behandlung von Borderline Patienten im ambulanten Setting werden verschiedene Wirksamkeitskriterien und Therapieprozessvariablen, wie die Qualität der Therapieallianz aus Patientenperspektive untersucht. Methode: In einer naturalistischen Studie absolvierten 47 Borderline-Patienten eine DBT-orientierte Behandlung. Das Therapieergebnis wurde mittels indirekten und direkten Veränderungsmaßen, wie Patientenziele erfasst. Prozessvariablen wurden qualitativ mittels halbstrukturierter Interviews nach einem Jahr Therapie untersucht, wobei 28 Interviews in die Analyse einflossen. Speziell die Therapiebeziehung wurde zusätzlich quantitativ mit Hilfe des Working-Alliance-Inventory erfasst, welcher nach jeder Therapiesitzung erhoben wurde. Quantitative wie qualitative Analysen wurden integriert. Ergebnisse: Die meisten Patienten zeigten im Behandlungsverlauf Fortschritte innerhalb direkt, wie auch indirekt erhobener Therapieerfolgsmaße. Die Therapieallianz steht dabei in positivem Zusammenhang mit der Therapiezielerreichung und einigen BPS-relevanten Symptomen, nicht jedoch mit Reduktion von Selbstverletzung/Suizidalität. Die qualitativen Analysen der retrospektiv erlebten Wirkfaktoren zeigen hilfreiche und weniger hilfreiche Aspekte im Therapieverlauf, wobei Beziehungsfaktoren und Therapeutenvariablen durch die Patienten als besonders wichtig bewertet werden. Schlussfolgerung: Aus Patientenperspektive wird die Bedeutung der Therapieallianz hervorgehoben, die mit der Erreichung individuell definierter Therapieziele und der Reduktion einiger borderline-typischer Symptome in Verbindung steht. Die Therapieallianz wird aus Patientenperspektive vor allem durch therapeutische “Soft Skills”, wie Empathie, Selbstoffenbarung und Verständnis geformt. Darüber hinaus wird die Fähigkeit des Therapeuten, sich auf die Bedürfnisse des Patienten einzulassen und verschiedene DBT-spezifische Fertigkeiten vermitteln zu können betont. / Objective: To investigate the patient`s perspective about the key mechanisms of change, especially the quality of the therapeutic alliance and to analyse different criteria of outcomes in the first year of out-patient dialectical behavioral therapy. Method: Participants were 47 outpatients diagnosed with BPD, who enrolled in a naturalistic trial of DBT. Severity of symptoms were assessed at intake and one year after beginning of treatment. Direct and indirect methods of measurement were used, for example individual goals from patients perspective. Alliance was assessed with the Working-Alliance-Inventory for patient´s perspective for every session and in addition with a qualitative interview after one year for 28 persons of the sample. Furthermore the interview includes all more or less helpful aspects of the process of psychotherapy. The research integrates quantitative and qualitative methods. Results: Patients showed positive changes over the course of treatment measured with direct and indirect methods. Results indicate an association between alliance and some BPD symptoms and achievement of individual goals but not self-injurious acts or suicide attempt. The qualitative analysis supports differentiation between helpful and unhelpful aspects of the key mechanisms of change from patients perspective. In the client’s view, the strongest categories comprised relationship factors and therapist variables. Conclusions: Results emphasize the importance of a strong therapeutic alliance in the treatment of patients with BPD from patients perspective, but not consistently for the assessed outcomes. The alliance was experienced and formed mainly by the therapist’s “soft skills” such as empathy, self-disclosure and understanding. The therapist’s ability to attune to the client’s needs implied the use of a wide range of DBT-specific skills.

Text in Afrikaans / In this study the researcher explored and described the use of Gestalt play therapy with specific focus on self-support with the child in middle childhood years. A literature study was undertaken to examine the concepts of child, Gestalt play therapy, self-support and the play therapy process. This literature study forms the theoretical frame in which this study was done. After the completion of the literature study, the empirical study was conducted. The researcher made use of unstructured interviews within a intrinsic single case study in order to compile research data. During the empirical study ten therapy sessions were conducted with the participant which was explored within the framework of qualitative research methodology. The researcher was able to use ample Gestalt play therapy concepts and principles during the description of the case study in order to explore self-support within the child during middle childhood. These concepts and principles will be discussed in depth within this study. / Social Work / M.Diac. (Spelterapie-rigting)