The aim of this study was to describe the psychoanalytically-oriented therapist's experience of identifying, differentiating and processing the patient's transference-based and reality-oriented reactions. In order to investigate the therapist's lived experience of being receptive to the total communication of the patient in the analytic situation, the researcher adopted the empirical phenomenological method. This descriptive and intuitive method grounded the researcher in the concreteness of the everyday life-world of the therapist, and enabled him to explicate the therapist's immediate, pre-theoretical experiences of his patient. The appropriate central research question, formulated to elicit the experience of this phenomenon, emerged through the process of enquiry during the pilot study. Thirteen experienced, psychoanalytically-oriented psychotherapists were interviewed and the five protocols considered most revelatory of the phenomenon under investigation were analyzed in detail. The remaining eight protocols were used to illuminate central themes and to clarify areas of uncertainty during the phase of formal explication. The central findings revealed that the oscillating process of the therapist as he shifts from being immersed in the world of his patient to being in a position of observation and self reflection is the fulcrum around which he evaluates the nature of his patient's communications. During this ongoing process of discrimination, living in duality, the therapist comes to experience himself as a patient scrutinized by his own and his patient's confrontations. His journey of disentanglement, the endeavour to differentiate his responses from his patient's actions, is dependent on his ability to engage in honest selfreflection and to access his pre-theoretical and articulated cognitions of his patient. This allows him to acknowledge his own role in what has unfolded interpersonally and to appropriate his previously denied feelings for and attitudes towards his patient, a prerequisite for the accurate and full appraisal of the nature of his patient's communications. Forsaking fixed judgements, the therapist becomes open to the confluence between the reality-oriented responses and transference-based reactions of his patient. This salient discovery, when dialogued with the literature, reinforced the theories of Greenson and Langs that not all the interactions between the patient and the analyst/therapist are transference-based and that it is therefore imperative that the analyst/therapist reflect on his participation in the analytic situation.

The purpose of the study was to examine the efficacy of virtual reality exposure therapy (VRET) to treat driving phobia using a multiple baseline across-subjects design. The sequence of events included a pre-treatment assessment, a baseline phase, 8 weekly VRET sessions using a standardized treatment protocol, a post-treatment assessment, and 1- and 3-month follow-up assessments. A sample of seven treatment seeking adults with a primary diagnosis of specific phobia (driving) was recruited. Five completed the treatment and follow-up phases. One individual withdrew after the pre-treatment assessment, and the other, after the first treatment session. It was hypothesized that VRET would reduce driving anxiety and avoidance symptoms between pre- and post-treatment assessments using several outcome measures. Visual and statistical analysis methods were used to assess treatment outcome. Three participants showed clear improvement in driving anxiety and avoidance symptoms between pre- and post-treatment assessments. There was a marginal improvement in these symptoms for one participant. The remaining participant showed very little improvement, and some outcome measures revealed slight deterioration in some of her symptoms. There was negligible change in actual driving frequency in any participant. Some gains were lost at the 1- and 3-month follow-up assessments, but symptoms remained far below pre-treatment results. Possibilities for future research and practice implications are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

This study investigated whether Reality Therapy classroom management techniques could be used effectively to improve teacher attitudes, student attitudes, student achievement, and student classroom behavior. The findings of the study support the following conclusions. 1. Reality Therapy inservice education and implementation of Reality Therapy Teaching techniques in classrooms produce significant changes in the way teachers regard student discipline. 2. implementation of Reality Therapy practices in junior high classrooms produces positive changes in attitude toward school environment. 3. Implementation of Reality Therapy techniques in junior high classrooms does not seem to be effective in producing changes in student attitude toward self. 4. Implementation of Reality Therapy techniques in junior high classrooms can be effective in producing higher student grade point averages. 5. Reality Therapy techniques in junior high classrooms are not effective in producing lower rates of student misbehavior.

This study reports on an investigation of the effectiveness of the "Positive Approach to Discipline" (PAD) system for classroom management. The data from the study were analyzed by the analysis of variance with repeated measures. The data indicate several implications for the utilization of the PAD system for classroom management. The findings of the study indicate that, 1) teachers utilizing the PAD system significantly reduced the number of students referred to administration, and 2) teachers utilizing the PAD system significantly reduced the number of Black students referred to administration, and 3) the PAD system was effective in reducing the number of students suspended from school.

Traditional management and public administration literature have failed to recognize the existence of the problem employee in the workforce. The purpose of this study has been to remedy this failure, and, then, to determine if Reality Therapy is an effective strategy for dealing with the problem employee. To this end, an Interactive-Holistic theory which brings together the conceptual streams of psychology and administration has been developed in the form of fifteen propositions. Then an evaluation of Reality Therapy and other methods of dealing with the problem employee has been conducted. Theory development and evaluation of strategies for dealing with the problem employee were a response to the challenge of Chester Barnard that an administrator perform the “function of the executive“ by keeping both the needs and goals of the organization in balance with those of the employee. To explore heuristically the probability that theory propositions are true and to determine the likelihood that Reality Therapy will be an effective strategy for dealing with a problem employee, The Computer Consultant was utilized For the manager, the desired situation in the workplace is that employee behavior contributes effectively to the accomplishment of organizational goals. In determining the probability of this occurring, likely affect of Reality Therapy as a management technique, and the likelihood of other methods being effective, over one hundred conditions were identified as relevant to, and possible detractors from, the accomplishment of organizational objectives. From this input into TCC, the following results were calculated. When all possible conditions are taken into consideration, the likelihood of an employee becoming a problem was calculated to be .62. If a manager has been using Reality Therapy as a management technique, this likelihood is reduced to .40. If an employee becomes a problem and a manager does nothing, the likelihood of the problem being eliminated and the employee contributing to organizational effectiveness is only .01. If an Employee Assistance Program is utilized, the likelihood of the employee's behavior contributing to the accomplishment of organizational goals was calculated to be .48. If Reality Therapy is utilized, this likelihood rises to .71. The use of both the EAP and Reality Therapy increases the likelihood of the employee's behavior changing positively to .84. Thus, it was concluded that Reality Therapy is a viable strategy for managing a problem employee. / Ph. D.

published_or_final_version / Social Work / Master / Master of Social Work

Background: The use of telemedicine was gaining momentum. Although the strength of the therapeutic alliance (TA) correlated with treatment outcomes, there was no research exploring the skills, attitudes and behaviours that enhanced the TA during Skype consultations in palliative care. Aims: This study identified the skills, attitudes and behaviours that affected the TA between palliative care patients and health care professionals during Skype consultations and identified strategies that enhanced the TA. Study Design: Two cycles of action research engaged the participants in self-reflective inquiry and encouraged the identification of strategies that enhanced the TA and the Skype experience. Participants: Six health professionals and nine patients were recruited from a Hospice out patient service in one Health Authority in England. Data Collection: Data from the audio-recorded consultation were managed quantitatively and the TA was measured using the Working Alliance Inventory (S). Qualitative data were collected from participant interviews and focus groups attended by the professionals. Data Analysis: The analysis ran in parallel with the data collection, started after the first consultation and all sources of data were cross-referenced. Thematic analysis was used to sequentially code the qualitative data to help identify, examine and record patterns within the data set. Findings: The findings suggested that it was possible to establish and a positive therapeutic alliance between health professionals and palliative care patients when using Skype. There was a shift in perception for those health professionals who had reservations about their ability to establish a therapeutic alliance (TA) via a computer link. It was demonstrated that advanced communication skills were transferrable between face to face and video consultations. No additional communication skills training was needed to enable a strong TA when using Skype. Including some social talk, working with the patient’s as opposed to the professional’s agenda and actively offering solutions improved the Skype experience for the patients. The strategies that health professionals promoted to enhance the TA included using Skype with appropriately selected patients to complement the existing Service. Mandatory training in the effective use of Skype was recommended even for those health professionals who used Skype socially. Clarification to address the challenge of clinical governance was recommended. In keeping with an action research design the change impacted on both the health professionals own practice and the Organisation’s approach to telemedicine. The potential for using action research to engage nurses and doctors in critical self-reflective inquiry and to empower them to be change facilitators was demonstrated. Conclusion: Although a small sample size, this study identified strategies that enhanced the TA during Skype consultations. The findings were significant because they added to the current body of knowledge about using Skype to facilitate consultations within the palliative care population. Additionally, the findings may be transferable to different populations and healthcare contexts.

Thesis (M.S.W.)--University of Hong Kong, 1980.

Cerebral Palsy (CP) is the most common condition leading to severe motor impairment in children. Children with CP must go through extensive therapy. Current therapy approaches are coming to use computer games therapeutic tools. However children with CP often have trouble using many of these virtual systems due to equipment challenges. This thesis uses the Kinect to design and create two therapeutic games (DODGEWALL and Reach+) that are tailored to be used in therapy for children with CP. It evaluates the usefulness of the system in a therapeutic context for children with CP through a study involving 6 therapists and 8 children with CP. It was found that overall, children were engaged and enjoyed playing the games. Further, the games developed were judged therapeutically relevant and will be included in a newly constructed VRT suite at Holland Bloorview Kids Rehabilitation Hospital and used in therapy with appropriate children.

Cerebral Palsy (CP) is the most common condition leading to severe motor impairment in children. Children with CP must go through extensive therapy. Current therapy approaches are coming to use computer games therapeutic tools. However children with CP often have trouble using many of these virtual systems due to equipment challenges. This thesis uses the Kinect to design and create two therapeutic games (DODGEWALL and Reach+) that are tailored to be used in therapy for children with CP. It evaluates the usefulness of the system in a therapeutic context for children with CP through a study involving 6 therapists and 8 children with CP. It was found that overall, children were engaged and enjoyed playing the games. Further, the games developed were judged therapeutically relevant and will be included in a newly constructed VRT suite at Holland Bloorview Kids Rehabilitation Hospital and used in therapy with appropriate children.