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In Western culture, "hearing voices" is often considered a symptom of mental illness. After reinterpreting this phenomenon from perspectives that emphasise the socio-cultural aspects of the construction of these voices, this paper describes a case report involving a psychological intervention divided into six phases. The aim is to challenge the dominant narratives that stigmatise the experience of hearing voices, and propose alternative meanings that can improve the hearer's ability to manage the voices by converting them from a disease into a personal and relational resource. Using the metaphor of an "inner dialogue", we show how changes in the client's interpretation of the voices, and way of relating to them, can be co-constructed by the client and the therapist. The paper concludes with some critical reflections on the medicalisation of mental distress, highlighting the importance of expanding our understanding of the experience of hearing voices, not only in clinical terms, but also on a social and cultural level. [ABSTRACT FROM AUTHOR]

Little is known about the relationship between treatment organization characteristics and client outcomes or drug-related harms in community opiate substitution therapy. In the absence of sufficient scientific evidence, the organizational configuration of addiction treatment services is often decided on an ad hoc and sometimes politically motivated basis as the evaluation of the impact of policies or practices on clients at the organizational level is limited. The objective of this multi-site cross-sectional study was to identify and understand how client characteristics and staff perceptions of organizational functioning related to client engagement in community-based opiate substitution therapy services in Ireland. This paper reports on a cross-sectional survey of clients (n = 262) and staff (n = 132) questionnaires across 12 discrete community-based prescribing service providers (organizations) in Ireland. Measures of client engagement in treatment were shown to be higher in organizations with more positive staff ratings of organizational functioning. In particular, in organizations where staff reported having greater job autonomy, clients reported better overall engagement. Specifically, greater staff autonomy in organizations related to greater levels of treatment participation (p = 0.034), treatment satisfaction (p < 0.001), and better rapport with staff (p < 0.001). Clients who were the longest in treatment expressed significantly poorer rapport with staff (p = 0.44) and were less likely to seek out support from peers (p = 0.023), while those in stable accommodation reported greater participation in treatment (p = 0.009). Levels of peer support were not related to organizational characteristics, but clients with lower levels of education (p = 0.002) and those in early treatment (p = 0.017) were more likely to seek support from peers. The findings establish the importance of assessing organizational and client attributes as part of an overall strategy for enhancing the quality of treatment. This paper provides valuable information for policymakers and provides an ample basis for further exploration of how treatment organizations work, and not just that they work. Policymakers and planners need to consider introducing specific interventions for clients or staff in the context of a 'whole systems' approach. From an organizational and planning perspective, this should involve further consideration of measures that relate to increasing staff's sense of autonomy. This paper provides further evidence that the success of policy-making or planning relating to treatment organizations can be successfully measured at the client and organizational levels. [ABSTRACT FROM AUTHOR]

Although the value of humor is appreciated in mental health care, little is known about how professionals employ humor. The purpose of this systematic review was to explore how mental health professionals use humor. Academic databases were systemically searched. Papers were subjected to quality appraisal. Ten studies met eligibility criteria. Mental health staff used humor to cope with stress and adversity. They also used humor to enhance relationships with service users, and to erode team-related power dynamics. It was suggested that knowing when to use humor appropriately was dependent on experience and how well staff knew service users. However, it was also found that staff's use of humor was sometimes negatively perceived by service users, as it could reinforce power dynamics. Due to the limited and low level of evidence, it is recommended that rigorous research in the area of humor in mental health practice is undertaken. [ABSTRACT FROM AUTHOR]

This paper explores isomorphic patterns in social work group supervision and social work practice through the lens of the psychoanalytical concept of parallel process and Bion's theory of learning from experience. Empirical data from group supervision sessions are presented, and a link is theorised between sessions characterised by high levels of anxiety and the presence of parallel process, whereby 'unthought' anxiety provoking phenomena described in social workers' practice appear to be repeated in supervision. Implications for supervision practice and social work more broadly are then discussed. [ABSTRACT FROM AUTHOR]

Single session therapy (SST) is an increasingly popular approach to mental health treatment that aims to address clients' presenting difficulties in a single appointment. However, experiential approaches to SST are limited. In this paper I describe the theory and practice of "chairwork" – an integrative, action-focused method of intervention centred on the concept of self-multiplicity – and outline how these procedures can be coherently applied in a single-session format. A preliminary protocol for delivering single-session chairwork (SSC) or "brief dialogical psychotherapy" is presented, alongside a case illustration that demonstrates features of this approach. Finally, directions for future research and the continued development of chairwork as a psychotherapeutic modality are considered. [ABSTRACT FROM AUTHOR]

There are growing numbers of young children with complex life-limiting conditions as well as varying degrees of physical, sensory and cognitive limitations currently surviving birth. As a trainee art therapist, I needed to clarify exactly what art therapy actually was and how to implement it with this clientele, which initially looked the least likely of the creative therapies to be practical. This article offers an account of my journey providing art therapy to a ten year-old girl during my final year trainee placement within a children's hospice and what she contributed in terms of my development and understanding. Neurobiological studies of sufferers of trauma (who can display similar restricted sensory, emotional and cognitive processing capacity) suggest that art can function in a direct manner on the brain, enabling expression and communication. Art therapy becomes feasible with these children if their anger and frustration is seen as embodied very much like trauma as generally understood. Initial sessions concentrated on creating routines and structures without expectation of an art product even though these could be mistaken for sensory or messy play. Finally, my client engaged with art materials and was able to employ controlled gestures resulting in making marks on paper. A noticeable positive change over my client's attitude occurred. By not focussing on expectations around the marks produced in terms of art, a therapeutic relationship developed. Neurobiological studies involving these children as a specific group and art therapy are recommended. This article offers an account of providing art therapy to a ten year-old girl who has the cognitive facility of someone much younger, is registered blind, has limited fine-motor skills, and has a life-limiting degenerative neurological condition. That she could engage in any form of making art (an often assumed prerequisite of art therapy) may seem improbable. As a result, children with similar abilities are more likely to be offered sensory or messy play, as these might appear immediately more directly accessible. Nevertheless, art materials do feature in messy/sensory play, and though the end result may, indeed, present as a mess, drawing on neurological theory I reason this could still result in therapeutic value as a mode of expression/communication. Part of the initial difficulty for me involved issues around what art therapy was. Consequently, I struggled with the idea of whether what I was doing with my client was art therapy. Although, at times, I felt I was offering sensory or messy play, I was finally able to accept that I had done so in the service of art therapy. A key factor was to do with the role of the art therapist as 'container' for the client's emotions. The art therapist's role is therefore upheld as essential to defining whether it was art therapy or not. Much of the time, what took place did not necessarily emulate what I thought of as 'normative' art therapy practice. However, these sessions were necessary to build up trust, and eventually, my client constructively engaged with art materials. The results were not pictorial, but they were controlled rather than random and were accompanied by a marked change of behaviour. I concluded that art therapy specifically was possible in this situation, and affirm that this client group should not be denied the opportunity because of potentially preconceived expectations. [ABSTRACT FROM AUTHOR]

Drawing on findings from a psycho-social qualitative doctoral study, this paper considers the intimate and extraordinary emotional intensity, ambivalence and pain associated with the experience of mother social workers engaging with mothers and their infants in the context of child protection work. In this yearlong study undertaken with a group of female Irish child protection social workers, their role as mothers was an unanticipated emergent theme and was found to be inextricably linked to their work and their capacity for realistic decision-making. We consider the wider contexts of societal ambivalence about motherhood, mothering and social work itself, as a way of locating these experiences as fully psycho-social. The work discussion seminars offered as part of the research study afforded a rare opportunity for workers to talk about predicaments, failures and worries, in conditions of containment for anxiety, support for their learning, and a confidential reflective setting. [ABSTRACT FROM AUTHOR]

Trauma- and violence-informed care (TVIC) has become an important lens to guide health and social services. TVIC emphasizes service providers' understanding of trauma and its impact, including structural aspects of victimization. Emotionally and physically safe environments, service user opportunities for choice, collaboration and connection, and the use of strengths-based and capacity-building approaches are prioritized. The majority of writing on TVIC has focused on its application to services for survivors of trauma and abuse. In this paper, we argue that a modified trauma-and violence-informed lens has the potential to improve our work with men who perpetrate violence in interpersonal relationships, and even more importantly, that without such a lens, we are likely to miss very important opportunities to act in ways that enhance the safety of potential victims of abuse. Using examples drawn from practice, we explore specific examples of how applying TVIC principles may increase service providers' ability to recognize and respond to potentially dangerous situations, thereby improving services to perpetrators and enhancing safety for potential victims of abuse. [ABSTRACT FROM AUTHOR]

For relational therapists who are acutely aware of male privilege, working with male clients may be challenging, including in (but not limited to) couple and family therapy. This challenge may be particularly true for beginning therapists. This paper outlines a guide to working in relational therapy with male clients from a gender-critical and socio-culturally attuned perspective. To this aim, the paper first summarizes a framework for gender-critical therapists to work with male clients. It then outlines recommendations based on the clients' level of endorsement or relationship to gender-normative masculinity (i.e., stereotypical, challenged, and disempowered relationship to masculinity). In the final sections, clinical vignettes show the application of some of these recommendations. This guide will benefit relational therapists who are questioning their ability to work with male clients in an inclusive fashion while remaining truthful to their gender-critical views. [ABSTRACT FROM AUTHOR]

The importance of reflective practice in psychotherapy has long been acknowledged. However, there is a paucity of work that elucidates the process of reflection in the context of therapist development. The current study employs reflexive action research for a supervised group-work in a tertiary mental health hospital carried out by two trainee therapists. Group-work intervention was chosen because it was viewed as a cost-effective method given the client-clinician ratio. It also provided a richer context to boost reflective practices in various interactions- with the participants, the supervisor and the co-facilitator. Reflective notes and discussions among trainees, supervisor, as well as verbatim feedback from clients were the sources of information. The paper describes this process of reflection as well as the critical events in the process that posed a challenge for the therapists and opportunities for reflection in these interactions during the course of therapy. The paper, with its reflective stance, has implications for promoting and documenting reflective practice in psychotherapy training using different methods and modalities. [ABSTRACT FROM AUTHOR]

In this paper, we present our development of a previously articulated approach to counselling education of transformational learning through a relational dynamic approach (Macaskie et al., 2013). We replace the idea of integration with a values-based approach and supplement the notion of transformational relational learning with a not-knowing attitude. This perspective on education and learning in counselling parallels the attitude within psychotherapy that we teach our students. We argue that this unites relational approaches to learning and psychotherapy across modalities and offers a trans-theoretical approach that could explain the common factors research in psychotherapy. [ABSTRACT FROM AUTHOR]

This article presents an attempt to analyze the specifics of ethical norms in the work of psychologists in Ukraine, with an analysis of historical preconditions, current challenges and cultural characteristics. Ukraine, as a modern developing country striving for integration into the European space, is intensively developing psychology and trying to overcome the problems that it has today. Having well-trained psychologists, psychology in Ukraine has many vulnerabilities, such as the lack of legislation in this field and licensing. Professional communities, by virtue of their competencies, strengthen psychology in Ukraine through an attempt to implement ethical standards and highlight problematic topics. The article contains a review of Ukrainian psychologists' understandings of confidentiality, informed consent and multiple relationships. This paper is an analysis and attempt to explain to the reader potential areas of growth and the unique cultural formations that we have in our practical work today. This exploration includes factors such as the features of importance in the relationship between a psychologist and a client in the Ukrainian context, and the historical, social, economic, cultural, and political factors that influence the perception of ethical standards among Ukrainian psychologists. [ABSTRACT FROM AUTHOR]

Many music therapists propose that chaos, such as destructiveness and disintegration, could thwart music therapy group processes and should be minimised or resolved. From a paradoxical approach, however, chaos is understood as a transformative complement to ordered, formative music therapy experiences. The research in this paper explored how music therapists and adolescents could engage with chaos as a resource in music therapy groups. From a paradoxical approach, the music therapist--researcher facilitated two short-term group music therapy processes with nine young South Africans from under-resourced and often violent communities, referred for committing offences. The researcher utilised crystallisation, including constructivist grounded theory, participatory action research, and abduction, to analyse how group members could engage with chaotic group experiences. Findings, constructed through a cyclical process of data collection, analysis, and inclusion of group feedback, are presented in a matrix. The matrix shows how groups could utilise chaos to explore multiple possibilities for responding to challenges. They expressed themselves courageously and played unconventional group roles through their musicking and participation. They juggled paradoxical tensions between observational and active, integrative and disintegrative, engagement styles. This supported their transformation in the group, and potentially within the chaotic South African context. Music therapists can use the matrix to support adolescents in music therapy groups to engage with chaos as a transformative resource. They can accompany young people through offering holding, resources and collaborative support. When it is safe, music therapists may allow or encourage chaos that empowers adolescents to cope with challenges independently. [ABSTRACT FROM AUTHOR]

Belonging is a human need, one that is particularly difficult for children of immigrants to achieve. The Second-generation youth hangs in a balance between the culture of their parents and that of their friends and peers. Often these youth feel that they are not heard or seen by those around them, enhancing the feeling of not belonging in their communities, or even in their country. Therapeutic interventions could potentially create a "third space" in which they feel a sense of belonging. This paper explores the complexity in the experience of belonging in second-generation Latinx youth through a review of the literature, psychodynamic theories, a composite clinical case example and the reflections and implications to and from Second-generation Latina therapist. [ABSTRACT FROM AUTHOR]

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This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

From their earliest inquiries on sex, researchers have noted the connection between religion and sexual repression. However, because many see religion as beyond reproach, secularly trained professionals are often frustrated over ways to help their clients heal from problematic religious teachings without damaging their faith. This paper offers concrete ways to reframe the issues to assist clients in extricating themselves from problematic beliefs. By setting science in dialogue with religion, this strategy is based on some of Christianity's basic principles. From this stance, the client can be led to both understand the nature of traditional Christianity's obedience framework and to entertain an alternative spiritual discernment framework with multiple sources of spiritual authority. Professionals do this by (1) affirming the client's faith experiences that undergird their religious experience, (2) identifying their beliefs and their sources, (3) providing information of other church-recognized sources of spiritual authority and noting where individual discernment is applauded, and (4) offering scientific evidence relative to the presenting sexual issue. This approach is not dependent upon the personal religious background or faith stance of the professional. Further, clients may choose to retain their faith while aligning new religious understandings that are more congruent with sexual health. [ABSTRACT FROM AUTHOR]

In 2020, almost 46,000 individuals in the United States died from suicide, 1.2 million adults made a suicide attempt, and 12.2 million had serious suicidal thoughts. Clinicians in diverse practice settings will work with clients experiencing suicidal thoughts and behaviors. Due to a strong association between trauma and suicidality, suicidology experts have recommended the use of trauma-informed practice when working with clients with suicidal thoughts and behaviors. However, although there are guidelines for trauma-informed care and for working with clients with suicidality, there are no models, explanations, or discussions about how clinicians can provide trauma-informed care in their work with individuals with suicidal thoughts and behaviors. This conceptual paper describes examples of the application of the Substance Abuse and Mental Health Services Administration (SAMHSA)'s trauma-informed care principles to clinical work with individuals with suicidal thoughts and behaviors. Strategies are provided for each of the guiding principles, and case examples used to illustrate strategies, barriers, and potential pitfalls. [ABSTRACT FROM AUTHOR]

This paper describes a study analysing eye care professional students' written reflections following their engagement with clients with low vision conditions. By embedding a reflective practice model (Schon's reflection-in-action and reflection-on-action) within a higher education curriculum, students' assumptions and beliefs were challenged. Analysis of fifty-two reflective essays were analysed using the Braun and Clarke's 6-phase process for inductive thematic analysis. This generated three themes: (i) Students' perceptions that visual limitations do not necessarily equate to a poorer quality of life; (ii) Extrinsic and intrinsic influences affect patient care; and (iii) Eye care professionals' role expands to holistic care. An additional outcome of this study supports embedding reflective practice activities within the curriculum. By providing students with a platform to reflect and challenge their assumptions, may have the potential to enhance their understanding and improve future practice. [ABSTRACT FROM AUTHOR]

This paper aims to explore and understand the social issues that sex workers face as mothers and to improve social work practices with high stigmatized persons. This study has adopted a qualitative methodology. Data were collected through 12 semi-structured interviews and thematic analysis was performed. Despite several constraints, including socioeconomic issues and stigma, having children is central for sex workers' lives and they considered themselves as good mothers, whose self-sacrifice on their children's behalf is not socially recognized or approved. Social representation of sex work undermines sex workers' self-perception as mothers and their relationship with social workers. We suggest a non-judgmental and holistic approach to address the special needs of sex workers who are also mothers. Furthermore, it is important to raise awareness on social representations that support social workers' everyday practices. [ABSTRACT FROM AUTHOR]

Psychological hotlines are widely used, convenient, and effective means to help people overcome their stress reactions. In this article, we focused on integrating somatic and mental-micro interventions into the psychological assistance hotline process. In addition to verbal communication, dance movement therapy based on the body-mind interaction can help clients re-establish their connection with psychological resources, such as creativity and resilience in addition to verbal communication. Based on the basic steps and core points of the SAFER-R model, we explored how embodied movement elements can be applied to the hotline setting for body-mind micro-interventions. Furthermore, we proposed the CREATE model and explained how it can be used to intervene and realise the basic functions of psychological hot line service through four case vignettes. Through this article, we added new perspectives and options for the provision of psychological support during public health events, and we enriched the working methods of psychological hotline assistance. [ABSTRACT FROM AUTHOR]

This paper concerns the book Tribute to Freud, by Hilda Doolittle (H.D.) (1886–1961). In the book, H.D. – an important person in the modernist poetry scene – presents her psychoanalysis with Sigmund Freud (1856–1939). She describes how literature, sculptures, mythology, and symbols were central to their dialogues. I have analysed these dialogues with respect to the three components of poetry therapy, the receptive, the expressive, and the symbolic. Based on the analysis, I discuss how poetry therapy and psychodynamic practice can be integrated and how practitioners from the two orientations can learn from and inspire each other. I reflect on the presence of symbols and mythology in the book and suggest that the symbolic component, which has received the least attention, could be strengthened by the psychodynamic tradition's acknowledgement of symbols and mythology. I also discuss how poetry therapy could inspire psychodynamic practitioners to acknowledge the expressive component. [ABSTRACT FROM AUTHOR]

Purpose: The impact of a stroke is particularly evident during the transition home, with reported unmet needs. However, little is known about post-stroke adaptation in Portugal. This study aimed to understand how Portuguese people with stroke and their informal carers/family adapt over time, and how health professionals support their adaptation. Methods: A multi-perspective, longitudinal qualitative study was conducted using in-depth semi-structured interviews one and six months after inpatient discharge. A purposive sample of 24 participants (8 triads) participated. Thematic and narrative analysis strategies were used. Results: Three themes were identified: Managing change over time; Balancing support over time; Changing priorities. These suggest the importance of time and gradual adjustment of health professionals' approach throughout the rehabilitation process tailored to people with stroke' and carers' needs. Both valued positive thoughts and support from others to adjust life goals and find a balance between a mutual/bidirectional support and time for themselves. Conclusions: Findings show that the manner in which changes after a stroke are approached may be positively transformed to provide strength. As a result of the deeper understanding gained from this study, health professionals may be better placed to acknowledge the needs of people with stroke and carers and find effective ways of supporting them. [ABSTRACT FROM AUTHOR]

Multicultural discourse, when focusing on systemic racism/discrimination, has recently come under scrutiny. Despite the long history of multiculturalism in counselling and other helping fields, critics espouse multiculturalism does not work and increases racial problems. This criticism persists despite recent events such as the racial unrest in Summer 2020 (due to the killing of numerous unarmed Black people), #Blackintheivory movement and the racially-charged US presidential election. Opponents state these problems exacerbate partially due to an unbalanced focus on race. Proponents believe not enough emphasis on multiculturalism is a contributing factor. This conceptually-driven, dialectical article highlights evidence for and against multiculturalism by providing a critical overview of existing theoretical and empirical information for both. I conclude with the hope of an agreed-upon truth established through a systematic display of logical reasoning, utilising biology as a backdrop. Implications for the counselling field conclude the article. [ABSTRACT FROM AUTHOR]

To address child protection concerns countries often implement mandatory reporting (MR) laws. This ensures that relevant professionals alert child protection services of children who are at risk of or are currently experiencing abuse. However, these well-intended mandatory requirements can sometimes have unintended negative consequences that affect all those who are involved in the process. The current research investigated the experiences of Irish psychologists in implementing MR and examined if there was any personal or professional impact resulting from this process. All participants were qualified psychologists of various disciplines working in the HSE, the national health service of Ireland. A qualitative research design was implemented that consisted of thematic analysis of focus group transcripts. Three focus groups (n = 18) were conducted. Three major themes were identified within the data; the unintentional harm that is caused by MR, the contexts where reporting is needed, and the issues with the current MR system. Some benefits to MR exist but these advantages need to be considered within a greater context. The findings of the current study outlined how participants perceived aspects of MR as having significant detrimental consequences for victims of abuse. [ABSTRACT FROM AUTHOR]

This article aims to help child welfare professionals understand connections between the Indian Child Welfare Act (ICWA), Tribal sovereignty, and Native American well-being, and prepare to uphold ICWA in the face of the impending U.S. Supreme Court case. ICWA provisions, intentions, implementation, and impact are described, followed by summaries of prior legal challenges, judicial erosion, and the Haaland v. Brackeen case. The article explores implications if ICWA is overturned, including ramifications of non-preferred foster care and adoption placements and self-determination, health, and socioeconomic repercussions. Advocacy strategies for upholding ICWA are presented to help protect Native children, families, and Tribal Nations. [ABSTRACT FROM AUTHOR]

We examine challenges to confidentiality experienced by sports psychologists in men's English football academies. Sixteen psychologists, six women, and ten men working in English football academies participated in two semi-structured interviews. We carried out a reflexive thematic analysis after each round of interviews and developed two themes: (1) challenges to client-psychologist confidentiality; (2) a context of normalized surveillance. First, participants explained that several staff members (e.g., coaches, managers, and support staff) would use covert and subtle ways to make psychologists break confidentiality. This included trying to get the psychologist to "slip up." Second, the football academy context was characterized by widespread surveillance of players. It was evident that it is common practice for clubs to gather objective and self-report data creating extreme transparency in the young people's lives. We also propose two research-based solutions allowing psychologists to handle these issues. Lay summary: Using data for talent and performance development in men's professional football academies in England is changing the context in which psychologists work. It poses new issues for confidentiality between clients and psychologists, which practitioners, clubs, and federations must consider. We propose that psychologists should work at the organizational level with leaders and coaches to handle these issues. Players and parents need updated information on their rights and consent. Psychologists should work at the systems level with coaches and staff to prevent issues of confidentiality breaches. The Premier League and the English Football League must consider the influence of new technologies in developing guidelines for clubs. [ABSTRACT FROM AUTHOR]

Validation as a clinical strategy – communicating that a person's responses to a situation make sense – may be a particularly valuable skill for social work practitioners working within and across many traditions. This article makes several contributions to the literature on validation. It argues for a narrow definition of validation, reviews laboratory and clinical research on validation, and proposes research directions that will help determine how and if it works. It also uses psychodynamic and behavioural theory to posit mechanisms underlying its helpfulness and to suggest what to validate. Because of its many potential uses, clinical validation deserves to be widely taught in social work curricula alongside other interviewing strategies. [ABSTRACT FROM AUTHOR]

Cultural competence and cultural humility are hallmarks of social work practice. Cultural competence focuses on the clients' lived experiences. Cultural humility centers the lived experiences of the clinician and the client. However, few resources are available to illustrate how to apply cultural competence and cultural humility separately. Even fewer opportunities are available to apply both. We illustrate how to employ both, cultural competence and cultural humility in practice with Black women with depression. When used together, cultural competence and cultural humility appears to be more valuable than when used individually. Based on research information presented, implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Due to the COVID-19 pandemic and because of the critical and essential nature of child welfare work, this workforce moved out of agency settings to remote work. Drawing from the theory of large systems change, this study explored child welfare caseworkers' perspectives on how organizational changes due to the pandemic affected them as workers and their recommendations for sustained organizational change in child welfare. This narrative analysis explored secondary data collected in May 2020 about workforce needs related to the COVID-19 pandemic (N = 783). Regarding the impact of COVID-19, three themes emerged: (a) job impact (no change, limited change or positive outcome); (b) challenges (engaging with clients, conducting assessments, meeting with families, and using technology); and (c) impact on worker well-being (safety concerns, job stress, anxiety about the future). Three themes also emerged for recommendations for permanent workplace changes: (a) workplace flexibility (work from home, hybrid schedule); (b) better use of technology (virtual meetings and supporting remote access), and (c) worker well-being (support for worker safety and work–life balance and integration). The pandemic demonstrated that when responding to a natural disaster, pivotal change can happen quickly and effectively, even for large, complex systems like child welfare. [ABSTRACT FROM AUTHOR]

Social workers play a pivotal role in addressing equity and diversity within Australia using both culturally responsiveness skills and knowledge. This article describes a research project that resulted in the development of the Continuous Improvement Cultural Responsive Tools that can be used by social workers in their practice. This was a large project conducted over three years, which involved engagement and consultation with Aboriginal and Torres Strait Islander community social workers. The community engagement and consultation process included the provision of cultural governance and participation in interviews. The tools developed are linked to seven key domains (Ngurras) that aim to increase the skills, knowledge, and overall confidence of social work practitioners in their culturally responsive practice. This article discusses the tools that provide a clear structure to guide social workers' critical engagement in becoming more culturally responsive social workers and individuals when working with Aboriginal and Torres Strait Islander Peoples. IMPLICATIONS Social work practices need to address the social injustices faced by Aboriginal Peoples by becoming more culturall responsive. The tools were developed to support social workers in their practice to self-assess their transformation in becoming culturally responsive social workers. Continuous improvement in collaborative and culturally responsive social work will improve services for Aboriginal and Torres Strait Islander Peoples. [ABSTRACT FROM AUTHOR]

Counseling theory offers direction for counselors regarding a view of maladaptive behaviors and what role the counselor should take to move the client toward adaptive lifestyle change. The transtheoretical model (TTM) of behavior change is a developmental model that can be considered as the counselor tailors interventions based on a client's readiness to accept change. This article aims to illustrate how sandtray work can be implemented using the TTM. Specifically, we will use one case example and exemplify sandtray directives or prompts designed to meet the client at each stage of change in the TTM. [ABSTRACT FROM AUTHOR]

As practitioners, it is important to find new and innovative ways to connect with our clients. One way to accomplish this goal is by incorporating pop culture into family sessions. This article addresses how counselors can incorporate pop culture with the families they treat. Specifically, this article addresses how practitioners can use Spider-man: Into the Spider-Verse to relate to the clients they serve. The authors focus on how practitioners can use concepts from Structural Family Therapy, Solution Focused Brief Therapy, and Relational Cultural Theory to engage the families they serve. [ABSTRACT FROM AUTHOR]

We look at the subject of institutionalisation for children and young people who are in residential or foster care. We begin by exploring the concepts of institution and institutionalisation. The concepts have different meanings, which can even be contradictory. This draws attention to the reality that family life can also be institutionalising. We explore, what is important from a child's perspective? What is the quality of their experience? And most importantly how do their experiences equip them to move towards positive and fulfiling adult life? We believe it is important to focus on the quality of experience and outcomes rather than whether one kind of setting is inevitably better than another. We also recognise that different care environments can meet the needs of different children. [ABSTRACT FROM AUTHOR]

Social workers in England are key professionals involved in addressing safeguarding concerns affecting adults with learning disabilities, including the risk of harm from domestic abuse. This article reports the findings from an empirical study conducted with 15 social workers who participated in a 2-stage interview process. The findings and discussion examine social workers' approaches to risk management interventions in cases of domestic abuse against adults with learning disabilities. Informed by Beck's Risk Society theory, our analysis finds that interventions often focus on individuals taking responsibility for managing risk, with either the victim or the social worker becoming the risk decision-maker. Furthermore, in carrying out their work, social workers used bureaucratic tasks to protect the organisation and individual decision-makers from blame. The article concludes with recommendations for practice which explores more holistic understandings of risk and which seeks to promote more collective responses to risk management. [ABSTRACT FROM AUTHOR]

Indigenous voices and perspectives are necessary in advancing applied and global sport psychology. In Aotearoa New Zealand, Māori sport and exercise professionals are thriving despite existing systems that devalue, discriminate and exclude Māori from fulfilling their potential. This qualitative study investigated the perspectives of ten Māori sport and exercise experts including academics, allied health professionals, athletes, coaches and Māori healers in order to develop a critical understanding of their work related experiences and analyze the diverse forms of knowledge on which they draw. Participants-collaborators were interviewed using an insider research design to facilitate discussion about their current work. Results support a "space between" model and suggest that Māori sport and exercise work enables excellence in sport performance while also meeting holistic wellbeing needs of communities. Māori exercise professionals identified that their presence in their respective fields "speaks back" to racist practices and entrenched barriers that colonize Māori success. Further, applying holistic notions of wellbeing and ancestral knowledge to sport and exercise was seen as default and ordinary; shifting the illusion that sport and exercise operates in a culture-less, timeless and physical vacuum. From an applied and Indigenous perspective, these results emphasize that Indigenous sport leadership and practices are unequaled by Western methods and science alone. Māori exercise professionals demonstrate cultural innovation and intersectionality that not only revolutionizes sport, but brings with it essential community wellbeing. Lay summary: This article explores the experiences of ten Māori exercise professionals and analyses the diverse forms of knowledge they draw on in their work. The study provides insight into how Māori exercise professionals utilize their knowledge of social contexts and culture, in turn expanding the scope of sport and exercise psychology. [ABSTRACT FROM AUTHOR]

Internet-based delivery of evidenced-based Value Based Counseling (VBC) fulfills the demand for a low threshold, culturally-sensitive and short-term intervention located at a level below specialized mental health care which can help those who do not require such specialized care to activate their resources and to regain their everyday functioning quickly. A pretest–posttest design with a historical control group was used to investigate the efficacy of internet-delivered VBC in comparison with in-person VBC provided to 102 help-seeking clients, who included refugees residing mainly in Germany. Intention-to-treat analyses concluded that internet-delivered VBC, comparable to in-person VBC, resulted in a significant reduction of depression, posttraumatic stress symptoms, perceived stress, somatic complaints, and daily functioning impairment at the post-test. [ABSTRACT FROM AUTHOR]

This exploratory study examines how social work practitioners in England integrate service users' religion, belief and spiritual identities. The study involved 34 semi-structured interviews with Qualified Social Workers and took a qualitative investigational perspective. By means of thematic analysis, the study suggests that practitioners employ either avoidant or utilitarian approaches, which may indeed be a coping strategy before the vast religious plurality in practice. The study also highlights when professionals perceive religion, belief and spirituality important. Those times are a) initial assessments, b) conditional intervention, c) referrals and d) response to this subject when safeguarding and child protection issues arise. [ABSTRACT FROM AUTHOR]

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In Japan, the population aging rate highlights the need to examine various care provisions for older adults with dementia, including physical therapy. However, despite its positive effects, there are also many challenges associated with providing physical therapy for older adults with dementia. This qualitative case study examined the interactions between a physical therapist and a patient with dementia and the process by which physical therapy was provided to her. This study utilized a modified grounded theory approach to analyze the interview of one physical therapist, a woman with four years of clinical experience who specializes in physical therapy for older adults who provided a 20-minute physical therapy session to her client, a woman in her 80s with dementia who sought to maintain her ability to perform activities of daily living and preserve her independence. Data were collected in January 2017. Fifteen concepts that represent aspects of the services that the therapist provided to her client were identified. Five distinct categories were derived: 1) foundations of the relationship; 2) understanding individual factors; 3) supporting execution of functional activities; 4) assessing cognitive function; and 5) support to ensure safety in daily living. Physical therapists help older adults with dementia execute functional activities, which helps ensure their safety and independence, and fosters strong therapist–client relationships. Future studies should interview multiple physical therapists to generate additional concepts. Further, quantifying these concepts and developing tools to assess clients will improve care provision and inform physical therapists with limited experience in treating patients with dementia. [ABSTRACT FROM AUTHOR]

The multi-disciplinarity of long-term care for people with intellectual disabilities makes organisations seek stability and predictability, complicating implementing innovations. Interventions to implement a method for reducing restrictive measures were analysed through the lens of Normalisation Process Theory to understand the social mechanisms at play. Process notes, collected during a trial in which a method to reduce restrictive measures was implemented, were analysed guided by implementation interventions defined by Cochrane Effective Practice and Organisation of Care Review Group. These interventions were mapped to social mechanisms of Normalisation Process Theory. Implementation interventions were widely used in which clients' perspectives were expressed (client-related-interventions), and consensus processes were held with care professionals. These interventions initiated NPT's social mechanisms' Coherence, Cognitive Participation and Collective Action. The emphasis on consensus and clients' perspectives when methodically reducing restrictive measures reflects some unique implementation challenges in long-term intellectual disability care. [ABSTRACT FROM AUTHOR]

This qualitative study's objective was to understand how failure in psychotherapy develops from depressed patients' perspective. Forty-seven patients were interviewed after brief psychotherapy. Data analysis was conducted according to Grounded Theory. Patients evaluated their own psychotherapies' outcome according to their subjective criteria. Then, negative, positive and mixed-results evaluations were compared in the main categories. Results showed that patients reporting negative evaluations considered null or adverse outcomes as failure. Distrust in their psychotherapists (both as persons and professionals) developed in early stages of the process and was apparently hard to revert. This early onset of distrust led patients to a lack of collaboration and an unreceptive attitude. They perceived their psychotherapist as not understanding, distant, and uninterested, losing focus on relevant problems and not providing new information. The relationship was experienced as uncomfortable and distant, and sometimes became harmful. Therefore, distrust led patients to regard their psychotherapies as an unhelpful experience, in contrast to what occurred in patients with positive or mixed results evaluations. Conclusions contribute to a clarification of how patients conceptualize failure and suggest reevaluating the relevance of their perspective, which seems not to be fully reflected in current outcome measures. Clinicians should consider building trust as a baseline and encourage patients to disclose even the earliest negative feelings about treatment and psychotherapist [ABSTRACT FROM AUTHOR]

Shared decision-making about therapeutic methods has been proposed as a way of conceptualising, and assisting, collaboration in the therapeutic alliance. However, little is known about how psychotherapists actually create concrete, moment-by-moment opportunities for clients to share their ideas about what might be therapeutically helpful. We used conversation analysis to examine psychotherapists' questions about what might be helpful in audio-recordings of early sessions of a collaborative-integrative therapy. We examined forty-two sessions involving seven dyads and identified 28 cases of questions either inviting clients' ideas about helpful in-therapy methods or strategies outside the therapy room. Psychotherapists could invite clients' ideas by using simple questions, however clients could find such questions problematic. Alternatively, psychotherapists could add scaffolding: offering support to the client in terms of how they might respond. However, this could erode clients' autonomy to respond with their own ideas. We identified a conversational practice, de-specifying, which overcomes this dilemma: asking questions and providing scaffolding whilst also lessening the pressure on the client to go along with that scaffolding. A therapeutic style which includes scaffolding and de-specifying practices creates an opportunity for the client to contribute where clients are empathically supported, but not directed, in responding. [ABSTRACT FROM AUTHOR]

To evaluate health literacy learning modules designed specifically for physiotherapists in private practice. Mixed-method design was used, evaluating pre-post physiotherapist health literacy knowledge and competencies using questionnaires and semi-structured interviews. One rural and one metropolitan private physiotherapy practice were recruited. Clients, physiotherapists, and other clinic staff. The OPHELIA (Optimizing Health Literacy and Access) process was applied to identify the health literacy needs of clients; co-design interventions; and implement and evaluate the interventions. The health literacy learning modules were co-designed with the physiotherapists and included one 3-h face-to-face workshop, followed by two 1-h videoconference workshops. Health literacy knowledge (rated 1–5 for 10 items, max score 50) and skills (rated 1–5 for 5 items, max score 25) were assessed before and after the workshops. Data were analyzed by paired t-test. Interviews were recorded, transcribed, and thematically analyzed. Health literacy knowledge of 19 health professionals improved after the workshop by 63% (pre 26.0 (7.5), post 41.0 (2.7), p <.001). Health literacy skills improved by 65% (pre 4.2 (3.3), post 21.8 (2.3), p <.001). We identified three themes from interview data: 1) 'the multi-faceted nature of health literacy requires multiple strategies'; 2) 'changing practice to promote understanding'; and 3) 'reflection on roles of multidisciplinary private practice.' Improvements in health literacy knowledge and skills are possible through post-graduate professional development. Workshops changed physiotherapists' understanding of their role in promoting health literacy. [ABSTRACT FROM AUTHOR]

In Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers' perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers' work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

The study explored how common non-disclosure of suicidal ideation is in a sample of adult psychiatric inpatients (N = 171) plus associated patient characteristics. A large percentage (51.5%) withheld some information on suicidal ideation during admission. In multivariable analyses, correlates of non-disclosure included a diagnosis of emotionally unstable personality disorder, low satisfaction with stay, and symptoms of the suicide crisis syndrome. In univariate analyses, therapists' emotional response to the patient was also a correlate. Findings indicate that among acute psychiatric inpatients, non-disclosure of suicidal ideation is quite common, requiring awareness from clinicians relying on this parameter in suicide risk assessments. [ABSTRACT FROM AUTHOR]

The aim of this work was to qualitatively explore the personal perspectives of prosthetic and orthotic users, in the context of their past and present experiences and understand their insights for the future. A narrative exploration study design, employing a phenomenological approach was used. Semi-structured interviews were conducted with three female and two male prosthetic and orthotic users from Australia and the United Kingdom. Interviews were analysed, coded and key themes and sub-themes identified. Three themes were identified. The Maximising Opportunity theme linked sub-themes of recreation and pushing boundaries. The Health Care Network theme included sub-themes of communication, peer support and building a team. The final theme, Changes over time, included sub-themes of disability perception, advice and advancements over time. Prosthetic and orthotic users identified that there had been vast changes in disability perception, disability rights, and their role in the health care system, along with the variety of technology and materials available. Key findings were that prosthetic and orthotic users want to be listened to, considered central to the health care team, and had a deep understanding of their own health care needs. Prosthesis and orthosis users want to be listened to and considered central within the health care team. Attending medical and allied health teams must recognise that prosthesis and orthosis users have a fundamental understanding of their own health care needs. Themes, whilst potentially generalisable, are derived from specific individuals and may particularly relate to these individuals. [ABSTRACT FROM AUTHOR]

A number of innovative models of student practice placements are emerging due to pressures on universities to provide quality practice placements and on health services to deliver rehabilitation efficiently, safely and cost-effectively. The student-resourced service delivery (SRSD) group program is one such model in occupational therapy. There is a paucity of research evidence to guide services in planning, implementing and evaluating the SRSD model. The study aimed to explore and identify the factors that key stakeholders perceived as contributing to the successful development and implementation of the occupational therapy student-resourced service delivery group programs. Participants in this multi-site study were rehabilitation inpatients, clinicians, Clinical Education Liaison Managers and students completing practice placement in the student-resourced service delivery group program. Data were collected using face-to-face semi-structured interviews and focus groups. A total of 83 participants consented to the study. Four themes emerged from the data. Planning needs to be an iterative process that commences before and continues during the program. Support processes need to be established for students and clinicians during and across placements. The creation of an engaging, client-relevant and graded group dynamic is critical for success. Establishing a culture whereby groups are valued by the clients, therapy and multidisciplinary teams is important. The above-mentioned factors were perceived as contributing to successful operationalisation of a student-resourced service delivery group program, and may be helpful when developing student-resourced service delivery professional practice placements in other settings. Student-resourced service delivery of groups are one way to achieve additional professional practice placements for students and delivery of therapy services for patients. Ongoing investment for planning and preparation, provision of continual support for students, a culture of valuing groups and students, and creating a group dynamic that engages group participants were perceived by stakeholders as key ingredients for successful implementation of the student-resourced service delivery group model. Clinicians and educators are encouraged to use the perceived success factors identified in this study as a resource for future student-resourced service delivery program development. [ABSTRACT FROM AUTHOR]

To gain insights into psychologists' experience of working with refugees in Brazil, semi-structured interviews with 14 psychologists were conducted and analysed using thematic analysis. Results showed that participants experienced operating in a novel, precarious and xenophobic context, which led them to move beyond classical psychological work, engage in practical assistance and become very close to clients. Psychologists reported lack of public structures, insufficient competencies and high levels of fatigue. At the same time, they described gaining new perspectives and benefiting from witnessing their clients' resilience. In terms of facilitators for the work with refugees, participants pointed to the importance of psychologists being flexible, authentic, of showing a high frustration tolerance and of making use of group-based approaches. Participants suggested that, in order to better refugees' mental health in Brazil, efforts should focus on adopting a more social perspective in psychology, developing anti-discrimination campaigns, building policies for refugee' inclusion and scaling up investments in mental healthcare in general. Suggestions for future research are made, as well as for psychologists who work with refugees, such as fostering a more collectivity-focused and contextual understanding of mental health. [ABSTRACT FROM AUTHOR]