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Background: The unfamiliar atmosphere of the operating room, waiting for anesthesia, and the process of surgery and anesthesia are some of the factors causing fear and anxiety in patients. It leads to physical and psychological pressure on patients. Better understanding of patients' feelings, beliefs, or fears and recording their experiences for optimal care after surgery is helpful. This study explains the experiences of clients in the first entry to the operating room. Methods: This qualitative study was conducted using a descriptive phenomenological method. In this study, 17 patients who had the experience of entering the operating room for the first time as an elective surgery under general anesthesia over the last 6 months were purposefully selected as participants. Then, they underwent an in-depth and semi-structured interview. After conducting the interview, the participants' statements were qualitatively analyzed using the seven-step Colaizzi method. During the steps of this study, Lincoln and Guba's four reliable criteria were observed. Results: By continuous analysis of interviews about patients' experiences, 308 codes, 10 sub-themes, 6 primary themes, and 3 general themes were obtained. Themes included unpleasant emotions experienced, unpleasant atmosphere factors, and the induction of relaxation and hope. Conclusion: Patients' exposure to an unfamiliar place with new and unknown equipment, personnel with different clothing, stress, worry, psychosomatic reactions following stress, and annoying environmental factors can lead to an unpleasant experience for patients, if they are not managed. Also, the effective communication of the surgical team with the patients leads to reducing or removing the stress and complications caused by it. [ABSTRACT FROM AUTHOR]

This study aimed to explore clients' unique phenomenological experiences of eye movement desensitization and reprocessing (EMDR) and their meaning-making regarding this therapeutic approach within the context of an adult mental health service in Ireland. Interpretative phenomenological analysis was employed to collect and analyze data from six interviews with individuals who had completed an EMDR intervention. Three Group Experiential Themes were identified: "Trapped in trauma—self-disorganization," "Being 'in' the process of processing," and "Moving on—adaptive resolution of trauma." The study provides an in-depth insight into clients' experiences of EMDR in terms of the many processes and outcomes, and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Background When clients’ experiences with maternity care are measured for quality improvement, surveys are administered once, usually six weeks or more after childbirth. Most surveys conveniently cover pregnancy, childbirth and postnatal care all in one. However, the validity of measuring the experiences during pregnancy (antenatal experiences) after childbirth is unknown. We explored the relation between the measurement of antenatal experiences late in pregnancy but prior to childbirth (‘test’ or gold standard) and its retrospective measurement after childbirth (retrospective test). Additionally, we explored the role of modifying determinants that explained the gap between these two measurements. Methods and Findings Client’s experiences were measured by the ReproQuestionnaire that consists of an antenatal and postnatal version, and covers the eight WHO Responsiveness domains. 462 clients responded to the antenatal and postnatal questionnaire, and additionally filled out the repeated survey on antenatal experiences after childbirth. First, we determined the association between the test and retrospective test using three scoring models: mean score, equal or above the median score and having a negative experience. The association was moderate for having any negative experience (absolute agreement = 68%), for the median (absolute agreement = 69%) and for the mean score (ICC = 0.59). Multiple linear and logistic regression analysis for all three scoring models revealed systematic modifiers. The gap between antenatal and postnatal measurement was (partly) associated with clients’ experiences during childbirth and postnatal care and by professional discontinuity during childbirth but unrelated to the perceived health outcome. Conclusions The antenatal experiences should be measured before and not after childbirth, as the association between the antenatal experiences measured before and after childbirth is moderate.

Background. When clients' experiences with maternity care are measured for quality improvement, surveys are administered once, usually six weeks or more after childbirth. Most surveys conveniently cover pregnancy, childbirth and postnatal care all in one. However, the validity of measuring the experiences during pregnancy (antenatal experiences) after childbirth is unknown. We explored the relation between the measurement of antenatal experiences late in pregnancy but prior to childbirth ('test' or gold standard) and its retrospective measurement after childbirth (retrospective test). Additionally, we explored the role of modifying determinants that explained the gap between these two measurements. Methods and Findings. Client's experiences were measured by the ReproQuestionnaire that consists of an antenatal and postnatal version, and covers the eight WHO Responsiveness domains. 462 clients responded to the antenatal and postnatal questionnaire, and additionally filled out the repeated survey on antenatal experiences after childbirth. First, we determined the association between the test and retrospective test using three scoring models: mean score, equal or above the median score and having a negative experience. The association was moderate for having any negative experience (absolute agreementD68%), for the median (absolute agreementD69%) and for the mean score (ICCD0.59). Multiple linear and logistic regression analysis for all three scoring models revealed systematic modifiers. The gap between antenatal and postnatal measurement was (partly) associated with clients' experiences during childbirth and postnatal care and by professional discontinuity during childbirth but unrelated to the perceived health outcome. Conclusions. The antenatal experiences should be measured before and not after childbirth, as the association between the antenatal experiences measured before and after childbirth is moderate. [ABSTRACT FROM AUTHOR]

The current article focuses on client’s perspectives of the mechanisms of change in Dynamic Interpersonal Therapy (DIT), a brief psychodynamic therapy developed for the treatment of depression. Five participants were interviewed and the transcripts were analysed using Interpretative Phenomenological Analysis (IPA). The results point out four subthemes, capturing different active ingredients of DIT: therapy shedding light on previously sealed aspects of self; the relational exchange with the therapist challenging intimate fears; moving towards an interpersonal understanding of their difficulties; and putting the pieces of their lives together into a coherent narrative. Overall participants described an interplay between relational and insight-oriented mechanisms taking place. As part of the former mechanisms, participants reported the development of a secure attachment to their therapist and the provision of a new relational experience, partly via mechanisms corresponding to the concept of transference. Participants reported an increase in insight to have been achieved via an understanding of an interpersonal and emotional pattern as well as via the restoration of a coherent life-story. Processes that theoretically map onto the concept of mentalisation were also reported. The findings are discussed in relation to the DIT and psychodynamic theory about change and to relevant research literature. [ABSTRACT FROM AUTHOR]

Recent large scale surveys of religions in Taiwan showed over 80% of the surveyed subjects identified themselves with religious beliefs, 85% of the subjects agreed religion can help people find inner peace and happiness, and ease the pains and discomforts. 2014 American Pew Research Center’s Religious and Public Life Program reported Taiwan ranked second on the Global Religious Diversity Index. All the data indicated Taiwan has a high population in religion and is a multi-religious society. Western counseling researches and literatures showed that clients with religious/spiritual backgrounds brought problems into the counseling embedding their religious/spiritual perspectives and copings towards their problems. Counselors need to inquire and understand how these clients viewed their problems spiritually so that they could integrate religious/spiritual interventions into counseling to serve religious/spiritual clients more effectively. However, such research is rare in Taiwan, there is a need to conduct researches to call Taiwanese’ counselors attentions to the topic. The purpose of the present study was to explore the experiences of clients who had received counseling incorporating religion/spirituality. The research questions included to explore the clients’ expectations and attitudes towards receiving spiritually integrated counseling, the religious/spiritual issues raised and the religious/spiritual interventions received in the counseling sessions, and the reported counseling outcomes. Ten research participants with different religious/spiritual backgrounds and having experiences of receiving spiritually integrated counseling were recruited and participated in the study. Among them, three were Christians, three were Buddhists, two identified themselves with having multiple religion/spiritual backgrounds, and two identified themselves with no specific region/spiritual backgrounds. Among the ten, one was male and nine were females. Semi-structured individual interviews were conducted for data collection. Interviewed questions included the religious/spiritual identities the interviewees were holding, the spiritually integrated counseling experiences received, the expectations towards the counselors’ religious/spiritual backgrounds and the counselors’ integrated counseling approaches, the religious/spiritual issues raised in the counseling sessions, the counselors’ responses and the religious/spiritual interventions used in the counseling, and the resulting counseling outcomes. Thematic analysis was employed for data analysis. Seven themes were identified as the research finding. These seven themes were: clients with religious/spiritual backgrounds had motives, expectations, and concerns of receiving spiritually incorporated counseling, multiple religious/spiritual and psychological issues were intertwined and presented in the counseling sessions, clients received various religious/spiritual interventions from the counselors in the counseling sessions, facilitating and hindering factors which influenced the clients and /or the counselors to initiate and continue the religious/spiritual topics were identified, spiritually integrated counseling resulted in clients’ spiritual and psychological growth, most clients showed positive attitudes of receiving spiritually integrated counseling, and clients claimed the ethical principles of practicing the spiritually integrated counseling. The discussions were focused on five points: 1. It is important to explore the specific expectations and concerns of clients with religious/spiritual backgrounds. Clients hold specific expectations on counselors’ religious/spiritual backgrounds, integrating religious/spiritual interventions in counseling, and counselors’ openness towards their personal religious/spiritual experiences. 2. Highly religious/spiritual devoted clients expect counselors to help them understand their encountered personal or interpersonal problems with both psychological and religious/spiritual perspectives. 3. Taiwan is a multi-religious society, and clients may come from various religious/spiritual backgrounds. Counselors can better serve clients with religious/spiritual needs if they are equipped with various religious/spiritual traditions and interventions. 4. Both common and religious/spiritual specific factors identified which facilitate and hinder the initiation and continuation of the religious/spiritual topics between the interaction of counselors and clients. Common facilitating factors relate to the trusting and supporting relationship the counselors created, and clients’ readiness to change, openness to self-disclosure. Common hindering factors relate to clients’ high anxiety of disclosing self, counselors’ passivity, lack of direction, structure and counseling plans. Specific facilitating factors relate to counselors’ acceptance of clients’ religious beliefs, counselors’ competencies in facilitating religious/spiritual conversations, and clients’ recognition of the religious/spiritual interventions used. Specific hindering factors relate to clients’ un-comprehension to the religious/spiritual interventions used, counselors are unable to provide religious/spiritual interventions clients needed, and counselors avoid religious/spiritual topics. 5. Religious/spiritual clients’ counseling experiences and outcomes are positive when counselors integrate spirituality into counseling. However, counselors should not impetuously impose religious/spiritual interventions to those clients without religious/spiritual interests or backgrounds. Two suggestions were proposed in the end. Firstly, the result highlights the necessity of integrating religion/spirituality into counselors’ practices. Thus, students and counselors need to acquire the competencies of practicing spiritually integrated counseling through counselor education courses, supervisions, and continuing education. Secondly, future researches on counselors’ attitudes and perceived competencies of practicing spiritually integrated counseling, the positive and negative experiences of clients’ receiving spiritually integrated counseling, and the effectiveness of practicing spiritually integrated counseling interventions are all needed for enhancing the knowledge of this new area of spiritually integrated counseling. [ABSTRACT FROM AUTHOR]

The Boston Psychiatric Rehabilitation Approach (BPR) is person-centered and characterized by being based entirely on the individual's unique needs and preferences in the areas of working, learning, social contacts, and living environment. Nevertheless, the person-centered approach is lacking firm evidence regarding outcomes, and empirical studies regarding clients’ experiences of this particular model are needed. A qualitative content analysis of 10 transcribed semistructured individual interviews was used to describe and explore clients’ experiences of the BPR during an implementation project in Sweden. The findings from the interviews could be summarized in “A sense of being in communion with self and others” theme, consisting of three categories: increased self-understanding, getting new perspectives, and being in a trusting relationship. The results showed that clients do not always recognize nor are able to verbalize their goals before they have been given the possibility to reflect their thoughts in collaboration with a trusted person. The guidelines of the approach are intended to support the clients’ ability to participate in decision making regarding their own care. More research about efficacy of different rehabilitation approaches and exploration of fidelity to guidelines of rehabilitation programs are required.

Recent decades have seen a significant increase in the number of studies exploring client perspectives on, and experiences of, psychotherapy. The present article provides a practice friendly overview of this research, identifying common domains of inquiry, and providing examples of findings relevant to practitioners. Research in this area can be categorized in terms of the client's perspective pertaining to theoretical constructs, studies of client satisfaction, and qualitative studies that are either open-ended or explore specific aspects of client experiences. Examples of this latter category include studies looking at distinct processes (e.g., self-disclosure), particular theoretical constructs (e.g., therapeutic alliance), helpful versus unhelpful aspects of therapy, and significant events. Research suggests that therapist willingness to seek client perspectives, openness to hear what clients have to say, nondefensiveness in the face of negative feedback, and ability to modulate actions accordingly are all likely to contribute to stronger relationships with clients and stronger collaboration, correspondingly contributing to stronger therapeutic outcomes. [ABSTRACT FROM AUTHOR]

This is one of the few studies that explores preferences of and experiences with integrated sexual and reproductive health (SRH)-HIV care among users of mainstream family planning and postnatal care services who are women living with HIV (WLWH). This paper reports on the quantitative data from 179 clients attending public sector clinics and from 30 qualitative in-depth interviews with WLHIV in Kenya. Quantitative data show that integration is happening for the vast majority of these clients at their last HIV visit. However, qualitative data show that very often the care received by WLWH is fragmented as providers do not offer multiple same-day appointments for FP and ARV refills. Our study has shown factors that could either prevent or enable receipt of integrated SRH and HIV care for WLWH. To address these factors, management systems need to be able to support providers to make flexible decisions and facilitate better coordination and communication across clinics within facilities. [ABSTRACT FROM AUTHOR]

Dynamic interpersonal therapy (DIT) is a brief manualised psychodynamic intervention for depression. This is a first study exploring clients' experiences of DIT specifically and brief, manualised psychodynamic psychotherapy (PP) in general. Interpretative phenomenological analysis was the methodology employed. Five participants completed a semi-structured interview, three weeks to ten months after completing DIT. The scores of pre- and post-therapy outcome measures of depression and anxiety were also available. Two emerging superordinate themes are presented here: (1) 'The Distinct Features of DIT', referring to how its therapeutic style and time limitations were experienced and (2) the 'Impact of Therapy', referring to perceived outcomes. While previous findings showed that therapist's perceived limited activity in long-term PP was experienced as hindering/unhelpful, the perceived sense of direction in DIT appeared adequate to most participants. Secondly, the time limitations provoked complex responses. Reactions to the distinct elements of DIT are to be treated both as therapeutic opportunities and as challenges. Further, in line with psychoanalytic theory, most participants described relational changes that went beyond symptom relief and remained in progress after therapy ended. Intriguingly, there was no consistency between participants' qualitative accounts of change and the scores of the outcome measures. [ABSTRACT FROM AUTHOR]

Purpose: The main objective of this study was to explore clients' experiences of participating in a structured intentional personality change coaching programme designed to facilitate change on client chosen personality facets. Design: A qualitative design, using inductive thematic analysis was employed to explore participants' experiences with as few pre-conceptions as possible. Method: The current study used semi-structured, face-to-face interviews to collect data from 32 participants at the conclusion of a 10-week structured intentional personality change coaching programme. Transcribed interview data was then coded and analysed for themes, using steps and processes outlined in Braun and Clarke (2006). Results: Thematic analysis revealed four key themes. First, personality coaching promoted reflection, leading to greater self-awareness. Second, it fostered an authentic self and values consistent way of living, without loss of valued aspects of identity. Third, it produced tangible and practical life benefits including enhanced confidence and competence, and strengthened ability to relate to others. Finally, most clients viewed the structured personality change coaching programme as enjoyable, positive and beneficial. Conclusion: This study suggests personality change coaching is perceived by clients as providing opportunities for developing greater self-awareness, authenticity, and a values consistent way of living. Whereas personality change is the goal of such coaching, this translates into practical benefits, and is perceived by clients as a positive experience. Professional implications of expanding coaching into this relatively new area are identified. [ABSTRACT FROM AUTHOR]

The Boston Psychiatric Rehabilitation Approach (BPR) is person-centered and characterized by being based entirely on the individual’s unique needs and preferences in the areas of working, learning, social contacts, and living environment. Nevertheless, the person-centered approach is lacking firm evidence regarding outcomes, and empirical studies regarding clients’ experiences of this particular model are needed. A qualitative content analysis of 10 transcribed semistructured individual interviews was used to describe and explore clients’ experiences of the BPR during an implementation project in Sweden. The findings from the interviews could be summarized in ‘‘A sense of being in communion with self and others’’ theme, consisting of three categories: increased self-understanding, getting new perspectives, and being in a trusting relationship. The results showed that clients do not always recognize nor are able to verbalize their goals before they have been given the possibility to reflect their thoughts in collaboration with a trusted person. The guidelines of the approach are intended to support the clients’ ability to participate in decision making regarding their own care. More research about efficacy of different rehabilitation approaches and exploration of fidelity to guidelines of rehabilitation programs are required. [ABSTRACT FROM AUTHOR]

Aim: To investigate young people's views on the effects of school‐based counselling, and what they found helpful and unhelpful. Method: Eleven semi‐structured interviews were conducted and thematically analysed. Findings: Participants expressed predominantly positive views of school‐based counselling with changes in three main domains: emotional, interpersonal and behavioural. Participants viewed these changes as having had an important effect on their lives. The most commonly cited helpful aspects of counselling were related to talking or getting things out, and counsellor qualities. Conclusions: School‐based counselling is viewed positively by those who have experienced it, and appears to be an appropriate and valuable intervention for young people. [ABSTRACT FROM AUTHOR]

In this article the question about what counts (as results and evidence) in public services for the welfare of vulnerable children is discussed with reference to interviews with three former child protection clients. The purpose of the interviews was to learn how former clients experienced 'being under care', and what short- and long-term consequences or results they found it had in their case. The question that is being raised here is whether basic care, being cared for and loved without too much concern about obtaining specific goals, is in danger of being given less priority in result-oriented and evidence-based child welfare services. The context of the interviews which are referred to here is Norwegian child protection services, but the question that is raised on the basis of this study relates to a more wide-spread and general debate about what should count as evidence in child protection and welfare. [ABSTRACT FROM AUTHOR]

Title. Clients’ experiences of living at home with a mechanical ventilator. Aim. This paper reports on a study of how clients experience living with home mechanical ventilation and how they experience care and supervision of healthcare personnel. Background. The number of people living at home with mechanical ventilators is increasing, and this is considered a successful approach to reducing incapacity and mortality. Method. Qualitative interviews were conducted with 10 service users in 2006. The informants were 18–75 years old and had varying diagnoses and levels of functioning. The interviews were tape recorded, transcribed and analysed by qualitative content analysis. Findings. Two main themes emerged: Theme 1. Having a home ventilator enhances quality of life – a life worth living. The ventilator treatment builds up strength and improves well-being. Participants emphasized that it was important to feel in control of their own situation and had an overriding wish to live a normal and active life; Theme 2. Competence and continuity of healthcare personnel are factors for success. The experience was that competence and follow-up by healthcare personnel varied, and that good quality teaching and information were important. Conclusion. Users of home mechanical ventilators should be active partners in their own care so that their experience is taken into account. It is important for clients having home mechanical ventilation to be empowered and have control in their daily lives, as well as having competent caregivers and continuity of care. [ABSTRACT FROM AUTHOR]

This study explored clients' experiences of relational depth using a qualitative methodology. Semi-structured interviews were conducted with 14 participants who had been clients of predominately person-centred counselling. Participants were asked to focus on specific moments which they had experienced as relational depth. The clients' descriptions of those experiences showed some similarity to therapists' descriptions, including feelings of aliveness, realness, and openness, although there were also some significant differences described. Participants experienced their therapists as being holding, accepting, and 'really real', and as offering something over and above what they had expected from a professional therapeutic relationship. Such moments were often seen by participants as being highly significant moments in the therapy with an enduring positive effect. The implications of these findings are discussed and areas for further research highlighted. [ABSTRACT FROM AUTHOR]

This study explores clients' experiences of Dialectical Behavioural Therapy (DBT). Five participants, all with a diagnosis of borderline personality disorder, were interviewed following a semi-structured format about their experiences of an NHS regional DBT programme. The interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes were identified consisting of a number of sub themes: joining a DBT Programme (external and internal factors); experience of DBT (specific and non specific factors); and evaluation of DBT (change, evaluation and role of the past and future). The study provides an insight into clients' experiences of DBT. The results are discussed in relation to clinical practice and future research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to ascertain clients' experiences of their counselling. This was done through use of a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in agency located in a mid-sized city in New Zealand. Several themes were identified and discussed in relation to the literature on clients' perceptions of their own counselling. Specifically, clients were asked to comment on whether their counselling was effective, how much of their improvement was due to counselling versus other factors, the quality of the relationship with their counsellor, specific in-counselling events that were helpful or unhelpful, and how their counselling was terminated. Implications for practice were suggested. [ABSTRACT FROM AUTHOR]