Therapeutic Relationship

Objectives. The aim of this qualitative study was to explore the attitudes, beliefs, and preferences of Italian osteopaths regarding the management of transgender patients through a content analysis of emergent data from semi-structured interviews. Methods. This study was a content analysis based on the Standards for Reporting Qualitative Research guidelines. Purposive sampling of 10 Italian osteopaths was applied. Data were collected through semi-structured interviews, from March to April 2021, and subsequently transcribed verbatim with the content analysis carried out as an iterative process. Results. One participant was excluded during the first interview due to them being unsuitable for this study. Data saturation was reached after two interviews with the remaining nine participants. Data analysis revealed four main themes: microaggressions, acceptance and non-judgement, person-centered treatment, and education implementation. Conclusions. This study presents cisgender Italian osteopaths’ attitudes in the care of transgender people, revealing the desire to embrace and apply osteopathic tenets regardless of the patient’s gender identity.

Self-disclosure for mental health practitioners can have benefits for the therapeutic relationship. Most practitioners, however, are wary of doing so, or do not know how to navigate this. This paper aims to present a comprehensive framework to assist mental health practitioners when choosing to self-disclose lived experiences. This framework was created by a working group of academics, clinicians, service users and recovery workers, based on an international project investigating self-disclosure among professionals. Results from this project informed the content of this framework, considering theoretical models of supervision to guide development. The Sharing Lived Experiences Framework (SLEF) details six areas for practitioners to consider: Preparedness, Confidence, Competence, Relevance, Comfort and Supervision. The connection between preparedness and supervision is emphasised. Preliminary data on the SLEF indicates that staff felt more able to navigate disclosure after training on this framework. To the authors’ knowledge, this is the first comprehensive framework to guide practitioners through the disclosure process; from planning, to in-the-moment considerations, to post-disclosure reflection. Although limited available data exist on clinical utility, the SLEF crucially provides a framework for supervision discussions and guided self-reflection for a full range of practitioners on a range of lived experiences.

Purpose-The purpose of this paper is to investigate psychometric properties of the Self-Efficacy for Therapeutic Use of Self (SETUS) scales, a questionnaire based on the Intentional Relationship model, and to investigate the factor structure and internal consistency of the English version of three-part SETUS questionnaire in occupational therapy students. Design/methodology/approach-The sample of this cross-sectional study included 155 students with age range 18-30 years, of which 95% were women. Principal Components Analysis (PCA) was performed on the questionnaire scales, including the Self-Efficacy for Therapeutic Mode Use (SETMU), Self-Efficacy for Recognizing Interpersonal Characteristics (SERIC) and Self-Efficacy for Managing Interpersonal Events (SEMIE). The internal consistencies were calculated. Pearson correlation analysis was used to evaluate the strength of correlation among the scales. Findings-The PCA confirmed that the items of each of the three proposed scales loaded strongly on one factor (self-efficacy for three factors of therapeutic mode use, recognizing interpersonal characteristics and managing interpersonal events). The Cronbach's alpha for the SETMU, SERIC and SEMIE was 0.85, 0.95 and 0.96, respectively. The three scales significantly inter-correlated strongly (r ranging 0.74-0.83, all p < 0.001). Originality/value-The SETUS questionnaire comprises three valid and reliable scales. It can be used by occupational therapy supervisors as a means to reflect on students' self-efficacy in components of therapeutic use of self.

Little is known of the extent to which heterosexual couples are satisfied with their current frequency of sex and the degree to which this predicts overall sexual and relationship satisfaction. A population-based survey of 4,290 men and 4,366 women was conducted among Australians aged 16 to 64 years from a range of sociodemographic backgrounds, of whom 3,240 men and 3,304 women were in regular heterosexual relationships. Only 46% of men and 58% of women were satisfied with their current frequency of sex. Dissatisfied men were overwhelmingly likely to desire sex more frequently; among dissatisfied women, only two thirds wanted sex more frequently. Age was a significant factor but only for men, with those aged 35-44 years tending to be least satisfied. Men and women who were dissatisfied with their frequency of sex were also more likely to express overall lower sexual and relationship satisfaction. The authors' findings not only highlight desired frequency of sex as a major factor in satisfaction, but also reveal important gender and other sociodemographic differences that need to be taken into account by researchers and therapists seeking to understand and improve sexual and relationship satisfaction among heterosexual couples. Other issues such as length of time spent having sex and practices engaged in may also be relevant, particularly for women.

Background.The aim of this study was to investigate the nature of the relationships between healers and their clients in Germany.
Methods. An interdisciplinary research team performed semistructured interviews with healers and clients and participatory observation of healing sessions. All interviews were digitally recorded, transcribed, and analyzed using content analysis.
Results. Fifteen healers and sixteen clients were included. The healer-client relationship was described as a profound and unique experience, which brought forth interpersonal and spiritual connections. The healers were seen as rolemodels for healing to occur and Support for being connected spiritually. The clients had to be open-minded and responsible. The importance of the healers’ empathy was emphasized.
Discussion.The relationship between healer and client can be seen as a triangular connection between client, healer, and a transcendent source which is not the case in typical patient-doctor relationships. The spiritual connection is also said to
enhance the empathetic understanding of the healer. The personality and a partner-like attitude of the healer supported the Client in giving a more positive meaning to his life, in reconnecting to his spirituality, and in taking responsibility. Future studies should address the role of spirituality in health care and the development of enduring healer-client relationships.

Öz Mükemmeliyetçilik, klinik anlamda kişinin işlevselliğinde önemli düzeyde sıkıntıya ve bozulmalara yol açan, aşırı yüksek standartlara sahip olma eğilimi olarak tanımlanmaktadır. Bu çalışmada şikâyetlerinin odağı mükemmeliyetçilik olan ve özellikle iş ve çalışma alanlarında buna dair sıkıntı yaşayan bir vaka ele alınmıştır. Çalışmanın amacı şema terapi formülasyonu ve teknikleriyle mükemmeliyetçiliğin nasıl çalışılabileceğini örneklemektir. İstanbul Arel Üniversitesi Klinik Psikoloji Doktora Programı şema terapi süpervizyon dersi kapsamında danışanla haftada bir, 50 dakika olmak üzere toplamda 11 seans yapılmıştır. Değerlendirme evresinde, danışana Young Mod Ölçeği, Young Şema Ölçeği, Young Ebeveynlik Ölçeği, Young-Rygh Kaçınma Ölçeği ve Young Telafi Ölçeği uygulanmıştır. Kuramsal açıdan mükemmeliyetçiliğin mekanizmasında daha fazla rol aldığı belirtilen, başarısızlık, yetersiz özdenetim, yüksek standartlar, karamsarlık ve cezalandırıcılık şemaları, talepkâr ebeveyn, kopuk korungan ve kopuk kendini avutan şema modları ve uyumsuz başa çıkma biçimleri tespit edilmiştir. Bu şemalar, şema modları ve başa çıkma biçimlerinin zayıflatılması buna karşın sağlıklı yetişkin tarafın güçlendirilmesi, terapi hedefi olarak belirlenmiştir. Bu hedeflere ulaşabilmek için şema terapinin ilişkisel, yaşantısal ve bilişsel stratejileriyle müdahalelerde bulunulmuştur. Sonuç olarak, danışanın şikayetçi olduğu belirtilerdeki azalmalara ilişkin özbildirimleri değerlendirildiğinde mükemmeliyetçiliği köken odaklı şema terapiyle çalışmanın öngörülen değişim hedeflerine ulaşılmasını sağladığı tespit edilmiştir. Abstract Perfectionism is defined as the tendency to have extremely high standards, leading to significant distress and deterioration of functioning in the clinical sense. In this study, a case with perfectionism was the focus of the complaints especially in work and work related areas. The aim of the study was to illustrate how perfectionism could be studied with schema therapy formulation and techniques. Within the scope of schema therapy supervision course in Istanbul Arel University Clinical Psychology Doctorate Program, 11 sessions were conducted once a week for 50 minutes. During assessment stage, Young Mode Inventory, Young Schema Questionnaire, Young Parenting Inventory, Young-Rygh Avoidance Inventory and Young Compensation Inventory were applied to the patient. Accordingly, failure, insufficient self-control, unrelenting standards, pessimism and punitiveness schemas, demanding parent, punitive parent, detached protector, detached soother, vulnerable child schema modes, and maladaptive coping styles were identified. These schemas, schema modes and coping styles were aimed to be weakened, whereas the strengthening of the healthy adult mode was determined as the goal of the therapy. In order to achieve these goals, interventions were performed using relational, experiential and cognitive strategies of schema therapy. As a result, it was found that perfectionism-based schema therapy achieved the proposed goals which was also supported by the self-report of the patient.

This study aimed to qualitatively examine the perspectives of therapists using different theoretical orientations on rupture moments.
The study features a qualitative research design. Six different therapy session segments were presented to the participants and questions
were asked to gather their perspectives on the segments. The thematic analyses conducted on 20 therapists’ evaluations on the 6 rupture
segments of 5 patients were based on two categories: i) the causes of the rupture moments, ii) the recommendations for resolution.
Findings revealed that therapists are more likely to report patients’ negative contribution as the main cause of rupture moments. Participants
attributed less importance to the negative contribution of the therapist or to the therapist-patient relationship in rupture moments,
and therapists tended to suggest mostly technical resolutions to ruptures. This second-generation alliance research draws attention to
relational aspects of the rupture resolution processes for a positive outcome. However, our findings yielded that there was a lack in
therapists’ evaluations in addressing the contribution of the therapists and/or therapist-patient relationship to rupture moments. This
highlights the importance of supervision training to foster therapists’ awareness of rupture moments and develop their skills for resolution
in the context of the therapist-patient relationship.