Facteurs déterminants d’une expérience significative en psychothérapie : perspectives de clients adultes

La présente étude porte sur les facteurs déterminants d’une expérience significative en psychothérapie selon la perspective de clients adultes. Les deux principaux objectifs poursuivis dans cette thèse sont : 1) l’exploration et la description des facteurs déterminants d’une expérience significative en psychothérapie selon la perspective des clients; et 2) l’élaboration d’une représentation synthétique et structurée de ces facteurs. Les facteurs déterminants sont regroupés sous sept catégories (Clients, Psychothérapeutes, Relation thérapeutique, Environnements, Impacts, Temps et Investissements) et sous quatre sous-catégories (Corporelle, Émotionnelle, Cognitive et Interactive).

Interventions pour soutenir les infirmières dans l'appropriation de l'évaluation de la condition mentale des adultes avec trouble mental hospitalisés en soins physiques

Travail dirigé présenté en vue de l'obtention du grade de maîtrise en sciences infirmières, option expertise-conseil

Interventions pour soutenir les infirmières dans l'appropriation de l'évaluation de la condition mentale des adultes avec trouble mental hospitalisés en soins physiques

Travail dirigé présenté en vue de l'obtention du grade de maîtrise en sciences infirmières, option expertise-conseil

An interpretative phenomenological analysis of adult clients’ experience of My Career Chapter

This paper presents an investigation into the properties of a new narrative technique for career assessment and counselling, My Career Chapter: A Dialogical Autobiography. This technique is used to facilitate clients’ construction of a meaningful career-related autobiography. Previous research indicates the usefulness of My Career Chapter for adult clients and its alignment with recommendations for the development and application of qualitative assessment and counselling techniques. This study specifically commences research into the technique’s applicability for adolescents. A focus group, comprised of guidance counselling professionals whose work primarily pertained to the needs of adolescents, found that there is potential to develop a version of My Career Chapter that is suitable for adolescents.

What do clients learn from counseling?

Thirty-five clients who received counseling participated in this exploratory study by completing a letter to a friend that described in as much detail as possible what they had learned from counseling. The participants’ written responses were analyzed using a content analysis approach. The analysis indicated that the data were best categorized in terms of three broad areas of learnings (Self, Relations with Others, and the Process of Learning and Change). The Self taxonomy was found to consist of six hierarchical levels. The Relations with Others taxonomy consisted of five hierarchical levels, while the Process of Learning and Change taxonomy consisted of five hierarchical levels. The results suggested that these three taxonomies offer a promising and exciting way to view the impact of counseling within a learning framework. If these taxonomies are found to be stable in future research and clients are easily classified using the taxonomies then this approach may have implications for counseling. It may well be that to maximise the learnings counselors could use specific strategies and techniques to enhance their clients’ learning in the three areas.

Best Practice Guide : Clients

The Guide contains the distilled findings from a major, two-year research project to explore those factors considered by industry practitioners to be critical to the successful adoption of ICT, both within their firms and between their firms and their trading partners. In the context of this project Critical Success Factors (CSFs) have been defined as, “Those things that absolutely, positively must be attended to in order to maximise the likelihood of a successful outcome for the stakeholder, defined in the stakeholder’s terms.” The guide includes: o Perceived benefits of ICT use across the head contractors’ sector o Types and levels of ICT used across the sector o Self-assessment tool o CSFs for high-level ICT users, including o Best Practice Profiles o Action Statements The material contained in this Guide has been generated following a number of principles: o For a given situation there is not a single ‘right answer’, but a number of solutions that have to be evaluated using a range of relevant factors. o Since there are as many solutions as there are ‘solvers’, factors for evaluation will ‘emerge’ from collective wisdom.

Uncertainty avoidance: public sector clients and procurement selection

Purpose: Choosing the appropriate procurement system for construction projects is a complex and challenging task for clients particularly when professional advice has not been sought. To assist with the decision making process, a range of procurement selection tools and techniques have been developed by both academic and industry bodies. Public sector clients in Western Australia (WA) remain uncertain about the pairing of procurement method to bespoke construction project and how this decision will ultimately impact upon project success. This paper examines ‘how and why’ a public sector agency selected particular procurement methods. · Methodology/Approach: An analysis of two focus group workshops (with 18 senior project and policy managers involved with procurement selection) is reported upon · Findings: The traditional lump sum (TLS) method is still the preferred procurement path even though alternative forms such as design and construct, public-private-partnerships could optimize the project outcome. Paradoxically, workshop participants agreed that alternative procurement forms should be considered, but an embedded culture of uncertainty avoidance invariably meant that TLS methods were selected. Senior managers felt that only a limited number of contractors have the resources and experience to deliver projects using the nontraditional methods considered. · Research limitations/implications: The research identifies a need to develop a framework that public sector clients can use to select an appropriate procurement method. A procurement framework should be able to guide the decision-maker rather than provide a prescriptive solution. Learning from previous experiences with regard to procurement selection will further provide public sector clients with knowledge about how to best deliver their projects.

Integrated versus non-integrated management and care for clients with co-occurring mental health and substance use disorders : a qualitative systematic review of randomised controlled trials

The purpose of this paper is to conduct a qualitative review of randomised controlled trials in relation to the treatment of adults with co-occurring mental health and substance use disorder (MH/SUD). In particular, integrated approaches are compared with non-integrated approaches to treatment. Ten articles were identified for inclusion in the review. The findings are equivocal with regard to the superior efficacy of integrated approaches to treatment, although the many limitations of the studies need to be considered in our understanding of this finding. Clearly, this is an extremely challenging client group to engage and maintain in intervention research, and the complexity and variability of the problems render control particularly difficult. The lack of available evidence to support the superiority of integration is discussed in relation to these challenges. Much remains to be investigated with regard to integrated management and care for people with co-occurring and MH/SUD, particularly for specific combinations of dual diagnosis and giving consideration to the level of inter-relatedness between the disorders.

Do clients with acquired brain injury use the splints prescribed by occupational therapists? A descriptive study

Clients with acquired brain injury often demonstrate hypertonicity and decreased function in their upper limbs, requiring appropriate intervention. Splinting is one of the intervention methods that is widely used to address these issues. Literature shows that some clients are not using splints following fabrication. However, there is a paucity of research about the factors that influence clients to use or not use splints. This study aims to investigate these influential factors for clients with upper limb hypertonicity. Two survey tools including therapist and client questionnaires were developed and completed by both therapists and clients. Six therapists and 14 clients participated in this study and completed the relevant questionnaires. The results illustrate that most clients (13 out of 14) were continuing to use their splints four weeks following discharge from hospital. The main goals of choosing splints for both therapists and clients were prevention of contracture and deformity. The most indicated client reasons for adhering to the splint wearing program were therapist-related factors including clients’ trust and reliance on their therapists. Further reasons for clients implementing the recommended splint-wearing program and clinical implications are discussed.

A collaborative approach to home care delivery for older clients: Perspectives of home care providers

A collaborative approach to home care (HC) delivery for older clients has taken centre stage (Nies, 2006). In Finland, public home help and home health care services have been combined to form the home care unit, whose goal is to provide a collaborative approach to care delivery through cooperation and sharing of responsibilities. In this model, the general practitioner (GP), home care nurses (HCN) and home help workers (HHW) care for shared clients. GPs and HCNs provide health care, such as monitoring of clients’ health status, and HHWs assist with personal care tasks such as dressing, washing and meal preparation. As the needs of older clients are multiple, collaboration is needed as one professional group cannot take sole responsibility (Nies, 2006). This paper reports on a study undertaken to examine home care unit care providers’ perspectives of the collaborative approach to HC delivery for older clients.