Gender Aware Music Therapy: An Interpretative Phenomenological Analysis

The purpose of this phenomenological study was to explore the influence of gender on music therapy practice through the experiences and perceptions of gender aware music therapists (GAMTs). Participants (N = 5) included five board-certified music therapists or equivalent who have published scholarly literature on topics related to gender and music therapy. Participants shared their experiences in semistructured individual interviews; interviews were recorded, transcribed, and analyzed using interpretative phenomenological analysis (IPA). Six major themes emerged: (a) GAMTs recognize how socialization produces binary music participation, which is often perpetuated in music therapy practice; (b) GAMTs share the belief that gender roles and expectations create exclusive music practices that may restrict and limit musical expression and participation; (c) GAMTs create therapeutic spaces that encourage authentic music engagement by thoughtfully accepting and/or rejecting established gender stereotypes prevalent in music culture; (d) GAMTs suggest that gender is a marker of identity, which may or may not affect how the therapeutic relationship develops between music therapy clients and clinicians; (e) GAMTs utilize theories and therapeutic approaches that influence their music therapy research and practice; and (f) GAMTs recommend that practicing music therapists recognize their personal biases, develop a heightened awareness for how gender influences society, and actively pursue an inclusive practice that does not assume gender. Clinical implications and future research recommendations are discussed.

Learning to manage depression: A systematic review and meta-analysis of skills learned in therapy as a mediator of improved well-being

ObjectiveIn therapy, clients may learn skills to manage depression. Failing to learn such skills would increase the risk of relapse. To assess this hypothesis, we conducted a systematic review of studies that assess the mediating effects of learning skills in treatment for depression.MethodWe searched four databases using 11 keywords to find randomised trials using any intervention and reporting a skill-based outcome. We conducted full-text screening, data- extraction, and risk of bias in duplicate.ResultsSearches retrieved 4,506 unique records. After screening 28 full-texts, 13 met inclusion criteria. Acquisition of skills in psychotherapy was found to be a mechanism through which interventions reduce depression. Skills learned in psychotherapy either have a mediating effect on depression or are associated with positive therapeutic outcomes. Stronger skill-acquisition was also associated with reductions in depressive symptomatology.ConclusionsResults suggest that therapists should not only focus on the content and relationships built in therapy, but also attend to the pedagogy involved in treatment.

Guided Goal Setting in Therapy Towards Being Fully Functioning

This qualitative study considered whether the provision of a framework of potential goals based on Rogers’ idea of the fully functioning person would be of any benefit to therapy clients in their goal setting process. It also considered addressed whether client goal setting was methodologically acceptable to integrative therapists who used Rogers’ non-directive principles as the foundation to their approach. We provided a goal setting instrument to 9 therapists and 23 of their clients, enabling them to define therapy goals, and feedback on the process. The clients set their goals using the instruments, before having at least six sessions with their therapist. We then sought joint views on the process from the therapists through a questionnaire or an interview. The data from the responses were analyzed using Thematic Analysis. The majority of the therapists considered that guided goal setting using a description of the ‘fully functioning’ individual was helpful. In terms of the applicability of goal setting to an integrative approach based on non-directive, person-centered principles, the results were mixed and in some cases contrary to those expected. For example, some of the more directive therapists disliked guided goal setting processes, whilst the more non-directive therapists appreciated the approach.

Effect of community antiretroviral therapy on treatment outcomes among stable antiretroviral therapy patients in Nigeria: A quasi experimental study

Objectives This study evaluates the effect of Community Anti-retroviral Groups on Immunologic, Virologic and clinical outcomes of stable Antiretroviral Therapy patients in Nigeria. Method A cohort of 251 eligible adults (≥18 years) on first-line ART for at least 6 months with CD4 counts >200 cells/mm3 and viral load <1000 c/ml were devolved from 10 healthcare facilities to 51 community antiretroviral therapy groups. Baseline immunologic, virologic and clinical parameters were collected and community antiretroviral therapy group patients were followed up for a year after which Human Immunodeficiency Virus treatment outcomes at the baseline and a year after follow-up were compared using paired sample t-test. All the analyses were performed in STATA version 14. Result Out of the 251 stable antiretroviral therapy adults enrolled, 186 (75.3%) were female, 52 (22.7%) had attained post-secondary education and the mean age of participants was 38 years (SD: 9.5). Also, 66 (27.9%) were employed while 125 (52.7%) were self-employed and 46(19.41%) unemployed. 246 (98.0%) of the participants were retained in care. While there was no statistically significant change in the CD4 counts (456cells/mm3 vs 481cells/mm3 P-0.489) and Log10 viral load (3.54c/ml vs 3.69c/ml P-0.359) after one year of devolvement into the community, we observed a significant increase in body weight (60.8 vs 65, P-0.01). Conclusion This study demonstrates that community antiretroviral therapy has a potential of maintaining optimum treatment outcomes while improving adherence and retention, and reducing the burden of HIV treatment on the health facility. This study provides baseline information for further research and vital information for HIV program implementers planning to decentralize the management of stable antiretroviral therapy clients.

Weight Change and Its Predictors among Newly Initiated ART Clients in Dessie City, Northeast Ethiopia, July 2020. Longitudinal Data Analysis

Background The weight of HIV/AIDS patients is one of the classifications WHO clinical staging of the diseases. A positive weight change in antiretroviral therapy patients is one of the expected clinical outcomes within a few months after the initiation of antiretroviral therapy in previously naïve patients. But the weight change varies across clients, and the reason for this variation and the effect of time-varying clinical profiles on the weight of the clients is not well investigated. Method: A retrospective cohort study was conducted in Dessie City Health Facility in July 2020. The data were collected using a simple random sampling method in adult antiretroviral therapy clients who were enrolled to care between January to June 2019. Totally, 58 charts were reviewed within three months interval for 6 consecutive observations per chart. The data were entered into Epi-data, and analyzed using Stata 14. The effect of Panel and random effect model was assessed using Breusch and Pagan and Hausman's test, respectively. Finally, the Random Effect Generalize Least Square model was fitted, and variables with a p-value less than 0.05 were considered as the predictors of weight change. Result A total of 58 clients chart with 322 observations were assessed and the mean age (standard deviation) of participants were 37 (10) and 30 (51.7%) of them were female clients. The absence of opportunistic infection (β:1.85; 95% CI:0.66–3.03) the interaction of opportunistic infection and months on Antiretroviral Therapy (β:0.09; 95% CI:0.05–0.13) and advanced WHO clinical stage (β: -3.52; 95% CI: -6.71-(-0.34)) were significantly associated with the weight of adult Antiretroviral Therapy user overtime. Conclusion There is a significant positive weight change after imitation of Antiretroviral Therapy. The absence of opportunistic infection and its interaction with time have a positive change on the weight of adult Antiretroviral Therapy clients whereas, experiencing advanced WHO stage disease over time has a negative effect on the weight change.

Telehealth and Home Health Occupational Therapy: Clients’ Perceived Satisfaction With and Perception of Occupational Performance

Home health care agencies are restructuring service delivery models to address quality of care and client satisfaction while containing costs. New regulatory changes and the public health emergency as a result of the COVID-19 pandemic brought immediate need for alternative care models. Telehealth has been recognized as a feasible means to provide health care. This quasi-experimental pretest-posttest study examined the feasibility of performing occupational therapy telehealth visits as adjunct to on-site visits for homebound clients (N=9). The OASIS data collection set, Canadian Occupational Performance Measure, and a survey were used to collect data. This combination of visits resulted in clinically and statistically significant improvements in client perception of performance and satisfaction. Findings showed that participants felt this visit model met their needs and they would recommend to others. Results of this study warrant a larger study involving physical therapy and speech language pathology disciplines.

therapist’s emotional presence and its interactional functions in promoting client change in relationship-focused integrative psychotherapy

Therapeutic alliance is often posed as an explanation for why therapy works, and there seems to be a consistent finding that the stronger the alliance, the greater the therapeutic change. Although extensively documented in the professional literature as an essential aspect of therapeutic alliance, the concept of emotional presence and its actualization in moment-by-moment interaction have not been adequately described. This paper applies integrative qualitative methodology, including tools and insights from discourse analysis and conversation analysis, to five extracts of Relationship-focused Integrative Psychotherapy sessions with three different clients. It examines the concept of emotional presence operationalized in terms of the therapist’s invoking the client’s immediate experience. The analytical focus falls on an interactive sequence involving the therapist’s topicalization of the client’s (proffered) non-verbal cues aiming at eliciting emotion talk in the interactional here-and-now and the latter’s orientation to it. The psychotherapist’s strategy of emotional presence is proposed to play a salient role in promoting the client’s (gradual) change by focusing the talk on the client’s here-and-now experience. Thus clients are prompted to project their emotions and/or engage in overt self-reflexive examination of emotional and relational patterns in the immediate context of their concrete trouble-telling. By being regularly exposed to such practices in therapy, clients are instilled with a sense of being in touch with how they feel about a particular situation or person.