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In this paper, we present a literature review on integrating Eye Movement Desensitization and Reprocessing (EMDR) and Emotionally Focused Therapy (EFT) to treat trauma in couple therapy. Both are highly effective therapeutic models (one mainly used for individual trauma treatment and the other for strengthening attachment bonds in couples) that have gained significant traction and ample empirical support in the last three decades. Mental health therapists are increasingly experimenting with integrating these two models and have found that they can complement each other well; however, their integration is not well understood due to scant literature. Thus, we include research findings, clinical case examples, and theoretical discussions to provide readers with a comprehensive overview of the state of affairs on integrating these two models. We hope that this paper will highlight prior and existing practices and inspire clinicians to consider the clinical potential of integrating EFT and EMDR to increase effective therapy for couples affected by trauma. [ABSTRACT FROM AUTHOR]

Positive youth development (PYD) measurement tools are influenced by the social positionalities, ideologies, and interests of those who create them. Historically, racial, ethnic, and gender-minoritized practitioners and youth program participants have been excluded from the development and testing of PYD measures. In particular, they have been excluded from the conceptual work of defining and operationalizing central PYD constructs, from which PYD measurement and implementation are rooted. Furthermore, the existing constructs are subjective qualities, characteristics, and normative behaviors. The role and impact of power, privilege, and oppression on PYD are often missing from PYD constructs, yet they play an important role in PYD practice with racially, ethnically, and gender-diverse youth. This paper aims to center the knowledge and experiences of marginalized youth practitioners and youth in the conceptualization of PYD constructs. A multiple qualitative case study design and a purposive, convenience sampling approach were used to identify programs within a publicly funded, county-wide initiative in the pacific northwest that serves Black, Indigenous, or person of color, immigrant or refugee, and/or trans- or non-binary youth. The inductive analysis identified three key constructs: racial and social identity development, socio-emotional development, and youth-centered program environment. Participants emphasized communitarian understandings of identity development, a clear articulation of social justice principles across constructs, and emphasized relational practices and environmental factors over youth characteristics. We outline results in detail and discuss how youth and adult service providers' perspectives can help inform a more empowering and relevant model for evaluating PYD interventions. [ABSTRACT FROM AUTHOR]

Families of children with Down syndrome experience complex lives and needs, yet the few existing studies on these families are written in conventional academic prose that is not optimal for knowledge translation beyond academia, particularly for busy healthcare professionals. In this paper, we Depart Radically in Academic Writing (DRAW) (Mackinlay, 2022) and present data poetry and two case studies that draw upon semi-structured interviews with mothers, fathers, and siblings, who were interviewed separately about their experiences of having a child/sibling with Down syndrome. We introduce our interdisciplinary team that includes academics and clinicians to contextualise our focus on research translation. We demonstrate that writing with creative criticality (i.e. 'DRAWing') contributes an embodied and affective understanding of research participants' stories, which is largely lacking in the academic literature on families of children with Down syndrome and the sociology of health and illness field more broadly. Moreover, DRAWing can impact audiences emotionally as well as intellectually (Richardson, 2003, p. 924), which has important knowledge translation implications for both healthcare professionals and these families. DRAWing can capture healthcare professionals' attention, prompting them to critically reflect on their practices and opportunities for improving care and treatment for these families. [ABSTRACT FROM AUTHOR]

In this paper, we reflect on what inclusion can mean to the global Health Professions Education (HPE) community, the impact of lack of inclusion, and offer suggestions on how to be inclusive. To illustrate the impact of inclusion, we offer perspectives from the lens of a medical student, junior doctor, educators, and educational leaders. The viewpoints offered in this communication can be useful to broaden and nurture inclusive pedagogy and scholarship. Furthermore, since the aim of HPE is high quality patient care and social advocacy, emphasising inclusion in HPE could enhance inclusion in patient care. [ABSTRACT FROM AUTHOR]

Medical shadowing helps provide clinical exposure to aspiring and current medical students, mainly at the college level. This paper makes a case for making medical shadowing opportunities more widely available for high school students. Through the perspective of a high school student who got such an opportunity, we demonstrate that high school students can gain valuable clinical knowledge and exposure to the ethics involved in patient care, inspiring them to explore further pathways that will help them make better-informed academic and career choices. This high school student provides pointers on preparing for medical shadowing encounters through background research and developing a note-taking template. We also offer early-career and experienced physicians' perspectives on how providing medical shadowing opportunities to high school students benefits practicing physicians by energizing their motivation, reaffirming their commitment to the profession, and gaining a fresh perspective on their work. We believe that medical shadowing for high school students can open channels to attract and motivate a young and diverse talent pool to the medical profession that will help mitigate the projected shortfall of physicians in the next decade. [ABSTRACT FROM AUTHOR]

To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

Despite growing evidence demonstrating the psychotherapeutic potential of reading and writing poetry for various mental health problems, there remains limited evidence in relation to psychosis. This paper explores the therapeutic potential of poetry for psychosis by exploring the narratives of people with experience of psychosis who read and write poetry and people who are using poetry therapeutically within their practice. Nineteen participants were recruited to the research and data was collected via narrative interviews. Interviews were audio recorded, transcribed, and subjected to Labovian narrative analysis. Four themes were identified: i) the unsayable becoming sayable; ii) poetry supporting discovery, play and meaning making; iii) relational expression through poetry; and iv) poetry and recovery. The research offers a poetic window into the way in which we might begin to understand the language of psychosis and the interpersonal communication challenge therein. The authors propose the concept of the "poetic wavelength" which can inform the education of practitioners who are working with people who experience psychosis. Understanding the "Poetic Wavelength" offers an alternative form of meaning making, developing the capacity of practitioners in being able to accurately detect emotional states, and to respond accordingly, ultimately improving the experience of service users. [ABSTRACT FROM AUTHOR]

Voice therapy is a complex behavioural intervention. Understanding its components is integral for continued advancement of voice therapy research, translation of evidence into the clinical setting and improved client care. The Motor Learning Classification Framework (MLCF) offers an excellent opportunity for increasing such knowledge, specifically in relation to identifying variables that affect motor learning (ML), an important mechanism hypothesised to bring about voice change during voice therapy. The MLCF has shown promising results in identifying speech-language pathologists' (SLPs) use of ML variables during experimentally controlled voice therapy contexts. The purpose of this study was to test the feasibility of applying the framework in the clinical context of everyday voice therapy practice. Data consisted of two video-recorded voice therapy sessions representing usual voice therapy care. Classification of ML variables used by SLPs during the recorded sessions was attempted based on the MLCF. Several problematic features of the framework were identified. Based on deliberations between the authors of the current paper, the MLCF was revised using an iterative process. This resulted in the construction of an updated version of the framework (MLCF-V2). The MLCF-V2 organises ML strategies into two broad categories: directly observable behaviours and learning processes. The framework incorporates greater consideration of theory and empirical evidence supporting motivational, attentional focus and subjective error estimation influences on ML. Several examples of each ML variable are included as well as an attempt to provide clearer classification instruction. It is anticipated that the MLCF-V2 will provide a more useful and reliable classification for use in future investigations of SLPs' use of ML variables during usual voice therapy practice. [ABSTRACT FROM AUTHOR]

Poverty, poor living conditions, religious values and norms, lack of education, and gender discrimination influence the beliefs and behaviors of rural older women in many low-income countries. This paper aims to report the socio-ecological determinants of health-seeking beliefs and behaviors of rural older women in North-eastern Bangladesh and how these behaviors impact their recognition within the setting. It involved semi-structured interviews with 25 older women and 11 healthcare professionals. The findings revealed various determinants at the personal level (awareness of illness, mistrust toward medical treatment, self-treatment, and religious values and norms), the interpersonal level (isolation in family and communication with clinicians), community level (community perception of aging, neighboring and community organizations), and in the sphere of human rights (care affordability, social safety-net coverage and national policy). Four core determinants (poverty, education, gender and religiosity) were intertwined in shaping beliefs and behaviors. [ABSTRACT FROM AUTHOR]

Many people living with substance use disorder require multiple types of support to reduce use and mitigate harms. Recovery community centers have emerged alongside formal substance use treatment and mutual self-help groups as another option to support peoples' recovery. Research on the helpfulness of recovery community centers is limited. The purpose of this paper was to describe what Staff and Member Facilitators perceived as helpful components of a recovery community center. Semi-structured interviews were conducted with 10 Staff and six Member Facilitators of a recovery community center, Recovery Café, in Seattle, Washington. Qualitative interviews were analyzed via grounded theory approach. Eleven themes emerged on the helpful components of Recovery Café, including tangible/infrastructure and intangible/experiential strengths. Three themes related to opportunities for program improvement. Many themes on the helpful components were consistent with prior research on recovery community centers and other supports for recovery. Findings provide insight into potential active ingredients and mechanisms of recovery community centers and highlight the potential role of recovery capital. Additional research is needed to test these components to improve the understanding of if and how recovery community centers work to support people with substance use disorders in recovery. [ABSTRACT FROM AUTHOR]

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

A growing body of research has documented disrespectful, abusive, and neglectful treatment of women in facilities during childbirth, as well as the drivers of such mistreatment. Yet, little research exists on effective interventions to improve Person-Centred Maternal Care (PCMC)—care that is respectful and responsive to individual women's preferences, needs, and values. We sought to extend knowledge on interventions to improve PCMC, with a focus on two factors – provider stress and implicit bias – that are driving poor PCMC and contributing to disparities in PCMC. In this paper we describe the process towards the development of the intervention. The intervention design was an iterative process informed by existing literature, behaviour change theory, formative research, and continuous feedback in consultation with key stakeholders. The intervention strategies were informed by the Social Cognitive Theory, Trauma Informed System framework, and the Ecological Perspective. This process resulted in the 'Caring for Providers to Improve Patient Experience (CPIPE)' intervention, which has 5 components: provider training, peer support, mentorship, embedded champions, and leadership engagement. The training includes didactic and interactive content on PCMC, stress, burnout, dealing with difficult situations, and bias, with some content integrated into emergency obstetric and neonatal care (EmONC) simulations to enable providers apply concepts in the context of managing an emergency. The other components create an enabling environment for ongoing individual behavior and facility culture change. The pilot study is being implemented in Migori County, Kenya. The CPIPE intervention is an innovative theory and evidence-based intervention that addresses key drivers of poor PCMC and centers the unique needs of vulnerable women as well as that of providers. This intervention will advance the evidence base for interventions to improve PCMC and has great potential to improve equity in PCMC and maternal and neonatal health. [ABSTRACT FROM AUTHOR]

This paper examines health worker experiences in two areas of post-epidemic preparedness in Sierra Leone – vaccine trials and laboratory strengthening – to reflect on the place of people in current models of epidemic response. Drawing on ethnographic research and interviews with health workers in the aftermath of Ebola, it explores the hopes and expectations that interventions foster for frontline workers in under-resourced health systems, and describes the unseen work involved in sustaining robust response infrastructures. Our analysis focuses on what it means for the people who sustain health systems in an emergency to be 'prepared' for an epidemic. Human preparedness entails more than the presence of a labour force; it involves building and maintaining 'relational infrastructures', often fragile social and moral relationships between health workers, publics, governments, and international organisations. The COVID-19 pandemic has underscored the value of rethinking human resources from an anthropological perspective, and investing in the safety and support of people at the forefront of response. In describing the labour, personal losses, and social risks undertaken by frontline workers for protocols and practicality to meet in an emergency context, we describe the social process of preparedness; that is, the contextual engineering and investment that make response systems work. [ABSTRACT FROM AUTHOR]

Human African trypanosomiasis (HAT) is considered a highly promising candidate for elimination within the next decade. This paper argues that the experiential knowledge of frontline health workers will be critical to achieve this goal. Interviews are used to explore the ways in which HAT workers understand, maintain, and adjust their skills amidst global and national challenges. We contrast two cases: South Sudan where HAT expertise is scattered and has been repeatedly rebuilt, and the Democratic Republic of Congo (DRC) where specialised mobile detection teams have pro-actively tested people at risk for almost a century. We describe HAT careers where skills are built through participation in HAT technology trials and screening programmes; in the DRC expertise is also supported through formal rotations in screening teams and HAT referral centres for new health workers. As cases fade, de-skilling is a real threat as awareness of populations and authorities diminishes and previously vertical programmes evolve, re-configuring professional development and career paths and associated opportunities for HAT practice. To avoid repeating the mistakes of the 1960s, when elimination also seemed close at hand, we need to recognise that the 'last mile' of elimination hinges on protecting the fragile expertise of frontline health workers. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative research methods, grounded in an inductive analytic paradigm, increasingly inform clinical practice in the field of speech-language pathology. Social media research, often including qualitative methods, provides a valuable way to connect and listen to the voices of people with communication disabilities. With growing empirical evidence on the ways that people with communication disabilities use social media, and recognition of both benefits and limitations of its use, it is important to consider what will support clinicians to translate this work conceptually and safely into clinical practice. Method: In this paper, we use the tools of metaphor and arts-based knowledge translation to promote the translation of evidence into social media practice. Results: With social media being an important ecosystem to grow and nurture in speech-language pathology, a "picturing a social media garden" metaphor is proposed to further research translation. The metaphor will be used to frame strategies for applying qualitative techniques for speech-language pathologists to consider how to use social media in clinical and professional practice, as well as citing supporting literature to guide further reading. Conclusion: The suggested approaches could augment existing methods of assessment and intervention for people with communication disabilities and provide support for clinicians who want to develop their own strategy for using social media, build a vibrant social media ecosystem, and integrate social media interventions into their clinical services. [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate the psychometric properties of the Verbal and Social Interaction questionnaire for psychiatric outpatient care (VSI-OP) by using a confirmatory factor analysis. A further aim is to present the patient and staff perceptions of the frequency of these interactions in this context. The factor structure of the VSI-OP could be explained by three factors for both the staff and the patient versions. The three factors are: 'Inviting the patient to establish a relationship', 'Showing interest in the patients' feelings, experiences and behaviour' and 'Helping the patients to establish structure and routines in their everyday life'. The two first factors were the most frequently occurring actions according to the staff and the patients. [ABSTRACT FROM AUTHOR]

Healthcare professionals are the vanguard of battling the COVID-19 pandemic and they experience major challenges associated with their jobs in the context of this pandemic. We carried out a survey of 253 healthcare professionals and 189 employees working in other domains to explore differences in how they adapted to COVID-19. Our results show that healthcare professionals perceive a higher mortality threat, lower job satisfaction and engage in fewer counterproductive work behaviors compared to respondents from other professions. Building on the tenets of the Terror Management Theory, we show that dispositional differences in death anxiety are the main drivers of perceived mortality threat in relation to COVID-19, yet this positive association is weaker for healthcare professionals, pointing to the engagement of proximal defenses specific to this work domain. Mortality threat mediates the association between death anxiety and job satisfaction only when supervisory support is low, pointing towards the crucial role of social support at work as a buffering mechanism against the deleterious effects of COVID-19 threat. Our paper presents one of the first empirical attempts to compare healthcare professionals with other workers with respect to job satisfaction and counterproductive work behaviors during the pandemic. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the UK press featured headlines that heightened concerns around Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders, particularly the use of 'blanket' DNACPR orders applied to older people in care settings. The portrayal of DNACPR may impact professional and public understandings with implications for end-of-life care. To explore the portrayal of DNACPR orders in the general and academic press and consider implications for public and professional understandings and practice. Academic papers and articles published in the general press during the first wave of the COVID-19 pandemic in the UK were retrieved. Those pertaining to the use of DNACPR orders were analysed thematically. Analysis of 179 media articles and 11 professional commentaries identified mixed understandings of DNACPR as indicated within three themes: rationing of acute services, championing autonomy in DNACPR decisions, and communication and trust. The call to 'protect the NHS' marginalised palliative and social care services with DNACPR constructed as a rationing tool. This led to ethical challenges around autonomy, DNACPR decisions, communication and trust. Media coverage of DNACPR orders was contentious and raised questions around the value of life and quality of dying, particularly for vulnerable individuals. DNACPR orders were conflated with frailty, futility and rationing of acute services and the marginalisation of palliative care. Nevertheless, media outputs stimulated advocacy and support for human rights and autonomy. However, it is unclear what the legacy will be for public and professional understandings of advance care planning and the quality of dying. [ABSTRACT FROM AUTHOR]

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom. [ABSTRACT FROM AUTHOR]

The context of implementation plays an important role in the delivery of optimal treatments in stroke recovery and rehabilitation. Considering that stroke systems of care vary widely across the globe, the goal of the present paper is to compare healthcare providers' priority of key areas in translating stroke research to clinical practice among High Income Countries, Upper Middle- and Lower Middle-Income Countries (HICs, UMICs, LMICs). We also aimed to compare perceptions regarding the key areas' feasibility of implementation, and formulate recommendations specific to each socioeconomic region. Data related to recommendations for knowledge translation in stroke, from a primary survey from the second Stroke Recovery and Rehabilitation Roundtable were segregated based on socioeconomic region. Frequency distribution was used to compare the key areas for practice change and examine the perceived feasibility of implementation of the same across HIC, UMIC and LMICs. A total of 632 responses from healthcare providers across 28 countries were received. Interdisciplinary care and access to services were high priorities across the three groups. Transitions in Care and Intensity of Practice were high priority areas in HICs, whereas Clinical Practice Guidelines were a high priority in LMICs. Interventions specific to clinical discipline, screening and assessment were among the most feasible areas in HICs, whereas Intensity of practice and Clinical Practice Guidelines were perceived as most feasible to implement in LMICs. We have identified healthcare providers' priorities for addressing international practice change across socioeconomic regions. By focusing on the most feasible key areas, we can aid the channeling of appropriate resources to bridge the disparities in stroke outcomes across HICs, UMICs and LMICs. It is pertinent to examine the differences in priorities of stroke rehabilitation professionals and the feasibility of implementing evidence-based practice across socioeconomic regions. There is an urgent necessity for the development of clinical practice guidelines for stroke rehabilitation in Low-Middle Income Countries, taking into consideration the cultural, economic and geographical constraints. In upper-middle income countries, encouraging family support and timely screening and assessment for aphasia, cognition and depression appear to be the low hanging fruits to enhance quality of life after stroke. Innovative ways to increase intensity of practice and channelling of resources to improve transitions in care may prove to be the most beneficial in advancing stroke rehabilitation in high income countries. [ABSTRACT FROM AUTHOR]

A growing body of research shows the inimical impact of climate change on people's mental health. However, attention to mental health providers at the frontlines is rather sparse, especially in climate-vulnerable countries. This commentary aims to present the perspectives and experiences of mental health providers within the context of climate change in the Philippines. Specifically, this paper explicates the challenges faced by mental health providers in trying to address the increasing climate-related distress experienced by many Filipinos and the recent progress in promoting climate change and mental health nexus in the country. The recommendations offered in this commentary will hopefully provide the basis for a more comprehensive mental health framework that incorporates climate change and supports mental health providers in their pursuit to preserve Filipino mental health on a warming planet. [ABSTRACT FROM AUTHOR]

Protecting health-care provider (HCP) well-being is imperative to preserve health-care workforce capital, performance, and patient care quality. Limited evidence exists for the long-term effectiveness of HCP well-being programs, with less known about physiotherapists specifically. To review and synthesize qualitative research describing experiences of HCP, generate lessons learned from the greater population of HCP participating in workplace well-being programs, and then to inform programs and policies for optimizing psychological well-being in an understudied population of physiotherapists. This qualitative meta-synthesis included a systematic literature search conducted in September 2020; critical appraisal of results; and data reduction, re-categorizing, and thematic extraction (reciprocal translation) with interpretive triangulation. Twenty-five papers met the inclusion criteria. Participants included physicians, nurses, and allied health providers. All programs targeted the individual provider and included psychoeducational offerings, supervision groups, coaching, and complementary therapies. Four themes were constructed: 1) beneficial outcomes across a range of programs; 2) facilitators of program success; 3) barriers to program success; and 4) unmet needs driving recommendations. The findings enhance our understanding of diverse individual-level programs to address HCP well-being. Beneficial outcomes were achieved across program types with system-level support proving critical; however, HCP described barriers to program success (HCP characteristics, off-site programs, institutional culture) and remaining needs (resources, ethical dissonance) left unaddressed. Organizations should offer individual-level programs to support physiotherapists in the short term while pursuing long-term, system-level change to address drivers of well-being. [ABSTRACT FROM AUTHOR]

This study is an attempt to bridge the gap between the understanding of strengths and challenges of people with autism to operationalize a strength-based approach to serve people with autism effectively. By virtue of being based on firsthand accounts by parents and practitioners the people who spend prolonged periods with people with autism in natural settings, and are privy to direct observation of abilities and challenges, the study yields in-depth information that addresses a continued gap in the existing literature on the subject. Twenty participants (13 parents and seven practitioners) took part in the study through a semi-structured questionnaire and face-to-face interviews. Data were analyzed following qualitative thematic analysis methodology. Strengths and related challenges experienced were extracted as the broad themes, based on which support needs were derived and future directions recommended. The paper recommends strategic home–school collaborations with crucial, concurrent roles played by parents and practitioners. [ABSTRACT FROM AUTHOR]

This paper analyzes patient-provider interaction (PPI). More precisely, it deals with the form-function relationship in questions used in counselor-patient interaction. The study is based on naturally occurring primary data collected at the Department of Pediatrics and the Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), located in Aligarh Muslim University, India. The data are composed of audio-visual recordings of Hindi-Urdu interaction between 8 counselors and 27 patients. We identified compliance and condescension as the two unique functions the counselors seeks to accomplish and/or fulfill through the use of questions in their interaction with the patients. We also found four other functions – information seeking, recall, greeting, and diagnosis, which are sought by the counselors through their use of questions. The findings also suggest that these functions maintain and promote what can be termed as a counselor-centered interaction, and thus reflect asymmetrical power relationship between counselors and their patients. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of healthcare providers (n = 10), policymakers (n = 5), and drug users (n = 5) in Puerto Rico (PR) after Hurricane Maria hit in September 2017. We draw upon ecosocial theory and theories of coloniality to interpret the findings from semi-structured interviews conducted between 2018–2020. The data from the study reveal the unacknowledged absence of illicit drug use in public policies on emergency management in response to the catastrophe and its association with barriers in the provision of health care services (i.e. mental health, opioid agonist therapy, and harm reduction) for drug-using patients. These individuals have been largely invisible in policy discussions on healthcare post-Maria. Our analysis highlights three intersecting factors that should be addressed in post-disaster policymaking addressing substance users. First, changes in the government's medical plan one year after the Hurricane hampered the coordination of services for patients and providers. Therefore, the aid offered tended to be exclusively economic rather than addressing disparities in health service access. Second, policies have not addressed the mistreatment and prejudice toward substance users in hospital and emergency room settings. Third, there was evidence of relapses in the use of controlled substances and the replacement of routine drugs with fentanyl due to the interruption of regular transportation, affecting supplies and illegal substances. Failure to address addiction constitutes a real threat to the survival of a significant population in PR and embodies the historical oppression wrought by colonialism, discrimination, and stigma in a society that dismisses substance users in its public and budgetary policies. [ABSTRACT FROM AUTHOR]

Standardized assessment and progress monitoring are an important part of evidence-based practice. Despite efforts to embed standardized assessments into routine practice, they remain underutilized by practitioners. This underutilization has been attributed to a variety of factors, one of which is the concern that standardized assessments are a burden for individuals to complete. This study sought to gather the first descriptive data on substance users' attitudes toward the use of standardized assessments as part of an initial assessment and for progress monitoring. Seventy-one Australian substanceusing individuals (54.9% male) recruited via online forums, practitioner networks, and advertisements placed in relevant treatment services completed an online survey. The majority of substance-using individuals believed standardized initial assessment and progress monitoring measures to be beneficial to fill out, not burdensome, and valuable in monitoring treatment progress. Individuals would also prefer to choose the administration format of assessment (e.g. computer, mobile device, pencil-and-paper). Findings challenge the assumption that including standardized assessments in routine practice will be considered too burdensome by individuals who use substances, and offer insights that can inform patient-centred implementation. [ABSTRACT FROM AUTHOR]

Unexpected lucidity is a phenomenon of scientific, clinical, and psychological relevance to health professionals, to those who experience it, and their relatives. This paper describes qualitative methods used to develop an informant-based measure of lucidity episodes. The approach was refinement of the operationalization of the construct; review of seminal items, modification, and purification; and confirmation of the feasibility of reporting methodology. Modified focus groups were conducted with 20 staff and 10 family members using a web-based survey. Themes included reaction when hearing the term; words that come to mind; description of and first reaction to referenced or observed 'lucidity' events. Semi-structured cognitive interviews were conducted with 10 health professionals working with older adults with cognitive impairment. Data were extracted from Qualtrics or Microsoft 365 Word® for analysis using NVivo. Conceptual issues, as well as issues regarding comprehension, interpretation, clarity, semantics, and standardization of definitions derived from an external advisory board, focus groups and cognitive interviews informed items' modification, and resulted in the final lucidity measure. An obstacle to understanding the mechanisms and estimating the prevalence of lucid events among individuals with dementia and other neurological conditions is the scarcity of reliable and valid measures. The substantive and varied data gathered from multiple methods including the collaborative work of an External Advisory Board, modified focus groups with staff and family caregivers, and structured cognitive interviews with health professionals were central in creating the revised version of the lucidity measure. [ABSTRACT FROM AUTHOR]

Early identification of children and youth who engage in problematic sexual behavior is important for all parties involved, such as children who exhibit and are impacted by the behavior. There are several reliable and valid identification tools that can be used to recognize problematic sexual behavior in children and youth (PSB-CY) in clinical practice; however, professionals who work with children in non-clinical settings (i.e., child development centers, youth programs, and schools) often have limited resources and tools when they encounter PSB-CY. This paper describes the development, content, and user feedback of a referral tool (RT) that was designed to help identify incidents of PSB-CY for use with military agencies and schools. Specifically, the RT was designed to help professionals, who may have observed or who may have been made aware of sexual behaviors in children and youth, organize their observations of the behavior in alignment with evidence-based information about PSB-CY and consistently document these occurrences. The RT guides users in determining if the observed behavior is normative, cautionary, or problematic and promotes informed decisions about whether the behavior needs to be referred to those who have experience using clinical tools for further review and the identification of next steps for supporting the children and families involved. Early adopters provided feedback on the use of the RT. The feedback suggested that the tool was user-friendly, understandable, and helpful as they made objective decisions about how to identify and handle referrals of PSB-CY. [ABSTRACT FROM AUTHOR]

Young people with severe and complex depression experience substantial social connectedness difficulties. The aim of this qualitative study was to evaluate the role of social connectedness in a novel group therapy (Relate) for youth living with severe and complex depression from clinicians' perspectives. Semi-structured interviews were conducted with 11 clinicians practicing at Orygen's Youth Mood Clinic in Melbourne. Eight of the 11 clinicians were female, with the sample aged 30–42 years (M = 34 years, SD = 3.6 years) and having an average 4.5 years clinical experience at Orygen. Four key themes were identified by codebook thematic analysis. The first theme pertained to clients' difficulties with social engagement, which impacted their attendance of Relate, but were addressed by the intervention. In the second theme, clinicians identified Relate as providing a safe space. In the third theme, clinicians identified opportunities for positive relational experiences. In the fourth theme, clinicians observed social and clinical improvements in Relate clients, but marked recovery did not always occur after attending. Findings provide initial support for the continuation of Relate. Recommendations for future iterations of Relate include refining the intake criteria for referring clients to Relate and potentially lengthening the program's duration. What is already known about this topic: Group interpersonal therapy is an effective intervention for depression and interpersonal functioning in young people. Few studies have evaluated treatments for young people with severe and complex depression and high suicide risk. Few studies have evaluated group programs within early intervention services. What this paper adds: A relationally-focussed group therapy could improve social connectedness and interpersonal functioning for youth living with severe and complex depression. The Relate group emphasises a safe environment for sharing and social risk-taking, providing opportunities for positive relational experiences with similar others which might be particularly useful for youth with complex social difficulties. Identified issues with engagement suggest clients could benefit from an explicit rationale for how their participation in the group benefits their depression treatment. [ABSTRACT FROM AUTHOR]

In this paper we aimed to explore: (1) challenges that people with mental illnesses (MIs) describe in engaging in smoking cessation, (2) challenges that mental health providers (MHPs) perceive that people living with MIs face, and (3) how the perceived challenges are similar and/or different from both perspectives. Semi-structured interviews were used to obtain narrative data from 16 MHPs and 13 psychiatric inpatients with MIs. We identified themes purport societal, group, and individual factors may influence smoking cessation treatment engagement. The scope of the perceived challenges appeared varied in the narratives of MHPs as compared to those with MI. [ABSTRACT FROM AUTHOR]

Professional confidence and knowledge are essential in effectively responding to sibling sexual abuse (SSA). If professionals do not have knowledge of the area and confidence in their skills to deliver effective support, then there could be negative consequences for the victims. The methods consisted of narrative interviewing of N = 30 professionals and N = 2 young victims/survivors. This approach was chosen as it provided a thorough and robust picture of practitioner responses to SSA. Through thematic analysis, three dominant themes emerged across both the young person and practitioner data in relation to practitioner responses to SSA, these being minimisation, exaggeration, and catastrophising. SSA is an area in its own right with its own nuances and considerations that make it distinct from other forms of sexual abuse, which means that professional responses and training need to be re-examined to develop new, more appropriate ways of working with victims as well as those who commit SSA. The impact of this paper is both clinical and professional. It gives insight into a little-researched area and highlights the complex issues in relation to sibling sexual abuse and how this is framed and approached by professionals. This points to the critical need for more work and training in this area when working with SSA and the need for more bespoke professional knowledge. [ABSTRACT FROM AUTHOR]

As the population of older adults continues to grow, the need for health care professionals trained in the delivery of interprofessional care for older adult patients is critical. The purpose of this paper is to detail the outcomes of an interprofessional, geriatrics training program for healthcare professionals with a faculty appointment. Specifically, we gathered outcomes at four levels: reactions/satisfaction, learning, behavioral, and organizational. Our findings suggest that programs structured like the Faculty Development Program (FDP) have the potential to increase the amount of geriatrics content introduced in already existing health professions curricula, as well as to offer faculty needed training in how to provide their students with interprofessional learning experiences. [ABSTRACT FROM AUTHOR]

Despite its historic prominence in group work, there is little empirical research to support our understanding of the professional use of self in group work. This paper reports the results of a SPARC endorsed study, which focused on group workers' experience and struggle with their professional uses of self in groups in responding to diversity. Using focus groups, a semi-structured interview format, and Straussian grounded theory data analysis, two key themes emerged – grappling with professional uses of self and disengagement from professional uses of self. When grappling with professional uses of self, group workers employed intentional self-disclosure, opened space, and supported norms for the expression of diversity, humility, genuineness, and reflexivity. Disengagement occurred in response to fear and often resulted in an overemphasis on group tasks. Our results suggest that the effective professional use of self in the here and now of group dynamics creates a sense of safety for both the group workers and the group members when responding to diversity. The implications of this study highlight the need for a method that supports critical self-reflection in real-time in group and builds capacity for responsibly responding to diversity in groups. [ABSTRACT FROM AUTHOR]

The aim of this project is to survey academic health sciences librarians to learn about the challenges they face when they are part of a growing health system. Thirty-seven librarians completed a survey about the challenges they face in the current academic health sciences environment, highlighting specific concerns related to affiliated health system growth. This paper describes the results of the survey to enhance understanding among academic health sciences librarians regarding how library collections, budgets, and technology can be impacted by growth in affiliated health systems. [ABSTRACT FROM AUTHOR]

In this paper, we present and discuss partial findings of a thematic analysis on the experiences of 13 licensed clinicians who integrate Emotionally Focused Therapy (EFT) and Eye Movement Desensitization and Reprocessing (EMDR) in couple therapy. We cover five of the seven themes that emerged from the data. These themes refer to practical factors of implementation, such as identifying and assessing the conditions necessary for effective integration, risks of integrating, and timing of integration in couple therapy. One additional theme refers to the institutional and training factors that might hinder model integration. After presenting the findings, we contrast them with available literature. We conclude by discussing clinical and research implications. [ABSTRACT FROM AUTHOR]

Background: Deaths due to opioid overdose continue to rise in the United States. Despite availability of effective treatment for opioid use disorder, uptake is low among those who misuse opioids. Methods: This paper explores the role of misconception, stigma, and misinformation in influencing decisions to initiate medications for opioid use disorder among patients and providers. Conclusion: Misinformation about opioids has been prevalent among future healthcare providers and first responders as well as pharmaceutical companies, which may have implications for treatment. Among individuals with opioid use disorder, treatment uptake and adherence have been negatively affected by misconceptions about treatment efficacy and side effects, as well as stigma. We discuss the role of social media, education, and the community, in mitigating misinformation and addressing misconceptions about opioids and treatment options. [ABSTRACT FROM AUTHOR]

Prevention of chronic diseases happens within systems of action across whole communities. In local communities, organisations play important roles that influence health, but many are in non-health sectors where health or 'prevention' is not their main remit. In this paper, we explore how organisations in communities perceive their role as part of a local system of chronic disease prevention. We use interview data from 'Prevention Tracker', an investigation undertaken with Australian communities that aimed to describe how local prevention systems are organised. Four communities participated – one regional, one remote, and two urban. In each, local advisory groups identified key informants for semi-structured interviews (n = 80). We applied the Ottawa Charter for Health Promotion as a sensitising framework to categorise responses; and undertook inductive thematic analysis to generate deeper insights into organisations' orientation to prevention. While some respondents clearly recognised and articulated linkages between their organisation's activities and prevention, sometimes drawing from health promotion principles to do so, many did not and were prompted by the interview to consider their contributions. A proportion explicitly distanced themselves from prevention despite their work directly addressing the social determinants that underscore health. For some, this distancing reflects a tactical decision to reduce competition and promote partnership between organisations, and to engage clients. This study demonstrates that diverse organisations make contributions to prevention – often outside of 'core business' – whether or not the organisations themselves realise, relate to and/or self-identify as playing this role. [ABSTRACT FROM AUTHOR]

The book "Islam and Mental Health" seeks to examine Islam as a resource and a liability for mental health among Muslims. This paper describes the translation of this book into Persian, examines how mental health professionals in Iran view its contents and reviews whether the information is consistent with Iranian religious beliefs based on views of Shiite Islamic scholars. For this purpose reviewing relevant research and Islamic sources, the book's text was presented both independently and together to religious scholars and to mental health professionals for comments. The results revealed consistencies and inconsistencies with Muslim beliefs and Iranian cultural traditions. [ABSTRACT FROM AUTHOR]

Cancer patients frequently experience pronounced rates of stress and associated psychological disorders. Unfortunately, many oncology departments only offer limited psychotherapeutic services. This study evaluates if Conflict Analysis (CA), a brief self-guided psychotherapeutic intervention, can help fill this void. CA combines self-report questionnaires, drawing, creative writing, and structured self-reflection. Previously implemented in psycho-educational and clinical contexts, the study presents CA's first psycho-oncology implementation. This study evaluates CA's psychosocial benefits for oncology patients interested in mental health services. CA's abbreviated paper-version (estimated 2.5 h) was provided to nine patients. Before immediately after, and two weeks after, participants completed hope, growth, and motivation measures. Cancer-care-providers completed benefit evaluations. A sample case is discussed. Six participants completed CA. Measures showed nonsignificant improvement. Cancer-care-providers and participants rated CA as therapeutic, diagnostically accurate, and personally relevant. CA appears to be a meaningful, relevant, and accessible intervention for cancer patients. Limitations include illness/treatment influence and sample size. Evidence supports larger cohort replication. [ABSTRACT FROM AUTHOR]

The present paper outlines parental pathological projective identification as a form of childhood adversity that some patients attempt to address in psychotherapy. This phenomenon involves a parent's unconscious relocation of an unbearable state of mind, combined with the interpersonal evocation of such in the child. A child's effort to deal with this experience may involve the development of pathogenic beliefs about the self. These beliefs subsequently cause difficulties in living and considerable distress. Through understanding the dynamics of parental pathological projective identification, clinicians may help patients to develop insight into the origins of their pathogenic beliefs, along with appropriate corrective experiences. The integration of Control-Mastery Theory with the concept of parental pathological projective identification can facilitate such understanding. A clinical example is provided to illustrate these concepts and their relevance to psychotherapy with adult patients. [ABSTRACT FROM AUTHOR]

The long-term care workforce is a significant provider of palliative care. The majority of older people being admitted to long-term care have palliative care needs and many are approaching end of life. The long-term care workforce comprises both registered health care professionals and unlicensed health care workers (UHCW) who provide most direct care. Studies that have examined palliative care competence in long-term care have focused on staff knowledge. However, it is also important to understand staff attitudes, beliefs, and values towards palliative care because these attributes influence behaviours related to care provision. The aim of the qualitative evidence synthesis is to identify and appraise the best available qualitative evidence on the attitudes, beliefs, and values of the long-term care workforce towards palliative care. The review will consider original research that reports qualitative findings of long-term care staff and their attitudes, beliefs, and values regarding palliative care for residents of long-term care facilities. The following databases will be searched for eligible papers: CINAHL, EMBASE, PubMed, PsychINFO, and Scopus. Studies that meet the inclusion criteria by addressing all of the phenomena of interest will be reviewed using the Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence. Two reviewers will independently assess the studies for methodological quality. The data will be extracted using the standardized JBI SUMARI extraction tool. Specific details about authors and publication date, study design, aims, context, population, cultural and linguistic background, location, main findings, limitations, and conclusions will be extracted and a level of credibility assigned. Categories will be developed from the findings. The findings will be presented diagrammatically and accompanied by a narrative to explain categories and synthesised findings. The review of the literature will synthesis key findings pertaining to the attitudes, beliefs, and values of the workforce providing palliative care to older people in long-term care, beyond what is known about palliative care knowledge in this workforce. [ABSTRACT FROM AUTHOR]

Background: End-of-life treatment decisions present special challenges for prehospital emergency providers. Paramedics regularly make value-laden choices that transcend technical judgment and professional skill, affecting the type of care, how and to whom it is provided. Changes in prehospital emergency care over the last decade have created new moral challenges for prehospital emergency providers; these changes have also accentuated the need for paramedics to make rapid and reasoned ethical judgments. Objective: The purpose of the study was to explore the decision-making process that occurs when prehospital emergency teams respond to an end-of-life call with a focus on how state authorized documents such as a Non-Hospital Do Not Resuscitate (NHDNR) or Medical/Physician's Orders for Life-Sustaining Treatment (MOLST/POLST) or lack thereof inform decision-making. This paper presents the specific circumstances that informed the need for intervention from Online Medical Direction (OLMD) framed in the perspectives and words of the prehospital providers seeking that assistance. Methods: This study involved in-depth in-person interviews with 50 providers to elicit participants' experiences in their own words using a semi-structured interview instrument. Interviews were audio recorded and transcribed with permission. Results: Five themes emerged that illuminated how and when OLMD was involved in emergency end-of-life decisions: Termination of Resuscitation (TOR); Family Revoked DNR; Missing Documents; No Documents and No CPR; and Unusual Situations. Participants illustrated how the decision to terminate efforts was best-supported when it was made by collaboration between the on-scene provider and OLMD. Participants described ethical dilemmas when families asked them to initiate CPR in the presence of DNR orders and cognitive dissonance when CPR has been initiated but a valid DNR/MOLST is subsequently located. Conclusions: The study findings demonstrate the invaluable contribution of OLMD for complex end-of-life care decisions by prehospital providers, especially when there are difficult legal, ethical, and logistical questions. OLMD provides far more than technical support. [ABSTRACT FROM AUTHOR]

Attention and communication difficulties are common yet often invisible following Traumatic Brain Injury (TBI). The focus of this paper is to use practice-based evidence from health professionals working with individuals following TBI to gain a deep and relevant understanding of the impact that attention and communication can have in the lives of individuals following TBI. This dataset comes from a larger mixed-methods study that includes a survey with both open and closed questions and focus group data sources. Thematic analysis was completed on a single open-ended question from the survey of health professionals. It asked health professionals about the outcomes they believe are directly related to attention difficulties that result in specific communication difficulties. Responses from 73 health professionals who work in neurorehabilitation generated five themes: behavior, connections, self, purpose, and empowerment. The themes were pervasive across all aspects of the recovery journey for individuals post-TBI The implications for clinical practice and future research indicate a need to focus on attention-related strategies for language deficits; treating communication difficulties related to relationships and friendships; and redefining a sense of self following TBI. [ABSTRACT FROM AUTHOR]

Women living with HIV (WLWH) are at increased risk of anal cancer compared to women without HIV, often due to persistent human papillomavirus (HPV) infections. This paper describes current practices and challenges conducting anal cancer screening for WLWH at an urban integrated safety-net system and a non-profit community-based HIV clinic. We conducted 25 semi-structured interviews with clinical and administrative stakeholders to assess knowledge, clinic practices and procedures, and experiences with anal cancer screening. Interview transcripts and fieldnotes were thematically analyzed using an iterative deductive and inductive coding scheme. Findings were organized by the Consolidated Framework for Implementation Research (CFIR) domains and constructs. Provider-level barriers to conducting anal cancer screening included limited knowledge of guidelines. System-level barriers included: structural characteristics such as lack of coordination between clinics to discern provider roles and responsibilities; and limitations in available resources such as configuration of electronic health records and infrastructure to manage referrals of abnormal anal Pap results. We conclude that anal cancer screening and follow-up for WLWH requires organization and coordination between multiple care teams, updated clinical information systems to facilitate communication and support anal Pap ordering and result documentation, and infrastructure that includes policies and protocols for management of abnormal results. Trial registration: ClinicalTrials.gov identifier: NCT02135419. [ABSTRACT FROM AUTHOR]

A significant burden and treatment gap associated with serious mental illness (SMI) exists in low- and middle-income countries (LMIC). In order to address these issues, a range of community-based rehabilitation models in alignment with the Capabilities Approach is necessary, including opportunities for people with SMI to be rapidly engaged in meaningful work within their communities. This paper outlines the development processes and evaluation of the proof of concept for the Community REcovery Achieved Through Entrepreneurship (CREATE) strategy in Kenya. The CREATE strategy pairs Work Integration Social Enterprises (WISE) with a focused, low-cost, recovery-oriented Psychosocial Rehabilitation (PSR) toolkit within a peer involvement/support model as a means of addressing marginalization and fostering health, wellbeing, and participation of people living with SMI. Qualitative research methods were used to understand the experiences of a range of stakeholders involved in CREATE implementation in Kenya. Three overarching themes explicated the experiences of the various stakeholders involved: (1) experiencing a business like other businesses – yet different; (2) expanding capacities, opportunities, and networks through meaningful work; and (3) promoting knowledge and empowerment through education. Within each theme, there was evidence of the attenuation of central elements of marginalization. The CREATE strategy demonstrated acceptability and a variety of potential positive impacts in a low resource setting in Kenya. Application of the CREATE strategy to other low resource settings within Kenya and other LMIC merits further exploration. [ABSTRACT FROM AUTHOR]

Research into children's voices continues to receive significant attention due to the limited progress made around the world in meeting Article 12 of the Convention on the Rights of the Child: the right to be heard and participate in decision making. However, there is a paucity of research providing insights into children's voices in family support services linked with the child protection system. This paper contributes new understandings into the everyday practice experiences of 46 frontline urban and regional practitioners working in family support services for UnitingCare, a nongovernment organisation in Queensland, Australia. Critical and interpretive research utilising WorldCafé focus groups reveals hearing children's voices is not occurring as an everyday practice. It identified four intersecting influences that prevent rights-based children's participation: program, conceptual, organisational, and direct practice issues. A sustained paradigm shift to protection with participation is needed to ensure children's voices are included as an everyday practice in family support services. IMPLICATIONS Culture, program, organisation, and practice level challenges intersect to impede frontline family support services practitioners from hearing children's voices as an everyday practice. A paradigm shift to "protection with participation", a culture that values children and their voices, alongside steadfast leadership are needed to embed a rights-based, child-inclusive approach in family support services as part of the care continuum. [ABSTRACT FROM AUTHOR]

Purpose: Telehealth is rapidly becoming an essential part of speech-language pathologists' core business, and yet the experiences and opinions of community-based therapists in using telehealth remain relatively unknown. This paper describes a recent study in which speech-language pathologists were provided with access to a formal language assessment within a telehealth platform and asked to provide feedback about their experiences. Method: Twenty-seven speech-language pathologists in paediatric practice were recruited via callouts on social media, community contacts and professional networks. The participants were provided access to a telehealth platform with a built-in formal language assessment and asked to use the assessment with their own caseload as clinically indicated and provide feedback after each assessment. Questionnaire data was collected via an online survey system and contained questions about each assessment including the most enjoyable and most difficult aspects of the assessment and their overall experience of the platform. Result: More than 100 assessments were completed during the 3-month trial, with clinicians reporting that on most occasions, video and audio quality was adequate or more than adequate, and that interactions with their child clients were effective. Qualitative data indicated that technical difficulties were a drawback to the assessments, but that ease of use of the assessment, the added functionality of using the assessment within the telehealth platform and factors including general benefits of telehealth, particularly that of being able to continue to provide services when face-to-face work was not possible were seen as positive elements. Conclusion: This study adds clinicians' voices to the research into telehealth, indicating that the assessment within the telehealth platform was generally easy to use, and provided an unexpected depth of insight and connection for clinicians and their clients. Future research may consider the voices of other stakeholders in telehealth interactions, including parents and child clients. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. To that end, I conducted a case study in a Swedish municipality. The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four conditions of the Consumer Direction (Control and Direct services – Variety of digital technologies for ageing in place options – Information and Support – Participation in systems design) were met to a very low degree. I propose that the municipality in question creates a proper knowledge-sharing platform so that occupational therapists are well informed about digital technologies for ageing in place, to allow them to provide accurate information and support to elderly with dementia, resulting in a possible increase in use of technology and subsequently support the empowerment goal of Consumer Direction. I also believe, according to the findings of this study, that the module of Information and Support should be treated as the most important condition for achieving increased Consumer Direction. Elderly with dementia and their relatives do not receive sufficient information about digital technologies for ageing in place (DTAP). There is not enough information regarding the available options and their use. This often denies elderly with dementia and their relatives the services they are entitled. Occupational therapists knowledge about DTAP affects the variety of options presented to elderly with dementia and their subsequent use. Once a person is diagnosed with dementia, physicians tend to suggest medicinal solutions, overlooking the dissemination of DTAP information. Thus hindering their early access to DTAP. [ABSTRACT FROM AUTHOR]