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Sökning: L773:1650 1977 OR L773:1651 2081 > Karolinska Institutet

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1.
  • Alfonsson, Sven, 1977-, et al. (författare)
  • Clinical supervision in cognitive behavior therapy improves therapists' competence : a single-case experimental pilot study
  • 2020
  • Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 49:5, s. 425-438
  • Tidskriftsartikel (refereegranskat)abstract
    • Clinical supervision is a cornerstone in psychotherapists' training but there are few empirical evaluations on the effects of supervision on therapists' competencies. The aim of this study was therefore to evaluate the effects of standardized supervision on rater-assessed competency in Cognitive Behavior Therapy (CBT). Six therapists with basic training in CBT were provided with protocol-based clinical supervision in CBT in a single-case experimental multiple baseline design. The supervision focused on specific CBT competencies and used experiential learning methods such as role-play. Each therapist recorded weekly treatment sessions during phases without and with supervision. The therapists' CBT competence was assessed by third-party raters using the Revised Cognitive Therapy Scale (CTS-R). Statistical analyses showed that the therapists' CTS-R scores increased significantly during the phase with supervision with a mean item increase of M = 0.71 (range = 0.50-1.0) on the supervision focus areas. This is one of the first empirical studies that can confirm that supervision affect CBT competencies. The results also suggest that supervision can be manualized and that supervisees have a positive perception of more active training methods. Further studies are needed to replicate the results and to find ways to improve the impact of supervision.
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2.
  • Alfonsson, Sven, 1977-, et al. (författare)
  • The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy : a systematic review
  • 2018
  • Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 47:3, s. 206-228
  • Forskningsöversikt (refereegranskat)abstract
    • Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists’ competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists’ competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists’ competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.
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4.
  • Agnew, Louise, et al. (författare)
  • Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III : a cross-sectional analysis
  • 2015
  • Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 47:6, s. 546-551
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III.Design: Cross-sectional analysis.Patients: A total of 166 working age patients with chronic whiplash-associated disorder.Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability.Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R-2 = 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress.Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.
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5.
  • Ahlgren, Åsa, et al. (författare)
  • Selection of clients for vocational rehabilitation at six local social insurance offices. : a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.
  • 2008
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 40:3, s. 178-184
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to evaluate possible differences between local social insurance offices with regard to their selection of clients for vocational rehabilitation. A further aim was to determine whether social insurance officers from different local insurance offices have uniform attitudes regarding professional practice in their application of the insurance system. METHODS: A register-based investigation of 815 vocational rehabilitees served by 6 local social insurance offices in a Swedish county. The study was supplemented with a questionnaire to 30 officers about attitudes to social insurance. RESULTS: The office with the lowest rate of sick-listing periods exceeding one year, and a high frequency of employment training, showed the highest degree of work resumption and the lowest pension rate after vocational rehabilitation. There were wide differences in attitude among the local social insurance officers regarding professional practice in their application of the system. CONCLUSION: Intra-county differences occur in handling people on sick-leave who undergo vocational rehabilitation. The local social insurance offices with the highest and lowest outcome rates of work resumption and disability pension, respectively, select clients for vocational rehabilitation from different categories of cases. Social insurance officers from different local offices differ in their attitudes towards the social insurance system and its clients.
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7.
  • Andersson, Jenni, et al. (författare)
  • Long-term perceived disabilities up to 10 years after transient ischaemic attack
  • 2021
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:3
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The long-term impact of transient ischaemic attack is largely unknown.OBJECTIVES: To assess the long-term perceived impact of transient ischaemic attack and explore the influence of sex and age on these perceptions; and to evaluate the relationships between activities of daily living, participation and overall recovery, and the other domains of the Stroke Impact Scale 3.0 (SIS).METHODS: A retrospective study among adult community-dwelling individuals from 6 months up to 10 years after onset of transient ischaemic attack. A total of 299 survivors of transient ischaemic attack responded to the SIS.RESULTS: Most self-reported disabilities involved emotion, strength, and participation domains of SIS and remained stable until 10 years post-transient ischaemic attack. Women reported significantly more disabilities for emotion and hand function. Elderly subjects (age > 65 years) reported more disabilities for strength, mobility, hand function, activities of daily living/instrumental activities of daily living, and participation. The activities of daily living/instrumental activities of daily living, participation, and overall recovery demonstrated significant, although low-to-moderate, associations with other SIS domains after transient ischaemic attack.CONCLUSION: The broadly perceived disabilities were demonstrated consistently and played a significant meaningful role in everyday life and recovery among community-dwelling individuals up to 10 years after a transient ischaemic attack. These findings indicate the need for long-term multi-professional follow-up with holistic rehabilitation to improve overall recovery among survivors of transient ischaemic attack.
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8.
  • Andersson, Åsa, 1963-, et al. (författare)
  • How to identify potential fallers in a stroke unit : validity indexes of 4 test methods
  • 2006
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:3, s. 186-191
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to describe general characteristics of patients with stroke who have a tendency to fall and to determine whether certain test instruments can identify fallers. METHODS: Patients treated in a stroke unit during a 12-month period were included. At inclusion assessments were made with Berg Balance Scale Berg Balance Scale, Stops Walking When Talking, Timed Up & Go (TUG) and diffTUG. At follow-up 6 or 12 months later, patients who had fallen were identified. RESULTS: During the time from discharge to follow-up on 159 patients, 68 patients fell and 91 did not. Fallers fell more often during their initial hospital stay, used sedatives more often and were more visually impaired, compared with non-fallers. The Berg Balance Scale, Stops Walking When Talking and TUG results differed between fallers and non-fallers. The combined results of Berg Balance Scale and Stops Walking When Talking increased the possibility of identifying fallers. CONCLUSION: Berg Balance Scale, Stops Walking When Talking and TUG can be used to evaluate which patients have a tendency to fall in order to carry out preventive measures. Berg Balance Scale can be used in all patients. Stops Walking When Talking can give additional information if the patient is able to walk. TUG is a possible choice, but fewer patients can perform it.
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9.
  • Awad, Amar, et al. (författare)
  • Preserved somatosensory conduction in a patient with complete cervical spinal cord injury
  • 2015
  • Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 47:5, s. 426-431
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel ethodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury. Methods: Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback. Results: In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury. Conclusion: Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.
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