• Identifying and working with non-responsive and deteriorating patients within the process of supervision: methods of practicing supervisors

      Rast, Katrina Anne; Gifford, Valerie; David, Eric John; Geist, Charles; Lardon, Cecile; Whipple, Jason (2018-05)
      Clinical supervision is widely considered to be an essential part of psychotherapy training, encouraging trainee growth, and ensuring the best possible outcome for patients. The use of routine outcome monitoring (ROM) systems in clinical practice has been shown to be beneficial in improving patient outcome within psychotherapy. In addition to its utility in clinical practice, research has suggested that the use of ROM systems and patient feedback within the supervisory process may also have a positive impact on patient outcome. Despite these potential benefits, there is no existing literature about how supervisors identify and work with patients at risk for deterioration within the supervision process. This study aimed to explore the influence on regulatory focus and the use of ROM systems within supervision. Additionally, this study sought to explore two questions: 1) How do supervisors currently identify supervisee patients who are unresponsive to treatment or deteriorating? and 2) How do supervisors currently work with unresponsive or deteriorating patients in supervision? Using a quantitative approach, results suggest that the majority of supervisors rely heavily on clinical judgment in order to identify treatment non-responders and irregularly use ROM systems in order to identify these patients. In addition, the results suggest that the majority of supervisors respond to deteriorating patients in a way that coincides with existing literature pertaining to common practices within psychotherapy. Furthermore, there appears to be a prominent lack of understanding of the purpose and use of ROM systems within supervision. Finally, results indicate that promotion scores are a predictor of the use of ROM within supervision. Implications for research and clinical practices are discussed, in addition to limitations and future directions of the study.
    • Meeting the bereavement needs of older adults with cognitive challenges

      Glendinning, Terry; Renes, Susan; Dahl, Heather; McMorrow, Samantha (2017-06)
      Approximately 5.5 million people in the United States are living with cognitive challenges such as Alzheimer's and other dementias. People with cognitive challenges, following the death of a loved one, often experience unacknowledged grief. This paper first describes grief as it occurs in older adults who are not cognitively challenged. This is followed by a review of literature focusing on the grief of older adults with cognitive challenges. The project looks at methods for accommodating the cognitive and communication needs of this population as they work through their grief process.
    • "We did listen": Successful aging from the perspective of Alaska Native Elders in Northwest Alaska

      Boyd, Keri M.; Gifford, Valerie M.; Whipple, Jason; Lewis, Jordan; David, Eric John (EJ) (2018-05)
      Alaska's older adults are growing faster in proportion to the overall population creating concern regarding how adequate care will be provided in the coming years. Statewide, rural community members are looking for innovative, culturally appropriate ways to promote successful aging for their growing population of elders, allowing them to age in their home communities. This qualitative, phenomenological study sought to establish a deeper understanding of how Alaska Native Elders in Northwest Alaska understand and experience successful aging to inform program development and service delivery. The present project was embedded within a larger community-based participatory research study and conducted in collaboration with community members and an Alaska Native Elder Advisory Committee. The 14 community-nominated Elder participants universally identified engagement with family and community, self-awareness and care, and a sense of gratitude as essential elements of successful aging. Elders who age successfully listened to and learned from their Elders, enact their traditional values and practices, and pass their wisdom and knowledge to future generations. The results provide a culture and context specific understanding of successful aging that will help communities develop Elder-centered programs and service delivery and contributes to field of successful aging by presenting a perspective of successful aging that is not currently represented in the literature. Finally, by recording the Elders' knowledge and stories of successful aging this project also helped preserve some of the traditional cultural knowledge held by Elders in this region to be shared with generations to come.