Telerehabilitation offers a unique solution for continuity of care in pediatric rehabilitation under physical distancing. The major aims of this study were to: (1) describe the development of telerehabilitation usage guidelines in a large hospital in Israel, and to (2) evaluate the implementation of telerehabilitation from the perspectives of healthcare practitioners and families. An expert focus group developed guidelines which were disseminated to multidisciplinary clinicians. Following sessions, clinicians filled The Clinician Evaluation of Telerehabilitation Service (CETS), a custom-built feedback questionnaire on telerehabilitation, and parents completed the client version of the Therapist Presence Inventory (TPI-C) and were asked to rate the effectiveness of sessions on an ordinal scale. Four goals of telerehabilitation sessions were defined: (1) maintenance of therapeutic alliance, (2) provision of parental coping strategies, (3) assistance in maintaining routine, and (4) preventing functional deterioration. Principal Components Analysis was used for the CETS questionnaire and the relationships of CETS and TPI-C with child’s age and the type of session were evaluated using Spearman’s correlations and the Kruskal–Wallis H test. In total, sixty-seven telerehabilitation sessions, with clients aged 11.31 ± 4.8 years, were documented by clinicians. Three components (child, session, parent) explained 71.3% of the variance in CETS. According to therapists, their ability to maintain the therapeutic alliance was generally higher than their ability to achieve other predefined goals (p < 0.01). With younger children, the ability to provide feedback to the child, grade treatment difficulty and provide coping strategies to the parents were diminished. Families perceived the therapist as being highly present in therapy regardless of treatment type. These results demonstrate a potential framework for the dissemination of telerehabilitation services in pediatric rehabilitation.
1 September 2014 in Research in Developmental Disabilities
While much research has been devoted to examining individual differences in one’s interpersonal attachment, very little research has been devoted to examining individual differences in one’s attachment to God (ATG). Particularly, how ATG dimensions relate to different religious denominations (RD). To explore the relationship between ATG dimensions (avoidance/anxiety) and Jewish RDs. As the attachment theory was conceptualized to understand human reaction to separation and loss, the current study examined the relationship between ATG and RD among bereaved parents. Seventy-seven bereaved Jewish parents completed questionnaires referring to their RD and ATG. The results revealed different relationships between ATG and RD for each of the two ATG dimensions. Avoidant ATG was negatively correlated with RD in a linear order, whereas the relationship between the anxious ATG and RD was quadratic, revealing the highest levels of attachment-anxiety among participants affiliated with the traditional RD (“Masorti”). Methodologically, these findings support the argument that ATG dimensions are distinct and separable from each other. Additionally, the findings highlight the importance of considering participants’ RD when exploring their ATG, as different denomination-based manifestations of ATG do exist. Clinical implications include using RD to detect bereaved parents at risk (i.e., traditional ones), due to their high anxious ATG dimension.
27 October 2016 in Journal of Developmental and Physical Disabilities
Aim: To synthesize the evidence about the main intervention characteristics of cognitive behavioral therapies (CBTs) for individuals with cerebral palsy and identify barriers and facilitators to their success, focusing on aspects of feasibility and markers of success.Method: A scoping review methodology informed a literature search for papers published between 1991 and 2021. Articles were screened, reviewed, and categorized using the DistillerSR systematic review software, and critically appraised for quantitative and/or qualitative criteria.Results: Out of 1265 publications identified, 14 met the inclusion criteria. Elements associated with the specific study participant characteristics (46% female; aged 6–65 years), type of CBT techniques used (third‐wave [n = 6], cognitive [n = 3], cognitive and behavioral [n = 2], biofeedback training [n = 2]), and features of the study context and methodological quality (two randomized clinical trials and small sample sizes [n ≤ 12]), were identified. Most studies had psychological targets of intervention (n = 10) and secondary physiological (n = 3) or social (n = 2) objectives. Feasibility indicators were described in nearly one‐third of the papers.Interpretation: This study highlights the high flexibility within CBT interventions, enabling their adaptation for individuals with cerebral palsy. However, relatively little, and only low‐certainty evidence was identified. More high‐quality research in terms of specific CBT techniques, optimal treatment doses, and detailed population characteristics are needed.