Internationalisation in higher education involves the incorporation of international themes into teaching and learning and is an important tool that occupational therapy education programmes can use to prepare students to work in culturally diverse environments. Research indicates that internationalised education programmes aid students in developing a better understanding of their own values and beliefs, an understanding of and respect for other cultures, a wider view of their profession, and verbal and nonverbal communication skills. Recent developments in occupational therapy, such as the understanding of how international issues affect daily occupations, the changing demographics of the client base and the widening scope of practice, have increased the need for education programmes to embrace internationalisation.

Payment by Results represents an important change in the way that the National Health Service reimburses health care providers for services in England. The purpose of this new payment system is to pay health care providers fairly and transparently while rewarding efficiency, encouraging volume growth and supporting patient choice initiatives. Payment by Results will have a profound effect on occupational therapy practice, particularly regarding cost containment, documentation and patient-centred practice. Therapists working under the Payment by Results scheme require a better understanding of financial opportunities and constraints to ensure that occupational therapy services flourish under this new payment system.

Background The importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed. Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.

Reference: Horton A, Hall J (2008) Redesigning occupational therapy service provision to increase efficiency, effectiveness and stakeholder satisfaction.

Introduction Emotion regulation may be an important tool that therapists and patients use to build and maintain therapeutic relationships. This exploratory study investigates how patients use intrapersonal and interpersonal emotion regulation strategies during interactions with occupational therapists and physiotherapists. Methods A two-staged qualitative study was conducted. In the first stage 11 patients were interviewed regarding their use of emotion regulation during their therapeutic relationships. In the second stage, 14 patient/therapist dyads were observed during the course of the therapeutic relationship and then interviewed individually at the end of the relationship. Results Patients utilise the full range of intrapersonal emotion regulation strategies that can be categorised in Gross’s (1998) process model of emotion regulation including situation selection, situation modification, attentional deployment, cognitive reappraisal and response modulation. They used interpersonal emotion regulation strategies to a lesser extent, only reporting using strategies that fit into one of the four interpersonal emotion regulation strategies identified Williams’ (2007), altering the situation. Conclusions This study makes an important contribution to research on patients’ contribution to therapeutic relationship development/maintenance. It is the first study to explore patients use of intrapersonal and interpersonal emotion regulation in response to negative and positive emotions arising from interactions with therapists.