In this study, an examination was made of the clinical reasoning processes used by expert occupational therapists and post-ellnlcal fourth-year occupational therapy students. Using nominal group technique, the factors Involved In clinical reasoning were derived and their relative Importance determined.The most highly valued skill for the experts was good communication, while the most highly valued skill for the students was a knowledge of and understanding of disability. The experts considered a wider range of factors when making clinical decisions than did the students, and rated their level of clinical reasoning at a higher level than did the students. For the experts, the factors Identified as Important In clinical reasoning were concerned more with gaining an understanding of the patients both by using general princIples of diagnosis and Illness and by gaining an understanding of the Illness as It affected the Individual patient. Meanwhile, for the students, greater emphasis was placed upon the Influence of pragmatic factors on treatment, such as resources, time constraints and other environmental factors.

No abstract

This study aims to investigate how dramatherapists and dramatherapy clients experience change in therapy and whether change processes identified are consistent across dramatherapeutic approaches. Method: Seven dramatherapists and seven dramatherapy clients were interviewed about their experiences of dramatherapy. Using a grounded theory method three core themes were constructed from the data. Results: The resulting core categories 1. working within a safe distance; 2. the client being allowed and allowing self to play and try out new ways of being and 3. being actively involved in therapy: creating something visible and having physical experiences using the body, capture the experience of change for both dramatherapists and clients in therapy. Key change mechanisms were also proposed, these included: developing new awareness and finding a language to communicate. Main conclusions: A focus on developing new awareness and increased insight into self are important outcomes for therapy and need to be clearly communicated as such. Future research should include further exploration of the key themes identified and the client developing increased reflective functioning as a key change mechanism during dramatherapy.