Currently, the majority of Spinal Cord Injury (SCI) treatment resources are being expended to address and resolve problems occurring during the acute and immediate post-acute phases following injury. Major national funding sources for SCI research have followed this pattern with few, if any, proposals submitted for the support of research into the effects of aging on the SCI individual requiring long term institutional care. Yet, data recently available from the National Spinal Cord Injury Research Center and the Veterans Administration show that there is an increase in the numbers of older SCI persons requiring medical care. In anticipation of increasing utilisation of health care resources by older SCI persons, the Veterans Administration has begun to make appropriate plans. But a broadened information base is needed to support these plans. Statistical data concerning the characteristics of the total SCI population, empirical information of older SCI persons' extended care needs, and information regarding proper treatment for older SCI persons is necessary.
A pilot evaluation study was conducted to explore the impact of a training course aimed at helping drug counselors establish effective therapeutic relationships with their clients. Counselor abilities to reflect accurate empathy, sensitivity to client values and attitudes, and use of specified problem-solving techniques were measured before and after training through counselor self-ratings and ratings of counselor behaviors provided by clients and supervisors. The preliminary findings reveal a trend toward improved drug counselor functioning along these dimensions following training. However, the findings also suggest that the greatest impact of training may be a shift in drug counselor self-perceptions toward more confidence in their own capability to establish effective therapeutic relationships.
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