Browsing by Author "Wagner, Blake Douglas"

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    An evaluative investigation of the effects of establishing a personalized system of prosthetic aids to memory for dementing persons in the home environment
    Wagner, Blake Douglas (Virginia Polytechnic Institute and State University, 1986)
    This research project was a systematic evaluation of the effects of a personalized system of prosthetic aids to memory established in the home environment for individuals with mild to moderate dementia. The system of aids developed were in the form of a free-standing "Memory Center" unit. Caregivers were responsible for actively training their relatives to use the aids to compensate for deficits in orientation and memory for information necessary for daily functioning. The investigation was conducted in two phases, using a modified multiple baseline across subjects design. The two clients in Phase I met research criteria for Alzheimer type dementia and received a clinical dementia rating of moderate progression. Of the three clients in Phase II, two satisfied research criteria for Alzheimer type dementia, while one met research criteria for vascular dementia. All three were determined to have mild dementia. The effects of the intervention on the clients and the caregivers were examined over a four week intervention period and at a one month follow-up. The primary question addressed was whether clients could be trained to effectively use the prosthetic aids to orient themselves and compensate for deficits in memory function. This was assessed via daily assessments of verbal orientation. Weekly ratings of the behavioral functioning of clients were provided by the caregivers. And finally, caregivers rated their own stress and mood levels on a weekly basis throughout the study. Although the rates of learning varied, all of the clients increased their levels of verbal orientation following the introduction of the prosthetic aids and training. Evidence for generalized effects on the behavioral functioning of the clients was found. Overall, the clients were rated as expressing fewer negative emotions and as evidencing more oriented behaviors and less confused and disturbed behaviors during the intervention and at follow-up. Overall, the caregivers reported a consistent pattern of decline in their levels of stress and dysphoric mood. A common area of improvement was a reduction in negative emotions felt and expressed toward their relatives. Factors related to the success of the intervention and potential causal elements of change were discussed. Finally, recommendations for clinical practice and future research were provided.
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    An investigation of the relationship between therapist competence and client outcome
    Wagner, Blake Douglas (Virginia Polytechnic Institute and State University, 1984)
    This research project was a descriptive study conducted at a clinical psychology practicum center which investigated the relationship between supervisory ratings of student therapist competency and respective client outcome. Cases were assigned to one of four outcome categories on the basis of six outcome criteria. These included: client and therapist assessment of change in presenting complaints and adaptive functioning, client satisfaction with treatment, type of termination, and session attendance. Clinical faculty supervisors completed subjective competency ratings of student-therapists and also rated the difficulty of client cases. A semi-partial correlation was calculated between competency and outcome scores with the effects of case difficulty partialled out of the outcome scores. It was hypothesized that a significant positive semi-partial correlation would emerge. Forty-eight client cases that were month period were included in the study. seen during a six Also, 14 student therapists belonging to four practicum teams participated. The major finding of this investigation was that overall, therapist competency ratings were not significantly related to the outcomes of clients, (r=-. 12, p>.05). However, when assessing the relationship between therapist competency and outcome for each of practicum teams individually, a significant negative semi-partial correlation was found for one of them, (r=-1.03, p<.01). Problems with subjective assessments of competency were discussed and recommendations for improving evaluations were given. Results of a fine grained analysis of outcome data and related variables were presented and discussed as they apply to clinical training and service issues.