Giving Patients Choices During Involuntary Admission: A New Intervention

an article by Erin Burn, Maev Conneely and Domenico Giacco (Queen Mary University of London, UK) and Monica Leverton (University College London, UK) puvlished in Frontiers in Psychiatry (July 2019)

Abstract

Background
People who receive involuntary treatment are some of the most vulnerable in psychiatric services. They are more likely to have poorer social and clinical outcomes and to be disillusioned with and disengaged from care. Research indicates that patients’ experience in the first week of involuntary treatment is a critical period: a better experience of care in the first week predicts better quality of life and reduced readmission 1 year later. Patients have identified involvement in clinical decisions as key to improving their experience of care. The aim of this study was to test the feasibility and acceptability of an intervention to facilitate involvement in decision making for involuntary inpatients called OPeNS (Options, Preferences, Negotiate, and Summarise).

Methods
This was a mixed method study. The OPeNS intervention was developed based on previous research carried out by a multidisciplinary team. Clinicians were trained to deliver it to involuntary inpatients. Feasibility indices (rates of participation in the intervention and time required to deliver it) were collected. Patients (N = 14) and clinicians (N = 5) provided qualitative data on their experience of the intervention in semi-structured interviews which were analysed using thematic analysis.

Results
The OPeNS intervention was found to be acceptable by both patients and clinicians and feasible to conduct within the first week of involuntary treatment. Patients’ and clinicians’ experiences of the intervention fall into two themes: ‘Enabling a different dynamic’ and ‘Clashing with usual practices and priorities’.

Conclusion
The OPeNS intervention provides a structure that can be used by clinicians across disciplines to facilitate involving involuntary patients in decision making. Although challenges related to changing usual practices were identified, the intervention was received positively and was feasible to conduct in the first week of involuntary treatment.

Full text (PDF 9pp)

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The return of the policy that shall not be named: Principles of industrial policy

a column by Reda Cherif and Fuad Hasanov for VOX: CEPR’s Policy Portal

The 'Asian miracles' and their industrial policies are often considered as statistical accidents that cannot be replicated.

The column argues that we can learn more about sustained growth from these miracles than from the large pool of failures, and that industrial policy is instrumental in achieving sustained growth. Successful policy uses state intervention for early entry into sophisticated sectors, strong export orientation, and fierce competition with strict accountability.

Continue reading

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Workplace bullying and incivility: a systematic review of interventions

an article by Margaret Hodgins, (National University of Ireland, Galway) and Sarah MacCurtain and Patricia Mannix-McNamara (University of Limerick, Ireland) published in International Journal of Workplace Health Management Volume 7 Issue 1 (2014)

Abstract

Purpose
Workplace mistreatment has a negative impact on the health and well-being of approximately 20 per cent of workers. Despite this, few interventions have been evaluated and published. The purpose of this paper is to address the question “what interventions designed to reduce workplace bullying or incivility are effective and what can be learnt from evaluated interventions for future practice?”

Design/methodology/approach
A systematic review was undertaken in which 11 electronic databases were searched, yielding 5,364 records. Following screening on abstract and title, 31 papers were retained for detailed review and quality assessment. Subsequently, 12 interventions to address workplace bullying or incivility were critically appraised.

Findings
The papers spanned a wide range of approaches to and assumptions about resolving the problem of bullying and/or incivility. Half the studies focused on changing individual behaviours or knowledge about bullying or incivility, and duration of intervention ranged from two hours to two years. Only four studies were controlled before-after studies. Only three studies were classed as “moderate” in terms of quality, two of which were effective and one of which was partially effective.

Originality/value
A final synthesis of results of the review indicate that multi-component, organisational level interventions appear to have a positive effect on levels of incivility, and should be considered as a basis for developing interventions to address workplace bullying.

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The value of psychological flexibility: Examining psychological mechanisms underpinning a cognitive behavioural therapy intervention for burnout

Joda Lloyd and Frank W. Bond (Goldsmiths, University of London, UK) and Paul E. Flaxman (City University, London, UK) published in Work & Stress: An International Journal of Work, Health & Organisations Volume 27 Issue 2 (2013)

Abstract

Little is known of the mechanisms by which interventions for burnout work.

Employees of a UK government department were randomly assigned to either a worksite group-based CBT intervention called Acceptance and Commitment Therapy (ACT; n=43), which aimed to increase participants’ psychological flexibility, or a waiting list control group (n=57).

The ACT group received three half-day sessions of training spread over two and a half months. Data were collected at baseline (T1), at the beginning of the second (T2) and third (T3) workshops, and at six months’ follow up (T4).

Consistent with ACT theory, analyses revealed that, in comparison to the control group, a significant increase in psychological flexibility from T2 to T3 in the ACT group mediated the subsequent T2 to T4 decrease in emotional exhaustion in that group.

Consistent with a theory of emotional burnout development, this significant decrease in emotional exhaustion from T2 to T4 in the ACT group appeared to prevent the significant T3 to T4 increase in depersonalization seen in the control group. Strain also decreased from T2 to T3 in the ACT group only, but no mediator of that improvement was identified.

Implications for theory and practice in the fields of ACT and emotional burnout are discussed.

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Can Theories of Empire Explain the American Political Response to the Financial Crisis?

an article by Brandon Tozzo (Queen’s University, Canada) published in Critical Sociology Volume 39 Number 1 (January 2013)

Abstract

The repercussions of the 2008 financial crisis, which began in the USA, were felt around the world: credit markets froze, consumer demand collapsed, and major banks and industries required government money to avoid bankruptcy.

Given the severity of the crisis and the American Government’s unprecedented intervention in the economy, the financial crisis presents an ideal case for a critical reassessment of major theories of empire.

There are three prominent, yet distinct, views of empire that will be examined in this article.

The first is the Empire offered by Michael Hardt and Antonio Negri.

The second theory of empire is that of Leo Panitch and Sam Gindin.

Finally, there is David Harvey’s ‘new imperialism’.

The purpose of this article is to challenge several limitations in each theory of empire, and to conclude that Harvey’s ‘new imperialism’ provides the greatest insight into the USA’s immediate responses to the economic crisis.

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PACE – Client Experience Survey

a report by IFF Research commissioned by Skills Development Scotland on behalf of the PACE Partnership

Executive summary

Introduction and background

1. PACE (Partnership Action for Continuing Employment) is the Scottish Government’s national strategic partnership framework for responding to redundancy situations. Its aim is to ensure that public sector agencies respond to potential and proposed redundancies as quickly and effectively as possible.
2. The Scottish Government set up a national strategic group chaired by the Minister for Skills and Lifelong Learning, to oversee a continuous improvement programme to enhance the operation of PACE. In June 2009 the “PACE Partnership” was established which brought together the Scottish Government with 18 partner organisations.
3. Skills Development Scotland commissioned IFF Research Ltd. on behalf of the PACE Partnership to evaluate the performance of the refocused PACE as part of the continuous improvement programme.
4. The findings in this report are based on a telephone survey of 803 individuals conducted between 15th March and 8th April 2010. Interviews were conducted by telephone, using Computer Aided Telephone Interviewing (CATI), from IFF Research’s telephone centre at its offices in London.

Aims and objectives

5. More specifically, the core aims of this piece of research were to:
   • gauge the extent to which clients have accessed specific PACE services;
   • examine the perceived relevance, usefulness and timeliness of each service that PACE clients have received, as well as their satisfaction levels more broadly;
   • establish the influence that PACE has had on clients’ progression into learning and/or (intended/desired) employment, as well as the extent of “softer” benefits to individuals’ lives such as self-confidence and motivation;
   • channel the insight gained from the study into the development of recommendations for further enhancing the focus and effectiveness of the PACE initiative.

Key findings

6. The PACE service is perceived as having a positive influence on users’ employment and employment prospects, and on their motivation to find work. Around half of those who had left their redundant job role by the time of survey had secured new employment at some stage post-redundancy (51%), and most of these (58%) felt that the PACE service had helped them to move into (new) work.
7. Almost two-thirds (63%) of PACE service users who had left their redundant job role had either found new employment or undertaken training or development.
8. The PACE service also helps people to develop new skills. A quarter (26%) of PACE service users who had left their redundant job role had undertaken training or development since their job was selected for redundancy. Three fifths (59%) reported that the PACE service led to improvements in their ability to write a CV or job application, and around one in five (19%) said that PACE had greatly increased their motivation to apply for more jobs.
9. Most users believed the intervention to have been delivered at exactly the right time. Seven in ten (70%) agreed that the initial presentation/information pack was perfectly timed; among the remainder there was a more or less even split between those who believed it to have been delivered too early (17%) and those who believed it to have been delivered too late (13%).
10. Users are highly satisfied with the package of support that the PACE service is delivering, and perceive it to be useful and relevant to their needs. In terms of the specific elements of the PACE services:
• 89% of users who reported they had received a general group presentation and information pack from PACE rated it as relevant, 91% as useful and 94% were satisfied with the intervention;
• Personalised support with regard to CV development, job search and application processes and interview technique are seen as the most relevant and most effectively delivered aspects of the service (each with satisfaction scores of over 90%);
• Other support services were also rated positively.
At least 75% of people who used each PACE service were satisfied with the service they received.
11. Advice on business start-up and also money management were accessed by lower numbers of service users than more general careers guidance. Significant proportions of clients who received this advice thought that it was not relevant or useful to them (as many as two fifths in the case of advice on business start-up).
12. It is worth noting that – against the backdrop of tough economic conditions and a challenging jobs market – three in five of those who had moved into new employment had moved into a role associated with a lower rate of pay (60%), and two-fifths (38%) reported that the level of skills required for the new role was lower than for the role from which they were made redundant.
13. It is also worth noting that only half (50%) of individuals surveyed had actually left their redundant job role by the time of survey (the remainder were still working in the job selected for redundancy).

Full text (PDF 22pp (A4 landscape))

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Learning the lessons of property-led regeneration: Maximising the employment legacy of major physical developments

an article by Alexander McTier, Andrea Glass and Alan McGregor (affiliation(s) not provided) published in Journal of Urban Regeneration and Renewal Volume 6 Number 1 (Autumn 2012)

Abstract

The UK’s Urban Development Corporation property-led regeneration of the 1980s and 1990s has been widely criticised for its failure to leave an employment legacy for local communities. The trust placed in the jobs from major physical developments ‘trickling down’ to neighbouring deprived communities has been proved misguided.

However, despite these past failings, there still remain regeneration projects based around major physical developments that proceed without an explicit employment legacy aim.

To help address this, this paper revisits the lessons from 1980s and 1990s property-led regeneration policy and tests these against 13 local employment interventions linked to major physical developments across England and Scotland.

In assessing whether the lessons remain valid, the paper identifies the practical steps taken to maximise the local employment legacy from the 13 major physical developments, which in turn will help to inform future interventions.

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Impaired cognitive performance and responsiveness to reward in burnout patients: Two years later

an article by Arno van Dam (Institute for Mental Health, Bergen op Zoom, the Netherlands), Ger P.J. Keijsers, Eni S. Becker and Paul A.T.M. Eling (Radboud University Nijmegen, the Netherlands) published in Work & Stress: An International Journal of Work, Health & Organisations Volume 26 Issue 4 (November 2012)

Abstract

Relatively little is known about the course of symptoms in patients suffering from burnout and even less about the status of their cognitive functioning.

We followed 40 burnout patients and 40 healthy controls who had participated in a previous study on the effect of motivational interventions on cognitive performance in an experimental task and repeated these measurements two years later (T2).

The burnout patients, who had received psychological treatment, showed substantial improvement regarding burnout symptoms and cognitive performance at T2. The pre-post-effect size for symptom reduction was large.

Importantly, cognitive performance and responsiveness to motivational interventions improved to normal levels. The patients no longer fulfilled the criteria for burnout or any other psychiatric disorder. Despite these improvements, burnout patients still experienced more exhaustion, general fatigue, depressive symptoms and general distress in comparison to healthy controls and compared to normed groups.

The same pattern was observed with regard to cognitive performance: performance improved but remained below normal levels. Perceived job competence, involvement in work and responsiveness to rewards had returned to normal levels. The results indicate that although recovery from burnout is possible, symptoms may persist over the long term (here, two years). This should be taken into consideration by employers.

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Individual differences in response to cognitive training: …

Using a multi-modal, attentionally demanding game-based intervention for older adults

an article by Laura A. Whitlock, Anne Collins McLaughlin and Jason C. Allaire (Department of Psychology at North Carolina State University, USA) published in Computers in Human Behavior Volume 28 Issue 4 (July 2012)

Abstract

The effectiveness of a game-based cognitive training intervention on multiple abilities was assessed in a sample of 39 older adults aged 60–77.

The intervention task was chosen based on a cognitive task analysis designed to determine the attentional and multi-modal demands of the game. Improvements on a measure of attention were found for the intervention group compared to controls.

Furthermore, for the intervention group only, initial ability scores predicted improvements on both tests of attention and spatial orientation. These results suggest cognitive training may be more effective for those initially lower in ability.

Highlights

► We provided a multi-modal game intervention to older adults of varying abilities.
► We examined changes in several abilities compared to a control group.
► Older adults with initially worse abilities appear to benefit more from cognitive training.
► Future investigations should include study of individual differences in training benefit from cognitive training interventions.

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Employment key to social mobility

an Evidence Briefing paper published by the Economic and Social Research Council

Introduction

Research demonstrates a negative relationship between worklessness and outcomes for children over and above what would be expected due to other factors, such as material deprivation and low income. This underlines the importance of supporting parents to move into the labour market.

In addition, the high number of young people not in education, employment or training is a huge risk to the skill development of the current cohort of young people. Other research points to the pressing need for interventions, such as apprenticeships, that improve employability combined with strategies to improve the quality, flexibility, sustainability and progression routes of the jobs on offer.

Key findings

• Family background characteristics are still influencing who gets the UK’s top jobs. Consistent with other evidence on social mobility, this trend appears to have worsened for many of the top professions over time.
• The extent to which our economy will be able to produce more and more ‘top jobs’ needs to be considered. Avoiding future poverty may for many people be just as much a matter of being able to make a ‘good life’ from lower paid, lower status employment, and to find this worthwhile.
• The first few years of life are not totally decisive, and interventions aimed at promoting mobility throughout the rest of childhood, adolescence and into working life are also important. Interventions that change students’ decisions at key points (e.g., the decision about whether to stay in full-time education beyond age 16) rather than influence their skills directly, could still have a positive impact on social mobility.
• Apprenticeships used to offer not just skill acquisition but also five years of structured, disciplined relationships with adults. For many young people who have not experienced this at home, the apprenticeship system offers a chance of psychological growth and development. However, demand from potential apprentices for training significantly outstrips the supply of places made available by employers.
• Targeted educational opportunities for mature women from ethnic minority groups are needed to assist ethnic minority women into the workplace, improve workplace culture and to progress in employment.
• Developing the evidence base on ‘what works’ in terms of intervention is vital. Robust field trials of promising interventions should become a core part of the child poverty strategy, building an evidence base of action which is proven to work, cost-effective and capable of being scaled up to the required level.
• While inducing lone mothers to work could lift some children out of poverty, encouraging young mothers to take up any employment might also impact negatively on their children, particularly in the absence of good quality childcare. Supporting employment through the provision of good quality childcare is a priority.
• Undertaking interventions to improve social mobility at the very bottom of the skill or income distribution may be more difficult and more expensive than interventions to improve the social mobility of those nearer the middle of the distribution.
• Understanding how to manage money requires complex skills and those with poorer levels of education can find financial decisions difficult, particularly in terms of accessing appropriate advice, products and services.

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Gutter to Garden: …

Historical Discourses of Risk in Interventions in Working Class Children’s Street Play

an article by Jane Read (Roehampton University) published in Children & Society Volume 25 Issue 6 (November 2011)

Abstract

This article investigates interventions in the gutter play of British working class children in the first decade of the 20th century through their re-location within Free Kindergartens. In contemporary literature, the street child was viewed through a binary lens, as both ‘at risk’ and ‘as risk’, reflecting wider societal discourses in a period of rapidly developing social policy. The paper interrogates the motivations of free kindergarten activists from the standpoint of a range of theory and builds on recent papers discussing 21st century urban childhoods. The findings suggest both historical continuities and discontinuities in the theorisation of risk, which have implications for current social policy, urban design and early childhood education. The questions raised include issues of children’s rights, citizenship, inclusion and cultural diversity.

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