Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

Dialogic communication in the health care context: A case study of Kaiser Permanente's social media practices

This case study examines how one of the largest not-for-profit health care organizations in the US, Kaiser Permanente, uses social media to communicate with its stakeholders. Through content analysis and interviews, this study identifies the communication models reflected in a sample of social media posts and examines the organization's approach to using social media. The study finds evidence of both one-way and two-way communication models, as well as principles of dialogic communication. The implications of these findings are discussed.     

Translating Spirituality: Universalism and Particularism in the Diffusion of Spiritual Care from the United States to Israel

Research on the transnational diffusion of ideas and practices shows how cultural objects go through translation, adaptation, and vernacularization when implemented in new localities. Less attention is given to the translators themselves and their heterogeneous and often conflicting visions. Drawing on the notion of transnational social fields (TSF s), this article investigates how cultural objects get vernacularized differently in different parts of the TSF , demonstrating how processes of translation reflect larger social and political struggles over questions of identity. As a case study, we focus on the attempt of actors from Israel and the United States to institutionalize spiritual care in Israeli health‐care organizations. The analysis reveals how spiritual care functioned as a porous cultural object, open to a wide range of interpretations and debates. While actors in New York saw in spiritual care the opportunity to bridge to Israeli Jews and create a global Jewish identity, Israeli actors split between using spiritual care as a vehicle for creating a local Israeli Jewish identity and seeing in spiritual care the opportunity to establish universal identities, broader than the Jewish one. The disagreement and conflicts between the groups influenced the translation process, turning it into a contentious struggle that involved different positions on the continuum between particularism and universalism.     

Ethical living: relinking ethics and consumption through care in Chile and Brazil

Mainstream conceptualizations of ‘ethical consumption’ equate the notion with conscious, individual, market‐mediated choices motivated by ethical or political aims that transcend ordinary concerns. Drawing on recent sociology and anthropology of consumption literature on the links between ordinary ethics and ethical consumption, this article discusses some of the limitations of this conceptualization. Using data from 32 focus groups conducted in Chile and Brazil, we propose a conceptualization of ethical consumption that does not centre on individual, market‐mediated choices but understands it at the level of practical outcomes, which we refer to as different forms of ‘ethical living’. To do that, we argue, we need to depart from the deontological understanding of ethics that underpins mainstream approaches to ethical consumption and adopt a more consequentialist view focusing on ethical outcomes. We develop these points through describing one particular ordinary moral regime that seemed to be predominant in participants’ accounts of ethics and consumption in both Chile and Brazil: one that links consumption and ethics through care. We show that the moral regime of care leads to ‘ethical outcomes’, such as energy saving or limiting overconsumption, yet contrary to the mainstream view of ethical consumption emphasizing politicized choice expressed through markets, these result from following ordinary ethics, often through routines of practices.     

Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change

A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.     

人口老龄化背景下机构养老国内外研究比较

当前学界对机构养老的讨论日趋热烈，但遍观国内现有文献，对国外机构养老研究进展普遍关注不足。本研究通过从机构养老的概念界定、养老机构、入住老年人群、机构养老服务质量这四个维度对国内外机构养老研究成果进行归类梳理，发现国内机构养老研究在功能界定、管理与运营、服务质量监管等方面差距较大，而对于入住老年人群的需求和入住意愿分析方面则与西方差距较小。同时，我国机构养老的理论对于实践的指导作用并不显著，我国理论界相对于养老实践有滞后之虞。基于以上分析，本文提出以下建议：探索机构养老发展的新模式，完善养老机构管理与运营结构以及发展第三方服务监管体系。     

Perceived emotional intelligence and social competence in neglected adolescents

This research work analyses the emotional intelligence (EI) and the social cognitive attitudes and strategies in adolescents between 12 and 17 years of age in residential care. The aim of the work is to identify those aspects that hinder their socio-emotional competence, requiring a more urgent intervention. We explore the presence of significant differences between the variables under study according to gender and age range (12–14 and 15–17) and we analyse the relationship between the dimensions of their EI and their social competence. The results show a lack of EI in these adolescents, with all three dimensions being affected: emotional attention, clarity of feelings and emotional repair. As for social competence, it can be seen that the adolescents are characterised by a lack of confidence and firmness in their interactions. Worthy of note is the impulsive cognitive style, as are the rigidity of thought and the tendency towards social mistrust and suspicion. There are many difficulties concerning the strategies for resolving social problems. This research highlights the need to design training programmes for the residential care centres that will favour their socio-emotional development.     

Children's participation in foster care placements

This article presents results from a study of the birth children of foster carers and their experiences of growing up with foster siblings. Data were gathered from focus groups (17 participants), discussion groups (16 participants), a questionnaire (684 responses) and eight individual interviews. The children's participation in the fostering placements is in focus. Accounts from the children show that several of them participate in care-giving activities in everyday life. Their participation in the official assignment is however limited and can lead to children taking on responsibility with no support from adults. The tension between children's agency and position in society is addressed. The study shows how power relations between children and adults come into play, how both children and adults (re)-produce positions where children's rights to have a say in questions that concern them are not reflected within fostering processes.     

Tracing disorder across theories of autism,empathy, and mental health care

Abstract

Categories of mental disorders are generally understood through a biomedical paradigm of clinical research, diagnosis, and intervention. Here, diagnoses operate as professional tools, facilitating care organization and information exchange across diverse social contexts. In this article, I focus on how the diagnosis of autism-spectrum disorder operates in this manner. Autism conceived as a biomedical disorder is then contrasted with proposals by the neurodiversity movement, who understand core qualities of autism as alternative expressions of otherwise normal processes of brain development. Finally, I supplement these conversations with insights from Gerald Edelman’s theory of neural plasticity and Felix Guattari’s paradigm of ethico-aesthetic care. Understood together, these allow mental disorders and community care generally to be reconceived in terms of networks of expressive, embodied, and dynamically embedded rhythms that transcend individual persons. This serves, additionally, to illustrate a concept of empathy that traverses neurological, psychological, and sociocultural domains.