Managing care in the community: Analysis of a training workshop

Summary

Managing mental illness in the community is an anxiety provoking business. Yet the legislative emphasis on business management and rapid re-structuring both creates anxiety in workers and carers and appears to devalue those traditional psychotherapeutic skills which facilitate the containment of anxiety. Anxieties that are put out of mind (not contained) have damaging and dangerous consequences for carers, users and members of the public.

This paper is about a ten-week workshop with the task of providing a safe, constructive setting where the anxieties generated by community care of the adult mentally ill could be identified, addressed and thought about. The developments within the workshop are analysed as the process shifts back and forth between paranoid-schizoid and depressive position modes of functioning gradually progressing towards the latter. Members gradually found the ability to combine therapeutic and business management skills so that they could regain their authority in relation to the work while retaining an openness to mental disturbance in others and in themselves. This emerged through a greater appreciation of the complex relationships that exist within communities. In this way the workshop also offered members a model of containment that could be internalised.     

Diversity training for the community aged care workers: A conceptual framework for evaluation

Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis; Reactions; Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people’s experience of healthcare.     

Learning about child protection

Where do social workers acquire the knowledge they use in child protection work? What opportunities exist for them to access and use research? Should they bother? This paper addresses these questions using information provided by twelve local authority social workers involved in child protection work and findings from relevant research.

In a learning and work climate which appears not to encourage interest in research findings or knowledge from books generally, the paper considers both how knowledge from research might best be brought to the attention of busy workers and what are the necessary conditions for workers to develop and use knowledge in child care and protection practice.     

The myth of transition: contractualizing disability in the sheltered workshop

This paper investigates notions of transition and independence, as well as the current circumstances that detain countless disabled people in employment endeavors that not only pay meager wages but also cement a lifelong servitude to the workshop. Sheltered workshops exist on the basis and replication of a structure that incarcerates disabled people within vocational-like settings. This paper begins a discussion of the social contract that occurs between the disabled person in the workshop. The workshop is no longer a place of societal liberation that affords the individual the opportunity to learn vocational skills, but rather it has become an institution that creates its own army of workers that will forever be subjected to a life in the workshop because of their disability status.     

When Emotion Work is Doomed to Fail: Ideological and Structural Constraints on Emotion Management

This paper explores how workers try to manage their emotions under conditions that doom them to fail. The workers in question—floor instructors at a sheltered workshop for people with developmental disabilities—were expected to infuse clients with positive feelings about work and to help transform them into committed workers. But structural conditions—boring, poorly paid assembly work and long gaps between contract jobs—forced them to obtain clients' compliance through coercive and confrontational emotion management techniques that contradicted their ideological beliefs. The floor instructors sought to peacefully increase their control over clients through “preventive emotion management” but most often they experienced a loss of control, leading some of them to experience “burnout.” This paper defines burnout as “occupational emotional deviance” that workers experience when they cannot manage their own and other's emotions according to organizational expectations.     

Content validation on the Work Performance Rating Scale for sheltered workshop workers

The purpose of this study was to revise the content of the Work Performance Rating Scale (WPRS) as a valid assessment tool for sheltered workshop workers. A focus group of 11 sheltered workshop workers was recruited to collect their opinions about the relevance of the WPRS from the service users' perspectives. A panel of 23 frontline practitioners who had experience in using various work assessment instruments provided at their work setting was recruited to review the content of the WPRS. A 14-item amended version of the WPRS with five new items added was proposed based on the opinions of service users, frontline practitioners, and the concept of the Minnesota Theory of Work Adjustment (MTWA). An expert panel of 12 professionals at the senior level from various vocational rehabilitation settings was recruited to comment on the content validity of the 14-item amended version of the WPRS. The expert panel agreed that the amended version of the WPRS was related to the concept of job satisfactoriness which could be used to assess the work performance of sheltered workshop workers. Thus, the use of the MTWA for improving the content validity of the WPRS to assess the employability of sheltered workshop workers was supported by the findings of the study.     

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop

ABSTRACT

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, “Multiple Approaches to Understanding and Preventing Elder Abuse,” in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.     

A controlled case study of supervisor training to optimize response to injury in the food processing industry

The role of supervisors to aid injured workers, access health care, and provide reasonable accommodation may prevent prolonged disability among workers reporting musculoskeletal pain. Although supervisor training has been a common element of broad-based ergonomic interventions to prevent injuries, the impact of supervisor training alone to improve injury response has not been studied. In a controlled design, 11 supervisors in an intervention group and 12 supervisors in a delayed intervention control group from the same plant were provided a 4-hour training workshop. The workshop emphasized communication skills and ergonomic accommodation for workers reporting injuries or health concerns. Workers' compensation claims data in the 7 months before and after the workshop showed a 47% reduction in new claims and an 18% reduction in active lost-time claims versus 27% and 7%, respectively, in the control group. Improving the response of frontline supervisors to employees' work-related health and safety concerns may produce sustainable reductions in injury claims and disability costs.     

Using the Image Exchange to Enhance Interdisciplinary Team Building in Child Welfare

A team building activity, the image exchange, was helpful to interdisciplinary teams in clarifying perceptions and opinions of participants about the roles of each discipline (child welfare, domestic violence, mental health, and substance abuse workers) at a five-day interdisciplinary training workshop. Discussion of team members’ perceptions and views provided opportunities to develop insights about misperceptions. Training in team development and role clarification provided a foundation for the development of effective interdisciplinary collaboration, which may improve interdisciplinary practice.Dr. Packard is an Associate Professor and Dr. Jones is a Professor in the School of Social Work at SDSU. At the time of writing, Ms. Nahrstedt was a Research Assistant in the School of Social Work at SDSU. This project was funded by a grant from the U.S. Department of Health and Human Services, Administration for Children, Youth, and Families.     

Domestic Workers in Saudi Arabia and the Emirates: Trafficking Victims?

This paper is a response to R. Jureidini's “Trafficking and contract migrant workers in the Middle East”, published in International Migration. Jureidini discusses the difficulty of establishing whether migrant domestic workers are victims of trafficking. He discusses the questions of (i) whether trafficking can be determined ex post or whether it must also be ex ante, and (ii) whether there must be a proven intent to engage in trafficking. On the basis of data concerning domestic workers in Saudi Arabia and the Emirates, I argue that they often are victims of trafficking. In these two countries, forced confinement and exploitation do not concern individual cases, but standard labour conditions. Agents in the countries of origin regularly misinform or even deceive domestic workers, while agents in the countries of destination actively stimulate confinement and exploitation. Furthermore, the lack of prosecution of traffickers is not caused by legal obscurities, but by societal issues. The paper concludes with some policy suggestions to better address the issue of trafficking.     

Interventions to prevent needle stick injuries among health care workers

Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster three-armed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a 'safety device plus workshop', to a group that was subjected to a 'workshop only' or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI's.     

Pensions and the uses of ignorance by unions and firms

Pensions are contingent claims contracts that are often fashioned by collective bargaining under conditions of asymmetric information and market power. Pensions are not an employer’s or a union’s optimal contract; they represent compromise. Employers use pensions to minimize labor costs and to adjust to market changes. Pensions help unions improve and protect their members’ work lives and help unions to survive as institutions. When workers’ estimations of their pensions differ from their employers’ estimations a moral hazard can exist. Less mobile workers and those with less influence subsidize the pension benefits of other workers or reduce an employer’s costs. Econometric results based on data from the President’s Commission on Pension Policy show that certain workers, namely women, overvalue their plans, which provides an opportunity to lower labor costs and redistribute benefits. Unions have a contradictory effect on information. The author thanks participants in the Cornell University Collective Bargaining workshop and the Harvard Labor Economics workshop. I especially thank James Medoff for his comments.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

Revisiting The New Politics of Immigration

This article follows from the workshop that Professor Mireille Paquet organized in Montreal in June 2018, to discuss my book, The New Politics of Immigration and the End of Settler Societies (Cambridge, 2016; Dauvergne 2016). In relation to this event and the articles of this special issue, this paper embarks on revisiting The New Politics of Immigration, now more than three after it first appeared in print. In this paper, I reflect on whether my arguments stand up to the test presented by the events of the past three years. Recent events lead me to nuance some of my original arguments, but on the whole even the most recent surprises fit well into the New Politics framework that points to increasing salience, legalization and urgency in politicizing immigration.     

AN ECONOMIC THEORY OF WORKAHOLICS AND ALCOHOLICS

This paper considers the role of alcohol in agency problems in order to provide an economic rationale for alcoholics and workaholics. In our model, alcohol reduces productivity, but also can make imbibers blurt private information. We show that in the optimal contract, low‐productivity workers are compelled to over‐indulge in alcohol, while high‐productivity workers overproduce output. Thus, workers are made into “alcoholics” and “workaholics” depending on their productivity. We conclude that excessive drinking (working) may be the result, not the cause, of low (high) productivity of workers. (JEL D82, VSOP)     

A ``European Consensus' on the Growth Agenda? A Discussion of the Sapir Report

This paper offers a discussion of An Agenda for a Growing Europe: Making the Economic System Deliver, a report to the President of the European Commission prepared by a group of independent experts. The paper reflects the results of the 3rd Milan European Economy Workshop (May 28–29, 2004) and my personal views. The workshop was organised by the Department of Economics, University of Milan and the Jean Monnet Chair of Economics of European Integration, with the participation of more than twenty distinguished speakers from several institutions across the European Union.     

‘Something to Deal With’: Customer Sexual Harassment and Women's Retail Service Work in Canada

While sexual harassment in the workplace has been extensively researched over the past two decades, the majority of studies have focused on employer–employee or co-worker relationships. In contrast, the issue of ‘customer sexual harassment’ (i.e. the sexual harassment of employees by customers) has been less explicitly explored. This paper examines customer sexual harassment in the Canadian context, drawing on a study of 63 female retail service workers and 20 security workers. It focuses on the nature, prevalence, and consequences of this form of harassment for women who work in various jobs in retail sales (e.g. flower shops, book shops). Findings from the study suggest that customer sexual harassment is a significant problem. Not only have a majority of women been sexually harassed by customers in their current job, but they appear to be highly constrained in dealing with such behaviour. To the extent that the work environment privileges the customer, through its emphasis on customer satisfaction, women are reluctant to confront harassers and may engage in behaviours (e.g. avoiding male customers, being less friendly) which potentially impact their performance on the job. The paper examines the dilemmas facing female workers and the policy issues raised.     

A code of practice

At a CCETSW workshop external assessors and examiners looked at the contribution they could make to promoting anti-racist practice.     

Letting Gender Secrets Out of the Bag

In this paper I record the understandings which have emerged for me through facilitating a series of workshops with family therapists and social workers, designed to help let ‘secrets' about gender issues and power relations between men and women ‘out of the bag’. I outline the background to these workshops, and describe both the workshop process used and the key themes which were addressed by participants. It is written in the hope that others will be encouraged to facilitate similar workshops in one anothers' agency groups.     

Power,participation and post modernism: User and practitioner participation in mental health social work education

The focus of this paper is service user and social work practitioner participation in the teaching for the mental health social work course. A review of the programme seeks to illuminate the value and significance of participation. The obstacles exposed through interviews and a collective workshop suggest a blocking opposition between idealistic education and ‘the reality of practice’. However this opposition is challenged by user and black advocacy participation. The value of participation appears in terms of anti-discrimination and extended possibilities to bring about change. Theory and practice divides are also dissolved. Participation is connected to power and modern and post modern approaches to education provide the theoretical framework.