Claiming Competence: Biographical Work among Victim‐Advocates and Counselors

Advocates and counselors at agencies that assist victims of domestic violence and sexual assault argue that they are especially suited to help their clients develop safe and practical strategies to protect themselves from further abuse. Yet the backstage of these agencies can depict a reality of confusion, doubt, and sometimes fear—especially when clients’ cases do not go according to plan. Data collected from in‐depth interviews and participant observation over fourteen months show how advocates and counselors engaged in “biographical work” (Gubrium and Holstein 2000) to construct coherent and consistent narratives as competent service providers in the aftermath of their clients’ unanticipated outcomes. Calling on different discursive strategies accessible to them according to their position within the agency, both groups were able to interpret negative results as beyond their responsibility. However, the counselor's rhetoric of “professionalism” proved more effective in this regard compared with the advocates’ “empowerment.”     

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.     

Evaluation of Family Therapy: A Comparison of Therapists' and Clients' Views**

In this evaluation of therapy experience for 82 families by brief therapy at Bouverie Clinic to 1976–1977, therapists' and clients' rating of outcome were obtained. After termination of therapy both therapists and clients reported high improvement rates in the presenting problem(s) as well as in the quality of family relationships and in the family's ability to deal with further problems. High agreement was found between therapist’ and clients' ratings of outcomes. Therapists were more favorable than clients in their ratings of change in the presenting problem and in their ratings of change in the quality of family relationships, but not in assessing the change in family's further problem solving ability. At follow-up clients were predominantly satisfied with their therapy experience. In addition, therapists' ability to predict outcome accurately, after the second of therapy, was strongly supported by our finding.     

Negotiating Clothing Identities on the Sales Floor

How do salespeople negotiate “clothing identities” with customers? To answer this question, I conducted fieldwork in the women's departments of several luxury goods stores in Paris that sell ready-to-wear clothes. In this negotiating context of personalized service, lower-status individuals (salespersons) propose new identities to higher-status consumers. This comparison of how saleswomen and gay salesmen negotiate clothing identities with women customers examines both their identification with the customers and the role-playing involved. The sales area as a “backstage” permits the “expertise” of the sales staff to mitigate the status differences and gives gay male sales staff latitude in their interactions with female clients. Through a construction of clothing identity from articles from the store, saleswomen present an image of possibilities to customers. Playing the role of personal audience, gay salesmen use their ambiguous gender identity to sell clothing.     

The Everyday Drama of Coproduction in Community Mental Health Services: Analyzing Welfare Workers' Performance as the “Undercover Agent”

Current welfare policy encourages “coproduction” between citizens and welfare workers so that “lay expertise” effectively becomes part of the provision of services. Drawing on fieldwork from Danish mental health services, this article analyzes how expertise and authority are organized and performed in a network linking welfare workers and users as well as new participants (e.g., volunteers) and artifacts. Theoretically, the article employs Goffman's dramaturgical distinction between “frontstage” and “backstage.” The findings indicate that welfare workers coproduce services by covering their authority and expertise in “frontstage” meetings with users. However, relational and material resources in encounters “backstage” make welfare workers appear as accountable experts, which both fosters and threatens their credibility.     

Which therapist perceptions best predict client outcomes? A naturalistic examination

Examining associations between therapists' perceptions of therapy sessions and client-reported outcomes in naturalistic settings (real-life therapy settings) can provide valuable guidance for the assessment, treatment, and monitoring of clients. This study included data of 1334 sessions from 127 clients (86 individual and 41 couple cases) and 15 therapists, collected at a therapy training center. Clients reported their personal functioning and individual symptoms before each session. Therapists rated clients' participation, receptivity, session progress, goal progress, and therapeutic alliance at the end of each therapy session. Multilevel Structural Equation Modeling analyses revealed that therapist-rated client participation and goal progress predicted better personal functioning, beyond clients' previous personal functioning scores. In contrast, none of therapist-rated session variables predicted clients' individual symptoms, beyond previous symptom scores. Power analyses suggested sufficient statistical power to detect small effect sizes. Findings of the current study have clinical implications for treatment planning and progress monitoring.     

A CHILD PSYCHOTHERAPIST IN PRIMARY MENTAL HEALTH

This paper outlines the author's application of psychodynamic thinking and approaches to brief therapeutic work with children, adolescents and their families in community mental health settings. It is the author's belief that systemic and narrative therapy insights and techniques combine well with psychoanalysis in the assessment and treatment of many concerns felt and expressed by parents and young people. The therapist's tasks are to listen empathically to clients who are in distress and to explore the clients' beliefs about the origins of their problems, as well as their previously attempted solutions. In proceeding at the family's pace, opportunities arise for facilitating more effective ways of resolving conflict. Clients are often more free than they realise to change their interpretation of their experience, and this has important consequences for the maintenance and solution of problems. Brief therapy seeks to remind clients of their strengths and resources and to share ways to encourage clients to resume effective ways of learning about themselves.     

Measuring the Influence of Social Context Referents in Substance Abuse Treatment: An Instrument Validation Study

ABSTRACT

This paper introduces a newly developed assessment tool, the Ecological Assessment of Substance abuse Experiences (EASE) that has been designed to measure the influence of social context referents (i.e., family, peers, and community) on clients' attitudes and outcome beliefs related to substance abuse and recovery. An initial exploratory factor analysis was conducted with a small sample of adult treatment-seekers (N =103) to identify its underlying factors and to examine the instrument's item-factor fit. Items clustered onto four orthogonal factors: “belonging-recovery,” “belonging-drugs/alcohol,” “disconnect-recovery,” and “attitudinal congruence-recovery.” Preliminary findings suggest that socio-emotional outcome beliefs and attitudes about drug use and recovery behaviors, as related to family, peers, and community contexts, may be significant areas to address during routine assessment practices that may lead to more comprehensive and contextually appropriate treatment plans.     

Child welfare clients and school satisfaction

Despite long-standing knowledge about child welfare clients' poor educational outcomes, we know less about these vulnerable young people's situation in school. This article addresses school satisfaction among upper secondary students who have been in contact with the child welfare services. These child welfare clients' school satisfaction is compared with their peers' satisfaction. The results from a survey indicated that the majority of child welfare clients were satisfied with school but that they were less satisfied with school than were their peers. The results showed that the association between school satisfaction and positive school experiences explains a large part of this difference. Among students who reported they were doing well in school, had supportive teachers and friends at school, the difference in school satisfaction between child welfare clients and others was small. Among students who did not report similar positive experiences in school, difference in school satisfaction between child welfare clients and their peers was more substantial. These results show that school can be a good place for child welfare clients, but that facilitating support from teachers, increasing opportunities for making friends at school, and working to develop the child welfare clients' academic performances are important as efforts to improve school satisfaction.     

The protection of children's rights as ceremony and myth:: A critique of the review of institutional placements in Quebec and Ontario

The establishment of mechanisms to review the institutional placements of children is important for the protection of clients' rights. This article suggests that formal review processes can become forums or media for conducting ceremonies which establish and perpetuate the myth of justice and appropriate service provision. The reviews of institutional placement in Quebec and Ontario are described. The underlying principle of the processes in both provinces is identified as “escape from conflict.” The article concludes with the suggestion that, in order to be meaningful, a review process must induce the public expression of interprofessional and interorganizational disagreements. It must also address the disparities of power between children/families and professionals in a way that will allow the actual participation of clients in central decision-making processes.     

Can't Buy My Love: A Typology of Female Sex Workers' Commercial Relationships in the Mexico–U.S. Border Region

Female sex workers (FSWs) experience elevated risk for HIV and sexually transmitted infections (STIs) through unprotected sex with male clients, yet the complexity of these commercial relationships remains understudied. From 2010 to 2011, we explored FSWs' conceptualizations of various client types and related risk behavior patterns using semistructured interviews with 46 FSWs in Tijuana and Ciudad Juarez, Mexico, where FSWs' HIV/STI prevalence is increasing. Our grounded theory analysis identified four types of commercial relationships: nonregular clients, regular clients and friends, clients who “fell in love” with FSWs, and long-term financial providers who often originated from the United States. As commercial relationships developed, clients' social and emotional connections to FSWs increased, rendering condom negotiation and maintaining professional boundaries more difficult. Drug abuse and poverty also influenced behaviors, particularly in Ciudad Juárez, where lucrative U.S. clients were increasingly scarce. While struggling to cultivate dependable relationships in a setting marked by historical sex tourism from a wealthier country, some FSWs ceased negotiating condom use. We discuss the need for HIV/STI research and prevention interventions to recognize the complexity within FSWs' commercial relationships and how behaviors (e.g., condom use) evolve as relationships develop through processes that are influenced by local sociopolitical contexts and binational income inequality.     

Validation of a Multivariate Career and Educational Counseling Intervention Model Using Long‐Term Follow‐Up

In this study, the author sought to validate the effectiveness of a multivariate career and educational counseling intervention model through long‐term follow‐up of clients seen in private practice. Effectiveness was measured by clients' commitment to and enjoyment of their chosen career paths and the relationship of these factors to adherence to program recommendations. Findings indicated that 65% of clients adhered to program recommendations. Those who adhered to program recommendations were significantly more committed to their careers; however, no significant difference was found in clients' enjoyment of their careers. Additionally, 85% of clients reported that the program met their needs, and 95% would recommend the program.     

Client Psychological Distress: An Important Factor in Career Counseling

The authors explored client psychological distress as a variable in career counseling. Forty‐two clients in a naturalistic setting were seen for a total of 290 sessions by 21 counselors‐in‐training. The results indicated that (a) 60% of the clients were psychologically distressed, (b) clients' scores decreased significantly from pretest to posttest on psychological distress variables, (c) significant linear growth occurred in the clients' perception of the working alliance across sessions, and (d) the psychological distress outcome variables were significantly related to both the first session level of the working alliance and its linear growth.     

Time,Trust and Hazard: Hairdressers' Symbolic Roles

Field work on five hairdressers in a small, suburban beauty shop shows that routine hazards provide an organizational justification to establish and maintain processes which create and sustain trust, both with coworkers and clients. The study analyzes data from interviews and weekly observations, and details the types of workers and clients; the hairdressers' roles as caretakers, friends and riskbearers; the necessity of establishing “professional” identities with clients by scheduling appointments; and the construction of shared futures among “regulars.” In the course of observing the symbolic and temporal processes associated with trust, hazards to hairdressers from chemicals, equipment, and procedures are examined, followed by the kinds of risks effecting clients from chemicals, equipment, and hairdressers' technical competence and moral responsibility, as framed by their “honorific” professional roles.     

The Pastor in the Basement: Discourses of Authenticity in the Networked Public Sphere

Applying Altheide's method of ethnographic content analysis, this article tracks competing discourses of authenticity in media coverage of Jeremiah Wright and Sarah Palin. The “pastor problems” of the last election demonstrate a bias toward issues of sincerity and authenticity in the networked public sphere. Pundits and bloggers use viral videos to construct rival representations of candidates’ backstage identities. Such debates favor “flat” notions of authenticity, however, and decontextualization tends to thwart the critical gatekeeping functions of journalism. Religion serves as a proxy for issues of race, prophetic critique is demonized, and apocalyptic thinking is normalized.     

Are You Truly a Recovering Dope Fiend? Local Interpretive Practices at a Therapeutic Community Drug Treatment Program

Previous qualitative research on treatment programs for drug addiction/alcoholism has primarily focused on those processes whereby participants are expected to construct a new sense of self according to institutional parameters. The present article builds on that research and explores how contemporary programs attempt to resolve the problem that it is almost impossible to tell if someone has engaged in this self‐construction process. Informed by five months of ethnographic fieldwork at an adult residential drug treatment facility, the article asks: under what circumstances do program members call into doubt a client's efforts to create an institutional self, and how do they express this skepticism? The article reveals that staff and clients employ a set of local interpretive practices about community and emotions to assess whether clients are constructing the institutional self of a “recovering dope fiend.” It specifically considers how they interpret a client's emotional displays to represent that client's current self under construction. That is, a client's ability to control anger appropriately or to handle anxiety demonstrates s/he is effectively “doing the program” of self‐construction.     

‘Bad Therapy’ as a Training Technique: An Empirical Analysis

The purpose of the present study was to gather empirical data to examine the usefulness of an intriguing training technique called “bad therapy”. The technique, developed by Lang (1980, 1982), is utilized in a role-play setting for experienced therapists who are having difficulty with specific clients showing little improvement. The therapist is instructed to disregard his or her usual style of treatment, and instead, within a role-play format with a colleague who plays the part of a client, to try an alternative style of treatment. This new treatment, termed “bad therapy”, instructs the therapist to try to make the client worse rather than better. Interestingly, reports from both the role-play therapist and client indicate that the “bad therapy” session was considered more beneficial than the therapist's usual mode of treatment. As well as empirically investigating Lang's assertion, the present study also attempted to look at different perspectives of bad therapy. Is “bad therapy” a directive to be harmful and destructive, or is it a suggestion to be more daring and to take more risks? Subjects were 56 therapists who formed twenty eight pairs of therapist-client dyads. First, each pair conducted a “session” where the therapist performed his or her typical therapy. Then, therapists in one group (N= 11) were given directives to try to make their clients worse rather than better (“destructive” set), while therapists in another group (N=11) were told to say and do things that they wished to, but never dared (“daring” set). Finally, six therapists were told to simply repeat their usual type of therapy (“control” set). Results indicated that clients perceived the destructive and daring groups differently with the daring group being perceived more favourably, yet more authoritarian. Similarly, therapists perceived the daring and control groups more positively than the destructive group. The results are discussed in terms of training techniques and current trends in psychotherapy.     

Nonprofit and For-Profit Home Care in Israel

Clients' assessments of differences between nonprofit and for-profit organizations delivering home care services to Israel's frail elderly were studied. No significant differences were found between nonprofit and for-profit providers with respect to organizational efficiency; speed of placement and replacement of home care workers; responsiveness to clients' complaints; and supervision of care plans, schedules, and service delivery. Systematic differences were found, however, in clients' perceptions of workers employed by nonprofit versus for-profit service providers. The differences related to the home care workers' adaptation to clients' needs and wants; how well workers delivered services; and how satisfied clients were with the services received. Indications are that the relatively high efficiency of nonprofit organizations can largely be attributed to the performance of their home care workers.     

Practice What You Preach? The Role of Rural NGOs in Women's Empowerment

Abstract

If NGO employees are facilitating change for self-empowerment, such behavior must be modeled for successful transmission, as suggested in self-efficacy models of behavior change. Rural NGOs in India often depend on employees from the local population who are as likely to be marginalized as their clients. This may cause a gap between what the employees may be trained to “preach” and what they “practice,” thereby diminishing their effectiveness. We examine the employees of a successful rural NGO in India to establish if this gap exists. Using three empowerment instruments, we find that employees indeed “walk the talk.”