‘Reasonable and necessary’ care: the challenge of operationalising the NDIS policy principle in allocating disability care in Australia

Disability reform in Australia centres on a National Disability Insurance Scheme (NDIS), which aims to provide lifelong, individualised support based on the principle of ‘reasonable and necessary’ care. As a universal rights‐based scheme it represents a historical shift in allocation principles in Australia's disability policy. Nonetheless, attention will be on determining who receives what care given the diversity of personal and family contexts. The aim of this paper is to discuss the operational complexities of a principle of reasonable and necessary care with reference to the findings of a three‐year study on the experiences and perspectives of disability care of 25 adults with acquired disability, their 22 nominated family members and 18 service providers. Evidence from this study suggests enacting the principle of reasonable and necessary care and support will be problematic, in particular as it relates to personalising the level and scope of services, balancing formal and informal care, and principles of equity. The paper contributes to the literature about allocation principles in social policy and the challenges of implementation. Further, it provides an empirically informed discussion of some of the specific policy implementation challenges concerning the NDIS.     

Do Marginalized Youth Experience Strengths in Strengths-Based Interventions? Unpacking Program Acceptability through Two Interventions for Sexual and Gender Minority Youth

ABSTRACT

Strengths-based interventions have potential to improve the wellbeing of sexual and gender minority youth (SGMY). This study examined the youth program acceptability of two strengths-based programs tailored for SGMY: ASSET (group counseling), and strengths first (SF) (care coordination). A mixed-methods approach was applied to secondary data extracted from client files (n = 247). Most participants were aged 15–18 (89%). Gender identities included woman (66%), man (30%), and transgender (<1%). Sexual orientations included bisexual (32%), lesbian (26%), gay (23%), and queer/pansexual (14%). Most participants identified as White, Hispanic (47%), Black, Non-Hispanic (17%), and Hispanic, No other race (19%). Program acceptability was measured using the 11-item Youth Acceptability and Strengths Scale. Quantitative analyses indicate program acceptability was high for SGMY participants and did not significantly differ across program type, gender identity, sexual orientation, or ethnoracial identity. There were no differences between strengths enhancement or client satisfaction between intervention types. Compared to group counseling, care coordination significantly increased problem-solving skills. Qualitative analysis identified that strengths-based interventions provided: (a) social support; (b) community; (c) confidence; and (d) positive mentors. Findings demonstrate the acceptability of strengths-based programming for SGMY. Strategies are provided to incorporate intervention program acceptability, yet future research is needed to explore youth acceptability.     

Exploring the Role of Working Memory in Dynamic Social Cue Decoding Using Dual Task Methodology

Decoding nonverbal social cues involves skills such as understanding emotions and discerning kin relationships. Social cue decoding has been described as an automatic process which does not tax cognitive resources. However, clinical deficits in social decoding are often interpreted in terms of deficits in attention and working memory. Two experiments are described which used dual task methodology to investigate the role of working memory in dynamic social cue decoding tasks: the Interpersonal Perception Task (IPT, Experiment 1) and the Profile of Nonverbal Sensitivity (PONS, Experiment 2). Results revealed that decoding social cues from the IPT did not require working memory resources, while social perception in the PONS made heavy demands on working memory. Implications for theoretical interpretation of these tasks and their use in clinical populations are discussed.

The revised safe at home instrument for assessing readiness to change intimate partner violence

This article describes the development and factor structure of the Revised Safe At Home instrument, a 35-item self-report measure designed to assess individuals' readiness to change their intimate partner violence behaviors. Seven new items have been added, representing content specific to the Maintenance stage, and other items have been revised to strengthen the assessment of earlier stages and address gender concerns. Confirmatory factor analysis using multisite data (two sites, a total of 281 men at intake) supported the conclusion that a four-factor model (Precontemplation, Contemplation, Preparation/Action, and Maintenance stages) was consistent with the observed covariances. A high degree of correlation between the Preparation/Action and Maintenance scales was observed, but subsequent testing indicated a need to treat the two as distinct factors in the model. It is recommended that scoring include only 31 items that perform well.     

Child health and parental paid work

We ask how the paid work of Canadian married mothers and fathers is affected when a child has a physical/mental condition or health problem that leads to restrictions in daily activities. Using the Statistics Canada National Longitudinal Survey of Children and Youth, we find that married mothers of children with disabilities are less likely to engage in paid work and/or work fewer paid hours per week. No statistically significant changes in paid work participation or hours are apparent for fathers of the same children. We find, moreover, evidence that the degree of specialization within families increases when there is a child with a disability. These responses are consistent with traditional gender roles within families, and may make sense as a ‘household’ coping strategy. However, such a division of labor may generate economic vulnerability for mothers compared to fathers.     

Eliciting representative samples of personal networks

In this paper we introduce and evaluate a method for eliciting a representative sample of total personal networks. First names were used as a cue to elicit a sample of 14 alters from 712 respondents through a telephone interview. Network characteristics for each respondent were calculated as averages and proportions across the 14 alters. These were compared to other studies using more specialized network generators. Our method produced results which are logically consistent with those expected from a generator that elicits a sample from the total rather than a specialized subset of the total network. The proportions of kin relations, average tie strength and frequency of contacts are found to be lower than network generators designed to elicit networks of social support. Given our conclusion that the sample is representative of the total network, we examine the varying characteristics of respondents and their networks based on the domination of a particular relation type in their network. This analysis provides answers to such questions as ‘What characteristics of respondents account for the proportion of family relations in their network?‘ and ‘What are the similarities between respondents whose networks are made up of mostly work-related relations?’     

How financial crisis history informs ethical corporate communication: Insights from corporate communication leaders

This study explored how financial crisis history can inform corporate crisis communication practice across industries and over time. Thirty-eight interviews with chief communications officers (CCOs) and their counselors were conducted to explore what lasting lessons these corporate communication leaders learned from their crisis communication practice during the 2008 Financial Crisis. Key lessons learned include: 1) the importance for corporations to tailor their financial communication strategies according to victim vs. perpetrator perception and ethical response expectations held by stakeholders; 2) the importance of stakeholders, and employees in particular, when creating and implementing the plan; 3) the balance between speed and legal concerns, as well as the need for reducing complexity by making sure stakeholder communications are delivered with clarity and accessibility; and 4) a recipe for success includes honesty, transparency, trust/integrity, taking action to reform questionable practices, and abiding by one’s own personal morals. Insights from this study shed light on how learning contributes to ethical corporate communication practice in times of crisis and crisis spillover.