Understanding Career Plateauing: Implications for Counseling

The pyramidal shape of most organizations dictates that virtually all careers will level out before an employee reaches the top of the institution, agency, or corporation. How to maintain or enhance worker productivity and job satisfaction when an employee remains at a career level that discourages one's aspirations are concerns for career counselors, their clients, and organizational executives. This article defines career plateauing, explains types and sources of plateauing, and suggests counseling interventions that can help individuals to recognize and adjust to plateauing. In addition, we recommend proactive measures that will perpetuate the work motivation of effectively-performing plateaued workers as well as remediate the work behavior of the ineffective, plateaued worker. One of life's maxims is that all careers reach a level after which no higher achievement can be expected. From night watchguard to chief executive officer, each person's career has its apex. Thus, career plateauing is inevitable for all who strive and struggle in the work world (Bardwick, 1986). The point in time when an individual will experience, if not recognize, career plateauing is difficult to predict as is the extent to which that person can influence the timing or impact of this phenomenon.     

Subgroup analyses in cost‐effectiveness analyses to support health technology assessments

‘Success’ in drug development is bringing to patients a new medicine that has an acceptable benefit–risk profile and that is also cost‐effective. Cost‐effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision‐makers in the determination of the cost‐effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost‐effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost‐effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost‐effectiveness analyses. In summary, we recommend planning subgroup analyses for cost‐effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost‐effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.     

Grief support groups used by few--are bereavement needs being met?

Few adult bereaved attend closed grief support groups, yet many of those who do attend say they are extremely helpful. This research explores factors influencing support group attendance, and the extent to which bereavement support needs are being met. Focus group discussions reveal that a broad scope of sources of support is available to the bereaved. Results show what is seen as unhelpful to them, and what might be more helpful to them. The study indicates many adult bereaved suffer from an overall lack of support and would benefit from more caring overtures from those around them. Findings from this small frontline hospice bereavement study point toward ideas for adjustments in support groups and innovative bereavement education and programming.     

Non-abusive mothers of sexually abused children. The role of rumination in maternal outcomes

This study of 125 mothers examined the role of rumination in maternal emotional and behavioral outcomes subsequent to discovery of the sexual abuse of their children. Abuse severity, a maternal history of child abuse experiences, and life hassles were examined as predictors of negative outcomes. The central finding was that these factors, many of which are not controllable, were less likely to predict poor maternal outcomes than was rumination, a cognitive process that may be alterable. Rumination was the strongest correlate with each outcome. Further, the effects of most predictors on outcomes in this study were mediated by a ruminative cognitive style. Abuse severity, income, ethnicity, and education lacked significant relationships with maternal outcomes. This study asserts that rumination is a central component for understanding maternal outcomes in the post-discovery phase of sexual abuse cases. It recommends that rumination be routinely assessed both for research and treatment purposes.     

Variations from the Therapeutic Frame

This article provides a commentary and discussion of alterations in the therapeutic frame in a paper by Paula Shatsky.     

High School Family Centers: Transformative Spaces Linking Schools and Families in Support of Student Learning

ABSTRACT

This study explores school, family, and community partnership at the high school level, using eight family centers as the entry point for the investigation. The purpose of the study was to identify ways that parents and school staff could collaborate to support high school students' achievement. The study findings led to the development of a model that represents three inputs that are crucial to the creation of a successful family center: (1) a supportive infrastructure, (2) the existence of skilled center staff, and (3) the presence of responsive programming. These three inputs led to the creation of a thriving center that acts as a transformative space, a “zone of community,” that results in four outputs: (1) the creation of relational trust among adults, (2) shift in parents' role construction and efficacy, (3) the generation of student relational trust, and (4) the development of student efficacy. The data from this study suggest that the relational trust developed in these transformative spaces called family centers can have a positive effect on student efficacy. The study concludes with seven recommendations for schools and districts looking to establish family centers in high schools as a way to expand family engagement at the high school level.