Steps towards an integration of basic therapeutic skills: a qualitative study of the development of the ideas of 15 social work students about being helpful to clients

Social work students ( n =39) were shown 10 videotaped client situations prior to and after participating in a communication skills training course. At both times, they were asked to write proposals for helpful answers for each of these situations. Proposals made by a sample of 15 students were analyzed with regard to patterns in their answers before and after the training course. These 15 were selected by using quantitative data identifying those students who changed their level of communicated empathy during the training course and those who did not. The communication course is described. Patterns in the proposals are examined and discussed in relation to central concepts of helping; such as acknowledging, empathic communication and working alliance. Three steps in the development of skillfulness are described and suggested as more general steps in the acquisition of therapeutic competence. The validity and reliability of the study are discussed, as well as possible implications of the findings for social work education.     

Partnerships, Power and the "New" Politics of Community Participation in British Health Care

Multi–sectoral approaches to health improvement in its broadest sense have entailed an emphasis by the British government upon partnership working in and around community involvement in planning processes. New service planning and delivery organizations in the health service—primary care groups and primary care trusts—thus have to ensure that public and patient involvement strategies reflect a coordinated, if not integrated, multi–sectoral approach to such involvement. But how are these enforced partnership arrangements shaping the approach taken by primary care groups and trusts to the issue of public and patient involvement? More particularly, is the traditional dominance of health service managers and the medical profession in decision–making processes under challenge? This article draws on a study of primary care groups and trusts in three districts in order to gauge perceptions and calculations with regard to partnerships for involvement. Results appear to suggest that health service managers and practitioners continue to exercise considerable influence in comparison to that of patients and citizens. But, if the findings are viewed in the broader contexts of government managerialist strategies of surveillance and accountability and the growth of service–user and advocacy organizations, partnerships may offer significant scope for “lay” challenges to managerial and medical power.     

Dominance and Efficiency in Multicriteria Decision under Uncertainty

This paper proposes several concepts of efficient solutions for multicriteria decision problems under uncertainty. We show how alternative notions of efficiency may be grounded on different decision contexts, depending on what is known about the Decision Maker's (DM) preference structure and probabilistic anticipations. We define efficient sets arising naturally from polar decision contexts. We investigate these sets from the points of view of their relative inclusions and point out some particular subsets which may be especially relevant to some decision situations.     

Public Opinion and Dynamic Representation in the American States: The Case of Environmental Attitudes*

Objective. We investigate causal processes linking environmental conditions, attitudes, and policies in the American states: Is public opinion about ecology shaped by environmental conditions? Are state policymakers responsive to environmental opinions? Does public opinion respond to policy adoption? Methods. Using public opinion data from the DDB Worldwide Life Style Survey to measure aggregate state attitudes about the environment, as well as measures of water quality and policy intervention, we capture the dynamics of representation in the American states on the environment during the late 1980s and early 1990s. Results. Our findings support a thermostatic model of representation—state environmental opinions are influenced by environmental conditions and are responsive to policy outputs alongside improved environmental conditions. Conclusions. This model of the opinion‐policy linkage refines our understanding of representation and focuses us not just on the passage of public policy to address public desires, but the effectiveness of that policy as well.