Comparing the Social Images of Youth In and Out of Residential Care

The literature indicates that youths in residential care have been associated with negative social images. However, there have been few studies focused on these social images, specifically, comparing them with the images of youths in normative contexts. To address this issue, we conducted two studies comparing the social images people have about youths in residential care to those they hold about youths living out of care. Both studies were conducted in Portugal: Study 1 explores these images through an open‐ended questionnaire; Study 2 examines these images with a quantitative instrument. Overall, the results indicate that the perception about youths in residential care was more negative than the perception about youths out of care. Additionally, the first study probed the effect of socioeconomic status of the youths on the social images held about them and the second examined the role of the respondents' professional contact with youth in care population on these social images. The implications of the social images people have about youth in residential care for the research and intervention towards the wellbeing of this population are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

From Transcendence to Ethics: Shaping spirituality to schools

Although Education Acts require schools in England and Wales to make provision for the spiritual development of pupils, there is continued debate about the meaning of the word 'spirituality' and what it should mean for schools. This article explores these issues using interview material collected from ten people from a variety of faiths and worldviews. The interviews documented individuals' personal understandings of spirituality. Synopses of these different accounts are presented here. The interviews also documented individuals' perceptions of spirituality for school and it was observed that these involved much greater agreement than the accounts of personal spirituality. Agreement was reached by a common shift of emphasis away from transcendent phenomena toward ethical values. The shift toward ethics and consensus is discussed here in relation to National Curriculum Council and OFSTED definitions of spirituality. It is suggested that a drive toward consensus is detrimental to the spirit of spiritualities.     

Measuring the quality of residential care

Administrative personnel require objective, reliable and valid information in order to monitor the effects of allocating resources to different components of the service that they are providing. The initial problem is to define and measure the dependent variable—the ‘quality of care’ —against which the effects of changing various independent variables can be evaluated. The paper describes an attempt to use the operant conditioning model as a basis for constructing such a measure of the quality of care provided in residential settings for severely mentally handicapped people. The rationale for adopting this model is described, against a background of other studies in which the same problem has been addressed. The hypothesis, the tasks generated, and the methodological problems encountered, are outlined and discussed.

A subsequent paper will present the results obtained when using the method to measure the quality of care, so defined, in two residential units for severely mentally handicapped children.     

Uncovering the mystery: factors of African American suicide

Traditionally, African Americans have registered lower rates of suicide than other ethnic groups. In the last 20 years this pattern has changed, particularly among young African Americans. To date, the research conducted regarding this phenomenon has been limited for a variety of reasons and previous research has been inconclusive in determining risk factors of African American suicide. The purpose of this paper is to identify risk and protective factors specific to African American suicide. To determine the factors, the 1993 National Mortality Follow-back Survey was analyzed. The risk factors identified include being under age 35, southern and northeastern residence, cocaine use, firearm presence in home, and threatening others with violence. Some of the protective factors associated with African American suicide include rural residence and educational attainment. These results provide valuable information about completed African American suicides in relation to Whites. Several of these factors are unique to African Americans.     

Mathematical modeling of movement between residential placements: A systems analytic approach to understanding systems of care

Although the concept of a system of care for children and adolescents with a severe emotional disturbance has become core to treatment philosophy, very little research has focused on systems of care as systems. This article attempts to contribute to the development of a systems research paradigm in children's mental health as well as to add to the substantive knowledge of utilization of and movement between residential options in a statewide multiagency service delivery system. Information on residential placement gathered at six month intervals over a three year period is used to develop a mathematical model of the system of care. This model can help administrators to predict future needs for residential care, and to project probable outcomes of alternative strategies for meeting the needs of these children and adolescents.     

Living circumstances of children and adults with mental retardation or developmental disabilities in the United States, Canada, England and Wales, and Australia

The purpose of this article was to collate evidence to describe where people with mental retardation or developmental disabilities live in five developed countries: United States, Canada, England, Wales, and Australia. Family homes are important dwelling places for people with mental retardation. They are the home of the great majority of children with mental retardation and a considerable proportion of adults with mental retardation. The likelihood of placement outside the family home increases with adulthood and progressively as people age. Adults with mental retardation live in a wide variety of settings, with formal residential provision frequently dependent on the arrangements that the authorities responsible for providing service support have chosen to make. There has been a considerable move away from accommodating people in large segregated and geographically isolated institutions in the countries considered. However, the current range of accommodation includes much with a distinctively different character to the homes where other citizens live. Many people still live in larger groups than would be ordinarily found in typical homes and this may necessitate departure from the architectural norm. In all of the countries considered, there has been a recent trend towards small community settings, compatible with typical housing architecture. This appears furthest advanced in the U.S. but is discernible elsewhere. Availability of residential services at a national level varies between 100 and 155 places per 100,000 total population. Regional variation within countries is even greater. In no case is the national availability considered adequate to meet the demand arising from changing need or expectations. MRDD Research Reviews 7:115-121, 2001. (c) 2001 Wiley-Liss, Inc.     

The social context of Hong Kong's booming elderly home industry

Hong Kong experienced a rapid increase in private homes for elderly people in recent years. This paper examines the social background of that development. Private elderly homes thrived in a context of rising demand due to changing demographics, particularly massive emigration secondary to political instability, which created a large potential market of elderly people in need of residential care. However, entrepreneurs would not be attracted unless it is a profitable business, and much of that profit is likely derived from social security payments to elderly people. Because the amount of social security benefits is way below the level required for purchasing good quality service in the private sector, many elderly people are bound to live in very poor residential settings. The preparation of this article was supported in part by CPHK Grant No. 903089. I am grateful to Alfred Chan, Man-fuk Leung, Alice Chong, Nicky Hamid, Murray Levine, and three anonymous reviewers for their helpful comments on an earlier version of the article.     

从恢复体验到地方依恋:环境偏好与居住时长的作用

探究源自环境的恢复体验(如,放松、平静等)对居住者地方依恋(包括地方依赖和地方认同两个维度)的预测作用,并分析其中的内在过程与情境条件。采用问卷研究法(N=410),结果发现:(1)恢复体验能显著正向预测个体地方依恋;(2)环境偏好在恢复体验与地方依恋之间起完全中介作用;(3)居住时长调节环境偏好与地方依恋(主要是地方认同)之间的关系。研究将有助于探寻环境心理学视角下的压力管理与城市管理协同路径。     

Wraparound care in vermont: Program development,implementation, and evaluation of a statewide system of individualized services

Over the past decade, there has been a dramatic shift in the provision of mental health services to children, adolescents, and their families. This shift has been marked by a movement away from restrictive treatment options toward the development of comprehensive community-based systems of care designed to keep the most challenging children in their homes, schools, and communities. Based on a model of intensive case management referred to as Wraparound Care, Vermont's statewide approach emphasizes aggressive outreach, use of the least restrictive treatment options, and care that is flexible, unconditional, and child- and family-centered. We chart the development of Vermont's Wraparound Care Initiative and present residential, educational, and behavioral outcome data for a cohort of 40 youth receiving Wraparound Care over a 12-month period. The results showed that after 12-months, youth who had been previously removed from their homes or were at imminent risk of such removal, were residing in significantly less restrictive community-based living arrangements and exhibiting significantly fewer problem behaviors than at intake. These results are discussed in light of recent national studies and previous studies on similar cohorts of Vermont youth receiving Wraparound Care.     

Improving partnerships with families and carers in in‐patient mental health services for older people: a staff training programme and family liaison service

In spite of policies advocating the involvement of families in the care of mental health service users in the UK, there are few examples of initiatives to develop staff confidence and skills in partnership working. This article describes a whole team training initiative and family liaison service to promote family inclusive working on in‐patient wards for older people in Somerset, UK. A three‐day staff‐training programme is described and training outcomes are reported. Staff report a substantial increase in confidence and family meetings held. A pre‐and post‐ training case note audit shows increased consideration of the needs of families. To further increase face to face meetings with families a family liaison service has been established, whereby a staff member with systemic family therapy training joins ward staff to hold family meetings as part of the assessment/admission process. Evaluation of this service has shown it to be effective with positive feedback from families and staff.     

Staff support strategies to increase the involvement of individuals with disabilities in meal preparation

In recent years, residential services for persons with disabilities have changed radically, reflecting a shift from custodial care to habilitation and community participation. This has resulted in a significant shift in the roles of direct-care staff. Improvement of staff performance is recognized as a major objective of agencies providing residential support to persons with disabilities. This study examined the gap between existing technologies of support and performance of direct-care staff, and focused on participation in an important activity of daily living, meal preparation. This study compared initial, baseline levels of participation to levels of involvement observed during three experimental intervention phases introduced sequentially within a multiple-baseline design: staff prompting by interventionists, staff self-management, and staff training. Increases from baseline levels of participation were observed for all five participating staff-resident dyads. High levels of variability were observed in some dyads and amounts of increase differed across dyads. Findings are explained in terms of dyad-specific information. A model of staff performance is presented along with implications for high-quality residential service.     

居住流动性与消费：基于调节定向理论的阐释

居住流动性是指人们改变居住地(即搬家)的频率。作为关键的社会生态因素之一,其会对个体的认知、情绪以及行为产生重要影响。已有学者从健康福祉、社会关系以及教育结果等方面对居住流动性的后因结果进行了综述。居住流动性对消费者心理和行为也会产生重要影响,但目前未发现有综述研究对居住流动性引发的消费者行为反应进行总结,也未见研究从理论层面对这一影响机制进行归纳解释。在梳理居住流动性导致的消费者心理与行为反应的研究之后,借用调节定向理论对相关研究结论进行了归类论述,指出居住流动性会导致消费者分别采取促进型反应策略或预防型反应策略。进一步地,提出居住流动的自主性(主动vs.被动)以及方向性(向上vs.向下)能够解释经历居住流动的消费者何时会选择促进型策略或预防型策略。最后,针对所搭建的居住流动性促进和预防策略框架,提出几个潜在的研究议题,以供学者进一步探究讨论。     

CORE-OM mental health norms of students attending university counselling services benchmarked against an age-matched primary care sample

Whilst concern has been expressed at the increasing severity of the mental health of students, there has been very little research on this growing population outside of small, single institution studies. The aims of this paper are to provide CORE Outcome Measure (CORE-OM) norms for the psychological health of students across multiple sites receiving university counselling, and benchmark these against an age-matched sample of people receiving treatment in NHS primary care settings. Results indicate that students using university counselling services show severity levels only marginally lower than young people presenting in primary care, with the differences being at a functional/relationship rather than a symptomatic level and with levels of risk to self being similar. This suggests that university counselling services deliver a service to people who closely resemble NHS primary care clients in terms of severity and risk to self.     

A Palliative Approach to Spirituality in Residential Aged Care

SUMMARY

This paper describes how a palliative approach to care is relevant in the context of residential aged care, with specific focus on the spiritual needs of residents. Three issues are described that make attention to spirituality in residential aged care particularly challenging: effects of cognitive changes, potential threats to dignity, and uncertainties about how to provide bereavement support to the range of people who experience loss in this care context. Reflections on how residential aged care staff might better assess the spiritual needs of residents are offered with suggestions from the literature about how to sensitively respond to these needs.     

Towards an Italian model of therapeutic community

In this paper the author reflects on research undertaken by the Association Myth and Reality in the context of the psychiatric reforms in Italy which resulted in the closure of the asylums and the organisation, over the last 20?years, of a network of services in the community. These include thousands of residential units operating on a rehabilitative model. The focus of this paper is on the concept of the therapeutic community as a dynamic evolutionary path, individually tailored to people with different diagnoses and different ages – e.g. psychosis; borderline; adolescents and children. The therapeutic – and more specifically the environmental – factors are presented here. This includes the aesthetics of living and the sensory/emotional climate in relation to the care of the self and protection, regulation and safety, transitional playful climate, everyday life and the sharing implicit in relationships. The emotional climate is a fundamental component that transverses and intersects all the other factors. Treatment is central to the group with its potential for containment and dynamism in relation to relationships, cohesion, belonging, integration of the self in the community and connections with social networks outside the group aimed at reintegration into society of the resident as a citizen. A system of evaluation through peer reviews between therapeutic communities in Italy is being built in order to continuously improve the quality of service delivery.     

Spirituality promotes better health outcomes and lowers anxiety about aging: The importance of spiritual dimensions for baby boomers as they enter older adulthood

Baby boomers present unique challenges to aged care service provision. Like previous generations, baby boomers will face challenges of ageing. Spirituality in later life, understood largely as meaning in life, is crucial to well-being. Little has been studied about this dimension of ageing for baby boomers. This mixed methods study used survey and focus groups methods to investigate spirituality in a sample of baby boomers (N = 143). Participants comprised staff, children of adults in care, and Uniting Church congregational members. We examined associations between physical and mental health, and ageing anxiety with spirituality and whether baby boomer spirituality buffered the impact of negative life events. Focus groups revealed fears of future frailty, loss, and fears of dementia. Religious affiliation in study was lower, yet spirituality was important, even with those without religious affiliation. Closeness of association of staff with older people in their care seemed to account for lower levels of fear of older people amongst staff, but higher fears of future loss compared with the other groups. Higher levels of spirituality were related to better mental and physical health and lower anxiety about and fear of ageing, and buffered the impact of negative life events where they occurred.     

Ensuring an independent future for young people with special educational needs and disabilities (SEND): a critical examination of the impact of education,health and care plans in England

This article examines the implications of the new education, health and care (EHC) planning process for career professionals in England. The new process comes in the wake of a succession of legislation relating to young people with special educational needs and disabilities (SEND) in England. There is much to recommend the new process as it represents a shift to a more holistic and person-centred approach. However, there are four main criticisms which can be made of the new process: (1) the policy has an excessive focus on paid work as an outcome which is unrealistic (for some young people); (2) the resourcing in local authorities is too limited to successfully operationalise the policy; (3) there is a lack of clarity about the professional base delivering EHC planning (especially in relation to the career elements); and (4) the policy is too narrowly targeted. While the new legislation offers some major opportunities, realising these will be difficult. In this paper, questions are raised about the resources required to deliver these services; the responsibilities relevant to such services; and the role and scope of these services in supporting the transitions of vulnerable young people into learning and work in an environment where universal careers provision has been substantially diminished.     

Actions,Feelings, and Values: Foundations of Meaning and Personhood in Dementia

SUMMARY

Viktor Frankl's writings on the sources of meaning in human life are compared to emergent views on personhood in older individuals with dementing illnesses. An ethnomethodological study of a CBRF (community based residential facility) with two sections, each housing about 10 persons, revealed meaning in residents' actions, feelings, and expressions of values. These individuals showed it is possible to retain what Frankl called “tragic optimism” despite cognitive deterioration. Through active engagement with their environments and with one another, a wide range of expressed emotions including happiness and humor, and caring sensitivity toward others, these elders showed that given a supportive environment, dementia does not destroy meaning. These observations form the basis of suggestions for pastoral care and ministry with people with dementia.     

Self-defining future projections: exploring the identity function of thinking about the future

The act of projecting oneself into meaningful future events may significantly contribute to a person's sense of self and identity. Yet if the role of memories, in particular self-defining memories (SDMs), in grounding the self is now well established, the identity function of anticipated future events has received comparatively little attention. This article introduces the construct of self-defining future projection (SDFP) to address this issue. Two studies show that people can readily identify significant future events that they frequently think about and that convey core information about who they are as individuals. Furthermore, a person's particular style of constructing SDMs is similarly manifested in SDFPs, suggesting that both types of events can be used to ground the self. Notably, people who display a stronger tendency to extract meaning from their past experiences also reflect more about the potential implications of imagined future events. The results further demonstrate that SDMs and SDFPs both give rise to a strong sense of personal continuity over time and are meaningfully related to self-esteem. Together these findings lend support to the idea that a person's sense of self and identity is in part nourished by the anticipation of significant future events.     

对希波克拉底警句的深层解读--审美修养是从医之必需

试图透过医学与艺术的联系,深入到医学与美学关系的层面,进而发掘希波克拉底关于"医学的艺术乃是一切艺术之中最为卓越的艺术"这一论断的深刻内涵,指出希波克拉底警句蕴涵着:医学是美的职业,它具有崇高地位和独特的重要性;医学所追求的是健康而美好的人生,医学所创造的是健康之美、生命之美、至善之美、仁爱之美.既然医学是最为卓越的艺术,医务工作者就应该重视美学修养,并让医学审美意识牢牢植根于自己的医学实践之中.换句话说,审美修养是从医之必需.