Non-directive counselling in a general practice

Many patients in general medical practice are not ill in the physical sense, but bring their unhappiness to the surgery. An experiment is described in which a counsellor was attached to a general practice in north London, to help to deal with problems of this kind.     

Forum: Insiders,Outsiders, and Disclosure in the Undergraduate Classroom

In this set of essays, three authors provide different perspectives on whether personal religious sensibilities and identities affect the ways we teach religion. Elliott Bazzano discusses how, as a white Muslim convert teaching at a Catholic college, he incorporates selective autobiographical anecdotes into his classes as a way to problematize the meaning of “insider” and “outsider,” and pushes his students to recognize the many layers of identity that any given person embodies at a given time. In the second essay, Audrey Truschke explains why she makes no reference to her own religious beliefs or affiliations in class as part of her strategy to demonstrate how students can study any religion regardless of personal convictions. In the third essay, Jayme Yeo explores the benefits of discussing personal religious identity as a means to resist the categories of “inside” and “outside,” which she sees as heterogeneous concepts that do not always offer explanatory power upon close examination.     

Fiduciary Duty and Boundaries: Acting in the Client's Best Interest

The task of defining boundaries and boundary violations in the therapeutic relationship is examined from several perspectives. This paper reviews the ethical rules of the major mental health associations and the American Medical Association to determine the professions' ethical positions with regard to boundary maintenance and boundary violations. It also analyzes judicially sanctioned causes of action for recovery by clients for damages suffered as a result of boundary violations. The authors examine the ways in which fiduciary theory is used in the formulation of the ethical rules and to support the imposition of civil liability for boundary violations. The authors conclude that fiduciary theory provides a useful paradigm for setting and evaluating boundaries that acknowledge and address the fiduciary nature of the therapist–client relationship. The authors point out that measuring boundary violations with the yardstick of fiduciary duty serves the interests of both the client and the therapist. © 1997 John Wiley & Sons, Ltd.     

Gender and Teachers' Attrition: The Occupational Destination of Former Teachers

Based on the resources–rewards model and on the sex segregation perspective, the study was designed to examine gender differences in teachers' attrition by comparing three groups: teachers who remained in the educational system, teachers who left the labor market, and teachers who left teaching and entered other occupations. The study also addressed the type of occupations into which former teachers moved. The sample was 2,108 teachers who participated in the censuses of 1983 and 1995 and are represented in the inter-generation dataset of the Israeli Central Bureau of Statistics. The findings indicated that one-third of the teachers did not continue teaching. Most of them moved to other occupations. Gender was found to be related to teachers' attrition and to their occupational destination. The data support the sex segregation perspective and suggest that working in a female-dominated occupation has different implications for women's and men's attrition and patterns of changing occupations, which contribute to maintaining the sex segregation structure in the labor market.     

Integrating fieldwork into employment counseling for methadone‐treatment patients

An innovative employment counseling model, Customized Employment Supports, was developed for methadone‐treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, “vocational fieldwork,” the delivery of services in the community rather than only within the clinic, was assessed through a quasi‐experimental study of the first 55 patients receiving the model in 2 clinics. Employment outcomes after 6 months were compared between patients who received vocational fieldwork (n = 18) and those who did not (n = 37). Logistic regression analysis demonstrated that patients receiving vocational fieldwork had significantly better outcomes for competitive work, informal work, and any paid work.     

For There is Work to be Done: Poetry and Commentary

Poetry illuminates the work of health care professionals well beyond procedure guidelines, clinic schedules or best practice policy. Poems and commentary from the perspective of a nurse, an emergency medical technician and two physicians are accompanied by an exploration of the meaning of work and the role of medical humanities.