Effects of a token reinforcement system on journal reshelving

A token reinforcement program involving two levels of token value and backup reinforcers to increase journal reshelving behavior in a large university library was experimentally evaluated. Results showed that instructions (in which signs asked users to reshelve journals) had no impact. By contrast, token reinforcement contingent on reshelving behavior led to a marked increase in journals reshelved. A return to instructions-only conditions, when data were corrected for library usage, showed an increase in unreshelved journals over the token reinforcement period, though the increase was not to baseline levels. For the next 11 months, library staff maintained a modified token program. Follow-up data collected after that interval showed that number of unreshelved journals remained markedly lower than levels at baseline and the first instructions-only period, though they were slightly higher than at the token reinforcement period. Token reinforcement of the variety employed in this study constitutes an efficient, economical means of changing the behavior of library users who fail to reshelve books and journals.     

Improving staff nutritional practices in community-based group homes: evaluation, training, and management.

We evaluated the effectiveness of a staff training and management package on nutritional practices in two community-based group homes serving adults with developmental disabilities. Food storage, menu development, and meal preparation were trained in a multiple baseline format, followed by supervisor feedback. All staff behaviors increased after training and were maintained for up to 1 year. Biological indices reflected collateral improvements in the health of consumers, and surveys of staff and parents established social validity.     

EFFECTS OF A VOICE OUTPUT COMMUNICATION AID ON INTERACTIONS BETWEEN SUPPORT PERSONNEL AND AN INDIVIDUAL WITH MULTIPLE DISABILITIES

We evaluated a means of increasing staff members' interactions with an individual with multiple disabilities through use of a voice output communication aid (VOCA). When activated, the VOCA allowed the individual to communicate through synthesized speech. Results indicated that staff members interacted with the individual more frequently when she had access to the VOCA, suggesting that VOCAs may represent an alternative to more traditional staff management programs for increasing interactions.     

A PARTICIPATIVE MANAGEMENT APPROACH FOR IMPROVING DIRECT-CARE STAFF PERFORMANCE IN AN INSTITUTIONAL SETTING

The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed.     

Reciprocal peer management: Improving staff instruction in a vocational training program

To test the feasibility and utility of involving peers as sources of feedback, 6 subjects, instructors in a vocational program for adults with mental retardation, participated in a staff training and management program. Subjects' teaching interactions were assessed during baseline, in-service training (on effective teaching), return-to-baseline, peer management, and follow-up phases. Peer management was introduced in multiple baseline fashion across pairs of subjects. Members of each pair were trained to monitor peer teaching, to record and graph data, to provide feedback, and to set goals with the peer. Each pair then performed these procedures on the job for several weeks, during which time 4 of the 6 subjects increased their use of effective teaching methods (over baseline). However, inconsistencies in the magnitude and durability of these increases require that the study be viewed as inconclusive, although it has heuristic value as a promising model for involving co-workers in staff management programs.     

Experience from a Staff Support Service

The paper describes an overview of the work of one NHS Staff Support Department, its history, development of a proactive and reactive model, and extent of the work involved. It goes on to give three case studies of bullying in the workplace, all of which are real and ongoing. © 1997 John Wiley & Sons, Ltd.     

Psychological consequences of positive results in cervical cancer screening

Abstract

This study was carried out to assess the psychological impact of abnormal cervical smear results. Existing literature contain only uncontrolled studies or controlled studies with non-standardised measures. Subjects were recruited from women attending two general practices for routine cervical smears over a six month period. A comparison was made between women with positive results who were referred for colposcopy, with mild abnormalities who were asked to return for a repeat smear in six months, or negative smear results. Psychometric assessment by postal questionnaire was carried out one week after receiving the result. The measures used were the 28-item General Health Questionnaire (GHQ-28), Spielberger State Anxiety (STAI), and a measure designed specifically for use in the study, the Cervical Screening Questionnaire (CSQ). Results indicated that women with positive smear test results who were referred for colposcopy had significantly higher scores on GHQ (p<.01) STAI-S (p<.05) and CSQ (p<.001) than women with mild abnormalities or negative results. Significant differences between the groups with mild abnormalities and negative results were found on the CSQ (p<.05). These findings suggest that positive results on cervical screening are associated with a significant psychological impact including a range of specific concerns about gynaecological health and cancer, increased anxiety and impaired well-being. Even mildly abnormal results, which involve a recommendation for early repeat screening, cause raised concern about cancer for the recipients. The procedures for providing smear results should be organised to minimise the level of distress.     

Positive aspects of voice-hearing: a qualitative metasynthesis

Voice-hearing occurs in clinical and non-clinical samples, and the role of spiritual and cultural frameworks of understanding for percipients has received increased attention. This review aimed to identify and synthesise the existing qualitative literature relating to positive aspects of voice-hearing experiences, and to make recommendations based on these findings for clinical practice and future research. Qualitative papers that included positive aspects of voice-hearing were identified by undertaking a systematic search of six electronic databases, resulting in 22 papers. The quality of each paper was assessed and the meta-ethnographic approach was used to extract and synthesise the data. Six themes were identified relating to voices providing safety and protection, guidance, creating psychological and emotional well-being, providing companionship, facilitating personal growth and development, and connecting hearers to religious or spiritual belief systems. The findings suggest positive aspects of voice-hearing that may have clinical and research implications.