Front-line services,complexity, research and policy

The evidence-based culture of modern mental health policy and service delivery is being extended through funded efforts to accelerate implementation of research findings in practice settings. In this paper, we argue that this linear model of research and policy-making is profoundly ill adapted to the nature of practice realities and real-world policy-making processes. Both need to be re-conceptualised using the theoretical and practical resources deriving from modern complexity theory. A short case study illustrates the nature of ‘complexity’, the reframing of the notion of ‘evidence’ it implies and the different relationship between research, practice and policy that flows from this more attuned model of mental health and therapeutic processes.     

The changing UK careers landscape: tidal waves,turbulence and transformation

ABSTRACT

This article explores how the UK careers landscape in each of the four home nations is changing in response to neo-liberal policies. In this context, careers services are increasingly under pressure to demonstrate their added value, impact and returns on investment. As fiscal arrangements tighten and governments state their preferences and priorities for national careers services, differing strategic responses are beginning to emerge. A quasi-market, experimental approach is now the dominant discourse in England, in contrast to differing and complementary arrangements in Northern Ireland, Scotland and Wales. The article suggests that insofar as these developments are transforming national careers services, they are also creating significant challenges which require new forms of policy imagery and imagination for high-impact, all-age careers services.     

Impact of Workplace Bullying on Emotional and Physical Well-Being: A Longitudinal Collective Case Study

Bullying and mobbing are occupational safety hazards pervasive in developed and developing countries. Our study aim was to determine whether bullying and mobbing caused poor health for a victim and a witness from the same workplace in western Canada. Longitudinal semistructured interviews were conducted in 2007 and 2008 with both parties. The interviews were transcribed, analyzed, and arranged into arrays using chronological ordering and time sequencing. The victim felt targeted because she represented a threat to the bully, with victim and witness experiencing negative health outcomes. The authors suggest that wellness programs should place greater emphasis on mental health promotion to discourage workplace bullying.     

Survivors’ Advice to Service Providers: How to Best Serve Survivors of Sexual Assault

Recognizing the relatively low rate at which sexual assault survivors seek services, researchers in the last decade have turned their attention to better understanding survivors’ experiences with victim services. Surprisingly, limited research has directly asked sexual assault survivors for recommendations on how to improve victim services, including both criminal justice and community-based services. The current study builds on the existing literature to gather input from women survivors that can translate into ways to improve victim services. As part of a larger longitudinal study, the current investigation asked 224 ethnically diverse adult (aged 18–62) women survivors of recent sexual assault to provide recommendations for how victim services can best serve survivors of sexual assault at multiple time points. Nearly all women in the study (91%) offered specific recommendations on how to improve victim services. Recommendations included ensuring availability of a female provider, improving communication with survivors as well as within and between service providers, helping survivors obtain resources, believing and not blaming survivors, demonstrating greater understanding of trauma-related responses and approaching survivors with greater compassion, and implementing better training on effectively working with survivors. Implications for victim service provision are discussed.     

Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals

Obese individuals tend to behave more impulsively than healthy weight individuals across a variety of measures, but it is unclear whether this pattern can be altered. The present study examined the effects of a mindful eating behavioral strategy on impulsive and risky choice patterns for hypothetical food and money. In Experiment 1, 304 participants completed computerized delay and probability discounting tasks for food-related and monetary outcomes. High percent body fat (PBF) predicted more impulsive choice for food, but not small-value money, replicating previous work. In Experiment 2, 102 randomly selected participants from Experiment 1 were assigned to participate in a 50-min workshop on mindful eating or to watch an educational video. They then completed the discounting tasks again. Participants who completed the mindful eating session showed more self-controlled and less risk-averse discounting patterns for food compared to baseline; those in the control condition discounted similarly to baseline rates. There were no changes in discounting for money for either group, suggesting stimulus specificity for food for the mindful eating condition.     

Relationship between food habituation and reinforcing efficacy of food

Reinforcing value and habituation are two processes that have been used to study eating behaviors, but no research has examined their relationship, how they relate to energy intake, and whether they respond in a similar manner to food deprivation. Twenty-two female subjects were randomized to food deprived or non-deprived conditions, and assessed for food reinforcement, habituation to food and ad libitum eating. Results showed food reinforcement and habituation are correlated (r = 0.62, p = 0.002) and both independently predict energy intake. Hierarchical regression showed that the rate of habituation accounted for 30 percent of the variance in eating (p = 0.008), and adding food reinforcement increased the amount of variance accounted for up to 57.5 percent (p < 0.05). This suggests that both processes may influence energy intake in a meal.     

人类干细胞之伦理原则与监管政策（上）

本文分两大部分。第一部分从干细胞的功能、来源与社会争议性3种角度划分了人类干细胞的种类,并讨论与人类干细胞研究及临床应用相关的9条伦理原则,特别强调了西方国家对胚胎捐赠在知情同意方面的伦理耍求。第二部分讨论了制定监管人类干细胞研究的3个原则,并简单地介绍了在英美各国监管的情况,其中较详细地评论了英国的种种立法过程、设立的法定机构和执行的种种政策与机制,作为在我国讨论类似政策参考之用。     

Voluntary sector counselling: Has inadequate research resulted in a misunderstood and underutilised resource?

Although much counselling already takes place in the voluntary sector, little is known about the nature of the work being done or about its effectiveness or the training and experience of its practitioners. Given the gap between the demand for and supply of psychological therapies in Britain today, lack of research into the effectiveness of this work could mean that a valuable resource is being under‐utilised. This paper describes a study of a large, generic counselling centre and, using the CORE monitoring and evaluation system, makes comparisons between its work and that of a number of NHS psychological therapy services. It shows; that it is of at least as complex or severe a nature; and that it is as effective. It also shows that the therapy carried out in this agency is done by appropriately qualified and experienced practitioners.     

A Comprehensive Training Initiative for Educators to Develop and Implement Effective Anti-Bullying Policies in K–12 Schools

Although most states across the United States have enacted anti-bullying legislation, state laws vary greatly in detail and direction, leaving many school districts wondering how to best address the problem of bullying and comply with their state’s legislative requirements. In response, a comprehensive, statewide training initiative was conducted for school personnel to offer guidance on developing and implementing such policies at the local level. In the present piece, the authors explicate the process by which they (a) derived theoretically grounded, empirically driven recommendations; (b) developed training materials and a project website; and (c) disseminated the material and recommendations across the state. They also present key outcomes as a result of this training initiative.