Conducting community‐based participatory research in an urban Malaysian community: Lessons learned and challenges in establishing partnerships

This paper presents the process of how partnerships are established between an urban residential community and an academic institution in Malaysia by employing community‐based participatory research, which involves researchers, community members, and organizational representatives as coresearchers. The research process encompasses colearning, power sharing, and coconstructing of knowledge, with the community members driving the research direction. The research paradigm is grounded on conducting research with the community. This paper highlights the experience and lessons learned while applying the principles of community‐based participatory research that promotes social participation of older persons living in a residential community. Two pertinent challenges surface in the research process. The first challenge involves the complexity noted in the gap between the emancipation of community‐based participatory research and the hierarchical social structure of the society. The second challenge is the prevalence of unspoken yet subtle domination that undermines the local cultural values affecting the process of coconstructing knowledge with the community. Recommendations for addressing these challenges include future partnerships with other Malaysian communities as well as cross‐border research partnerships.     

ICU医护沟通与协作的现状与思考

许多研究表明ICU医护之间的沟通与协作存在重大问题,特别是在临终决策中存在分歧。护士的作用经常被忽视。加强医护之间的沟通与协作有助于提高医疗质量并改善医护、患者及家庭满意度。许多旨在改善沟通与协作的措施已经证实有效并可应用于临床实践,并应对此进行更深一步的研究。     

Artificial consciousness, artificial emotions, and autonomous robots

Nowadays for robots, the notion of behavior is reduced to a simple factual concept at the level of the movements. On another hand, consciousness is a very cultural concept, founding the main property of human beings, according to themselves. We propose to develop a computable transposition of the consciousness concepts into artificial brains, able to express emotions and consciousness facts. The production of such artificial brains allows the intentional and really adaptive behavior for the autonomous robots. Such a system managing the robot’s behavior will be made of two parts: the first one computes and generates, in a constructivist manner, a representation for the robot moving in its environment, and using symbols and concepts. The other part achieves the representation of the previous one using morphologies in a dynamic geometrical way. The robot’s body will be seen for itself as the morphologic apprehension of its material substrata. The model goes strictly by the notion of massive multi-agent’s organizations with a morphologic control.     

Collaboration and a Self-Help Orientation in Therapy with Suicidal Clients

Working with suicidal clients historically has placed a heavy burden of responsibility on the therapist for a successful outcome. This orientation generally has left clinicians feeling stressed and in need of controlling their clients' behavior; clients, in turn, often have developed unrealistic expectations of therapy or resistance of the therapist's interventions. In this context, the chance for a potentially valuable collaboration between client and therapist is often lost. This paper builds on previous work that has introduced the notion of a collaborative working relationship with suicidal clients. It is argued that the therapeutic process ideally should not only utilize the therapist's knowledge and skills in treating suicidal clients, but also cultivate self-efficacy by encouraging the client to adopt a self-help orientation to therapy. Several general principles of a collaborative/self-help orientation to working with suicidal clients are discussed and a variety of specific therapeutic strategies consistent with this orientation are described.     

Collaboration and Social Inquiry: Multiple Meanings of a Construct and Its Role in Creating Useful and Valid Knowledge

The concept of collaboration in community research and intervention, although not new, has grown tremendously in importance in the past 20 years. Yet, it is both a contested concept in terms of its intent and a still evolving idea in terms of its meaning and implications. The purpose of this monograph is to begin to "unpack" the collaboration construct in terms of its many meanings, rationales, goals, models, dynamics, and accomplishments. Although models of collaboration are often well articulated there is "partial paradigm acquisition" (E. J. Trickett, 1984) in terms of understanding their behavioral and ethical implications. There is more theology than conclusion. The promise of collaboration, although considerable, is still in need of multiple and varied empirical examples of how collaboration contributes to both the process and goals of community research and intervention, however defined. The monograph closes with a brief overview of what we have learned from reviewing this literature, an articulation of the kinds of questions that need to be addressed, and a series of recommendations for how to increase our understanding of the collaboration construct in community research and intervention.     

The center of gravity

In As far as possible: discovering our limits and finding ourselves (Barish and Vida, 1998), we struggled with the constraints of being two nice girls in the context of our individual professional identities as traditionally trained psychoanalysts. We were surprised to discover, through sharing with one another some painful, confusing, and even terrifying clinical experiences, how wedded we were to certain psychoanalytic conventions. It was not a pleasant discovery. What we had to face was the extent of our submissiveness to psychoanalytic theory, and of the cost to our authentic selves of that submissiveness. This daughter-paper is about our learning not to do what we were supposed to do. Its gestation has taken a form that we could not have anticipated, for, as we pursued the writing of this sequel, we seemed to get lost along the way. After working with this over a very long time, we can see now that the paper that was ultimately born, this paper, has functioned as a vehicle for us to experience ourselves in relation in an uncertain, mingling way, conscious and unconscious, trying not to be self-conscious and not defensive. This, we can also see, is how we approach the center of gravity, where our irreducible and irreconcilable tendencies are struggling to maintain a balance. And even more to the point, this paper is also a demonstration, a look at what developmental transformation is really like, the process to which we all give lip service, but hardly any of us ever pays attention to it in our real lives, and if we do, we never, never talk about it.     

Ecological Factors Impacting Provider Attitudes Towards Human Service Delivery Reform

Although reform efforts are substantially altering the structural operations and guiding ideological framework of the human service delivery system, little empirical work has been done to systematically examine these transformations. This study examines providers' attitudes regarding two reform elements that are being widely implemented: an increased emphasis on inter-agency collaboration and a shift from a medical model service delivery philosophy, that focuses on client deficits, to one that emphasizes consumer strengths. Through survey data collected from 186 providers from 32 human service agencies in one county, the relationship between providers' perceptions of contextual support for human service delivery reform and providers' attitudes towards these initiatives is explored. The findings from this study support the importance of attending to the ecology in which we initiate system reform efforts. For both reform elements, working within contexts that are perceived as providing ideological and functional support for change was associated with positive provider attitudes towards those changes. Staffs' perceptions of the external environment played the most critical role in shaping staff attitudes. Interestingly, unique aspects of providers' work environments were related to positive attitudes towards the two different reforms. The implications of these findings for the success of human service delivery reform are discussed.     

Developing community alternatives to group home placement for SED special education students in the Ventura County System of Care

Interagency planning and resource development were used to improve available services for severely emotionally disturbed special education students who were in or at-risk of being placed in residential care. Augmented local school-based and regional day treatment services were financed by a Ventura County Social Services Agency trust fund and delivered cooperatively by the County Mental Health Agency and local education agencies. Revenues generated by the new service positions were planned to restore the trust fund. Outcomes following service implementation included: (a) an average reduction of 3.5 youths in the expected number of youths in group home placement per month; (b) a total reduction of $290,011 in the expected annual cost of placement; and (c) generation of $281,238 in Medi-Cal revenue by the school-based and day treatment components of the system of care. The implications of these outcomes are discussed in terms of existing trends in numbers of identified seriously emotionally disturbed students and their service needs and the processes that were involved in planning and implementing the service augmentation.     

Family Therapy and Alternative Medicine: Acupuncture as a Case in Point

Collaboration between family therapists and alternative medicine practitioners is recently cultivated ground that may prove to be fertile territory for the application of family therapy skills. Acupuncture and family therapy are two healing practices that differ in cultural tradition, language, and technique, yet they appear to share some underlying assumptions suggestive of a natural alliance in helping people with a variety of biopsychosociospiritual problems. This paper describes the process of interdisciplinary collaboration between an acupuncturist and family therapist via a clinical vignette, identifying different types of referral situations, and suggesting factors of effective collaboration that can synergistically enhance a patient and family's treatment.     

Developing Black Mental Health Provision: Challenging Inequalities in Partnership

This article describes and comments upon the process of developing the Sanctuary project in London, a project that will provide two community-based crisis support services for African and African-Caribbean women and men in mental crisis and distress. This initiative is informed by the extensive research documenting the ways in which mainstream, mental health services fail Black people, and by evidence suggesting that innovations in service provision for Black people are often vulnerable and limited in their impact. In an effort to avoid replicating these problems, considerable emphasis has been given to developing the project in partnership with the main stakeholders—in this instance statutory and Black voluntary sector agencies as well as Black users, carers and community members. Within this context, issues relating to inequalities can be proactively addressed, thereby reducing the risk that they undermine the effectiveness of service provision at a later stage. However, working in partnership can also hinder or delay service developments if discussions between stakeholders become protracted or conflicts unresolved. The author draws on experience gained from this project to identify the potential as well as the difficulties of using a partnership approach to developing effective Black mental health provision. The author's role in the development of these projects has been as representative of one of the partners, the King's Fund Centre for Development.