Gender differences in the pricing of professional services: Implications for income and customer relationships

This study extends our understanding of the effects of gender on both pricing behavior and owner income by examining both relationships in an experimental simulation involving owners of veterinary practices. Consistent with prior research, women owners are found to employ “compassionate pricing” more than men, even when the same services are offered. The process by which gender influences price, however is found to depend in part on one’s relationship orientation. Specifically, women are found to have a higher relationship orientation than men and relationship orientation is found to directly bias women’s transactional pricing towards more compassionate pricing. The relationship between role orientation, pricing, and income, however, is rather complex. While lower prices have a negative relationship with owner income, relationship orientation is found to have a positive direct influence on income. As a result, the influence of relationship orientation on income is found to be both negative, due to lower prices, and positive, due possibly to the resulting customer loyalty.     

Improving access to psychological therapy: Initial evaluation of two UK demonstration sites

Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed ‘demonstration sites’) during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55-56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed.     

Collaborative Helping: A Practice Framework for Family-Centered Services

This article offers a framework for collaborative family-centered practice that can reinvigorate our work with families who have not responded to more traditional approaches. Collaborative Helping is grounded in family-centered principles that include: striving for cultural curiosity, believing in resourcefulness, working in partnership, and making our work more accountable to the clients we serve. The article introduces collaborative inquiry as an organizing metaphor for clinical practice and offers a five-step practice framework with clinical illustrations and sample questions. The framework draws from appreciative inquiry, motivational interviewing, the signs of safety approach to child protection work, and solution-focused and narrative therapies.     

The Age of Uncertainty: Parent Perspectives on the Transitions of Young People with Mental Health Difficulties to Adulthood

For young people aged 16–24, the transition from adolescence to young adulthood involves predictable and unpredictable changes and they may encounter challenges in their roles, relationships, and responsibilities. Young people with mental health difficulties face additional challenges as they and their families navigate this transition. As a result, families commonly experience anxiety, uncertainty, frustration, and turbulent relationships. After learning to become advocates to secure appropriate services for their children, in late adolescence and young adulthood, parents are likely to find themselves excluded from their children’s treatment planning and services. This article reports findings from a recent qualitative study of the experiences and perceptions of 42 family members supporting their children with mental health difficulties during the transition years. Family members described their goals for their children, their frustrations trying to access appropriate services for their children, and their strategies to provide the support their children needed. Recommendations are for service providers to connect transition age youth with practical assistance and supportive mentoring relationships. Family members requested service providers to consider them as resources and potential collaborators in supporting young people with mental health difficulties to live successful lives in the community.     

An evaluation of counselling and rehabilitation courses for Chronic Fatigue Syndrome

The aim of the current study was to evaluate the services offered by Action for ME to sufferers of Chronic Fatigue Syndrome using measures developed and validated in previous research. Preliminary studies had suggested that clients attending rehabilitation residential courses were benefiting from the service. A further, more in‐depth evaluation process with a greater number of health‐related outcome measures was warranted. In addition, assessment was widened to include other services offered to sufferers of the illness. Data relating to the usefulness and success of the services (rated by the clients) were also collected. Data from client volunteers were collected at baseline (that is, before intervention) and approximately six months later. Quantitative comparative analyses were conducted using within‐group comparisons to assess any improvements in scores at six‐month follow‐up from baseline. Fifty‐six participants completed wide‐ranging questionnaires assessing illness history, psychopathology, psychosocial factors and health and well‐being. Data relating to improvements in illness status and acceptability of treatment were also collected by means of global outcome measures. Both the counselling and residential groups showed improvements in many areas assessed at follow‐up. Most importantly, improvements were indicated in areas such as fatigue and the levels of disability suffered by patients. In addition, there were significant improvements in ratings of mood, anxiety, depression and physical symptoms. Overall, clients reported satisfaction with the care received and most found the services useful. All of the participants who completed the evaluation stated that they would recommend Action for ME services to fellow sufferers. The outcome of the current study is encouraging. The data presented provides evidence of the high level of support and advice Action for ME offers to sufferers of this illness. Furthermore, measurable improvements in scores relating to illness status were accompanied by improvements in mental health and psychosocial variables in the patient group.     

关于中国心理健康服务体系建设的若干问题

从我国心理健康服务的基本模式、技术体系、服务主体、教育培训、管理监督等五个方面回顾了我国心理健康服务体系的现状。近二、三十年来,我国心理健康服务体系从无到有,发展迅速,但也存在若干亟待解决的问题:服务的技术体系不完善,心理服务的从业机构和个人良莠不齐、总体水平偏低,从业人员的教育培训、从业人员和机构的资质认证缺乏有效的监督管理机制等。目前我国的心理健康服务体系难以适应社会对心理健康服务的需求。需要立足国情,借鉴外国的成功经验并结合我国传统文化,以扎实的研究和细致的工作来完善我国的心理健康服务体系。     

Two Case Studies of Community Schools Serving Latino and Southeast Asian Children

Recent attention has focused on establishing school-based integrated services centers which offer educational and noneducational services to students and their families. We present two comparative case studies of client participation in school centers established in low income Latino and Southeast Asian communities. The cases focus on types of center services utilized by families, culturally compatible practices of the centers, and impact of coordinated services on students and families. The data reveal the limited capacity of high poverty families to cope with daily and persistent life challenges and how the schools have been transformed into family support environments which assist families to manage their lives in ways that lead to self-sufficiency and growth.     

Referral Source Differences in Functional Impairment Levels for Children Served in the Comprehensive Community Mental Health Services for Children and Their Families Program

We report one of the first multi-site investigations into referral source variation in functional impairment for children with serious emotional disturbance served in systems of care settings. Baseline data collected as part of the national evaluation for the Comprehensive Community Mental Health Services for Children and Their Families Program was used to assess the comparability of functional status for children referred from traditional mental health versus non-mental health agencies. Results indicate that children referred from child welfare and family groups have significantly lower levels of overall dysfunction than those referred from mental health, while children referred from school and juvenile justice agencies have comparable levels. Clinical and research implications are discussed.     

Wrapping community-based mental health services around children with a severe behavioral disorder: An evaluation of project wraparound

During the past two decades there has been a significant increase in community-based mental health and educational services for children and youth with serious emotional and behavioral problems and their families. However, in the vast majority of programs there are no reliable longitudinal data on the adjustment of the children that are served. Project Wraparound was a community-based individualized treatment program which served children and youth with severely maladjusted behavior and their families by providing intensive home and school-based services. The purpose of this paper is to provide a longitudinal analysis of client and family adjustment data. Data on client adjustment within the home and characteristics of the home environment were obtained at intervals of 3 months, 6 months, and 1 year. Data on client adjustment in school was obtained at four points over a period of 2 years. The results from 19 cases indicate that substantial change occurred on measures of the home environment and client adjustment in the home with no significant change in adjustment in the school. Implications of the findings are discussed.     

Adolescents' perceptions of outpatient mental health services

Thirty-three adolescents from three mental health service settings were interviewed regarding their perceptions of the purpose, goals, expectations, frustrations and benefits of mental health experiences. They provided satisfaction ratings and importance rankings of seven domains of satisfaction: (a) Convenient/Accessible, (b) Meeting Needs, (c) Staff Competence, (d) Personal Relationship with Staff, (e) Effectiveness of Treatment, (f) Comfort/Appropriateness of Center, and (g) Costs and Paperwork. In addition, participants completed the Client Satisfaction Questionnaire (CSQ-8). Results indicated that, in general, the adolescents were very satisfied with the services they received. Gender, race/ethnicity and treatment site were not related to satisfaction scores, nor was the adolescent's perceived choice in seeking services. Some significant gender differences were found both in terms of the rankings of satisfaction domains, as well as in the adolescents' perceptions of their reasons for initiating counseling and the perceived goals and benefits of counseling. Additional differences in perceptions of services were found for treatment site and race/ethnicity. In general, adolescents were able to generate informative, sophisticated responses to questions regarding their perceptions of mental health services, and demonstrated that they are capable of evaluating services they receive.