Dynamic interpersonal therapy in an NHS tertiary level specialist psychotherapy service

We describe the introduction of dynamic interpersonal psychotherapy (DIT) into an National Health Service (NHS) tertiary psychoanalytic specialist psychotherapy service. Training in DIT began as our contribution to Improving Access to Psychological Therapies and primary care services, supporting the training and supervision of their DIT practitioners. We then discovered DIT could be a valuable treatment within our own tertiary NHS service for patients with complex presentations. Currently fighting for survival, like many NHS psychoanalytic psychotherapy services nationally, we have adopted a manual-guided, psychoanalytically based therapy to broaden our tertiary clinical psychoanalytic service and accommodate trends in mental health service provision, whilst protecting the quality and integrity of our psychotherapy. DIT helped us continue providing relevant and beneficial psychoanalytic and psychodynamic services to individual patients despite limitations of the financially challenged NHS, NICE guidelines and Payment by Results. We outline the progress and outcomes for patients with complex mental health presentations, include individual case discussion and our experience of using the DIT approach within a traditionally longer term psychoanalytic psychotherapy service.     

The Political Consequences of Combat: Post‐Traumatic Stress and Political Alienation Among Vietnam Veterans

On average, veterans are more civically and politically engaged than civilians. Previous research on the effects of military service, however, did not account for differences in veterans’ combat experiences. Using survey data from a representative sample of Vietnam veterans, this study presents evidence that veterans who were exposed to severe combat trauma and veterans who exhibited attitudes and fears associated with post‐traumatic stress had significantly lower levels of political efficacy and trust. The negative consequences of combat exposure and post‐traumatic stress are not mitigated when veterans have quality social support or when they seek professional counseling. These findings inform political psychology and hold implications for claims regarding the empowering influence of service in the U.S. military, increased political engagement, in particular. Among Vietnam veterans, exposure to severe combat trauma and post‐traumatic stress were both associated with reduced political efficacy and trust.     

Modelling elderly patients’ perception of the community pharmacist image when providing professional services*

Professional pharmaceutical services may impact on patient’s health behaviour as well as influence on patients’ perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients’ beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients’ perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients’ HBs to patient’s perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that ‘Perceived benefits’ were significantly associated with ‘Perceived Pharmacist Image’ in the whole sample. Differences were found in the IG with also ‘Self-efficacy’ significantly influencing ‘Perceived pharmacist image’. A model of patients’ HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients’ HBs that in turn influence public perception of the pharmacist.     

Psychiatrists and community partners examine religion and spirituality

ABSTRACT

The commentary reflects on the definition of spirituality and religion and further implications for the practice of psychiatry. These include the possibilities to partner with spiritual and religious practitioners to support education and research, provide access to care for people with or at risk of mental ill health, and also consider how to the reduce the risks to the well-being of vulnerable people and families from some practices and settings. The World Psychiatric Association sees the possibilities for collaborating with its member societies and community partners including service users and family carers to develop resources on working with faith groups and spiritual healers in high- and low-income countries.     

Does snobbish service generate better sales? The case of luxury goods

The objective of this study is to explore whether a “bad” service encounter triggers a consumer's impulse purchase in a luxury goods store in an Asian emerging market. A 2 (service encounter: favorable vs. snobbish) × 2 (shopping companion: alone vs. with a close friend) between‐group factorial design was employed with 160 female consumers in an Asian emerging market to examine the antecedents of both the urge to save social identity and the impulse purchase of luxury goods. The results show that consumers in an Asian emerging market can be triggered to make an impulse purchase of a luxury good, not because they received excellent service in the store but because they encountered snobbish service, especially when shopping with a close friend. Research implications and limitations are also discussed.     

Introduction to the special issue on the intersection of professional selling and service

As organizational operations continue to evolve in response to increasing customer demands, frontline research has begun to consider how traditionally separate organizational functions may be complementary to firm performance. Specifically, as sales and service activities become increasingly intertwined within the frontline role, this special issue explores how the sales and service functions interact within an organization. The articles contained in this special issue consider the interaction of sales and service with respect to customer, employee, and firm outcomes. After introducing evolving thought in the area, we provide an overview of five articles that make up this special issue. We conclude by offering additional areas of research.     

对“医疗服务商品和市场”存在客观性和必然性的理性思考——兼评《对中国医疗卫生体制改革的评价与建议》

针对国务院发展研究中心课题组发表的《对中国医疗卫生体制改革的评价与建议》提出的卫生改革带来“问题的根源在于商业化、市场化的走向违背了医疗卫生事业发展的基本规律。”提出“医疗服务商品”、“医疗服务市场”的存在是客观的,并通过反驳《评价与建议》提出的四对矛盾,提出“医疗服务商品”、“医疗服务市场”的存在也是必然的,最后分析了所谓“卫生改革失败”的真正原因。     

论医院服务效益范畴及其评价

正确运用医院服务效益的评价指标,才能引导医院健康发展。在服务产品理论基础上,探讨医院服务的经济效益与社会效益范畴及其评价指标。通过分析两个效益的辩证关系认为,医院坚持社会效益首位原则与重视经济效益并行不悖。