Human motivation and professional practice: of knights, knaves and social workers

Efforts to improve the efficiency and responsiveness of public services by harnessing the self-interest of professionals in state agencies have been widely debated in the recent literature on welfare state reform. In the context of social services, one way in which British policy-makers have sought to effect such changes has been through the "new community care" of the 1990 NHS and Community Care Act. Key to this is the concept of care management, in which the identification of needs and the provision of services are separated, purportedly with a view to improving advocacy, choice and quality for service users. This paper uses data from a wide-ranging qualitative study of access to social care for older people to examine the success of the policy in these terms, with specific reference to its attempts to harness the rational self-interest of professionals. While care management removes one potential conflict of interests by separating commissioning and provision, the responsibility of social care professionals to comply with organizational priorities conflicts with their role of advocacy for their clients, a tension rendered all the more problematic by the perceived inadequacy of funding. Moreover, the bureaucracy of the care management process itself further negates the approach's supposedly client-centred ethos. The definitive version is available at www.blackwell-synergy.com

Education in occupational health psychology: Where have we been, where are we now and where are we going?

At the first full conference of the European Academy of Occupational Health Psychology (Lund, 1999), the decision was ratified to organise activities around three fora. These together represented the pillars on which the European Academy had been founded that same year: education, research and professional practice. Each forum was convened by a chair person and a small group of full members; it was agreed that a forum meeting would take place at each full conference and working groups would be established to move developments forward between conferences. The forum system has proven an effective means by which to channel the energies of individual members, and the institutions that they represent, towards advancements in all three areas of activity in occupational health psychology (OHP) in Europe. During the meeting of the education forum at the third full European Academy conference (Barcelona, 2001), the proposal was made for the establishment of a working party that would be tasked with the production of a strategy document on The Promotion of Education in Occupational Health Psychology in Europe. The proposal was ratified at the subsequent annual business meeting held during the same conference. The draft outline of the strategy document was published for consultation in the European Academy’s e-newsletter (Vol. 3.1, 2002) and the final document presented to the meeting of the education forum at the fourth full conference (Vienna, 2002). The strategy document constituted a seminal piece of literature in so far as it provided a foundation and structure capable of guiding pan-European developments in education in OHP – developments that would ensure the sustained growth of the discipline and assure it of a long-standing embedded place in both the scholarly and professional domains. To these ends, the strategy document presented six objectives as important for the sustained expansion and the promotion of education in the discipline in Europe. Namely, the development of: [1] A core syllabus for education in occupational health psychology [2] A mechanism for identifying, recognising and listing undergraduate and postgraduate modules and courses (programmes) in occupational health psychology [3] Structures to support the extension of the current provision of education in occupational health psychology [4] Ways of enhancing convergence of the current provision of education in occupational health psychology [5] Ways of encouraging regional cooperation between education providers across the regions of Europe [6] Ways of ensuring consistency with North American developments in education and promoting world wide co-operation in education Five years has elapsed since the presentation of these laudable objectives to the meeting of the education forum in Vienna in December 2002. In that time OHP has undergone considerable growth, particularly in Europe and North America. Expansion has been reflected in the evolution of existing, and emergence of new, representative bodies for the discipline on both sides of the Atlantic Ocean. As such, it might be considered timely to pause to reflect on what has been achieved in respect of each of the objectives set out in the strategy document. The current chapter examines progress on the six objectives and considers what remains to be done. This exercise is entered into not merely in order to congratulate achievements in some areas and lament slow progress in others. Rather, on the one hand it serves to highlight areas where real progress has been made with a view to the presentation of these areas as ripe for further capitalisation. On the other hand it serves to direct the attention of stakeholders (all those with a vested interest in OHP) to those key parts of the jigsaw puzzle that is the development of a self-sustaining pan-European education framework which remain to be satisfactorily addressed.

Foster Fathers: their experiences and contributions to fostering

The paper reports some of the findings of an exploratory study which looks at foster fathers’ experiences of fostering and discusses their routes into foster care and their perspectives on their roles and tasks. The study collected quantitative and qualitative data by approaching all foster fathers registered with a single independent fostering agency based in southeast England. They were asked about their personal and professional attributes, and their experiences of and views concerning the role of foster father. The study discusses the foster fathers’ motivation to foster, and argues that what they see as its positives and drawbacks, and how it fits into their own family lives, are all relevant to improving service recruitment, delivery and retention. The study produced some evidence about the distinctive and positive contribution which foster fathers see themselves making to the lives of the children they foster. Further research is needed to refine our knowledge of what this contribution may be. Such knowledge could potentially develop our understanding of the roles of fathers in child development more generally as well as fine-tuning practice in matching what particular placements have to offer to the needs of individual children.

A Utilitarian Perspective of Social and Medical Contributions to Three Illustrative Conditions, and Recent UK NHS Policy Initiatives

Background: To date debate concerning the relative merits of social and medical sciences has been largely academic. Aims: To outline and critically appraise a utilitarian approach to mental health research that reflects a critical realist perspective. Method: Consideration of the relative utility of differing approaches to illustrative ‘‘psychiatric’’ disorders, and recent policy initiatives. Results: Socially relevant outcomes of Bipolar Affective Disorder are determined by influences that operate independently of the characteristic instability of mood. There is now a highly specific and effective psychological treatment for Panic Disorder. Its benefits are still not fully exploited because of continuing lay and professional focus upon the condition’s social manifestations. Great numbers of people presenting in primary care are unhelpfully caused to adopt the role of ‘‘patient’’ due to practices limiting the professional response to a medical one. Such practices reflect public and professional perceptions of the nature of ‘‘mental health difficulties’’ much more than they do the achievements of medicine. Recent policy-supporting initiatives influencing UK NHS mental health services are much more likely to be supported by social sciences than by medical research. Conclusions: There is considerable scope for a contribution to applied mental health research from frameworks and methodologies that are rooted in a social sciences perspective.