Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination

OBJECTIVE: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. METHODS: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. CONCLUSION: Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. PRACTICE IMPLICATIONS: Professionals must critically consider the context in their choice of approach.

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing?

AIMS: Motivational interviewing (MI) is the most successfully disseminated evidence-based practice in the substance use disorder (SUD) treatment field. This systematic review considers two questions relevant to policymakers and service providers: (1) does training in MI achieve sustained practice change in clinicians delivering SUD treatment; and (2) do clinicians achieve a level of competence after training in MI that impacts upon client outcomes? METHODS: A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, examining training outcomes for MI in the SUD treatment sector, and for clinicians working in a SUD treatment role. We determined a training method to have resulted in sustained practice change when over 75% of participants met beginning proficiency in MI spirit at a follow-up time-point. RESULTS: Of the 20 studies identified, 15 measured training at a follow-up time-point using standard fidelity measures. The proportion of clinicians who reached beginning proficiency was either reported or calculated for 11 of these studies. Only two studies met our criterion of 75% of clinicians achieving beginning proficiency in MI spirit after training. Of the 20 studies identified, two measured client substance use outcomes with mixed results. CONCLUSIONS: A broad range of training studies failed to achieve sustained practice change in MI according to our criteria. It is unlikely that 75% of clinicians can achieve beginning proficiency in MI spirit after training unless competency is benchmarked and monitored and training is ongoing. The impact of training on client outcomes requires future examination.

Simmel, the police form and the limits of democratic policing

© 2015 The Author. I argue that the social theory of Georg Simmel can be used to illustrate certain limitations to the potential of democratic policing. Simmel makes a number of claims about trust, secrecy and accountability that are shown to have immediate relevance to my empirical case study of police-public consultation forums in Edinburgh, Scotland. Two particular aspects of the 'form' of the police-public relationship-the police's command of non-negotiable force and inequality in the reciprocity of information-play a key role in limiting some of the principal aspirations of democratic policing theory. There are permanent barriers to improving the democratic credentials of the police I argue, yet positive and progressive change is still achievable.

Police legitimacy, ideology and qualitative methods: a critique of procedural justice theory

I argue that there are unconsidered complexities to police legitimacy and use examples from my study of police–public consultation forums in Edinburgh, Scotland to illustrate. I make a number of conceptual and methodological critiques by drawing upon Steven Lukes’ social theory on power to show how legitimacy can be a product of authority relations as much as it is a cause of authority relations. This view finds support from systems-justification theory. I also tackle Beetham’s conception of legitimacy and argue that there is evidence from police studies that the police breach his key antecedents to legitimacy without incurring the expected consequences. Furthermore, I take an original methodological approach to studying police legitimacy which reveals additional insights. For instance, Bottoms and Tankebe suggest legitimacy addresses multiple ‘audiences’; I would also add that it addresses multiple recipients as legitimacy is shown to vary among officers and positions of rank.

Victoria’s banning provisions: ‘balancing’ discretionary police powers and individual rights

This thesis examines the parliamentary passage, implementation and ongoing scrutiny of Victoria’s banning notice provisions. Underlying political assumptions and justifications are explored to reveal how banning notices exemplify a move towards police-imposed discretionary justice, which undermines individual rights and reconfigures the notion of balance in the criminal justice system.

Police and prosecutors' perceptions of adult sexual assault evidence associated with case authorisation and conviction

This study examined the association between the quality of verbal evidence in cases of sexual assault reported by adults and professionals’ (police and prosecutor) ratings of the likelihood that the cases will result in a conviction at trial. Sixteen police detectives and 19 prosecutors (all specialists in sexual assault) each read two mock sexual offence briefs of evidence, one of a case involving rape of an adult and the other involving an adult reporting historical child sexual abuse. For each case type, two versions of the briefs were developed with regard to evidence quality, which varied according to the degree of elaboration in the responses by the witnesses and suspect, and contextual evidence. Participants rated the likelihood of proceeding with a case and conviction (on 10-point likert scales) and provided a rationale for their decisions. Almost all of the participants agreed that the cases would proceed to court. However, the likelihood of conviction was not associated with the likelihood of proceeding to court, or the evidence quality of the briefs. Differences were found in both the ratings of proceeding to court and conviction, and the factors underpinning the ratings across the two professional groups. The implications of the findings for police organisations are discussed.

Beacon of Hope? Lessons learned from efforts to reduce civilian deaths from police shootings in an Australian state

In the 1990s, the police service in Victoria, Australia, faced a crisis of community confidence due to a spate of civilian deaths from police shootings. In that decade, twice as many civilians died at the hands of the police in Victoria than in every other Australian state combined. Most of those killed were mentally ill and affected by drugs and alcohol, and were rarely a serious threat except to themselves. The problem was also almost entirely an urban phenomenon. Shootings in rural communities, where mentally ill people were more likely to be personally known to local police, were (and remain) almost unknown. The large number of fatalities was recognised as a serious threat to public confidence, and Victoria Police introduced a ground-breaking training programme, Operation Beacon. Operating procedures and weapons training were fundamentally changed, to focus on de-escalation of conflict and avoiding or minimising police use of force. In the short term, Operation Beacon was successful. Shooting incidents were dramatically reduced. However, during the first decade of the new century, the number of civilians being killed again increased. This article examines Operation Beacon, both as a successful model for reducing civilian deaths at the hand of police and as a cautionary tale for police reform. We argue that the lessons of Operation Beacon have been gradually forgotten and that old habits and attitudes resurfaced. Fatal shootings of mentally ill civilians can be prevented, but if success is to be other than temporary, the Beacon philosophy must be continually reemphasised by police management.

The footage is decisive’: Applying the thinking of Marshall McLuhan to CCTV and police misconduct

This article adapts Marshall McLuhan’s writings on mass media to ubiquitous and universal surveillance systems, looking at surveillance as media. The term ‘broadcast media’ is derived from an agricultural metaphor, a technique of planting. I argue that CCTV systems are an inversion of broadcasting: ‘harvest media’. Drawing on three case studies in which CCTV has been relevant to allegations of police misconduct, I explore how harvest media impacts on cultural and legal perceptions of evidence, and what can be known.

Revisiting the Tasty raid: lesbian and gay respectability and police legitimacy

This article extends beyond analysis of homophobic police practices at the Tasty raid that took place in Melbourne in 1994 to explore the ways in which queer politics interact with constructions of ‘respectability’ in the contexts of criminalisation, policing and state protection. I argue that the successful construction of legitimate victimhood by lesbian and gay Tasty patrons (achieved largely through signifiers of middle-class respectability and the paradigm of sameness) impeded police efforts to control media narratives and secure legitimacy in the aftermath of the Tasty raid. The formal apology issued by Victoria Police in 2014 indicates that the Tasty raid was considered a significant enough stain on police reputation to warrant addressing two decades after the event itself. I consider the apology as an attempt to cleanse and redeem the institution of the negative image of police resulting from the Tasty raid. This case offers unique insights into some of the ways in which lesbians and gay men may achieve legitimacy as victims in a heteronormative context and how this might come at the cost of a structural analysis of sexuality, power and violence. It also highlights how state institutions navigate and avoid accountability to a specific and historically targeted group.

A qualitative evaluation of the challenges faced by dieticians when interviewing children

BACKGROUND: Investigative interviewing is a critical and challenging skill involved in the assessment and design of appropriate interventions for children's dietary problems. The current study provided an evaluation of the challenges faced by professional dieticians when conducting child investigative interviews, in the hope that this would provide a framework for the development of further guidance and resources in this important area. METHODS: Fourteen professional dieticians were interviewed; they were asked about the information that they needed to elicit from children in particular situations and the questions that they would ask to do so. They were also asked to describe the strengths and limitations of the techniques that they used. RESULTS: The results revealed that professionals faced three main challenges. The first challenge was eliciting information from children who did not want to answer questions. The second challenge was determining the level of accuracy in children's (and caregivers') responses. The third challenge was eliciting very specific information in particular situations, such as determining the cause of an allergic reaction. CONCLUSIONS: Overall, professionals had difficulty articulating the questions that they would use to elicit the information that they required; indeed, their responses focused more on the content that they wanted to elicit (such as specific details) rather than the overall process that they would use to do so. Professionals may benefit from the development of guidelines to assist them in their interviews with children, based on what is currently known about interviewing children generally.

An application of an extended effort-reward imbalance model to police absenteeism behaviour

Purpose – Frequent absences from work can be highly disruptive, whilst also potentially indicating problematic working conditions that can lead to increased withdrawal behaviour. The purpose of this paper is to test the predictive capability of an expanded effort-reward imbalance model on employee absenteeism within the context of policing.

Design/methodology/approach – Three separate reward systems are identified by the effort-reward imbalance model. In this study, the authors assessed these individual components for their contribution to officer withdrawal behaviour in the form of absenteeism frequency. Data were gathered from a sample of operational officers (n=553) within a large Australian police agency.

Findings – Findings indicate that there was a strong influence of social rewards such as social support and recognition in the workplace on officer absenteeism rates. Low workload was associated with a higher frequency of absenteeism suggesting a potential underloading effect. There were a number of significant interactions providing support for the effort-reward imbalance mechanism and the separation of the reward construct. Security rewards were particularly influential and significantly moderated the relationship between effort and absenteeism.

Research limitations/implications – Differential effects of occupational rewards were identified in the study, indicating that there are significant opportunities for expansion of the effort-reward imbalance model along with opportunities for HRM practitioners in terms of employee recognition and remuneration programmes. This research was focused on a specific sample of operational officers, therefore should be expanded to include multiple occupational groups.

Originality/value – This paper considers and expanded model of worker strain and contributes a longitudinal assessment of the association between perceived effort and reward systems and worker absenteeism.

The mythical properties of police body-worn cameras: A solution in the search of a problem

Over the past few years, Australian police agencies have begun to enthusiastically introduce body-worn cameras on police personnel. These devices are now either implemented or under trial across the country. There is also an emergent ‘surveillance consensus’ (Hempel and Töpfer 2009) concerning their use amongst Australian police. While more detailed empirical examination of information flows that shape this surveillance consensus is warranted, this contribution to the debate seeks to draw from policing scholarship to critically explore the intersections between the rationalizations for body-worn cameras and the broader policing scholarship. More directly, body-worn cameras cannot be understood in narrow instrumental terms, but must be located within the broader literature on governing police and the law and order politics that surrounds many contemporary police and criminal justice reforms (Cox 2015; Gregg and Wilson 2015). I begin with a summary of the introduction of body-worn cameras in Australia. The article then identifies five problems body-worn cameras purportedly address and provides a brief case summary indicating how current ‘privacy protections’ fail to establish real limits to the collection, use, and dissemination of images from body-worn cameras.

Investigative Interviewing of Aboriginal children in cases of suspected sexual abuse

This study examined the investigative interviewing of Australian Aboriginal children in cases of alleged sexual abuse, with a focus on three commonly included components of interview protocols: ground rules, practice narrative, and substantive phase. Analysis of 70 field transcripts revealed that the overall delivery and practice of ground rules at the beginning of the interview was positively associated with the spontaneous usage of rules in children's narratives of abuse. When specifically examining the "don't know" rule, however, only practice had an effect of children's usage of the rule (as opposed to simple delivery or no delivery at all). Children spoke more words overall, and interviewers used more open-ended prompts during the substantive phase when the interviews contained a practice narrative. Children most often disclosed sexual abuse in response to an open-ended prompt; however, they produced the most words in response to suggestive prompts. This article concludes with a discussion of the effectiveness of ground rules, practice narratives, and questioning with Aboriginal children.

Exploring the suburban ideal: Residents' experiences of photo elicitation interviewing (PEI)

This article reports on how photo elicitation interviewing (PEI) was experienced by eight participants in a qualitative phenom- enological study of suburban lived experiences. Adopting a respondent-controlled approach, participants were required to photograph at least 10 aspects of their suburb that they perceived to be good and problematical and then explain the meaning of their images as part of a follow-up interview. This discussion also involved in-depth reflection on the photography exercise itself, with analysis revealing that taking photographs was perceived to be a purposeful exercise that offered a range of benefits. It gave a new perspective and appreciation for the community, while also helping to ensure their meanings were conveyed to the inter- viewers. The photography task was not without challenges. While some of these challenges influenced the images captured, the findings of this study highlight the importance for qualitative researchers who use PEI to not only consider the benefits and limitations for the research but also give due consideration to the experiences of the participant photographers.

Upholding whose right? Discretionary police powers to punish, collective 'pre-victimisation and the dilution of individual rights

This article uses the example of Victoria’s alcohol-related banning notice provisions to explore the changing conception of balance within criminal justice processes. Despite the formalisation of individual rights within measures such as Victoria’s Charter of Human Rights and Responsibilities Act 2006, the discretionary power of the police to issue on-the-spot punishments in response to actual or potential criminal behaviour has increased steadily. A key driver, evident across the parliamentary debates of the banning legislation, is a presumed need to protect the broader community of potential victims. As a result, the individual rights of those accused (but not necessarily convicted) of undesirable behaviours are increasingly subordinated to the pre-emptive protection of the law-abiding majority. This shift embodies a largely unsubstantiated notion of collective pre-victimisation. Significantly, despite the expectations of Victoria’s Charter, measures such as banning notices have been enacted with insufficient evidence of the underlying collective risk, of their likely effectiveness and without meaningful ongoing scrutiny. The motto of Victoria Police – Uphold the Right –appears to belie a growing uncertainty over whose rights should be upheld and how.