A relação terapeuta-cliente: na perspectiva do cliente

O presente estudo resulta de uma crescente preocupação e percepção da importância da relação terapeuta-cliente e procura compreender a perspectiva do cliente e a forma como este sente e vive essa relação ao longo de todo o seu processo terapêutico. O estudo realizado, de natureza qualitativa e de carácter exploratório, visa sobretudo analisar a influência da relação terapeuta-cliente na perspectiva do cliente, identificar e descrever os fatores que a influenciam e perceber a mais-valia desta relação ao longo do processo terapêutico. Para tal, foram entrevistadas dezanove pessoas que estão a receber tratamento de terapia ocupacional. Para a recolha dos dados foi aplicada a entrevista semi-estruturada por se pretender um contributo mais envolvente, particularizado e subjetivo dos clientes. Através da realização do estudo e de acordo com a perspetiva dos clientes entrevistados, concluiu-se que a capacidade do terapeuta em construir e estabelecer um vínculo com o cliente ditará grande parte do sucesso ou insucesso do processo terapêutico. Porém, tão importante como formar e estabelecer um vínculo terapeuta-cliente é preciso ter a preocupação contínua de o manter sempre vivo e fortalecido. Para que tal aconteça, o terapeuta não pode menosprezar a experiência de vida e expectativas do cliente e deve assumir um papel de permanente preocupação e atenção a todas as transformações quotidianas pois estas influenciam o envolvimento do cliente nas suas atividades/ocupações e afetam a sua saúde e desempenho. O novo milénio requer dos profissionais de saúde em geral e dos terapeutas ocupacionais em particular, novas habilidades e competências. É fundamental adquirir a consciência de que os clientes são o centro de todo o processo terapêutico. É necessário ter uma visão holística e não fragmentada do cliente. É importante interagir com os clientes e permitir uma troca de conhecimento, entre o saber do cliente e o saber do terapeuta. Essa troca gera convergências, fortalece laços e o processo terapêutico avança. Nesse relacionamento, ambos aprendem, progridem e crescem.

De la relation pharmaciens-usagers : reconfigurations et négociations dans une pharmacie suisse

À partir d'entretiens et d'observations réalisés dans une pharmacie de garde de Suisse romande, cette étude explore les relations que les pharmaciens d'officine entretiennent avec les usagers. Dans un contexte de démocratisation des savoirs relatifs à la santé, l'enquête effectuée montre que cette relation se reconfigure, selon la nature du problème de santé, au profit d'une plus grande autonomie des usagers. En effet, dans certaines situations, les usagers peuvent exprimer le désir de se passer de la compétence du pharmacien. Mais, dans d'autres circonstances, bien que s'efforçant de s'adapter aux demandes des usagers, les professionnels peuvent réaffirmer leur autorité d'expert si le problème soulevé ou les médicaments désirés nécessitent plus de vigilance. La relation pharmacien-usager oscille donc dans une négociation constante selon la marge de manoeuvre dont, dans une situation donnée, les uns et les autres disposent.

À l’écoute du soignant : relation de soins et considérations éthiques dans la pratique des soins psychiatriques communautaires

Un phénomène de résistance au traitement pharmacologique chez les personnes souffrant de maladies psychiatriques graves et persistantes comme la schizophrénie, tel que révélé par la pratique des soins psychiatriques communautaires de première ligne, sert de point de départ pour poser une distinction fondamentale entre les notions de traitement et de soins. Conséquemment, la question du consentement selon qu’il est attribué au traitement ou aux soins suggère des formes de consentement distinctes susceptible d’affecter la façon de faire face à des problèmes particuliers sur le plan de l’éthique. L’analyse conceptuelle d’un certain modèle d’interventions psychiatriques de crise, qui regroupe des travailleurs de la santé et des policiers au sein d’une même équipe de travail, permet de circonscrire des catégories de problèmes éthiques qui conduiront éventuellement à la formalisation d’une approche de résolution de problème. Trois façons d’approcher un problème d’éthique clinique sont proposées sous la forme d’enjeux, de dilemmes, puis de défis éthiques. L’intervention de crise y est catégorisée selon quatre niveaux d’intensité de crise, donnant lieu à une appréciation subjective par le soignant de la capacité de la personne soignée d’établir et de maintenir une relation de soins en situation de crise. Des parallèles entre les soins psychiatriques et les soins palliatifs permettent d’approfondir la question de la souffrance en lien avec la douleur et de distinguer à nouveau les notions de soins et de traitement. La relation de soins est présentée comme une occasion de normaliser les rapports entre soignants et soignés, de valoriser un état de souffrance à l’origine de la rencontre de soins, tout en mettant à profit la dimension relationnelle d’une condition qui appelle à être non pas traitée mais soignée. Ces considérations permettent de dégager une responsabilité nouvelle pour le soignant : celle de se faire le gardien de la relation de soins. Une transition du primum non nocere au primum non excludere : d’abord ne pas exclure est suggérée comme une maxime pour guider la relation de soins vers un consentement aux soins plus authentique.

SANMIGUEL Supreme Colombian Coffee

Este proyecto de emprendimiento llamado SANMIGUEL SUPREME COLOMBIAN COFFEE, surgió como iniciativa por parte del emprendedor Leonardo Sanmiguel Benavides; quien ha vivido durante toda su vida rodeado del sector caficultor, convirtiéndose en una de las razones por las cuales deseo incursionar en la creación de una empresa cien por ciento huilense, la cual exportará café especial diferenciado en producto terminado de media libra, libra y kilo que tendrá como mercado inicial y principal tres ciudades de los Estados Unidos, que son; Miami, Houston y Atlanta. En el proyecto de emprendimiento se muestra, como un producto de altísima calidad (café) asegurando su trazabilidad puede generar valor y ser más atractivo para el consumidor final; pero no es suficiente el emprendedor comprendió que se debe crear una relación cliente - empresa, no solo con la venta, sino antes, durante y después de la venta; permitiendo la creación de un vínculo de fidelidad entre las partes, también conocido como "Marketing Profesional”. De igual forma el éxito de la empresa debe ser también productor, por esta razón SANMIGUEL implementará una política de comercio justo, en la cual se recompensará la calidad al caficultor, permitiéndole mejorar su calidad de vida; SANMIGUEL reconoce lo valioso de crear constantemente valor a sus productos, es por esto que se compromete a mantener el pilar de la innovación como columna vertebral de la misma. SANMIGUEL una empresa comprometida con el caficultor, con el departamento del Huila y con Colombia, brindando el mejor café del mundo.

The role of rules-based compliance systems in the new EU regulatory landscape: perspectives of institutional change

Purpose The research objective of this study is to understand how institutional changes to the EU regulatory landscape may affect corresponding institutionalized operational practices within financial organizations. Design/methodology/approach The study adopts an Investment Management System as its case and investigates different implementations of this system within eight financial organizations, predominantly focused on investment banking and asset management activities within capital markets. At the systems vendor site, senior systems consultants and client relationship managers were interviewed. Within the financial organizations, compliance, risk and systems experts were interviewed. Findings The study empirically tests modes of institutional change. Displacement and Layering were found to be the most prevalent modes. However, the study highlights how the outcomes of Displacement and Drift may be similar in effect as both modes may cause compliance gaps. The research highlights how changes in regulations may create gaps in systems and processes which, in the short term, need to be plugged by manual processes. Practical implications Vendors abilities to manage institutional change caused by Drift, Displacement, Layering and Conversion and their ability to efficiently and quickly translate institutional variables into structured systems has the power to ease the pain and cost of compliance as well as reducing the risk of breeches by reducing the need for interim manual systems. Originality/value The study makes a contribution by applying recent theoretical concepts of institutional change to the topic of regulatory change uses this analysis to provide insight into the effects of this new environment

Conceptualising the requirements of CRM from an organisational perspective : a review of the literature

For an organisation to undertake a Customer Relationship Management (CRM) implementation program it needs to consider a multitude of requirements. Some authors have hinted at viewing CRM within a wider perspective than just  customer centric perspectives. The aim of this paper is to discuss the domain and conceptualise some of the requirements of CRM from an organisation’s point of view. However, CRM needs to be identified as the whole organisation, including its internal and external environments. Undertaking CRM in any organisation needs to be preceded by a sequence of stages. An organization needs to develop a roadmap outlining the path to become CRM centric. Therefore an organisation should address, or at least consider, a list of those factors at every stage of a CRM implementation program, for an implementation program to be effective. The main focus of literature in CRM has been customer centric. This paper, being the first stage of much wider research, will focus on the organisation and the internal environment. This paper will identify three information systems (IS) and information technology (IT) requirements in organisations that are integral parts of CRM. These need to achieve a level of synergy for successful CRM. To understand these three requirements (front-end systems, back-end systems, and datahandling technologies) in a CRM project is too great in magnitude at this early stage of the research. This paper begins to draw together the tenuous links between the three requirements of information systems (IS) and information technology (IT) systems. Writing this paper and shifting its focus towards requirements engineering, the author has realised that a whole area of literature has to be explored, because CRM is another IS implementation.

Losing innocence : finding the line between emotional bonds and boundaries in protective service work

This paper builds on existing literature on the notion of emotional labour by investigating work in a child protective service environment. Notable characteristics of formal organisations, such as child protective services, are that they operate within a legal framework and that workers' professional duties have great influence on clients. This paper examines the intricacies of the worker-client relationship and the emotional dynamics of the service interactions by interviewing a group of workers in a public hospital in Victoria, Australia. This research extricates the complexities in the client-worker relationship by examining a range of work characteristics including their roles as professional caregivers, the emotional bonds and boundaries in the workers-client relationship, the intensity and magnitude of felt and displayed emotions, as well as the self-management of emotions and clients' emotions. This study adds to existing knowledge on the emotional expressions, experiences and regulation of emotions of the professional work lives in a child protective service work environment.
This paper is divided into the following sections. The first section details protective service work within the larger framework of human service work, and how the worker-client interface is different from other front-line service work. This is followed the need to examine the emotional dynamics of work in a child protective service organisation. Next, a study of these emotional dynamics in a child protective service organisation is reported. The paper concludes with a consideration of the wider implications for the sociology of protective service work, and how affective issues differ other service work roles.

The process of interpersonal perspective taking

Perspective taking, the main cognitive component of empathy, has a particularly important and complex role to play in the clinician-client relationship, particularly in mental health nursing. However, despite extensive investigation into the outcomes of this construct (e.g. sympathy, altruism), the process by which people take another's psychological point of view has received comparatively little attention. The purpose of this study was to investigate what the individual does when attempting to take the perspective of another person. The aims were to identify the specific strategies people used to accomplish this task, to consider how and why these strategies were chosen, and the relationship between the strategies and subsequent outcomes. Participants described an example of their own perspective-taking experience. Adopting an interpretive phenomenological approach, analysis resulted in the generation of several themes of direct relevance to both the perspective taking process and the wider empathic experience. Of particular importance were two superordinate themes, use of other-information and use of self-information. One significant subordinate theme (within use of selfinformation) to emerge was that of past experience, where the participant had experienced either (a) a similar role to that which they occupied in the present situation, or (b) a similar situation to that of the target person. Both of these experiences were determinants of how easy participants perceived the task of apprehending the target’s perspective. Within the wider empathic experience, themes included emotional manifestations (e.g. sympathy), as well as judgements of appropriate behaviours. Implications of findings when working in clinical and mental health settings are discussed.

Uso da web nos serviços financeiros

As empresas do setor financeiro têm, desde há muito, estado entre as que mais investem em tecnologia de informação para apoiar os seus processos de negócio, buscar a eficiência empresarial e melhorar a qualidade dos seus serviços. Investimentos na Web estão contribuindo para a evolução dos serviços financeiros on-line, os quais podem ser classificados em três categorias: divulgação de informações, transações e relacionamento com os clientes. Este trabalho descreve pesquisa sobre a difusão do uso da Internet nos serviços bancários e entre as corretoras on-line no Brasil, comparando os dados recém obtidos com estudos desenvolvidos desde 1997 pelo autor.

Os significados de ludoterapia para as protagonistas do processo: crianças em atendimento

The ludic therapy in a Phenomenological-Existential perspective is conceived as a psychotherapeutic process in which, the listening and talking, mediated by playing activities, allow the child to deal with their grief/suffering. This study is based on the need to broaden the understanding of this modality of clinical intervention by emphasizing the speech of the protagonists in the process: children in therapy. The objective was to understand the ludic therapy from the children s perspective, knowing the meanings assigned to the therapeutic process, to the psychologist and to the involvement of the children in clinical consultations. The main ideas that underlie this research are presented in three theoretical chapters covering, respectively, the suffering of children and the demand for psychotherapy, the Phenomenological-Existential clinical psychology, and the psychotherapy for children, in Brazil, under this theoretical-methodological approach. The study was qualitative, on a phenomenological basis, and included six children as participants, aged between six and ten years, undergoing ludic therapy for at least six months, and referred by their own therapists. In the research s corpus construction, individual meetings were held and mediated by tools to support expressiveness (ludic and pictures/figures boxes), added by the storytelling of an incomplete story about a child s visit to the therapy session, and the request for the elaboration of a message to be passed to a child who will go to see a psychologist. The analysis of the data was based on a variant of the phenomenological method proposed by Amedeo Giorgi. The results reveal a lack of knowledge by the children about the psychologist s activities. Thus, the children develop fantasies about this intervention modality because of lack of information. These observations are consistent with the historical meanings assigned to clinical psychology, involving ideas of normality and guilt. The meanings associated with the motives for a referral to a psychologist highlight the conflict "be a problem versus having a problem" and an elitist conception of clinical psychology. Children understand the characteristics of the therapeutic process, such as the specifics of the therapist-client relationship and the notion of freedom. They also demonstrate remarkable pleasure in the therapeutic process. Finally, it was concluded that the meanings attributed to the ludic therapy by the children are consistent with that proposed in the literature about the children s psychotherapy process in the Phenomenological-Existential perspective. Moreover, the relevance of both the children s experience in the therapeutic setting and the meanings of these proceedings understood by the children are highlighted by the listening to the protagonists in the ludic therapeutic process. The comprehension of these aspects and their transference from the clients experience to the reflective field, promote advances in the understanding of child psychotherapy and indicate the need for further studies with children using this approach.

Interagindo com a criança hospitalizada: utilização de técnicas e medidas terapêuticas

O presente trabalho procura descrever a experiência vivenciada por aluna de graduação ao cuidar de criança hospitalizada numa unidade pediátrica. Utilizando-se das técnicas de comunicação terapêutica e medidas terapêuticas de enfermagem, a aluna desenvolveu relacionamento de ajuda com a criança, o que lhe permitiu prestar assistência de enfermagem de forma integral, envolvendo-se com ela e compartilhando experiências benéficas para ambas.

Eficiência bancária no Brasil: uma análise envoltória de dados (DEA)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

La consulenza in materia di investimenti

Il lavoro propone un’analisi critica delle disciplina italiana ed europea della consulenza in materia di investimenti. Si considerano innanzitutto le problematiche generali del rapporto tra cliente e intermediario nella prestazione della consulenza, con particolare riferimento ad asimmetrie informative e conflitti di interesse. Si discute, in particolare, il tradizionale paradigma regolamentare fondato sulla trasparenza: le indicazioni della finanza comportamentale suggeriscono, infatti, un intervento normativo più deciso, volto a caratterizzare in maniera fiduciaria la relazione tra cliente e intermediario. Dopo aver analizzato, alla stregua dei modelli teorici illustrati in precedenza, l’evoluzione storica della disciplina della consulenza nell’ordinamento italiano, si sottolinea il ruolo svolto dall’autorità di vigilanza nella sistematizzazione dell’istituto, nel contempo rilevando, tuttavia, la complessiva insufficienza delle norme vigenti al fine di un’adeguata tutela dell’investitore. Si esamina poi la disciplina introdotta dalla MiFID, con specifica attenzione alle implicazioni sistematiche dell’estensione della nozione di consulenza operata dalle autorità di vigilanza: la nuova configurazione del servizio ha determinato un’intensificazione dei doveri fiduciari imposti agli intermediari, testimoniando un superamento del paradigma di trasparenza e un percorso indirizzato verso un approccio maggiormente interventista sul lato dell’offerta. Le conclusioni sono, peraltro, nel senso di uno sviluppo solo parziale di tale processo, risultando dubbio il valore per il cliente di una consulenza non indipendente e potenzialmente esposta, soprattutto negli intermediari polifunzionali, al conflitto di interessi. Particolare enfasi viene posta sulla necessità di introdurre un’effettiva consulenza indipendente, pur nelle difficoltà che la relativa disciplina incontra, anche in ragione delle caratteristiche specifiche del mercato, nell’ordinamento italiano.

Relationships, Income Support and Decision Making: A Qualitative Synopsis

This qualitative study of one midwestern state’s child protective services addresses whether an income support measure for poor biological caregivers reduces the length of time that their children spend in foster care. The overall findings suggest that workers do value the worker-family relationship. However, some view the immediate worker-client relationship as secondary to the inclusion of extended familial supports particularly as related to sustained more long-term outcome achievement. Most workers additionally agree that client involvement during all phases of the reunification process is critical.

A korrupció társadalmi és intézményi szerkezete

A tanulmány első részében a megbízó-megbízott-kliens modellt fogalmi keretként alkalmazva a korrupció négy ideáltípusát mutatjuk be: míg a vesztegetést és zsarolást a megbízott és kliens közti, addig a hűtlen kezelést és csalást a megbízó és megbízott közti tranzakcióként definiáljuk. A korrupció ezen alaptípusait irányított gráfok segítségével ábrázoljuk. Ezt követően a korrupciós ügyletek szereplőinek lehetséges (pl. a tranzakciós költségek és a lebukási kockázatok csökkentésére irányuló) motivációit vizsgáljuk, vagyis azt, hogy mely tényezők ösztönzik leginkább a korrupciós helyzetek szereplőit arra, hogy tranzakcióikat különböző típusú személyes, üzleti, politikai és egyéb intézményes kapcsolathálókba ágyazzák. A második részben – támaszkodva korábbi kutatásaink eredményeire – néhány tipikus magyarországi korrupciós tranzakció társadalmi és intézményi beágyazottságát mutatjuk be. Négy esettanulmányt elemzünk részletesen, a bemutatott tipikus (pl. pártfinanszírozáshoz, vagy engedélyek megszerzéséhez kapcsolódó) korrupciós hálózatokat pedig többszereplős, bonyolult és multiplex gráfokkal ábrázoljuk. Végül a komplex hálózatok evolúciós vonatkozásait a szereplők számának, a kapcsolatok komplexitásának, valamint a személyi és/vagy intézményi beágyazottság mértékének tükrében vizsgáljuk. ______ In the first part of the paper four idealtypical corruption transactions are explicated in terms of the principal-agent-client model: bribery and extortion are described as two different types of agent-client relationship, while embezzlement and fraud as two different types of principal-agent relationship. The main idea is to describe these elementary corruption transactions as simple directed graphs. The next section of the paper takes into consideration different kinds of possible motivations (such as the reduction of risks or transaction costs) of the principals, agents and clients, in order to embed their corruption transactions in various kinds of personal, business, political and other institutional networks. In the second part of the paper some typical and stable network configurations are presented, based on a recent empirical corruption research carried out in Hungary. Certain corruption cases (such as party financing or granting of permit) are analyzed in details, and are described as complex and multiple networks. The paper concludes in showing some signs of the evolution of corruption networks in Hungary in terms of the number of actors, of the complexity of network configurations, of the level of personal or institutional embeddedness, and of the multiplexity of relationships.