Negotiating : experiences of community nurses when contracting with clients

A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: ‘assessment of needs’, ‘education towards enablement’, and ‘negotiation’. ‘Assessment of needs’ identified that community nurses assess both the client’s requirements for health care as well as the ability of the nurse to provide that care. ‘Education towards enablement’ described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, ‘negotiation’, involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.

Dietetic confidence working with clients with depression/anxiety is associated with client-focused practic and advocacy skills

Confidence in a professional role is a key element in the successful transition to competent practice. New graduate dietitians report that whilst they are confident about their general dietetic ability, they are not as confident when working with clients experiencing depression and anxiety. This study aimed to develop and validate a scale which measured confidence about working with clients with depression/anxiety. The 21-item Dietetics Collaborative Practice Scale was developed using research about dietetic practice in mental health, coping self-efficacy literature and collaboration with industry experts. A convenience sample of 189 Australian dietitians completed the questionnaire. Exploratory factor analysis suggests that dietetic confidence is best represented by a two dimensional solution consisting of (a) Client –focused practice (CFP, 50.8% variance) and (b) Advocacy for self and client care (ASC, 9.7% variance). The alpha coefficient of both dimensions (CFP ɑ=0.95, ASC ɑ=0.84) demonstrated the internal consistency of components. Combined, these two components account for 60.5% of variance. The scale components were not related to years of practice or working with mental health clients but were significantly related to overall dietetic confidence (ODC). Correlation coefficients between ODC and CFP were 0.501 (p<0.01), ODC and ASC were correlated at 0.465 (p<0.01) and CFP and number of years as a dietitian were weakly correlated at 0.24 (p<0.05). Results have implications for dietetic training and professional development. Client focus and advocacy for self and client appear to be important factors in overall confidence as a dietitian.

Perceived social support and community adaptation in schizophrenia

Prompted by the continuing transition to community care, mental health nurses are considering the role of social support in community adaptation. This article demonstrates the importance of distinguishing between kinds of social support and presents findings from the first round data of a longitudinal study of community adaptation in 156 people with schizophrenia conducted in Brisbane, Australia. All clients were interviewed using the relevant subscales of the Diagnostic Interview Schedule to confirm a primary diagnosis of schizophrenia. The study set out to investigate the relationship between community adaptation and social support. Community adaptation was measured with the Brief Psychiatric Rating Scale (BPRS), the Life Skills Profile (LSP) and measures of dissatisfaction with life and problems in daily living developed by the authors. Social support was measured with the Arizona Social Support Interview Schedule (ASSIS). The BPRS and ASSIS were incorporated into a client interview conducted by trained interviewers. The LSP was completed on each client by an informal carer (parent, relative or friend) or a professional carer (case manager or other health professional) nominated by the client. Hierarchical regression analysis was used to examine the relationship between community adaptation and four sets of social support variables. Given the order in which variables were entered in regression equations, a set of perceived social support variables was found to account for the largest unique variance of four measures of community adaptation in 96 people with schizophrenia for whom complete data are available from the first round of the three-wave longitudinal study. A set of the subjective experiences of the clients accounted for the largest unique variance in measures of symptomatology, life skills, dissatisfaction with life, and problems in daily living. Sets of community support, household support and functional variables accounted for less variance. Implications for mental health nursing practice are considered.

Characteristics of culturally and linguistically diverse mental health clients

The present study examined Queensland Transcultural Mental Health Centre (QTMHC) client characteristics in order to provide a better understanding for development of future health service delivery models. Archived data that was collected for 1499 clients over two years period (2007-2009) was analysed using descriptive statistics and Chi squares. The results indicated that clients were referred from a range of sources and were generally adults. There were more women than men, who sought services. At least half of the clients had language barriers and relied on bilingual workers. Most frequently expressed mental health issues were mood disorder symptoms, followed by symptoms of schizophrenia and psychosis and anxiety. Acculturation strains and stressors were described as the most common psychosocial issues. Mental health and psychosocial issues differed for age, gender and world regions from which the CALD clients originated. The findings provided an understanding of clients who seek services at QTMHC. Various ways in which transcultural services and data bases can be further improved are discussed.

Parent and adolescent perceptions of family functioning : a comparison of clinic and non-clinic families

In this paper two studies are reported which compare (a) the perceptions of family functioning held by clinic and non-clinic adolescents, and (b) the perceptions of family functioning held by adolescents and their mothers in clinic and non-clinic families. In Study 1, matched group of clinic and non-clinic adolescents were compared on their responses to a 30-item scale (ICPS) designed to measure three factors of family functioning: Intimacy (high vs. low), Parenting Style (democratic vs. controlled) and Conflict (high vs. low). Clinic and non-clinic adolescents were also compared on their responses to a multi-dimensional measure of adolescent self-concept. Although there was little difference between the two groups of adolescents in terms of their perceptions of family functioning, there were strong relationships between the self-concept variables and the family functioning variables. In Study 2, comparisons were made between the perceptions of family functioning held by mothers and adolescents for both clinical and non-clinic families. There were no differences between the two groups of adolescents in terms of their perceptions of family functioning, although there were clear differences between the two groups of mothers. In addition, clinic adolescents and their mothers did not differ in their perceptions of the family, whereas adolescents in the non-clinic group saw their families significantly as less intimate and more conflicted than did their mothers.

Managing the therapeutic relationship in online cognitive behavioural therapy for depression: Therapists' treatment of clients' contributions

This article examines how therapists and clients manage the therapeutic relationship in online psychotherapy. Our study focuses on early sessions of therapy involving 22 therapist-client pairs participating in online Cognitive Behavioural Therapy (CBT) for depression. Using Conversation Analysis (CA), we examine how therapists can orient to clients’ contributions, while also retaining control of the therapeutic trajectory. We report two practices that therapists can use, at their discretion, following clients’ responses to requests for information. The first, thanking, accepts clients’ responses, orienting to the neutral affective valence of those responses. The second, commiseration, orients to the negative affective valence of clients’ responses. We argue that both practices are a means by which therapists can simultaneously manage developing rapport, while also retaining control of the therapeutic process.

Child mental health after parental separation: The impact of resident/non-resident parenting, parent mental health, conflict and socioeconomics

Children of separated parents tend to have poorer mental health than children of intact families. Explanations to date have tended to focus on resident mothers, neglecting the potential importance of non-resident fathers. Using recent data from the Longitudinal Study of Australian Children, and independent teacher-reports of child mental health, this study 1) compares the mental health of children with resident and non-resident fathers and 2) explores predictors of poor mental health among children with a non-resident father. Children with a non-resident father had poorer mental health than those with a resident father, but this difference was explained fully by exposure to parental conflict, and to a lesser extent by socioeconomic status, parenting, and parent mental health. For children with a non-resident father, the strongest predictors of child mental health were mothers' employment and maternal parenting consistency. Policy implications are discussed.

Parent views of play in the Preparatory Year in Queensland

Over the past ten years, Queensland has experienced a period of significant education reform including the introduction in 2007 of a Preparatory Year of schooling for children aged five years. Recently, the development of a new Australian Curriculum represents a further curriculum reform impacting on Prep in Queensland, as Prep is, for the first time, part of the broader school curriculum and specific content is to be taught. The place of play as a context for learning is a current topic of interest during this period of change, and this thesis argues that consideration of parent views with regard to play and its place in Prep is timely and strategic. This thesis reports the findings of a research project that used case study to elicit and describe the ways in which eight parents viewed play in Prep. Analysis of parent interviews identified four themes: (1) parents interpreting play in Prep, (2) play and learning in Prep, (3) the Prep teacher's role in play and (4) parent tensions regarding play and learning in Prep. The results of the study suggest that variation exists in the ways in which parents may view and interpret play in Prep in Queensland. Analysis of the data further suggests that these interpretations may reflect parents' understanding of the Prep program and their attitudes to play and school generally. This thesis suggests that parents may spend limited time in Prep classrooms, which may impact on their understanding of play as a theoretical tenet in Prep and may highlight limitations in parent-teacher partnerships. The results of this study suggest that more attention be given to engaging parents in early childhood programs and eliciting their views on these programs. The results also suggest the importance of early childhood teachers advocating on behalf of play with their teaching colleagues, school leaders and policy makers.

International tax and the Australian wine industry: Is your client’s product destined to sail the seven seas?

The export market for Australian wine continues to grow at a rapid rate, with imported wines also playing a role in market share in sales in Australia. It is estimated that over 60 per cent of all Australian wine is exported, while 12 per cent of wine consumed in Australia has overseas origins. In addition to understanding the size and direction (import or export) of wines, the foreign locales also play an important role in any tax considerations. While the export market for Australian produced alcohol continues to grow, it is into the Asian market that the most significant inroads are occurring. Sales into China of bottled wine over $7.50 per litre recently overtook the volume sold our traditional partners of the United States and Canada. It is becoming easier for even small to medium sized businesses to export their services or products overseas. However, it is vital for those businesses to understand the tax rules applying to any international transactions. Specifically, one of the first tax regimes that importers and exporters need to understand once they decide to establish a presence overseas is transfer pricing. These are the rules that govern the cross-border prices of goods, services and other transactions entered into between related parties. This paper is Part 2 of the seminar presented on transfer pricing and international tax issues which are particularly relevant to the wine industry. The predominant focus of Part 2 is to discuss four key areas likely to affect international expansion. First, the use of the available transfer pricing methodologies for international related party transactions is discussed. Second, the affects that double tax agreements will have on taking a business offshore are considered. Third, the risks associated with aggressive tax planning through tax information exchange agreements is reviewed. Finally, the paper predicts future ‘trip-wires’ and areas to ‘watch out for’ for practitioners dealing with clients operating in the international arena.

Tools of the trade: quick measures and validated tools for assessing health and wellness. How you can better help your clients/employees help themselves

Worksite wellness efforts can generate enormous health-care savings. Many of the methods available to obtain health and wellness measures can be confusing and lack clarity; for example it can be difficult to understand if measures are appropriate for individuals or population health. Come along and enjoy a hands-on learning experience about measures and better understanding health and wellness outcomes from baseline, midway and beyond.

Parent-teacher engagement : a coteaching and cogenerative dialoguing approach

The accumulated evidence from more than four decades of education research strongly suggests that parent involvement in schools carries significant benefits for students as well as for the success of schools (e.g., Henderson & Mapp, 2002). Governments in Australia and overseas have supported parent involvement in schools with a range of initiatives while parent groups have indicated a strong desire for expanded school roles that include participation in formal educational processes namely curriculum, pedagogy, and assessment. Research has also signalled the need for teachers to engage parents rather than adopt traditional parent-school involvement practices so that parents can participate as joint educators in their children's schooling alongside teachers (Pushor, 2001). Actually improving the quality of contact and relationships between parents and teachers to enable engagement however remains problematic. Coteaching and cogenerative dialoguing originally emerged as an innovative approach in the context of teaching secondary school science. Coteaching brings together the collective expertise of several individuals to expand learning opportunities for students while cogenerative dialogues refer to sessions in which participants talk, listen, and learn from one another about the process (Roth & Tobin, 2002a). Coteaching and cogenerative dialoguing reportedly benefits students academically and socially while rewarding educators professionally and emotionally through the support and collaboration they receive from fellow coteachers. These benefits ensue because coteaching theoretically positions teachers at one another's elbows, providing new and different understandings about teaching based on first-hand perspectives and shared goals for assisting students to learn. This thesis proposes that coteaching and cogenerative dialoguing may provide a vehicle for improving quality of contact and relationships between parents and teachers. To investigate coteaching and cogenerative dialoguing as a parent-teacher engagement mechanism, interpretive ethnographic case study research was conducted involving two parents and a secondary school teacher. Sociological ideas, namely Bourdieu's (1977) fields, habitus, and capitals, together with multiple dialectical concepts such as agency|structure (Sewell, 1992) and agency|passivity (Roth, 2007b, 2010) were assembled into a conceptual framework to examine parent-teacher relationships by describing and explaining cultural production and identity construction throughout the case study. Video and audio recordings of cogenerative dialogues and cotaught lessons comprised the chief data sources. Data were analysed using qualitative techniques such as discourse and conversation analysis to identify patterns and contradictions (Roth & Tobin, 2002a). The use of quality criteria detailed by Guba and Lincoln (2005) gives credence to the way in which ethical considerations infused the planning and conduct of this research. From the processes of data collection and analyses, three broad assertions were proffered. The findings highlight the significance of using multiple coordinated dialectical concepts for analysing the affordances and challenges of coteaching and cogenerative dialogues that include parents and teachers. Adopting the principles and purposes of coteaching and cogenerative dialoguing promoted trusting respectful relationships that generated an equitable culture. The simultaneous processes and tensions between logistics and ethics (i.e., the logistics|ethics dialectic) were proposed as a new way to conceptualise how power was redistributed among the participants. Knowledge of positive emotional energy and ongoing capital exchange conceived dialectically as the reciprocal interaction among cultural, social, and symbolic capitals (i.e., the dialectical relationship of cultural|social|symbolic capital) showed how coteaching and cogenerative dialoguing facilitated mutual understandings, joint decision-making, and group solidarity. The notion of passivity as the dialectical partner of agency explained how traditional roles and responsibilities were reconfigured and individual and collective agency expanded. Complexities that surfaced when implementing the coteaching and cogenerative dialoguing approach were outweighed by the multiple benefits that accrued for all involved. These benefits included the development of community-relevant and culturally-significant curricula that increased student agency and learning outcomes, heightened parent self-efficacy for participating in and contributing to formal educational processes, and enhanced teacher professionalism. This case study contributes to existing theory, knowledge and practice, and methodology in the research areas of parent-teacher relationships, specifically in secondary schools, and coteaching and cogenerative dialoguing. The study is particularly relevant given the challenges schools and teachers increasingly face to meaningfully connect with parents to better meet the needs of educational stakeholders in times of continual, complex, and rapid societal change.

Teacher, parent and student perceptions of the motives of cyberbullies

Understanding the motivation of students who cyberbully is important for both prevention and intervention efforts for this insidious form of bullying. This qualitative exploratory study used focus groups to examine the views of teachers, parents and students as to the motivation of students who cyberbully and who bully in other traditional forms. In addition, these groups were asked to explain their understanding of what defines bullying and cyberbullying. The results suggested that not only were there differences in definitions of cyberbullying and bullying between the three groups, but also that there were differences in perceptions of what motivates some youth to cyberbully. The implications of these results are discussed for both prevention and intervention strategies.

Parenting from the outside-in : reflections on parent training during a potential paradigm shift

This article proposes that a paradigm shift that has implications for practitioners of parenting interventions is emerging. This shift represents a challenge to the dominant model of parent training. The Triple P Parenting Program is discussed as an example of parent training programme to highlight the relevant issues for practitioners, including common practitioner objections encountered in dissemination as identified, in part, by Mazzucchelli and Sanders. It is argued that apart fromthese objections, there are more essential concerns in relation to the adoption of parent training programmes by practitioners. Rather, the article argues that parent training is “mind-blind” and that approaches emerging from the field of interpersonal neurobiology represent developmentally sophisticated alternatives for intervention. The Circle of Security programme is discussed as one example of this emerging paradigm shift that integrates attachment, social neuroscience, and psychodynamic theory. Contrasts are highlighted between the models, and considerations for future issues in parent intervention conclude the article.