Examination of students' ability to observe domains of client behaviour in therapeutic recreation

When observing client behaviours, a therapeutic recreation specialist must have a base understanding of typical client behaviours to provide an informed analysis (burlingame & Blaschko, 2010). Providing students with the necessary tools for client observation is significant to the success of this process. The purpose of this study was to assess the relationships amongst the TR student demographic characteristics on acquiring the observation competency necessary to conduct a TR assessment. One hundred seventy-two TR college and university students, enrolled in post-secondary undergraduate TR programs across Ontario, observed a client assessment via video, and recorded their observations using the Tracking Behavioural Assessment (TBA) (Passmore, 2002). Independent samples t-tests and analysis of variance were calculated for the different student characteristics on the domains of the TBA. Significant findings indicated that university students scored more accurately than college students, and advanced students more accurately than novice students, on the emotional and socialization domains.

Habitus shock : a model for architect-client relationships on house projects based on sociological and psychological perspectives

The widening gap between architects and clients and the associated problems in the management of their relationship have long been recognised by practitioners and researchers alike. An emerging trend in recent studies is to develop descriptive models to describe behavioural characteristics of relationships based on observations of ' real world' practice, indicating the significance of understanding the complexities of the social environment in which the architect-client relationship is within. This research built upon the work of past descriptive models by exploring the architect-client relationship on house projects with a focus on the client's voice. It is an interdisciplinary study drawing theory from sociology to further understand this built environment industry problem. Sixty-nine percent of architects in Australia spend some of their work time on house projects and therefore improvements in this area can have significant impact on a considerably large portion of the profession. Habitus theory borrowed from sociology explains that the nature of architecture as a specialised activity places architects within an architectural habitus, distinguishing them from clients who are .not trained in the field. An underlying premise of thi s study is that a mismatch between the architect and client's habituses occurs as they enter into a relationship on the house project. This phenomenon is termed habitus shock, referring to the client 's experience of disorientation as they are confronted with an unfamiliar architectural habitus on the project. Culture shock theory is examined for its contribution to explain the process to which the client adjusts to the unfamiliar environment during habitus shock. The habitus shock model proposed in this paper suggests that the client may achieve learning during habitus shock and it is this client learning that can lead to successful relationships.

Client managment on house projects : faciliating client learning for successful architect-client relationships

This paper reports the findings of a study which examined architect-client relationships on house projects with a focus on the supportive role of architects in helping clients deal with project issues. Habitus theory explains that the nature of architecture as a specialised activity places architects within an architectural habitus, distinguishing them from clients who are not trained in the field, which is at the heart of the problematic architect-client relationship. An underlying premise was that habitus shock, that is, a mismatch between the architect and client's habituses Occurs as they enter into a relationship on the house project. Using the qualitative approach underpinned by the constructivist perspective for data collection and analysis, eight in-depth interviews were conducted across five case studies of successful architect-client relationships. The narrative inquiry approach was used to establish the extent to which habitus shock occurred and to describe the stages involved in the client's adjustment process during habitus shock. The findings indicate that habitus shock occurred on all five case studies, which resulted in client learning, enabling clients to function with competency in the unfamiliar environment. Client learning achieved during habitus shock was directly linked to the amount of difficulty experienced. This study has refined our understanding of the architect-client relationship on house projects by exploring more deeply client behaviour and the ways in which clients successfully deal with difficulties on house projects rather than simply identifying the uncertainties and conflicts that occur on projects. The findings demonstrate that client learning during habitus shock is a characteristic of successful relationships. One of the most significant outcomes of thi s study is that it demonstrated the potential to facilitate client learning during habitus shock to contribute to the development of successful architect-client relationships.

Transaction cost economics and industry maturity in it outsourcing: a meta-analysis of contract type choice

Recent reviews of the information technology outsourcing (ITO) literature report high variance in research results when Transaction Cost Economics (TCE) is used as the analytical framework. Informed by ITO market developments, including increasing commoditisation, market consolidation, and market transparency, we develop an explanation for these mixed results contingent on ITO industry maturity. We adopt meta-analysis to show that ITO industry maturity significantly explains variance in the choice of contract type (time and materials vs. fixed price) in ITO projects. Our results suggest that TCE is relevant to explain the choice of contract type in the emerging phase of the ITO industry, but not in its current mature phase. We conclude that a TCE-based analytical framework is not well suited for the study of ITO in the current mature industry phase. Instead, we propose that an "endogenous" ITO theory should be developed that focuses on differences in client behaviour rather than vendor behaviour.

Client fish ectoparasite loads and cleaner shrimp Urocaridella sp c hunger levels affect cleaning behaviour

Cleaning is a classic example of mutualism and determining the factors that maintain the balance between the costs and benefits for mutualist partners can assist our understanding of how cleaning relationships are maintained. Optimal foraging theory suggests two factors that might help to maintain the relationship between cleaners and their clients: client ectoparasite load and cleaner hunger levels. The ecological relevance and importance of foraging by cleaner fish in marine systems has been demonstrated repeatedly, yet there is little information available on this behaviour in cleaner shrimp. To determine whether cleaner shrimp base their choice of client fish on food patch quality (i.e. client fish ectoparasite load) we offered the yellow-beaked cleaner shrimp Urocaridella sp. c a choice of parasitized and unparasitized rock cods, Cephalopholis cyanostigma. To determine whether cleaner shrimp hunger levels influence cleaning time, we manipulated hunger levels in Urocaridella sp. c and examined their behaviour towards parasitized client fish. Cleaner shrimp preferred parasitized to unparasitized client fish and food-deprived cleaner shrimp cleaned parasitized rock cods more frequently than satiated cleaner shrimp did. Therefore, variations in client fish ectoparasite load and cleaner shrimp hunger level are two factors that affect the balance in this mutualism. Finally, our results meet some of the assumptions of biological market theory, a framework used to understand cooperative interactions, and thus this framework is suggested for future studies on this cleaning system.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Caution, helping may be hazardous: Client abuse, threats and assaults

The shooting of a social worker by a client on the Gold Coast in 1991 graphically illustrated the issue of physical assaults and violence by service users against social workers. In this article we look at the incidence of physical assault, threats of violence, abuse of agency property and verbal abuse to social and other welfare workers by clients, using data from a survey in Melbourne. We then look at probable causes of menacing behaviour, such as issues involved in work with involuntary clients' and we discuss options for preventing and coping with violence and abuse in the welfare work place.

Appraiser behaviour and appraisal smoothing: some qualitative and quantitative evidence

There is a substantial literature which suggests that appraisals are smoothed and lag the true level of prices. This study combines a qualitative interview survey of the leading fund manager/owners in the UK and their appraisers with a empirical study of the number of appraisals which change each month within the IPD Monthly Index. The paper concentrates on how the appraisal process operates for commercial real estate performance measurement purposes. The survey interviews suggest that periodic appraisal services are consolidating in fewer firms and, within these major firms, appraisers adopt different approaches to changing appraisals on a period by period basis, with some wanting hard transaction evidence while others act on ‘softer’ signals. The survey also indicates a seasonal effect with greater effort and information being applied to annual and quarterly appraisals than monthly. The analysis of the appraisals within the IPD Monthly Index confirms this effect with around 5% more appraisals being moved at each quarter day than the other months. More November appraisals change than expected and this suggests that the increased information flows for the December end year appraisals are flowing through into earlier appraisals, especially as client/appraiser draft appraisal meetings for the December appraisals, a regular occurrence in the UK, can occur in November. January illustrates significantly less activity than other months, a seasonal effect after the exertions of the December appraisals.

Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification

Background. Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. Method. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Results. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Conclusions. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

Care staff attributions toward self-injurious behaviour exhibited by adults with intellectual disabilities

Challenging behaviours may elicit negative emotional reactions and increase stress within care staff. The Leeds Attributional Coding System (LACS) was used to elicit spontaneous causal attributions of staff toward hypothetical clients with challenging behaviours. It was hypothesized that there would be relationships (1) between staff exposure to challenging behaviours and burnout, and (2) between staff cognitions and burnout. Using a cross-sectional correlational design, 41 care staff took part in a 10 minute interview about two vignettes depicting self-injurious behaviour. Staff also completed measures of demographic information and burnout. Participants made attributions toward self-injurious behaviour that were typically internal to the client, uncontrollable, unstable and specific.There was a significant association between number of clients cared for and emotional exhaustion and personal accomplishment. Staff who made fewer stable attributions had higher levels of burnout. There were no other relationships found between staff cognition and burnout. The LACS can be successfully employed in this context, and may have some benefits over other methods. Future research is required to explore the relationship between cognition and burnout.

Challenging behaviour profiles of people with acquired brain injury living in community settings

Primary objective: To determine the type and severity of challenging behaviours among a cohort of brain-injured persons referred to a community-based behaviour management service; and to determine whether different behaviour profiles were associated with aetiology of brain injury.
Methods and procedures: A sample of clients (n= 190) referred to the ABI Behaviour Consultancy for assessment and treatment of challenging behaviours was evaluated using the Overt Behaviour Scale (OBS) and other measures of disability and support needs.
Main outcomes and results: The most common challenging behaviour categories were, in order of frequency: verbal aggression, inappropriate social behaviours and lack of initiation. Clients typically exhibited four categories of challenging behaviour and multiple kinds of the behaviours represented by each category. There was some evidence of differences in occurrence of specific behaviours associated with aetiology of brain injury, particularly for hypoxia and alcohol-related brain injury.
Conclusions: A systematic assessment of challenging behaviours in community settings has revealed the profiles of broad behavioural disturbance that can occur following ABI. Assessing the breadth of disturbance is important in understanding a client's presentation and thus planning appropriate behaviour management interventions.

The client's complex decision-making environment on international mega projects

More than ever before, architectural, engineering and construction (AEC) firms are working on international mega projects. The mega project environment offers a range of opportunities for firms but is but is characterised by a high level of risk and uncertainty. International mega projects bring together networks of people with differing backgrounds and cultures to work in unfamiliar locations to integrate the social, economic, technical and political components of design and construction. Within such an intense environment there is a process of rapid relationship development at an unprecedented level. The interests and power relations on such projects are often very strong given the vast amount of money, jobs, environmental impacts, publicity and national prestige involved. Therefore in a field as costly or consequential as mega project design and construction there is an increased need to effectively manage these projects given the associated high risks of failure. Internationalisation is a relatively new field of research in the AEC sector and past research has tended to focus on explaining the attitudes and behaviour of the industry itself towards improving performance on such projects. To date there has been little research investigating the sophistication of the international client in terms of their regular business environment which is characterised by a set of social, economic and political responsibilities. The values that clients ascribe to their everyday practices and experiences inevitably condition how they act economically, which in turn impacts upon project decision-making. Clients establish the structural organisation of project teams through the procurement strategy and establish the context for effective decision-making. To a large extent they establish a unique culture that project team members need to work within and make decisions. Since clients establish the context within which firms operate the findings of past studies on the industry’s position and attitudes are more indicative than enlightening. Clients occupy a distinctly different position in the construction supply chain and therefore experience and respond to project matters based upon their environment and not the construction industry environment. Clients are confronted with uncertainties and need support to help them understand the critical role that they play in creating good decision-making environments. This theoretical paper seeks to develop a rationale for studying the client’s complex decision-making environment on international mega projects. Specifically it charts the quest for improved industry performance through client leadership as documented in various industry and government publications since the 1940s and highlights that there has been considerable attention to address industry problems through client leadership, however, with little evidence that the issues have been resolved. This paper is positioned within a PhD study, which seeks to move beyond the aspirations of policymakers and idealistic descriptions of how clients ought to behave to explain the reality of what really happens on mega project client decision-making based upon a critique of cultural political economy.

Client leadership capacity on international projects : exploring the client's complex decision-making environment through a critical cultural political economy lens

The global construction environment offers stakeholders a range of opportunities but is characterised by a high level of risks and uncertainty. Internationalisation is a relatively new field of research in the AEC sector and past research has largely focused on explaining the behaviour of the industry itself. To date there has been little research investigating the client's leadership role. Much effort has been placed on positioning clients towards overall industry performance improvement, however, with little emphasis on the client's capacity to undertake their role. Clients establish the decision-making environment through key early critical decisions including procurement strategy and team membership. To a large extent they establish a unique culture that project team members need to work within and make decisions, which is the social and cultural embedding of the economic activities on projects. This theoretical paper is positioned within a PhD study which undertakes a cultural political economy perspective to investigate the client's central role in setting the boundaries within which decisions affecting budgets, quality, design, project organisational structure and team membership throughout the project lifecycle come to be made. A conceptual model for client leadership on international projects is developed based upon two contextual indicators which seeks to describe and explain the economic decisions clients make, which are deeply embedded in social relationships, shared meanings and cultural norms and the associated power and influence clients have on the political economy of international design and construction practice. This paper also seeks to develop a research question for future empirical testing.

The content validity of the behaviour support plan quality evaluation tool (BSP-QEII) and its potential application in accommodation and day-support services for adults with intellectual disability

Background The quality of support provided to people with disability who show challenging behaviour could be influenced by the quality of the behaviour support plans (BSPs) on which staff rely for direction. This study investigated the content validity of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII), originally developed to guide the development of BSPs for children in school settings, and evaluated its application for use in accommodation and day-support services for adults with intellectual disability.

Method A three-round Delphi study involving a purposive sample of experienced behaviour support practitioners (n = 30) was conducted over an 8-week period. The analyses included deductive content analysis and descriptive statistics.

Results The 12 quality domains of the BSP-QEII were affirmed as valid for application in adult accommodation and day-support service settings. Two additional quality domains were suggested, relating to the provision of detailed background on the client and the need for plans to reflect contemporary service philosophy. Furthermore, the results suggest that some issues previously identified in the literature as being important for inclusion in BSPs might not currently be a priority for practitioners. These included: the importance of specifying replacement or alternative behaviours to be taught, descriptions of teaching strategies to be used, reinforcers, and the specification of objective goals against which to evaluate the success of the intervention programme.

Conclusions The BSP-QEII provides a potentially useful framework to guide and evaluate the development of BSPs in services for adults with intellectual disability. Further research is warranted to investigate why practitioners are potentially giving greater attention to some areas of intervention practice than others, even where research has demonstrated these others areas of practice could be important to achieving quality outcomes.

Dissemination of therapist-assisted internet cognitive behaviour therapy : development and open pilot study of a workshop

There is considerable research suggesting that therapist-assisted Internet cognitive behaviour therapy (ICBT) is efficacious in the treatment of depression and anxiety. Given this research, there is a growing interest in training students in therapist-assisted ICBT in order to assist with the dissemination of this emerging modality into routine clinical practice. In this study, we developed, delivered, and evaluated a therapist-assisted ICBT workshop for clinical psychology graduate students (n = 20). The workshop provided both research evidence and practical information related to the delivery of therapist-assisted ICBT. The workshop also incorporated an experiential component with students working on and discussing responses to client e-mails. Before and after the workshop, we measured knowledge of therapist-assisted ICBT research and professional practice issues, as well as attitudes towards and confidence in delivering therapist-assisted ICBT. Statistically significant changes were observed in all areas. Eighty-five per cent of students are now offering therapist-assisted ICBT under supervision. We conclude by discussing future research directions related to disseminating therapist-assisted ICBT.