Empowerment versus power: consumer participation in mental health services

Consumer participation is regarded as increasingly important in the effective delivery of mental health services and for the empowerment of mental health consumers. In a qualitative study, 17 consumers and 10 occupational therapists discussed their perceptions of consumer participation in mental health services. These included the advantages and benefits of consumer participation, the barriers to participation and how health workers can facilitate participation. The research brought to light an uncertain relationship between empowerment and power. While empowerment was universally considered to be desirable, opinions about the transfer of power were more ambivalent. It is argued that consumers and health workers need to work together to find creative ways of addressing concerns relating to power so that real power can be shared to benefit all consumers. Limitations of the study included the small sample size and the sampling method, which restricted access to potential participants. Further research is suggested into consumer participation and consumer power. Copyright © 1999 Whurr Publishers Ltd.     

Human immunodeficiency virus/acquired immunodeficiency syndrome training from a union perspective.

The authors developed a union sponsored 2-day human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) "train the trainer" program for healthcare workers in the San Francisco Bay Area. The program incorporated the "education for action" approach in an effort to respond to the inadequacies in many traditional, institutional trainings. Service Employees International Union (SEIU) and Labor Occupational Health Program (LOHP) conducted the HIV/AIDS "train the trainer" program for approximately 100 healthcare workers in county public hospitals and community health clinics. After completing the program, these workers went back to their healthcare facilities, or community organizations, and led additional classes on HIV/AIDS transmission and prevention for approximately 600 more people. The goal of the program was to empower healthcare workers to: 1) identify the occupational risks associated with exposure to blood and potentially infectious body fluids at the workplace; 2) develop strategies to reduce those risks; 3) discuss their feelings about caring for an HIV/AIDS patient; and, 4) conduct HIV/AIDS workshops at the workplace.     

Utilizing the Clinical Social Work Model to Foster Collaboration Among HIV Providers in North Carolina

Abstract

This article demonstrates one effort to examine the applicability of client behavioral change models to medical provider and case manager behavioral change. The clinical social work model is used to explain the behavioral change process when providers were asked to utilize a voluntary and complex data management system to manage clients' HIV care. Through intense psychosocial support and training initiatives, providers were able to alter their behaviors so that they could successfully integrate new strategies and technologies into their practice while providing better quality care to their clients.     

The contribution of self‐help/mutual aid groups to mental well‐being

This article explores the contribution of self‐help/mutual aid groups to mental well‐being. Self‐help/mutual aid groups are self‐organising groups where people come together to address a shared a health or social issue through mutual support. They are associated with a range of health and social benefits, but remain poorly understood. This article draws on data from stage one of ESTEEM, a project which runs from 2010 to 2013. Stage one ran from 2010 to 2011 and involved participatory, qualitative research carried out in two UK sites. Twenty‐one groups were purposively selected to include a range of focal issues, longevity, structures and ethnic backgrounds. Researchers carried out 21 interviews with group coordinators and twenty group discussions with members to explore the groups' purpose, nature and development. Preliminary analysis of the data suggested that mental well‐being was a common theme across the groups. Subsequently the data were re‐analysed to explore the groups' contribution to mental well‐being using a checklist of protective factors for mental well‐being as a coding framework. The findings showed that groups made a strong contribution to members' mental well‐being by enhancing a sense of control, increasing resilience and facilitating participation. Group members were uplifted by exchanging emotional and practical support; they gained self‐esteem, knowledge and confidence, thereby increasing their control over their situation. For some groups, socio‐economic factors limited their scope and threatened their future. The article provides an evidence‐base which illustrates how self‐help/mutual aid groups can enhance mental well‐being. If supported within a strategy for social justice, these groups enable people with varied concerns to develop a tailored response to their specific needs. The authors suggest that policy‐makers engage with local people, investing in support proportionate to the needs of different populations, enabling them to develop their own self‐help/mutual aid groups to enhance their sense of mental well‐being.     

The Two-Part Film Technique: Empowering Dissociative Clients to Alter Cognitive Distortions and Maladaptive Behaviors

ABSTRACT

This paper describes and illustrates the two-part film (TPF) technique, an intervention characteristic of the Collective Heart model (Krakauer, 2001), a phase-oriented approach to treating dissociative disorders. Emphasis is on the technique's value in interdicting maladaptive interpersonal and intrapersonal patterns which perpetuate depression, anxiety, dissociation, and self-defeating behaviors. The approach is compared with similar internal screen techniques appearing in the hypnotic literature, and distinctive features of the TPF are noted. These include the minimally directive role of the therapist, reliance on the inner wisdom of the client, present and future orientation, and amplification of desired affective and somatic experiences. A verbatim clinical illustration is presented and discussed, with emphasis on the empowering impact of the TPF.     

Making and working of a new electronic resource for patients,carers and professionals: maxfacts.uk

Many maxillofacial patients have serious short, medium, or long-term problems, as well as having to make informed decisions about often life-changing interventions. Validated comprehensive information, at the right time and the right level for a diverse group of users (patients, carers, and professionals), is vital if patients are to make a serious contribution to their treatment. We describe the development of an online resource for this purpose. Maxfacts.uk aims to cover every aspect of oral and maxillofacial surgery and care, from neck dissection and ballistic wounds to physiotherapy and texture-modified foods.The principles of design, and the multilayered structure, interface, and functions of such a multiuser website are outlined, including accessibility and engagement. The maxfacts model and design could easily be adapted for other users with similar, complex, long-term needs.     

授权教育对慢性乙型肝炎患者生活质量的影响

目的探讨授权教育在慢性乙型肝炎患者健康教育中的应用效果,旨在推广授权教育的应用范围,提高慢性乙型肝炎患者的生活质量。方法 2013年9月至2014年2月,便利抽样法选择入住天津市第二人民医院的慢性乙型肝炎患者104例为研究对象,按随机数字表法将其分为对照组和观察组,每组52例。对照组患者在住院期间给予常规护理,观察组患者实施5次"一对一"的授权教育,60min/次。干预后,使用慢性病管理自我效能量表(self-efficacy for managing chronic disease 6-item scale,SES6G)、生活质量评价量表(MOS item short from health survey,MOS SF-36)对患者进行调查。分析比较两组患者干预前后的得分差异。结果经过干预调查后,观察组患者身体功能、躯体角色功能、躯体疼痛、总体健康感觉、精力、社会功能等6个维度评分都有所改善,与对照组相比,差异均有统计学意义(均P0.05)。观察组患者自我效能感高于对照组,差异有统计学意义(P0.05)。(P0.05)及生活质量(P0.05)。结论与常规护理健康教育相比,授权教育不但能促进慢性乙型肝炎患者的健康,而且能提高患者自我效能感和生活质量,值得推广。