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This analogue study investigated the relationship between the "therapeugenic" (Bloom & Trautt, 1978) factors of attitude similarity and expertness on perceived trustworthiness of a confederate counselor. Several investigators have demonstrated that attitude similarity is positively related to perceived attractiveness, likeability and competence of counselors (Good, 1975; Griffitt & Byrne, 1970; Trautt, Finer & Calisher, 1980). There has been mixed support, however, for the notion that counselors who are perceived as "expert" will positively impact the counseling relationship (Brischetto & Merluzzi, 1981; Kunin & Rodin, 1982; Strong & Schmidt, 1970). The present study expanded previous research by jointly manipulating attitude similarity and perceived expertness to allow for assessment of both independent and interactive effects. Fifty-one undergraduate students participated. Attitude similarity between "client" and "counselor" was manipulated by prescreening subjects with an attitude survey consisting of controversial topics (abortion, military spending, capital punishment, etc.). Subjects who scored in the extreme conservative or liberal range of the survey were randomly matched with a confederate counselor whose introductory biographical sketch depicted him or her as attitudinally similar or dissimilar to the subject as well as either relatively experienced/expert or inexperienced/nonexpert in the field. The Counselor Rating Form (CRF) (Lacrosse & Barak, 1976) was utilized to measure the subjects' perceptions of counselor trustworthiness. The mini-intake interview consisted of a 10-minute meeting between confederate counselor and subject. A set of questions were formulated to approximate topic areas covered in a clinical intake interview. Each subject was interviewed by a same-sex confederate counselor. Following informed consent procedures, subjects were read a brief biographical sketch of the counselor who would be interviewing them. This sketch contained aspects of education and experience as well as community/research activities and interests conveying both the degree of "expertness" and "attitude similarity". Immediately following the simulated interview, subjects completed the CRF. Prior to the data collection, a three-part pilot study assessed reliability and validity of the attitude survey instrument and of the interview procedures. Test-retest reliability of the attitude survey yielded an r=.94. Questions from the "mini-intake" interview were rated for level of personal intrusiveness to insure that all subjects would be asked the same proportion of personal questions during the 10-minute interview. Finally, the four biographical sketches were rated- on the expert/nonexpert, conservative/liberal attitude dimensions to check their validity as stimulus materials. A three-way ANOVA was performed with liberal/conservative, attitude similarity, and expertness as the independent factors and perceived trustworthiness as the dependent measure. No significant main effects were obtained. Similarly, the three-way interaction was not significant. A significant two-way interaction effect was demonstrated, however, between Liberalism/Conservatism and Expertness/Nonexpertness. Specifically, conservative subjects rated the nonexpert counselors significantly higher on trustworthiness than did the liberal subjects, while liberal and conservative subjects did not differ in trustworthiness ratings of expert counselors. Results were interpreted in terms of the conservative concept of individuality and nonintervention (Monaghan, 1984). Possible implications for the counseling setting were discussed.

The purpose of this project is to improve case managers' personal effectiveness with clients, and to foster client-centred care. The project describes the plan for the development, implementation, and evaluation of a client-centred care curriculum for community case managers at the Hamilton-Wentworth Community Care Access Centre (CCAC). Client-centred care is really about how we treat one another, and is supported in the literature. For this project, client-centred care means: honoring personhood, communicating therapeutically, being reflective, setting goals with clients, and therapeutic use of self. The concept of therapeutic use of self is about how one uses oneself to help clients (Whall, 1988). The project describes implementation and evaluation of a therapeutic use of self workshop which is one component of the entire curriculum. The curriculum is guided by principles of adult learning, including self-directed learning, and transformative learning. The guiding theoretical frameworks for this project include: Miller and Seller's (1990) transaction and transformation education positions, the Leithwood-lnnovations Profile For Implementation (as cited in Miller & Seller, 1990), and Patton's (1997) Utilization-Focused Evaluation. Although this project has the potential to make a significant impact on case managers and clients, the curriculum has yet to be tested. Recommendations for use of the curriculum within the CCAC are provided. / Thesis / Master of Science (Teaching)

When developing client acceptance and retention policies and procedures, an audit firm's policy-makers are required to adhere to quality control and auditing standards established by the Public Company Accounting Oversight Board (PCAOB) and American Institute of Certified Public Accountants (AICPA) that are not well defined. As a result, the policies and procedures across firms may differ significantly. These differences arise from the development as well as the implementation of client acceptance and retention policies when evaluating prospective and continuing clients. My research study examines these differences in client acceptance and retention policies and procedures and also investigates the potential differences in policies and procedures across firms of different sizes (international, national, and regional). Using a qualitative setting, I interview risk management and local office partners across multiple firms to gather firm-specific and partner-specific information about client acceptance and retention policies and procedures. My results contribute to the existing literature on the processes and procedures developed by audit firms to assess and evaluate risks that may arise from prospective and/or continuing clients. / Doctor of Philosophy / Auditing standards provide requirements and recommendations for audit firms to follow when performing financial statement audits. These auditing standards also include both required and recommended procedures related to an audit firm’s decision to accept new clients and retain existing clients. Using a qualitative research methodology, I interview audit partners from five audit firms who are responsible for helping establish the firm-specific policies and procedures around client acceptance and client retention processes. I also interview partners from the same five audit firms who are responsible for performing those procedures when deciding whether to accept a prospective client or keep an existing client. I find that there are differences between the two partner groups as to the importance of certain client acceptance and client retention procedures. I also find that there are differences among the firms as well as the individual partners within each firm as to which procedures are key considerations in the client acceptance and retention processes.

Magister Public Health - MPH / Long waiting times have, for many years, been synonymous with primary health care in South Africa, and this is evident by the long queues and consistent client dissatisfaction. There are multiple contributing factors that exacerbate waiting time in Primary Health Care (PHC) facilities such as shortage of health care providers, increase in the uninsured population and South Africa’s quadruple burden of diseases. Health establishments have initiated numerous strategies to reduce long waiting times with varying degrees of success. These strategies have mostly been quantified and linked to indicators to measure their level of success in relation to quality healthcare. This research explores the clients’ perception of one such intervention, which is the implementation of an appointment system in primary care facilities in the City of Cape Town. Qualitative, exploratory descriptive methods were used to gain understanding of the impact the appointment system has had on the clients’ experience of attending health care services. The researcher also explored how clients perceive their role with regard to the shaping of their clinic’s appointment system. Semi-structured in-depth interviews were conducted with fifteen purposively sampled clients from five City Health clinics, who have implemented an appointment system through the guidance of the Appointment System Learning Initiative (ASLI). Maximum variation in sampling ensured the inclusion of small, medium and larger facilities within different geographical settings. Data analysis was done using a thematic coding approach, the themes were derived from the emerging data and were used to guide the researcher in gaining a rich picture of the clients’ experiences within the clinics. Ethical approval was requested and received from both the University of the Western Cape (UWC) and City Health prior to engaging any participants.

Thesis (M.S.)--State University of New York at Binghamton, Thomas J. Watson School of Engineeering and Applied Science, Department of Computer Science, 2009. / Includes bibliographical references.

Indiana University-Purdue University Indianapolis (IUPUI) / All participants of the Indiana Special Supplemental Nutrition Program for Women Infant and Children (WIC) receive supplemental foods, nutrition education, and health care referrals. The Indiana WIC program established an online nutrition education program to help eliminate barriers to participants who are unable to be physically present for their second nutrition education appointments. The aim of this study was to compare the participation of WIC participants enrolled in standard in-person appointments with WIC participants enrolled in the Online Nutrition Education (ONE) pilot program by assessing the completion of the ONE lessons and the cash value benefit usage at 3 months after participants’ acceptance into the WIC program. A quasi-experiment was performed using a time series comparison of WIC participant attendance at their in-person nutrition education appointment to participants completion of an online nutrition education lesson. A second comparison of the two groups observed the participants redemption of their cash value benefit on fruits and vegetables (CVB). The increase in participation from 2019 to 2020 was statistically significant (P=0.035). Analysis showed that there was a significant difference (P ≤ 0.001) between the 2019 and 2020 CVB mean redemption rates. This study provides evidence that WIC participants are more likely to maintain their participation when offered the addition of an online nutrition education appointment type.

This study explored the effects of counselor dress style and counselor and subject gender on clients' expectations about counseling. Two hundred fifty undergraduate students were given Tinsley's Expectations About Counseling questionnaire. Dress style was shown to have no effect on the expectations measured. Significant main effects were found for client gender, counselor gender and their two way interaction on the measures of responsibility, acceptance, confrontation, empathy, genuineness, tolerance, trustworthiness, concreteness, and immediacy. Post hoc analysis revealed that both male and female participants had higher expectations of female counselors than male counselors. Participants of both genders also expected female counselors to be more confrontive, genuine, trustworthy, concrete, and accepting than male counselors. They also had a higher expectation that counseling would address their immediate concerns.

Client outcomes in psychology training clinics have been shown to be generally worse than other outpatient settings. Although this finding has been repeatedly demonstrated, no consensus of cause has emerged in the literature. One possible explanation of such findings may relate to psychotherapist effects, a historically neglected variable that has received increased attention in more recent literature. Among psychotherapist effects researched, competency has emerged as a compelling factor worthy of more research. Given that most growth in competence occurs during graduate training, investigating the relationship between competency and client outcome offers great potential benefit for informing optimal training, nature of client symptom improvement, and a more accurate depiction of differences in psychotherapist effects across training and non-training settings. The purpose of this study was to explore the trajectory of competence development during doctoral training in health services psychology and to investigate the association of trainee competency to the psychotherapy outcomes evidenced by their clients. Practicum evaluations of 36 trainees and outcome data (using the Outcome Questionnaire-45.2) from 244 adult clients were included in analyses. Results of the study suggest there is a positive relationship between cumulative semesters of training and competency scores (rs[118]= .34, p < .001). Notably, there was no significant difference in psychotherapy outcome between low and high trainee competence. The results of the current study, relevant literature and limitations are discussed. Suggestions for future research are proposed.