L’écoute est considérée comme une variable déterminante de la réussite des vendeurs et sa pratique est dépendante de conditions justifiant une recherche sur la relation bruits-écoute. La revue de littérature conduit à définir précisément les concepts de bruits et d’écoute pour les étudier dans un domaine peu exploité : la télévente en centre d’appels. Une étude exploratoire permet de valider et de compléter les construits sélectionnés avant de proposer une conception multidimensionnelle de l’écoute. Cette conception enrichit la théorie par l’intégration de deux écoutes spécifiques : l’écoute adaptative et l’écoute assertive complétant ainsi les techniques d’écoute passive et active. Une typologie des bruits axée sur des bruits externes (bruits de plateforme), des bruits de mission (challenge) et des bruits internes (anxiété, conscience de soi) est retenue pour analyser l’influence des bruits sur l’écoute. Des variables individuelles sont également intégrées à l’analyse. Les résultats de l’étude mettent en valeur l’existence d’influences différentes suivant les bruits expérimentés : les bruits externes et de mission ont une influence négative alors que les bruits internes ont des influences positives et négatives. Ces conclusions permettent d’enrichir les travaux sur le processus de communication-négociation en se situant du côté du téléconseiller « écoutant » et d’envisager des implications managériales en faveur d’une relation client qualitative. / Listening is considered as a determining variable for salespeople’s success and its practice depends on conditions justifying a study on the relation noises-listening. The literature review leads to define precisely the concepts of noises and listening to study them into a field that is less exploited : telesales in call centers. An exploratory study allows to validate and to complete the selected constructs before proposing a multidimensional conception of listening. This conception enriches the theory through the integration of two specific types of listening : adaptative listening and assertive listening thus completing the types of passive and active listening. A typology of noises aimed at external noises (platform noises), mission noises (challenge) and internal noises (anxiety, self-consciousness) is selected to analyse the influence of noises on listening. Individual variables are also integrated in the analysis. The results of the study highlight the existence of influences that are different according to the noises experienced : external and mission noises have a negative influence whereas internal noises have both positive and negative influences. These conclusions allow to enrich the works on the communication-negociation process by positioning oneself near the “listening” telesalesman and to consider managerial implications for a qualitative customer relation

ABSTRACT Assertive Community Treatment (ACT) is considered the primary service-delivery vehicle for integrating individuals with severe mental illness into the community. Research on the model suggests that it has been helpful in aiding service users to achieve basic levels of integration including stabilized housing and maintaining financial and social security (Bond, Drake, Mueser & Latimer, 2001; Mueser, Bond, & Drake, 2001). However, critics of the model emphasize its limited success in enabling higher-order aspects of integration such as mainstream employment, recreation and socialization (Estroff, 1981; Gomory, 1998, 2001, 2002a, 2002b). These are fundamental criticisms given the significant investment in the model by policy makers. The rationale for the failure to promote higher-order integration typically rests on two central assumptions: a) service users are incapable of realizing full integration; and b) practitioners lack the training, skills, and philosophical base required to foster full integration. By focusing on the personal and professional characteristics of practitioners and service users, these views serve to obscure organizing structures operating at organizational, systemic, and social levels that encourage common ways of thinking about and carrying out community integration practice. The concern of this thesis is to explicate the impact of these organizing structures on the everyday practices engaged in by individual practitioners. In particular this thesis focuses on how practice becomes shaped by external structures that overrule both personal and professional values and intentions. The current study used the method of institutional ethnography to examine the impact of organizing structures of ACT in shaping how community integration practice is conceptualized, carried out, and accounted for on an everyday basis. The study findings are threefold. First, they suggest that organizing structures foster goals associated with protection as opposed to empowerment. Second, they reveal that organizing structures advance an individual-level focus over a social-level focus, prohibiting the community capacity building and environmental change necessary for fostering social autonomy and empowerment. Third, they show that organizing structures encourage practices discordant with integration, resulting in contradictory and therefore inconsistent attempts to facilitate higher-order aspects of integration. The power of these organizing structures is such that the personal and professional intentions of providers to facilitate broad community integration are consistently overruled within the context of everyday practice. The results of this study highlight the powerful role played by organizing structures in shaping community integration practice and provide an important theoretical model for planning, implementing, and evaluating models of service delivery for individuals with severe mental illness. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2007-09-27 15:10:26.391

In British Columbia, approximately 11,750 adults with severe addictions and/or mental illness are homeless. People who live with mental illness or the ill social or physical effect of substance use represent a sub population of people who experience homelessness. Many factors have contributed to poverty and homelessness among people who are mentally ill and to the neglect of their physical and mental health needs. A key factor has been the policy decision to de-institutionalize mental health services in British Columbia from the hospital to the community setting. Individuals living with mental illness were discharged from the hospital into the community, where housing is expensive and individuals have limited opportunities to earn an adequate income. Moreover, the community setting lacked the infrastructure to support and promote the health of severely mentally ill individuals. In the studied region, Assertive Community Treatment (ACT) teams have been established to work with individuals to break the cycle of homelessness, mental illness, and addiction as well as to support the improvement and maintenance of the mental and physical health of these individuals living in the community. Among the criteria for care by these regional teams is chronic homelessness caused by the barriers of mental health and addiction. In this grounded theory study, I explore how four regional ACT teams support their clients to maintain housing. In addition to examining the successes and challenges experienced by ACT team members, I consider the strengths of the team as they attempt to provide a supportive infrastructure that enables clients to maintain housing. Data were collected from four ACT teams in the region. The data collection involved two focus group discussions, three observational sessions with team members in the field, twelve one-on-one interviews, and a review of documents and reports. Data collection and analysis occurred concurrently, and guided further interviews. Through systematic analysis a theory was constructed form the data. In this study, I explore and analyze the issues that team members encounter and how they resolve them. I also take into account the beneficial outcomes of their complex work to produce a grounded theory explaining how ACT teams assist clients in maintaining housing. The knowledge gained during this study can be used to inform practice guidelines and policy development for the ACT teams. This study also contributes to the evolving body of knowledge that may strengthen provincial initiatives to break the cycle of homelessness. This work also contributes to current discussions on how to provide optimal housing support to individuals with severe mental illness and/or addiction issues. / Graduate / 0569 / 0573 / 0347 / shonalalonde@gmail.com

The purpose of this study was to determine, under experimental conditions, which of two treatments (overt or covert rehearsal in conjunction with instruction, live modeling and reinforcement) would help chronic schizophrenic undifferentiated type inpatients learn new assertive behaviors (volume of speech and gaze) and transfer them to unfamiliar situations in the laboratory.The research was conducted at Dayton Mental Health Center, Dayton, Ohio. The sample population consisted of 30 subjects who were randomly divided into three groups of 10 subjects each. The groups were Treatment I (overt rehearsal), Treatment II (covert rehearsal) and No-Treatment (control). All subjects volunteered for the study. They were screened with the Wolpe-Lazarus Assertiveness Training Questionnaire; however, the results were discarded because many scored lower than the desired range. Subjects were videotaped at the end of the study.The two treatment groups were conducted twice weekly for a total of eight sessions in one month. Each session lasted about 45 minutes. Positive reinforcers such as cookies and cigarettes were provided to encourage attendance. The group leaders were two pairs of male and female psychology assistants and trainees. All were qualified for their randomly selected tasks. The treatment consisted of eight behavior situations designed by the writer based on the Behavior Assertiveness Test - Revised (BAT-R). Attendance was imperfect during the sessions as some subjects occasionally resisted groups. Following completion of the treatment, only 27 subjects accepted to be videotaped for testing; three refused to be taped.A posttest-only design was used in this study. Posttesting consisted of videotaped responses to a confederate who presented four trained and four untrained situations. Two qualified psychologists collected data by rating the subjects' behaviors on the video tape. The specific behaviors, volume of speech and gaze, were rated on the Qualitative Rating Scale for both the trained and untrained situations across all three groups. The effects of treatment were analyzed through several statistical steps:1. Three t-tests on pairs were used to analyze means between trained and untrained situations for both treatment groups and the No-Treatment group.2. Two separate one-way analyses of variance were computed on volume of speech and on gaze across all three groups. Scores of trained and untrained situations were summed for each variable.3. Four separate one-way analyses of variance were computed for volume of speech and gaze in each of the trained and untrained situations across all three groups.The results were not statistically significant at the .05 level. Thus, there were no differences between the treatment groups and the No-Treatment group with respect to untrained situations. Also, there were no differences between treatment groups and the No-Treatment group in the learning of new behaviors. These findings did not lend efficacy to the treatments or instruments used in this study. It is possible that those treatments may not succeed with lower functioning subjects such as those used in this sample.Recommendations for future research were to include longer treatment conditions and to use more sensitive training and testing instruments. Other suggestions included familiarization of subjects with videotaping prior to posttesting, inclusion of more variables and the use of pre-post measures as well as follow up measures.

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An experiment was conducted to investigate the relative effectiveness of a combined behavior rehearsal anxiety relief conditioning paradigm with a more conventional behavioral rehearsal program in the treatment of deficient assertive behavior.

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<p>Idag riktas allt mer fokus i samhällsdebatten och i politiken på personer med</p><p>allvarlig psykisk sjukdom. Man debatterar dels hur samhället skall kunna tillhandahålla en</p><p>högkvalitativ vård och ett bra omhändertagande, men också ur ett samhällsekonomiskt</p><p>perspektiv. Den psykiatriska slutenvårdens kostnader är höga och debatten handlar ofta om</p><p>hur dessa kostnader skall kunna reduceras.</p><p>Denna studie vill titta närmare på om metoden Case management enligt</p><p>Assertive Community Treatment (ACT) kan bidra till att den psykiatriska</p><p>slutenvårdskonsumtionen minskar för personer med allvarlig psykisk sjukdom. För att</p><p>granska detta har intervjuer med fyra brukare använts där frågeställningen var fokuserad på</p><p>deras subjektiva upplevelser av att erhålla Case management enligt ACT under en period av</p><p>tre år. Vidare granskades skattningar enligt Kvalitetsstjärnan som utförts under en tre års</p><p>period. Därefter inhämtades statistik från databas avseende respondenternas konsumtion av</p><p>psykiatrisk slutenvård under tre år. Dessutom har artiklar i ämnet Case management kontra</p><p>psykiatrisk slutenvård granskats.</p><p>Resultaten av intervjuerna visade att respondenterna upplevt att Case</p><p>management enligt ACT hade varit viktigt för dem för att undvika psykiatrisk slutenvård.</p><p>Kvalitetsstjärnans resultat visade på en ökad livskvalitet, minskade besvär och detta i</p><p>kombination med en minskad konsumtion av psykiatrisk slutenvård. Vidare visade statistiken</p><p>från respondenternas psykiatriska slutenvårdskonsumtion att antalet inläggningar minskade</p><p>och antalet dagar som inläggningarna varade minskade också. Den dokumentation som</p><p>granskats i vetenskapliga artiklar visar att Case management enligt ACT är den metod som</p><p>bäst medverkar till att den psykiatriska slutenvårdskonsumtionen minskar.</p><p>Slutsatsen är att genom arbetssättet Case management enligt ACT tillsammans</p><p>med en hög programtrohet och validerade mätmetoder såsom Kvalitetsstjärnan kan den</p><p>psykiatrisk slutenvårdskonsumtion för personer med allvarlig psykisk sjukdom minska.</p><p>Nyckelord: Case management, Assertive Community Treatment, ACT,</p><p>Kvalitetsstjärnan, psykiatrisk slutenvårdskonsumtion.</p>

Idag riktas allt mer fokus i samhällsdebatten och i politiken på personer med allvarlig psykisk sjukdom. Man debatterar dels hur samhället skall kunna tillhandahålla en högkvalitativ vård och ett bra omhändertagande, men också ur ett samhällsekonomiskt perspektiv. Den psykiatriska slutenvårdens kostnader är höga och debatten handlar ofta om hur dessa kostnader skall kunna reduceras. Denna studie vill titta närmare på om metoden Case management enligt Assertive Community Treatment (ACT) kan bidra till att den psykiatriska slutenvårdskonsumtionen minskar för personer med allvarlig psykisk sjukdom. För att granska detta har intervjuer med fyra brukare använts där frågeställningen var fokuserad på deras subjektiva upplevelser av att erhålla Case management enligt ACT under en period av tre år. Vidare granskades skattningar enligt Kvalitetsstjärnan som utförts under en tre års period. Därefter inhämtades statistik från databas avseende respondenternas konsumtion av psykiatrisk slutenvård under tre år. Dessutom har artiklar i ämnet Case management kontra psykiatrisk slutenvård granskats. Resultaten av intervjuerna visade att respondenterna upplevt att Case management enligt ACT hade varit viktigt för dem för att undvika psykiatrisk slutenvård. Kvalitetsstjärnans resultat visade på en ökad livskvalitet, minskade besvär och detta i kombination med en minskad konsumtion av psykiatrisk slutenvård. Vidare visade statistiken från respondenternas psykiatriska slutenvårdskonsumtion att antalet inläggningar minskade och antalet dagar som inläggningarna varade minskade också. Den dokumentation som granskats i vetenskapliga artiklar visar att Case management enligt ACT är den metod som bäst medverkar till att den psykiatriska slutenvårdskonsumtionen minskar. Slutsatsen är att genom arbetssättet Case management enligt ACT tillsammans med en hög programtrohet och validerade mätmetoder såsom Kvalitetsstjärnan kan den psykiatrisk slutenvårdskonsumtion för personer med allvarlig psykisk sjukdom minska. Nyckelord: Case management, Assertive Community Treatment, ACT, Kvalitetsstjärnan, psykiatrisk slutenvårdskonsumtion.