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The training literature suggests that ongoing support (e.g., consultation) following initial training enhances training outcomes, yet little is known about the critical components of ongoing support and the lasting effects of ongoing support. The present study examined components of consultation calls that were provided to 99 community clinicians following training in the delivery of cognitive-behavioral therapy (CBT) for youth anxiety. The 104 recorded consultation calls were coded for content and consultative methods present. A subset of the training sample (N = 50) completed a 2-year follow-up interview during which they reported on their implementation rates of CBT since ending consultation. They also completed measures assessing CBT knowledge and attitudes toward evidence-based practices (EBPs). It was hypothesized that active learning (i.e., role-plays) would predict therapist adherence, skill, self-efficacy, and satisfaction at postconsultation, but regression analyses found no significant relation. However, level of clinician involvement during consultation calls significantly positively moderated the relation between active learning and clinician skill. Analyses of the follow-up data indicated (a) high implementation rates of CBT and (b) maintenance of overall attitudes toward EBPs, willingness to implement EBPs if mandated, views regarding the appeal of EBPs, and beliefs regarding the clinical utility of EBPs. A significant decline in CBT knowledge and openness toward EBPs was observed. Consultation call attendance positively predicted therapist CBT knowledge, overall attitudes toward EBPs, and attitudes regarding the appeal and clinical utility of EBPs at the 2-year follow-up. Implications, strengths and limitations, and future directions are discussed. / Psychology

Family businesses are a specific type of businesses that combine the family system with the business system. In this new system, emotions play an important role due to the long term relationships that exist amongst family members. This emotional component provides family businesses with unique advantages as well as challenges. Marriage and family therapists (MFTs) understand human relationships from a systemic approach. This specific training allows MFTs to be particularly well suited to help family businesses better deal with relational issues they might face by providing families with a different perspective for solution. Currently there is no consensus regarding the specific training MFTs should undergo in order to be better prepared to provide consulting services to family businesses. To meet this need, the purpose of this study is to identify the content for a model curriculum for MFT graduate students in family business consultation. A modified Delphi method with a mixed methods approach was used to obtain the content that a model curriculum should have. The Delphi method was used to obtain consensus on the opinions of MFT experts in family business consultation. A mixed methodology was used to triangulate the data obtained and to enrich the data gathered from a quantitative analysis. The results of this study show that marriage and family therapists wishing to pursue a career as family business consultants would benefit from additional training in the following specific areas: multidisciplinary theoretical approaches to understanding family businesses, consultation as a business, differences between consultation and therapy, and supervised practice. These results allowed the creation of curriculum components that could be used for a family business consultation course, workshops, and other educational events. Specialized training can help therapists provide better services to family businesses as well as an additional career avenue for the field of family therapy. / Ph. D.

Yes / Background: In older people living with frailty, polypharmacy can lead to preventable harm like adverse drug reactions and hospitalisation. Deprescribing is a strategy to reduce problematic polypharmacy. All stakeholders should be actively involved in developing a person-centred deprescribing process that involves shared decision-making. Objective: To co-design an intervention, supported by a logic model, to increase the engagement of older people living with frailty in the process of deprescribing. Design: Experience-based co-design is an approach to service improvement, which uses service users and providers to identify problems and design solutions. This was used to create a person-centred intervention with the potential to improve the quality and outcomes of the deprescribing process. A ‘trigger film’ showing older people talking about their healthcare experiences was created and facilitated discussions about current problems in the deprescribing process. Problems were then prioritised and appropriate solutions were developed. Review located the solutions in the context of current processes and procedures. An ideal care pathway and a complex intervention to deliver better care were developed. Setting and participants: Older people living with frailty, their informal carers and professionals living and/or working in West Yorkshire, England, UK. Deprescribing was considered in the context of primary care. Results: The current deprescribing process differed from an ideal pathway. A complex intervention containing seven elements was required to move towards the ideal pathway. Three of these elements were prototyped and four still need development. The complex intervention responded to priorities about (a) clarity for older people about what was happening at all stages in the deprescribing process and (b) the quality of one-to-one consultations. Conclusions: Priorities for improving the current deprescribing process were successfully identified. Solutions were developed and structured as a complex intervention. Further work is underway to (a) complete the prototyping of the intervention and (b) conduct feasibility testing. / National Institute for Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC)

Consulting with the public on planning issues has become an endeavour formalized throughout Western democracies over the past half-century. However, there remains a dichotomy between the legislative minimums for this part of the planning process and the extraordinary efforts of some municipalities. Inefficiencies emerge as attempts are made by many municipalities to implement the contributions received, exposing the potentially different objectives held by each of the major consultation players. Academics suggest that the rationale for consultation appears to have advanced to the point where its value is beyond question, but that the means and frequency for its conduct are not. The literature on the subject is further split between that which focuses on the process of consultation and that which centres on its outcomes. Correspondingly, the fairness of consultation exercises can be viewed from the procedural and distributive points of view. To date, academic study in this field has largely been conducted along qualitative lines. Using a combination of questionnaires, interviews and a focus group to triangulate data received from the major players, an answer was sought to the hypothesis that consultation players possess distinct objectives for this planning exercise. The results indicated that planners and the public do subscribe to separate views for the purpose of consultation, which bias their paradigms of the other parties. Isolating other factors regarding each of these cohort groups further suggested that time, geography, and education often limit the participation of citizens, while planners feel constrained by time, apathy among participants, the political processes and certain fiscal realities. Therefore, changes to planning legislation are recommended that would indirectly reduce the burden for each of the major players by conducting anticipatory consultation. Such measures would reverse the onus of participating while requiring a lesser investment of staff and resources from municipalities. Future research would test the validity of this approach and engage political figures as the final cohort in the triangle of planning participation.

Consulting with the public on planning issues has become an endeavour formalized throughout Western democracies over the past half-century. However, there remains a dichotomy between the legislative minimums for this part of the planning process and the extraordinary efforts of some municipalities. Inefficiencies emerge as attempts are made by many municipalities to implement the contributions received, exposing the potentially different objectives held by each of the major consultation players. Academics suggest that the rationale for consultation appears to have advanced to the point where its value is beyond question, but that the means and frequency for its conduct are not. The literature on the subject is further split between that which focuses on the process of consultation and that which centres on its outcomes. Correspondingly, the fairness of consultation exercises can be viewed from the procedural and distributive points of view. To date, academic study in this field has largely been conducted along qualitative lines. Using a combination of questionnaires, interviews and a focus group to triangulate data received from the major players, an answer was sought to the hypothesis that consultation players possess distinct objectives for this planning exercise. The results indicated that planners and the public do subscribe to separate views for the purpose of consultation, which bias their paradigms of the other parties. Isolating other factors regarding each of these cohort groups further suggested that time, geography, and education often limit the participation of citizens, while planners feel constrained by time, apathy among participants, the political processes and certain fiscal realities. Therefore, changes to planning legislation are recommended that would indirectly reduce the burden for each of the major players by conducting anticipatory consultation. Such measures would reverse the onus of participating while requiring a lesser investment of staff and resources from municipalities. Future research would test the validity of this approach and engage political figures as the final cohort in the triangle of planning participation.

Die Kommunikation mit den Kunden und insbesondere die Kundenberatung sind in Zeiten permanent hohen Drucks am Markt durch Mitbewerber wichtiges Marketinginstrument, mit dem die Kunden möglichst dauerhaft an das eigene Unternehmen gebunden werden können. Auslöser für die vorliegende Arbeit war die Idee zur Realisierung einer Kundenberatung mittels Videokonferenzsystemen im Jahr 2000 im Zusammenhang mit dem durch das Bundesministerium für Bildung und Forschung (BMBF) geförderte Forschungsprojekt „intermobil Region Dresden“. Durch diese Implementierung sollten Internet-Informations- und Vertriebssysteme durch eine Funktion der Individualberatung ergänzt werden und damit ein persönliches Beratungsgespräch möglichst realitätsnah abbilden. Da im B2C-Bereich die Echtzeitberatung über das Internet eine bis jetzt weitgehend ungenutzte Beratungsform ist, obwohl die dafür notwendigen Technologien schon seit Jahren zur Verfügung stehen, verspricht eine wissenschaftliche Untersuchung dieses Gegenstandes neuen Erkenntnisgewinn und ist gleichzeitig wichtigste Motivation für diese Arbeit. Hauptziel und somit grundlegende wissenschaftliche Fragestellung ist es zu untersuchen, ob synchrone Videokommunikation ein geeignetes Echtzeit-Beratungsmittel für die Kundenberatung (in diesem Zusammenhang als Videoberatung bezeichnet) sein kann. In der vorliegenden Arbeit werden über die Planung eines Video Call Centers und den damit verbundenen Modellbetrachtungen Einsatzszenarios für die Videoberatung entwickelt. In diese Entwicklung fließen die Ergebnisse aus der Einzelfallanalyse des implementierten Videoberatungssystems ein. Diese Ergebnisse werden auf Basis der durchgeführten Labor- und Feldforschung gewonnen. Die Wirksamkeit des analysierten Video Call Centers in Bezug auf die Kundenzufriedenheit wird abschließend durch eine Evaluation unterstrichen.

Thèse d'exercice : Médecine. Médecine générale : Paris 12 : 2006. / Titre provenant de l'écran-titre. Bibliogr. f. 97-106.