A Study On Taiwan’s Management Consulting Industry ~ An Application Of The Structure-Conduct-Performance Analysis Student: Hui-Wen Chang Advisor: Dr. Yung-Chien Lou ABSTRACT Among the service industries, management consultancy is the most prominent due to its importance for the prosperity and competitiveness of enterprises. Therefore, the motivation of carrying out this study is to explore ways to facilitate the successful development of management consulting industry and ultimately revive Taiwan’s economy. The focus of this study is concentrated on the characteristics of Taiwan’s management consulting industry by understanding its evolvement path, current condition, composition of five competitive forces, and its organization economic model to discover the industry’s structure, behavior pattern of participants and overall performance. This study also aims at identifying fundamental causes of the industry’s long-lasting problems and factors that hinder the implementation of the most frequently proposed recommendations in the past two decades. Through the application of S-C-P paradigm and the feedback from industry experts, this study concludes that the most frequently raised pressing issues of Taiwan’s management consulting industry are actually symptoms of the industry’s unique structure with 88% of industry participants employed fewer than 10 people (i.e. the cause), which reflects the influence of the industry’s low entry barrier, as well as the nature of management consultation knowledge, mindset of consultants and clients’ behavior. And pertaining to factors hindering the implementations of most frequently proposed recommendations in the past 20 years, this study comes to the conclusion that lacking of legislation, characteristics of management consultation services, mindset of industry participants, and clients’ true needs are major issues adding difficulties to the execution of various recommendations proposed. Last but not least, this study also proposes several criteria to enhance the effectiveness of recommendations proposed by previous studies.

This research seeks to connect the philosophical focus of the agency-structure debate with the practice of management through a comparative study of organisational decision-making in situations involving stakeholder consultation. Set in the context of decision-making following an airport master plan consultation, the study considers how the stakeholder framework can be integrated within institutional theory using institutional logics as a theoretical link between these two literatures. This thesis, which adopts a critical realist perspective, takes a comparative case approach of four airports, each owned in different ways. Interviews with airport managers are supplemented by discussions with stakeholders and industry experts. Two sets of a priori themes were identified from the literature. The first focuses on the institutional logics prevailing in the field and their influence on managers as they make decisions. The second considers four decision-making strategies managers might employ in this situation. Findings centre on the causal powers acting upon airport managers as they make their decisions. Whilst normative isomorphic pressure enables stakeholder consultation, the coercive pressure on the decision-making process deriving from English planning law, the adversarial and oscillating nature of Central Government policy, and a mimetic response to the nature of local authority development plans constrain the actions of airport managers. Indeed, the current bureaucratic form of capitalism limits stakeholder contribution to final master plans. This research makes four main contributions: Firstly, reflecting upon the agency-structure debate from a critical realist perspective has facilitated development of a model integrating the stakeholder framework within institutional theory. Secondly, it improves our understanding of how stakeholder contribution is managed in master planning. Thirdly, the study adds to the growing body of work that employs a critical realist perspective. Lastly, since reconciling conflicting stakeholder opinions may well be of vital importance to the future of the UK’s airport infrastructure, this work has practical significance for airport managers, government policy-makers and stakeholders as they strive to formulate worthwhile airport consultations.

Visualisation of proposed plans and designs can be done with a number of differenttechniques within the field of architecture and urban planning. But which visualisationtechnique is best suited when presenting a design proposal at a public consultation? Is therea breaking point where the user can form a general understanding of the proposed designdepending on the degree of fidelity? To seek answers to these questions a qualitative studywas conducted where five different visualisation techniques were tested on ten users toassess their understanding of a proposed design. Our findings show that there is not asingle best visualisation technique for public consultation. Based on our results thepreferred alternative would be a combination of several techniques. We could also see thatthe general understanding of a space increased until a certain degree, and after that adeeper more detail oriented understanding was achieved.

A demanda crescente de usuários de implante coclear (IC) e a distribuição irregular de profissionais especializados no país, tornam necessário o deslocamento de pacientes por longas distâncias para os atendimentos, com consequente aumento dos custos diretos e indiretos do tratamento. A teleconsulta pode ser vista como uma alternativa em potencial para o acesso desta população a estes serviços. O presente ensaio clínico, randomizado, controlado, avaliou a eficácia da teleconsulta síncrona na programação dos sistemas de IC em usuários acompanhados em um Programa de Implante Coclear credenciado pelo Sistema Único de Saúde. Participaram do estudo 79 indivíduos com idades entre nove e 68 anos (média de 21,6), 41 do sexo masculino e 38 do sexo feminino, usuários de IC por um período de 0,58 a 24,75 anos. Estes indivíduos foram divididos em dois grupos, de acordo com o modo de programação do IC: controle (n=40), que realizou o procedimento face a face e experimental (n=39) que realizou a teleconsulta síncrona. Treze fonoaudiólogos sem experiência na programação do dispositivo atuaram como facilitadores das teleconsultas. Os procedimentos de programação do IC englobaram a telemetria de impedância, definição dos níveis de estimulação elétrica, varredura e balanceamento dos eletrodos e ajuste fino da programação. Como medidas de avaliação de resultados foram utilizados o tempo dispendido na consulta, a audiometria em campo livre, o percentual de reconhecimento de sentenças no silêncio e no ruído, o limiar de reconhecimento de sentenças no silêncio e ruído (HINT-Brasil), a avaliação da satisfação com a consulta (escala MISS-21) e de aspectos pertinentes à teleconsulta. Os facilitadores responderam as questões abertas referentes à suas impressões dos atendimentos. Os dados foram analisados por meio de estatística inferencial (testes t de Student, Wilcoxon, Mann-Whitney e correlação de Spearman). Os resultados mostraram que após a programação do IC, em média, os participantes apresentaram limiares audiométricos abaixo de 30 dB NA. O reconhecimento da fala pós atendimento, respectivamente para os grupos experimental e controle, foram de 81,3% e 83,8% (silêncio) e 57,9% e 58,1% (ruído). No HINT-Brasil os resultados foram, respectivamente, para os grupos experimental e controle 61,4 dB NA e 61,8 dB NA (silêncio) e relação S/R de 9,5 dB NA e 10,4 dB NA (ruído). Os participantes estiveram satisfeitos com a consulta. Não houve diferença estatisticamente significativa entre os grupos em nenhuma das medidas de resultado. Todos os participantes relataram que teleconsulta pode ser vista como uma alternativa viável ao atendimento face a face e sua aplicação clínica facilitaria a rotina de pacientes usuários de IC. Os facilitadores destacaram a sua importância para o aprendizado e como ferramenta de formação continuada. A teleconsulta síncrona foi eficaz na programação dos sistemas de IC e amplamente aceita pelos usuários e profissionais. / The growing number of cochlear implant (CI) users and the uneven distribution of specialized professionals in the country makes necessary patients traveling over long distances to receive care, with consequent increase in direct and indirect costs of treatment. The telehealth can be viewed as an alternative for this population to access such services. This clinical randomized, controlled clinical trial evaluated the efficacy of synchronous teleconsultation in the programming of CI systems in a Cochlear Implant Program accredited by the National Health System in Brazil. Participate in this study 79 subjects aged between nine and 68 years (average 21.6), 41 males and 38 females, CI users for a period from 0.58 to 24.75 years. The participants were divided into two groups, according to the nature of consultation: control group (n = 40), who performed the CI programming face-to-face and experimental group (n = 39) who performed the CI programming through the synchronous teleconsultation. Thirteen audiologists without experience in CI programming acted as facilitators of teleconsultation. The CI programming procedures encompassed the impedance telemetry, setting of electrical stimulation levels, sweeping and balancing of the electrodes and programming evaluation in live speech mode. The outcome measures were the time spent in consultation, free field audiometry, the percentage of sentence recognition in quiet and in noise, the sentence recognition threshold in silence and noise (HINT-Brazil), satisfaction with the consultation (MISS-21 scale) and aspects related to teleconsultation. The facilitators responded open questions regarding their impressions of the teleconsultations. Data were analyzed using inferential statistics (Student t test, Wilcoxon, Mann-Whitney and Spearman correlation). The results showed that after CI programming, on average, the participants had audiometric thresholds below 30 dB HL. The speech perception for the experimental and control groups post CI programming were respectively, 81.3% and 83.8% (in silence) and 57.9% and 58.1% (in noise). In HINT-Brazil the results were, respectively, for the experimental and control groups 61.4 and 61.8 dB (silence) and S/N ratio of 9.5 dB and 10.4 dB (in noise). Participants were satisfied with the teleconsultation. There were no statistically significant difference between the groups in any of the outcome measures. All participants reported that teleconsultation could be a viable alternative to facilitate CI users follow up routine. Facilitators emphasized the importance of teleconsultation for learning and for continuing education. The teleconsultation was effective in programming the CI systems and accepted by users and professionals.

Introdução: As consultas de seguimento com o profissional fonoaudiólogo após a aquisição da prótese auditiva são de extrema importância para a garantia da manutenção do uso com qualidade. As dificuldades enfrentadas pelos usuários no comparecimento ao serviço de saúde impedem que esse processo ocorra de maneira adequada e impactam negativamente no processo de reabilitação auditiva do indivíduo ocasionando, inclusive, o abandono do uso. A incorporação da teleconsulta nesses seguimentos seria uma solução para impedir a ocorrência de tal fato, por permitir que as intervenções de orientações e aconselhamentos sejam realizadas remotamente. Objetivos: desenvolver um programa de seguimento semipresencial para novos usuários de prótese auditiva e verificar sua aplicabilidade. Método: estudo prospectivo (exploratório), no qual dez indivíduos adultos novos usuários de prótese auditiva bilateral, pertencentes a um serviço público de saúde, foram avaliados e submetidos a uma consulta inicial, seguido pela teleconsulta e novamente avaliados numa última etapa presencial. As intervenções realizadas foram classificadas em primárias e secundárias. O questionário para avaliação da satisfação foi aplicado nas etapas presenciais e os dados obtidos pelos registros foram enviados para análise estatística descritiva. Resultados: todos os indivíduos necessitaram de pelo menos uma intervenção na consulta presencial inicial. A maioria esteve relacionada a orientações e aconselhamentos referentes ao uso e manuseio da prótese auditiva (consideradas intervenções secundárias). Na etapa da teleconsulta, todos os indivíduos precisaram de intervenções secundárias, diminuindo sua ocorrência na consulta presencial final. O questionário utilizado para verificar a satisfação apresentou média de escore global com valores de 5,7 na consulta presencial inicial e 6,1 na consulta presencial final, o que correspondeu à satisfação dos participantes. Todos os participantes atribuíram nota máxima ao programa desenvolvido, o que representou a \"muito satisfeitos\". Conclusão: O estudo traz contribuições para a área da Telessaúde em Fonoaudiologia, pois a utilização das teleconsultas permitiu a resolução de problemas secundários no processo de adaptação à prótese auditiva. Apesar dessa amostra ser reduzida, o estudo inicial foi satisfatório para a continuidade do programa demonstrado ser aplicável. Ainda estudos com maior amostra em diferentes populações são necessários com intuito de validar novos protocolos / Introduction: Follow-up visits with the audiologist after the hearing aid fitting process are critical to ensure the maintenance of quality use. The difficulties faced by users in adhering to sequential return visits directly affect this process in an inadequate way and negatively impact on individual auditory rehabilitation process, even causing the use abandonment. The inclusion of virtual assistance in these follow-ups would be a solution to avoid this situation, allowing interventions of orientations and counseling by remote consultation. Objectives: to develop a follow-up program combining face-to-face appointments and telehealth for new hearing aid users as well as verifying its applicability. Methods: prospective (exploratory) study evaluated ten new bilateral hearing aid users, seen in a public health service. The first and the last appointments were face-to-face and five followed-ups by virtual assistance. The required interventions were classified as primary and secondary. The questionnaire for satisfaction evaluation were applied during the face-to-face assessments and all registered data was sent for descriptive statistical analysis. Results: all study subjects required at least one intervention during the initial face-to-face visit. Most were related to provide informative counseling and to clarify new users\' doubts regarding the use of the hearing aid (considered secondary interventions). At telehealth assistance stage, all subjects required secondary interventions, reducing their occurrence in the final face-to-face assistance. The questionnaire used to verify the satisfaction showed an average overall score of 5.7 in initial stage and 6.1 in the final stage, which proved subjects\' satisfaction. All subjects attributed the maximum score to the developed program, which represented \"very satisfied\". Conclusion: The study contributes to Telemedicine, since the use of virtual assistance allowed the resolution of secondary problems in the hearing aid fitting process. Although this sample was reduced, the initial study was satisfactory for the continuity of this program which has been shown to be applicable. Further studies with larger samples in different populations are needed to validate new protocols

Ziel der vorliegenden Untersuchung ist es, zu versuchen, die Systemtheorie um die Möglichkeit der Einbeziehung von Bewusstseinsinhalten und den damit verbundenen teilweise für den Träger sehr irritierenden Emotionen zu komplementarisieren und wenn es möglich ist, zu erweitern. Die Vorteile der Systemtheorie für die Praxis sollen beibehalten und es soll geprüft werden, ob es möglich ist, die Systemtheorie auf ein erweitertes, erkenntnistheoretisches Fundament zu stellen. / Aim of this investigation is to try to alloy system theory to the possibility of including the content of the consciousness and the related partly very irritating emotions and if it is possible to expand the boundaries of system theory. The advantages of the system theory for the practice should be maintained and it should be examined whether it is possible to put the system theory on an advanced epistemological foundation.

Die vorliegende Arbeit beschäftigt sich mit der Tätigkeit konsiliarpsychiatrischer Dienste am Allgemeinkrankenhaus. In einem historischen Abriß wird zunächst die Integration des psychiatrischen Fachgebiets in die Allgemeinkrankenhäuser als wesentliche Bedingung für die Entwicklung der Konsiliarpsychiatrie am Beispiel der USA dargestellt, gefolgt von europäischen Perspektiven und der Entwicklung in Deutschland, unter besonderer Berücksichtigung der Psychiatrie-Enquête. Anschließend werden Aspekte somatopsychischer Komorbidät als Grundlage der Konsiliarpsychiatrie und ihre Implikationen für Diagnostik und Therapie skizziert. Vorschläge zur Bestimmung des Bedarfs der konsiliarpsychiatrischen Versorgung werden diskutiert. Das Spektrum konsiliar-liaisonpsych-iatrischer Versorgungsmöglichkeiten wird dargestellt, Interventionsmöglichkeiten mit ihren differentia specifica im Setting des Allgemeinkrankenhauses am Beispiel von supportiver Psychotherapie und Psychopharmakatherapie bei körperlich kranken Patienten werden verdeutlicht. Im empirischen Teil wird auf Grundlage einer Längsschnittstudie über einen 10jährigen Be-obachtungszeitraum eines amerikanischen, sowie einer Vergleichsstudie der Tätigkeit eines deutschen und eines amerikanischen Konsildienstes über einen einjährigen Beobachtungszeitraum versucht, einen Kernbereich konsiliarpsychiatrischer Tätigkeit am Allgemeinkrankenhaus zu definieren. In der Längsschnittuntersuchung wurde ein zeitüberdauernder Bereich konsiliarpsychiatrischer Tätigkeit identifiziert, der im Vergleich mit ähnlichen, allerdings weniger detaillierten Studien (Lipowski & Wolston 1981, Paddison et al. 1989) ebenfalls überwiegend Gemeinsamkeiten deutlich werden läßt. Auch die vergleichende Querschnittsuntersuchung zeigte, daß psychiatrische Konsiliartätigkeit über nationale Grenzen hinweg eine Reihe von Gemeinsamkeiten aufweist. Auch dies konnte im Vergleich mit anderen Studien bestätigt werden (vgl. Übersichten bei Hengeveld et al. 1984, Diefenbacher 1999, Huyse et al. 1997). Anschließend werden Veränderungen im Gefolge der Tätigkeit eines neu beginnenden psychiatrischen Konsiliars über einen einjährigen Beobachtungszeitraum untersucht und im Hinblick auf die Implementation eines Konsildiensten auf für die konsiliarpsychiatrische Praxis bzw. Interventionsforschung wichtige Parameter wie z.B. Zusammenarbeit mit den Stationsteams und Beeinflussung von Krankenhausverweildauer und Zeitintervall zwischen stationärer Aufnahme und Konsilanforderung diskutiert. Zusammenfassend wird ein Kernbereich konsiliarpsychiatrischer Tätigkeit beschrieben, von dem erwartet wird, daß er für die nahe Zukunft konstant bleibt und somit als Orientierungshilfe für administrative und evaluative Zwecke dienen kann. Abschließend werden Perspektiven weiterer Forschung in der Konsiliarpsychiatrie diskutiert und auf Aspekte der Fort- und Weiterbildung im psychiatrischen Konsiliar-Liaisondienst in der psychiatrischen Facharztweiterbildung, sowie auf Schnittstellen für eine mögliche Zusammenarbeit mit dem hausärztlichen Bereich eingegangen. / Psychiatric consultation-liaison (c-l) service delivery in the general hospital is the topic of this study. In the first part, an historical outline of the development of psychiatric c-l-services in the USA is presented, followed by recent developments in Europe and Germany, with special emphasis - for the latter - of the impact of the so-called "Psychiatrie-Enquête" (1975) on the implementation of psychiatric departments in general hospitals since the 1980s. The issue of somato-psychic comorbidity of general hospital inpatients, the very reason of existence of c-l-psychiatry, is discussed, as are its implications for diagnosis and treatment. Proposals for the evaluation of need for such services are presented, as is the scope of c-l-psychiatric interventions and their special nature with the example of supportive psychotherapy and psychopharmaco-therapy in the medically and psychiatrically ill inpatient. The second empirical part consists of a 10-year-longitudinal study of a c-l-psychiatric service in New York City, and a comparative cross-sectional study (over a 1-year-period) of a German and an American c-l-psychiatric service in order to delineate a common core of psychiatric c-l-service delivery in the general hospital. In both studies, a cross-national common core and a time stable course over time, respectively, are identified and then discussed in comparison to other less detailed studies (e.g. Lipowski & Wolston 1981, Hengeveld et al. 1984, Huyse et al. 1997). In addition, the implementation phase of a newly started psychiatric c-l-service is studied over a 1-year-period with regard to variables important for c-l-psychiatric intervention studies, such as influence on length of stay in hospital, lagtime between admission to hospital and day of consultation request, and cooperation with staff. In conclusion, a core field of psychiatric c-l-service delivery in the general hospital is identified, that is expected to remain stable in years to come and thus might help as an orientation for administrative and evaluative purposes. Finally, perspectives for further research in the field, for training and education, and for the cooperation with primary care doctors are discussed.

O desenho coletivo é utilizado como objeto mediador da intervenção institucional, de maneira semelhante ao squiggle game da consulta terapêutica, o desenho produzido pelo grupo facilita a comunicação entre os membros, promove associações livres verbais e gráficas, apresenta fantasmas, desejos e medos, comuns e compartilhados; informa sobre aspectos individuais e da instituição na associação discursiva e na produção pictográfica. A hipótese norteadora é que o desenho coletivo quando usado em um contexto de intervenção institucional, seja de diagnostico ou de tratamento, é um objeto mediador do diálogo no grupo. Devido ao acesso à representação e projeção de conteúdos inconscientes, o desenho manifesta conteúdos recalcados, aparentemente desconhecidos. Apresenta-se um histórico do desenho como linguagem nos primórdios da humanidade e a utilização e reflexão desde a medicina, pedagogia e psicologia. Valorizado para conhecer a alma infantil, posteriormente à psicanálise considera-o substituto da associação livre. Freud não aprofunda sobre o desenho como recurso terapêutico, mas mostra como usar o método psicanalítico na presença da imagem. De maneira semelhante ao sonho analisa o que se reitera, se condensa e desloca na imagem pictográfica. O primeiro desenho produzido no contexto vincular é descrito na Analise de uma fobia de uma criança de 5 anos, quando, da mesma maneira como Winnicott faz na brincadeira do squigglel game, Hans o pequeno paciente- introduz um traço para completar a idéia que deseja transmitir a respeito do tamanho do pênis da girafa. Na psicanálise de crianças, Winnicott e Dolto mostram caminhos para usar o desenho no processo terapêutico. Em contextos vinculares, poucos autores empregam o desenho no grupo como um recurso mediador do diálogo e do trabalho psicanalítico. Apresentam-se as contribuições teóricas para a psicanálise de grupo e instituição de autores como J. Bleger, E. Pichon Rivière, D. Anzieu e René Kaës. Identifica-se que no desenho é figurada a queixa, o inédito; detectam-se o aparecimento de traços, formas que enunciam e denunciam aspectos a serem destacados, trabalhados e elaborados pelo grupo no primeiro encontro. Um dos grupos apresentados era uma instituição que vivia várias queixas entre elas a equipe dividida, no encontro enquanto desenham surge uma ponte que une o que estava separado por um grande tronco: a equipe técnica da instituição de um lado e de outro o grupo de crianças e seus cuidadores. Outro caso descreve a intervenção da equipe de manutenção de uma empresa, que desenha um campo de futebol e no meio uma caveira, simbolizando o perigo de morte; o diálogo com os membros remete ao medo a serem demitidos. Os desenhos coletivos permitem que o psicólogo conduza e aborde, com facilidade, aspectos silenciados a partir de apontamentos de aspectos díspares, estranhos, repetitivos. / The collective drawing is used as the institutional interventions mediating object, in a similar way as the squiggle game of the therapeutic consultations; the drawing produced by the group facilitates communication among the members, improves free verbal and graphic associations, shows common and shared phantoms, desires and fears; informs about the individual and institutional aspects in the discourse association and in the pictographic production. The guiding hypothesis is that the collective drawing when used in a context of institutional intervention, whereas of diagnosis or treatment, it is a mediating object of the dialog in the group. Because of the access to the representation and projection of unconscious contents, the drawing expresses repressed contents, apparently unknown. We show a historical record of the drawing like the language in the beginnings of humanity, its used and thinking from Medicine, Pedagogy and Psychology. Initially Psychoanalysis valued it to know the childs psyche, after it considered a substitute of the free association. Freud doesnt deeper on the drawing as a therapeutic resource, but He shows how to use the psychoanalytic method with the image. As in a similar way like in a dream, Freud analyses what comes again, condenses and dislocates in the pictographic image. The first drawing produced in a bind context is describe in Analysis of a phobia of a child under 5 years, when, as in the same way like Winnicott does in the squiggle game, Hans the young patient- introduces a trace to complete the idea he wants to transmit in relation to the size of the giraffe\'s penis. In children psychoanalysis, Winnicott and Dolto show paths to use the drawing in the therapeutic process. In binding contexts, few authors utilize the drawing in the group like a mediating resource of the dialog and the psychoanalytic work. We show theoretical contributions for group and institutional psychoanalysis from authors like J. Bleger, E. Pichon Rivière, D. Anzieu and René Kaës. We identify that the complaint is figured in the drawing, the novel; we detect the emerging of traces, forms that enounce and denounce aspects to be underline, worked and elaborated by the group in the first encounter. One of the groups shown was an institution that experienced different complaints, among them the divided team, in the encounter while they draw it emerges a bridge that joins with a big trunk what was separated: the institutions technical team, by one side and a group of children and their care takers by the other. Another case describes an intervention in a companys maintenance team, that draws a football field with a skull in the middle of it, symbolizing the danger of death; the dialog with the members remits to the fear of being dismissed. The collective drawings permit that the psychologist lead and address in an easy way, silenced aspects by the pointing of despair, strange and repetitive aspects.

Background: Increased pressure, rising demand and cost constraints have driven a need for radical service re-design in the NHS. To deliver re-design objectives it is necessary to understand how they are perceived by service users and providers. Aim: To investigate the views of patients and health care professionals (HCP) on aspects of health policy and service re-design affecting primary care. Setting: Patients and HCPs from one geographical area in England. Method: Themes from phase one qualitative interviews were explored quantitatively using a questionnaire in phase two and a discrete choice experiment (DCE) in phase three. Factor analysis was used to explore HCP responses in phase two. In phase three the DCE was administered to explore patients‟ relative priorities of a range of attributes. Results: HCPs had concerns that the Quality Outcomes Framework (QOF) detracted from the patient‟s agenda and did not improve health outcomes. GPs felt continuity of care was important Monday through Friday but were not keen on its provision out of hours. Neither did they feel nurses could run chronic disease management clinics without a GP present. Patients felt continuity could be provided by different HCPs for different conditionsPatients stated continuity of care and consultation duration were the most important attributes in a primary care service. However, in the DCE they prioritised both being seen on the day and by a GP over longer appointments. Patient preference to be seen by a GP may reflect the low uptake of non-medical prescribing in the area. Conclusion: Continuity of care, while remarked as being important to both HCPs and patients, appears less important when weighted against other primary care service attributes. HCPs appear to want longer consultations whereas patients saw time as encompassing both the time to wait for an appointment and consultation length. For patients, the quality of the time with a HCP may be more important than its duration, additionally patients appear to want choice but not necessarily to choose.

Made available in DSpace on 2016-04-28T20:39:53Z (GMT). No. of bitstreams: 1 Rita Helena Cuce Nobre Gabriades.pdf: 737342 bytes, checksum: b07c08b4d810de238d4f54bc2ce2dd74 (MD5) Previous issue date: 2008-08-27 / The present work has originated from the researcher professional experience as an university professor of the Psychology Graduation Course, supervising the beginning of clinic practice probationary period for many years. It casts light in the possibility to reflect about the passage ritual of the first clinical consultations, that embraces the psychologist profession. The work consists of addressing the meaning of this experience on clinical consultation beginner trainees. The method has a phenomenological approach, aiming to address the feelings related to the clinical practice beginning. The trainee has been considered as an actor of a historic-socio-political context in which he/she lives, stressing the process of their continuous formation present on their experience perceptions discourse. Four trainee-therapists from a private university Applied Psychology Center in the City of Sao Paulo have been interviewed. They were on the 4th and 5th year of the Psychology Graduation Course, taking care of the Service School users for the first time. The study has focused the complexity of the trainees strategies to deeply live the passage ritual and its importance for the profession beginning. In the individual plan, it has been noticed the influence of supervisors and professors models as an endorsement to face this moment. Finally, it has concluded that is important to think the psychologist on his/her formation as compromised agents with the social reality / Iniciou-se esse trabalho a partir da experiência profissional do pesquisador como professora universitária no curso de Psicologia e que acompanha há vários anos estagiários no inicio da prática clinica, trazendo à luz a possibilidade de refletirmos sobre o ritual de passagem dos primeiros atendimentos clínicos, e que abraça ser psicólogo com profissão. O trabalho consiste em evidenciar o significado dessa experiência de estagiários iniciantes em atendimentos clínicos. O método teve a perspectiva fenomenológica, visando destacar os sentimentos relacionados ao inicio da prática clínica como participante do contexto histórico-político-social em que vive. Destacando o processo de formação contínua do estagiário no discurso de suas percepções desta vivência. Foram entrevistados quatro estagiários-terapeutas de um Centro de Psicologia Aplicada de uma universidade particular da cidade de São Paulo, que freqüentavam o 4º e o 5º ano do curso de Psicologia, atendendo pela primeira vez os usuários do Serviço - Escola. O estudo focaliza a complexidade dos recursos utilizados pelos estagiários para vivenciar o ritual de passagem e a importância do refletir sobre essa entrada na profissão. A importância no pensar o psicólogo e a formação como agentes compromissados com a realidade social. No plano individual pôde-se notar a influência de modelos dos supervisores e professores como respaldo para enfrentar esse momento