Background: Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP) is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP’s as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder. Methods/design: Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews) will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the ‘black box’ of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes. Discussion: The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen design we want to examine how and which elements of the CC Program could contribute to a better quality of life for the patients.
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There is mounting evidence that efforts to mitigate the adverse effects of human activity on climate and biodiversity have so far been unsuccessful. Explanations for this failure point to a number of factors discussed in this article. While acknowledging cognitive dissonance as a significant contributing factor to continuing unsustainable practices, this article seeks to explore hegemonic rationality of industrial expansion and economic growth and resulting politics of denial. These politics promote the economic rationale for exploitation of the environment, with pursuit of material wealth seen as the most rational goal. Framed this way, this rationality is presented by political and corporate decision-makers as common sense and continuous environmentally destructive behavior is justified under the guise of consumer choices, hampering meaningful action for sustainable change. This article underlines forms of alternative rationality, namely, non-utilitarian and non-hierarchical worldview of environmental and human flourishing, that can advance sustainability. LinkedIn: https://www.linkedin.com/in/helenkopnina/
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This text is structured as follows. Section 1 concerns the background to this public lecture: the fact that social participation is becoming increasingly important in our society. This is evident, for example, from the way we are evolving from a protective welfare state into an activational, participative society. This development has consequences for the social sector and therefore also for the professionals who work in it. Social work professionals are not necessarily expected to identify or solve participation problems; they are seen as intermediaries who enable citizens to take responsibility themselves. Social work professionals are therefore expected to provide the individual applicant with less direct support and to focus more on strengthening the social networks of people and the social contexts in which they find themselves. Section 2 connects sections 1 and 3, but may also be read independently. It is about the fact that social work professionals are not yet in the habit of providing systematic insight into the results of their actions, while policy makers, for example, are increasingly looking to them precisely for this. First of all, I set out the reasons why it is so important to make the products of their interventions more visible, not only to policy makers, but also to social work professionals themselves and to the customers/citizens who depend on them. Secondly, I set out how the results of social interventions can be made more visible than they are at present; and what research can contribute. In this, I advocate a change in thinking: from thinking in terms of the evidence to thinking in terms of the evident. This argument forms the basis of the type of research that is being taken up from within the research group. In section 3, I describe a number of research projects that will be conducted during my tenure. I also set out the main proposition of this address, which states that social work professionals should do more with the knowledge that peoples behaviour is determined to a significant degree by contexts. In particular, social contexts could play a bigger role in promoting citizen participation. At present, social work professionals normally intervene directly in peoples behaviour, such as with therapies for combating problem behaviour. Interventions in a broader, social, context are rare. Why is this? And couldnt citizen participation be more effectively promoted by these means than through direct behavioural interventions? I put forward four propositions in this regard, and explain each of them in reference to one of the current research projects within the research group. With this, in combination with the general outlines of the research presented in section 2, I hope to provide a clear and inspiring overview of the research that will be carried out within the research group in the coming years. Finally, in section 4, I will discuss the significance of the research group to the faculty of Society and Law at Hogeschool Utrecht University of Applied Sciences, and to parties outside of Hogeschool Utrecht University of Applied Sciences.
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