Objective: A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the ehabilitation approach used. Methods: Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner’s perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. Results: The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. Conclusions: A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes. Findings suggest that it is important to discuss clients’ wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.
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Objective: A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the rehabilitation approach used. Methods: Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner’s perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. Results: The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. Conclusions: A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes.Findings suggest that it is important to discuss clients’ wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.
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The concept of a working alliance is rooted in psychotherapy and has been studied extensively in that field. Much less research has been conducted into working alliances between chronic psychiatric patients and their case managers. The aim of this review was to identify what is known about the working alliance between chronic psychiatric patients and their case managers. An extensive survey of the literature produced 14 articles for this review. The results of studies conducted show that a good working alliance has positive effects on the functioning of patients, and that the quality of the alliance depends on both patient characteristics and the behaviour of the case managers. The results also indicate that the working alliance is largely determined in the first 3 months of the contact. Further research into the development of working alliances is necessary.
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A good working relationship between clients and professionals increases the chances of better intervention outcomes for clients. A longitudinal cohort study was carried out amongst clients who were in touch with professionals from a Dutch social street work (SSW) organisation. We used a questionnaire to examine client perspectives (n = 332) on the relational and goal-oriented part of the working relationship after a minimum of 8 months of contact with SSW. We furthermore examined to what extent both parts of the working relationship were influenced by client characteristics and SSW metrics. Clients were asked to reflect on the relational part and the goal-oriented part of the working relationship. Clients who only met SSW professionals in public areas perceived a weaker working relationship in both aspects. A stronger relational and goal-oriented working relationship was perceived when receiving more practical support. Clients who had been in contact with an SSW professional for a long period of time perceived a weaker goal-oriented working relationship. This study shows that a working relationship, with both relational and goal-oriented aspects, can be established between workers and marginalised people in their daily environment. Frequent contact and providing practical support can improve both parts of the working relationship. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
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Background: People with severe mental illnesses (SMIs) have difficulty participating in society through work or other daily activities. Aims: To establish the effectiveness with which the Boston University Approach to Psychiatric Rehabilitation (BPR) improves the level of social participation in people with SMIs, in the Netherlands. Method: In a randomized controlled trial involving 188 people with SMIs, we compared BPR (n = 98) with an Active Control Condition (ACC, n = 90) (Trial registration ISRCTN88987322). Multilevel modeling was used to study intervention effects over two six-month periods. The primary outcome measure was level of social participation, expressed as having participated in paid or unpaid employment over the past six months, as the total hours spent in paid or unpaid employment, and as the current level of social participation. Secondary outcome measures were clients’ views on rehabilitation goal attainment, Quality of Life (QOL), personal recovery, self-efficacy, and psychosocial functioning. Results: During the study, social participation, QOL, and psychosocial functioning improved in patients in both groups. However, BPR was not more effective than ACC on any of the outcomes. Better social participation was predicted by previous work experience and a lower intensity of psychiatric symptoms. Conclusions: While ACC was as effective as BPR in improving the social participation of individuals with SMIs, much higher percentages of participants in our sample found (paid) work or other meaningful activities than in observational studies without specific support for social participation. This suggests that focused rehabilitation efforts are beneficial, irrespective of the specific methodology used.
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Review in het kader van COST Action IS1106 Working group 3 In the review below, we summarize resent empirical research about practising offender supervision in The Netherlands on six theme’s: 1. The roles, characteristics, recruitment and training of key actors in the delivery of offender supervision. 2. Interactions and relationships between key actors in the delivery of offender supervision and other relevant professionals. 3. The delivery/practice/performance of offender supervision. 4. The role of tools and technologies in the delivery of OS. 5. The management, supervision and/or regulation of practitioners and their practice. 6. Reflections / contextual issues Ongoing research is discussed in the descriptions of the different theme’s. We conclude with a short reflection about research on practising supervision in the Netherlands. The review is limited to studies about adults. Studies on community sentences have not yet been addressed, we will do this in the next version.
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De publicatielijst bevat alle publicaties waar Wilma Swildens aan bijgedragen heeft
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Change is endemic in modern society, and the educational systems that operate in it. In Higher Education societal trends such as globalization and economic rationalism are impacting on teachers. Changes in the student population, new educational methods derived from shifting perspectives on the role of knowledge and re-structuring of the organizations within which teachers work have also led to transformation of the professional context. At European level policy initiatives such as the Bologna Declaration (1999) have necessitated an overhaul of educational provision. This research project attempts to focus on these wideranging changes through the lens of teacher autonomy in order to establish what is changing in the working lives of teachers in a Dutch university, how they are responding to these changes and how they can be helped to respond to change effectively and discriminatingly. This is an insider research project, using case study and semi-structured interviewing to yield data that is subjected to thematic linguistic analysis. It was piloted in 2006, and interviewing was resumed in February 2007. Findings indicate the contested nature of teacher autonomy, and suggest that professional autonomy can impede as well as facilitate teachers in processes of engaging with change. The team - operating as a community of practice - is identified as the location where change agency can operate most effectively. Distributed leadership - specifically perceived in the activities of team leaders and teacher change agents - is seen as crucial to processes of embedding change in educational practice.
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The increased use of instruments for assessing risks and needs in probation should lead to intervention plans that meet the criteria for effective practice. An analysis of 300 intervention plans from the Dutch probation service showed that the match between the assessed criminogenic needs and the goals and interventions in the intervention plan is fairly low. It was also found that the so-called risk principle is not fully applied by probation officers. In addition, personal goals that the offender values are often not taken fully into account. Finally, the intervention plans have a strong focus on improving human capital, while improving social capital and basic needs often is not part of the intervention plans, even if they were assessed as dynamic criminogenic needs.
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This article describes the relation between mental health and academic performance during the start of college and how AI-enhanced chatbot interventions could prevent both study problems and mental health problems.
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