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The purpose of this paper is to explore the impact of project settings on empowerment experiences of individuals and teams by examining the effects of specific project characteristics on facets of the empowerment concept (i.e. the structural and psychological perspectives).

A parallel questionnaire survey of client, consultant and contractor organisations was conducted in Hong Kong to test hypotheses relating three facets of the empowerment concept and five project-level antecedents. Hierarchical linear modelling and ordinary least square regression were employed to test the hypotheses.

The analyses show that dynamic project environments, high project team integration and high interdependence of project tasks lead to high individual psychological empowerment, while public-client projects (compared with private-client projects), a hostile project environment and high client integration lead to a low individual psychological empowerment. Uncertainty in project technology also leads to high team psychological empowerment, while hostile project environments lead to low team psychological empowerment. Further, dynamic project environments lead to more empowering work climate, while hostile project environments lead to less empowering work climate. However, project team integration, project complexity, project lifecycle and quasi-public-client projects (compared with private-client projects) have no significant association with the empowerment of individuals and teams.

This study examined task-related factors (i.e. project in this case) which traditionally have not been the focus of studies examining the antecedents of empowerment. Further, project-level antecedents and their link to an integrated perspective of empowerment comprising a sociostructural perspective, a psychological perspective and a team-based perspective are examined, which is a significant departure from the unitary perspective of empowerment taken in most previous studies.

The purpose of the paper is to identify and describe the themes underlying four concepts: client orientation, client involvement, provider empowerment, and client empowerment, which have been reported in the literature as influencing service participant interaction in the formation of a service. The meaning that service participants assign to each of those themes is also to be examined.

Triadic studies were undertaken in two separate locations with three discrete community‐based service networks, purposively recruited from the same aged healthcare organisation. Using a phenomological approach, 29 individual semi‐structured in‐depth interviews with managers, providers, and clients were conducted. Inductive and deductive analysis was used to identify the emerging themes and their meaning for each participant category.

Key themes were identified for each concept, but the meaning ascribed to each theme was found to differ between the participant categories. It is suggested that these results reflect participant role differences in the service co‐creation process.

The findings are limited by the small sample and its relative homogeneity.

The findings offer service managers insights into how to engage clients in the service creation process, which in turn will affect the ultimate quality of the service that is created. They also provide information that will assist with service design, staff selection, training, and assessment.

This is the first study that investigates the four concepts, client orientation, client involvement, provider empowerment, and client empowerment, in the context of service co‐creation. It identifies associated abstract themes and the applied meaning differences of the service participants.

The concept of empowerment is very familiar to the human services world where the goal is to empower clients to manage their own lives as much as possible. In the corporate world, however, empowerment is a fairly new concept. There are issues involved in the infusion of empowerment into the corporate structure which are addressed in this paper. These include the process of developing an empowerment structure that will continue to function, the identification of qualified employees who can manage their workloads within an empowerment system, and the commitment of managers to empowerment as a way of meeting production goals. Within the human services system, empowerment is an accepted form of practice. The corporate world is trying to develop this practice in an era of downsizing and redefining of structures. This paper maintains that the development of empowerment found in human services can be transferred to the corporate system because the process of infusing empowerment into each system is relatively the same.

The purpose of this paper is to investigate microlending outcomes among Latin American non‐governmental organizations (NGOs), specifically microfinance institutions (MFIs). While there is a growing movement of non‐profit ventures channeling small loans to the poor worldwide, assessments of their impacts are lacking. Thus, field interviews with clients who had various degrees of involvement in the process of receiving microloans from MFIs were conducted over a summer in Guatemala.

Using a dataset of 393 clients from Guatemalan MFIs, microfinance impacts from two dimensions are examined and impacts measured along financial and social dimensions by surveying new clients, current clients, and graduated clients of five MFIs in Guatemala.

Applying univariate and multivariate analyses shows that for Guatemala, MFIs do produce a measure of improvement in the lives of microfinance clients. This improvement is concentrated along the social dimensions of housing, health, and client empowerment.

A limitation of this paper is that it focuses on only five of several dozen MFIs in Guatemala. What is needed is further use of the survey instruments to carry out subsequent studies throughout more of Latin America, and beyond.

This research suggests that microfinance demonstrates promising results associated with social benefits to various client populations. As such, it holds a variety of implications for government and other policymakers as they consider innovative ways to reduce poverty and human suffering around the globe.

It is anticipated that this field study will contribute to the furtherance of literature on the effects of lending among the poor.

Following a recent government initiated change to a consumer-directed care model across the Australian community aged care sector, the purpose of this paper is to explore frontline home support workers’ perceptions of relational changes with clients in power and subordination within the triadic relationship between employer, employee and client.

Contextual interviews were held with managers (n=4), coordinators (n=10) and semi-structured face-to-face interviews with support workers (n=17) in three organizations. Interview transcripts were analyzed.

Some workers did not perceive a power change in their relationships with clients. Others perceived minimal change but were concerned about the incoming client generation (baby boomers) that were more aware of their rights. Others felt subordinated to the client, perceived a loss of control or that felt treated like an employee of the client. Consistent with the philosophy of consumer-directed care, senior staff encouraged clients to treat workers in this way.

Further research is recommended on worker and client perceptions of relationships within the context of a consumer or client focused model.

A clear and realistic understanding of the locus of power within a triadic relationship by all actors is important for positive workplace outcomes.

The increasing ageing population makes it essential that workers’ relationships with clients and with their organization are unambiguous.

This study makes a contribution to theories about change and power transfer in the implementation of consumer-directed care through the perceptions of support workers. Examination of power and subordination transfer through the perceptions of the actors of rather than through the prism of organizational policy deepens the understanding of frontline service work and relationships.

Eliciting client narratives and creating community-informed interventions have been effective methods of engaging those who are unstably housed in care. Previous studies have shown that these approaches foster client empowerment and provide insight as to the importance of creating community-driven solutions. However, few studies report the impact of these methods on homeless people living with HIV. The purpose of this paper is to describe methods used to engage consumers in sharing their stories, including formative focus groups, qualitative interviews, and feedback from peer staff.

Data for the case study were derived from program notes, board minutes, and feedback from founding board members of The Open Door. Two researchers who were involved with the program from its inception reviewed these data and then developed a schematic of the methods used to develop and inform the program itself. The authors determined that three methods were used to elicit client and community narratives to inform program decisions. These include a formative focus group that helped to structure and implement the program in its earliest stages; qualitative interviews, which helped to pinpoint effective program components and enabled the rapid expansion of the service delivery model; and feedback from peer staff, which has consistently allowed for the refinement and prioritization of services. Data were collected for the purposes of program development and improvement but since qualitative interviews were conducted by faculty affiliated with an academic institution, the institutional review board of that institution was consulted and the qualitative interviews were determined to be exempt from review.

The focus group informed the authors that they wanted to live in their own apartments but have on-site supports. They also indicated that traditional housing program rules such as abstinence were too restrictive for them to navigate. In the qualitative interviews, the clients reported an increased sense of community with peers and peer staff members, which helped to reduce stigma. Second, residents reported that supportive services helped them to connect to and maintain in HIV clinical care. Third, residents reported that the representative payee services were a key factor in helping them improve housing and financial stability.

There are a number of limitations to this case study that demand the need for caution in interpreting results. Although the authors used several different methods to elicit client narratives and community feedback, sample sizes were small, control groups were not utilized, and data were specific to individuals receiving services through one housing program. Thus, results are not generalizable. In addition, the methods reported herein mix those conducted for the purposes of research (in-depth qualitative interviews) with others conducted specifically to inform program delivery and improvement (focus group and peer staff feedback). Thus, rigor is not equally applied across all methods. In addition, the individuals conducting research and authoring this paper were directly involved with the creation of the program and ongoing service delivery. Therefore, interviewer and reporting bias also present threats to validity.

There are many strengths involved in utilizing the narrative feedback of the residents and peer staff to inform the practice. One is that this method is an incredibly cost-efficient way to assess client and program needs to inform intervention development and improvement. The results are also very transparent and easily translatable to the agency’s everyday work. These methods are practical in both their approach to clients and their ability to be easily incorporated into the daily work of clients and staff. These methods allow for rapid application as results are immediate and feedback can be implemented quickly.

When seeking client and staff feedback, it is important to be cognizant of believing the client and recognizing that all people have their own personal perspectives, including their own version of the “truth.” Eliciting this type of feedback puts individuals in a vulnerable place, so it is critical to guarantee their safety. All information solicited must be regarded in a positive light to inform improved service delivery and not as a means to receive information that “tells on” clients or peer staff. Feedback should be reviewed as an opportunity for learning and not as a mechanism for retaliation.

The clients and staff have been significantly marginalized in the society. It is possible that having providers be kind and respectful to them and asking for their opinions is a very new experience which might make them feel grateful and more likely to be favorable in their responses. Clients may feel loyal to the program and be much more likely to speak of it positively. Regardless of these potential biases, the quantitative results of improved health outcomes published elsewhere indicate that the clients may not just be being nice, but may in fact be receiving interventions that are working.

Democratic therapeutic communities (TCs), use a “flattened hierarchy” model whereby staff and clients are considered to have an equal voice, sharing administrative and some therapeutic responsibility. Using the sociological framework of interaction ritual chain theory, the purpose of this paper is to explain how TC client members negotiated and enforced community expectations through an analysis of power within everyday interactions outside of structured therapy.

The study used narrative ethnography, consisting of participant observation with two democratic communities, narrative interviews with 21 client members, and semi-structured interviews with seven staff members.

The findings indicate social interactions could empower clients to recognise their personal agency and to support one another. However, these dynamics could be destructive when members were excluded or marginalised. Some clients used their interactions at times to consolidate power amongst dominant members.

It is argued that the flattened hierarchy approach theoretically guiding TC principles does not operate as a flattened model in practice. Rather, a fluid hierarchy, whereby clients shift and change social positions, seems more suited to explaining how the power structure worked within the communities, including amongst the client group. Recognising the hierarchy as “fluid” may open dialogues within TCs as to whether, and how, members experience exclusion.

Explorations of power have not specifically focused on power dynamics between clients. Moreover, this is one of the first papers to look at power dynamics outside of structured therapy.

This paper seeks to focus on the reflections of therapists who were working professionally in Chile during the time of human right violations in an attempt to inform and to develop ways of working professionally in similar circumstances around the world.

The paper draws on the experiences of therapists who were working in Chile at the time and extrapolates from these experiences to provide suggestions and guidance for other therapists who find themselves in similar circumstances.

After Dr Salvador Allende was overthrown, Chile was governed by a military dictatorship that engaged in massive human rights violations. From the reflections of therapists 30 years later, this paper summarizes some of the psychological consequences of the traumas that therapists faced when dealing with clients who were directly affected by the same trauma. This included feelings of terror following state treachery, amnesia, fear of political resistance and guilt.

Therapists in these countries are encouraged to seek the protection of international organizations who deal with human rights violations, work in professional groups rather than isolation, and when challenging human rights violations by conducting therapy, to work similarly to a resistance movement.

Therapists in countries where there is no repression should form professional alliances with their colleagues in these repressive countries to help protect them and provide support for their ongoing work.

This paper highlights the extreme danger that ensues for therapists who simply continue with their work during state sanctioned repression, and how this may be perceived as political statements against the repressive regime. Ways of dealing with this professionally are discussed.

While theories of complex service systems have advanced important insights about integrated care, less attention has been paid to social dynamics in systems with finite resources. This paper aims to uncover a paradoxical social dynamic undermining the objective of integrated care within an HIV care service system.

Grounded in a hermeneutic analysis of depth interviews with 26 people living with HIV/AIDS (PLWHA) and drawing on Bourdieu’s (1984) theory of capital consumption to unpack dynamics of power, struggle and contestation, the authors introduce the concept of the service labyrinth.

To competently navigate the service labyrinth of HIV care, consumers adopt capital consumption practices. Paradoxically, these practices enhance empowerment at the individual level but contribute to the fragmentation of the HIV care labyrinth at the system level, ultimately undermining integrated care.

This study enhances understanding of integrated care in three ways. First, the metaphor of the service labyrinth can be used to better understand complex care-related service systems. Second, as consumers of care enact capital consumption practices, the authors demonstrate how they do not merely experience but actively shape the care system. Third, fragmentation is expectedly part of the human dynamics in complex service systems. Thus, the authors discuss its implications. Further research should investigate whether a similar paradox undermines integrated care in better resourced systems, acute care systems and systems embedded in other cultural contexts.

Contrasted to provider-centric views of service systems, this study explicates a customer-centric view from the perspective of heterosexual PLWHA.

The purpose of this paper is to deal with the question of whether the expectations of improved effects due to governance reforms have been met in nine European Union (EU) countries and how they are associated with the specific characteristics of the governance of activation.

The paper distinguishes three types of effect: first, the process effects, like the treatment of unemployed people, their voice and choice when involved in activation and the individualized nature of the service provision process. Second, the paper looks at output effects (policy effort), which include the range (scope) and variety of the programs, the coverage and outreach (targeting) of programs and services to specific groups and service content and quality. Last, the paper is interested in the outcome/employment effects (gross and net) on job placement.

The authors conclude that the effects of the governance reforms are not unequivocally in favour of the reforms. This is a remarkable finding since all the countries that have been studied show similarities and to some extent converging trends in activation reforms. The reasons for this discrepancy between aims and effects are not easy to detect; nevertheless, implementation difficulties are one explanation and problems with adequate financing may be another.

The complex model of the effects of activation is combined with a governance perspective. This makes it possible to disentangle the effects of governance reforms to some extent. The findings may stimulate further research and orient policy making in activation.