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Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present…
Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.
Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.
Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.
Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.
A number of recommendations concerning data collection and future service evaluations are made.
Returning to paid or unpaid activities has a high public health impact.
This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).
This chapter investigates the nature of the transformation of macroeconomics by focusing on the impact of the Great Depression on economic doctrines. There is no doubt…
This chapter investigates the nature of the transformation of macroeconomics by focusing on the impact of the Great Depression on economic doctrines. There is no doubt that the Great Depression exerted an enormous influence on economic thought, but the exact nature of its impact should be examined more carefully. In this chapter, I examine the transformation from a perspective which emphasizes the interaction between economic ideas and economic events, and the interaction between theory and policy rather than the development of economic theory. More specifically, I examine the evolution of what became known as macroeconomics after the Depression in terms of an ongoing debate among the “stabilizers” and their critics. I further suggest using four perspectives, or schools of thought, as measures to locate the evolution and transformation; the gold standard mentality, liquidationism, the Treasury view, and the real-bills doctrine. By highlighting these four economic ideas, I argue that what happened during the Great Depression was the retreat of the gold standard mentality, the complete demise of liquidationism and the Treasury view, and the strange survival of the real-bills doctrine. Each of those transformations happened not in response to internal debates in the discipline, but in response to government policies and real-world events.
The modern workplace contains many physical and interpersonal hazards to employee physical and psychological health/well-being. This chapter integrates the literatures on…
The modern workplace contains many physical and interpersonal hazards to employee physical and psychological health/well-being. This chapter integrates the literatures on occupational safety (i.e., accidents and injuries) and mistreatment (physical violence and psychological abuse). A model is provided linking environmental (climate and leadership), individual differences (demographics and personality), motivation, behavior, and outcomes. It notes that some of the same variables have been linked to both safety and mistreatment, such as safety climate, mistreatment climate, conscientiousness, and emotional stability.
In response to recent calls to better understand the brain’s role in organizational behavior, we propose a series of theoretical tests to examine the question “can brains…
In response to recent calls to better understand the brain’s role in organizational behavior, we propose a series of theoretical tests to examine the question “can brains manage?” Our tests ask whether brains can manage without bodies and without extracranial resources, whether they can manage in social isolation, and whether brains are the ultimate controllers of emotional and cognitive aspects of organizational behavior. Our analysis shows that, to accomplish work-related tasks in organizations, the brain relies on and closely interfaces with the body, interpersonal and social dynamics, and cognitive and emotional processes that are distributed across persons and artifacts. The results of this “thought experiment” suggest that the brain is more appropriately conceived as a regulatory organ that integrates top-down (i.e., social, artifactual and environmental) and bottom-up (i.e., neural) influences on organizational behavior, rather than the sole cause of that behavior. Drawing on a socially situated perspective, our analysis develops a framework that connects brain, body and mind to social, cultural, and environmental forces, as significant components of complex emotional and cognitive organizational systems. We discuss the implications for the emerging field of organizational cognitive neuroscience and for conceptualizing the interaction between the brain, cognition and emotion in organizations.
Over the last decades, the social sciences have become increasingly concerned with the role of the state and the politics of institutional restructuring. Within mainstream…
Over the last decades, the social sciences have become increasingly concerned with the role of the state and the politics of institutional restructuring. Within mainstream political science this has led to the development of a “state-centered” research program that emphasizes the autonomy of institutions. Marxist theory, however, has continued to adhere to a “society-centered” perspective, seeking to combine an ability to account for institutional change with the analysis of more structural social and economic forces. After some introductory comments that frame the problematic within which the paper is situated (Section 1), I discuss in Section 2 three of the most important recent Marxist attempts to construe the relation between socio-economic imperatives and political institutions. My argument is that Marxists’ attempts to relativize the autonomy of state institutions are too often still based on the postulation of an unexplained structural moment. This leaves them vulnerable to institutionalist claims concerning the autonomous nature of institutions. Section 3 proposes a different way of thinking the role of institutions in capitalist society. This approach breaks with a causalist, structuralist mode of explanation and relies on a more hermeneutic understanding of the role of institutions. I will shift the problematic to the relation between institutions and agency, arguing for a more pragmatist understanding of the role of institutions and an agency-based understanding of the formation of socio-economic imperatives. Section 4 concludes with some thoughts on the prospects held out, as well as the challenges faced, by the approach proposed in this paper.