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The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

This paper aims to illustrate by means of a case study how HKT-R Spider reference profiles of recidivists and non-recidivists may be supportive in leave decisions.

The authors describe what is known for recidivists and non-recidivists about changes in risk factors during treatment. The HKT-R Spider is introduced. By comparing a case study to group profiles, the authors illustrate how discussions about leave may be rationalised. From a study among 278 patients to explore the profiles, the authors report the inter agreement, and differences between recidivists and non-recidivists of the clinical HKT-R factors. Intra correlation coefficients, Wilcoxon signed ranks test and independent and paired t-tests are applied. To explore which combination of factors are discriminating between both groups, the authors also performed logistic regression analyses at six treatment stages.

The inter agreement reliability and internal consistency of the clinical HKT-R scale were acceptable to good in all six stages studied. The HKT-R Spider and profiles can be used to assist in evidence-informed decision-making about leave.

Globally recidivists had somewhat higher levels of clinical risk factors at all six decision moments, but the interpretation of HKT-R Spiders profiles should always be adapted to the individual’s context.

Applying the HKT-R Spider reference profiles on individual cases may structure and rationalize discussions lead to decisions based on clinical facts.

Borderline personality disorder (BPD) is a debilitating illness characterised by a pervasive pattern of emotional instability, interpersonal difficulties and impulsive behaviour in association with repeated self-injury and chronic suicidal ideation. People diagnosed with BPD also have high rates of co-occurring psychopathology, including disorders associated with disturbed impulse control, such as substance use disorder (SUD) and disordered eating behaviours. The co-occurrence of BPD and impulse control disorders contributes to the severity and complexity of clinical presentations and negatively impacts the course of treatment and recovery. This study qualitatively documents aspects of the lived experience and recovery journeys of people diagnosed with BPD and co-occurring SUD and/or disordered eating. This study aims to identify similarities with respect to themes reported at different stages of the recovery process, as well as highlight important factors that may hinder and/or foster recovery.

In-person, in-depth, semi-structured interviews were conducted with 12 specialist service consumers within a clinical setting. Ten women and two men (22–58 years; mean: 35.5 years) were recruited. Interview transcripts were analysed using thematic analysis principles.

As expected, participants with co-occurring disorders experienced severe forms of psychopathology. The lived experience descriptions aligned with the proposition that people with BPD engage in impulsive behaviours as a response to extreme emotional states. Key emergent themes and sub-themes relating to recovery comprised three domains: factors hindering adaptive change; factors assisting adaptive change and factors that constitute change. An inability to regulate negative affect appears to be an important underlying mechanism that links the three disorders.

This study highlights the potential shortcomings in the traditional approach of treating co-occurring disorders of BPD, SUD and eating disorders as separate diagnoses. The current findings strongly support the adoption of an integrative approach to treating complex mental health issues while concurrently emphasising social connection, support and general health and lifestyle changes.

The findings of this study contribute to the burgeoning BPD recovery literature. A feature of the current study was its use of in-depth face-to-face interviews, which provided rich, many layered, detailed and nuanced data, which is a major goal of qualitative research (Fusch and Ness, 2015). Furthermore, the interviews were conducted within a safe clinical setting with engagement facilitated by a clinically trained professional. There was also a genuine willingness among participants to share their stories in the belief that doing so would inform effective future clinical practice. Their willingness and engagement as participants may reflect their progress along the path to recovery in comparison to others with similar diagnoses. Finally, most of the interviewees were engaging in dialectical behavioural therapy (DBT)-style therapies; two were receiving mentalisation-based therapy treatment, and most had previously engaged in cognitive behavioural therapy or acceptance and commitment therapy-based approaches. The predominance of DBT-style therapy may have influenced the ways that themes were articulated. Future studies could supplement this area of research by interviewing participants receiving therapeutic interventions other than DBT for the treatment of BPD and heightened impulsivity.

We are currently experiencing, in western societies, a new reality in health systems, the emergence of an epidemic of chronic diseases, which test and raise new challenges to the health systems. This exponential increase in chronic diseases has not been accompanied by updated training of health professionals in this area. The chronic illness implies a bilateral relationship, of commitment and compromise for life, in which the involvement of the sick person must be the rule. The scope of therapeutic education (TE) is making the person autonomous and helping them to maintain or improve their quality of life. To treat patients with chronic disease, health professionals need to adapt their knowledge to their new role in the therapeutic relationship. As for the methodology, a participative observational methodology will be carried out with the training of health professionals who work in this area. It is a descriptive work based on studies and works published by the main schools working in this area, with emphasis on the School of Geneve. The purpose is to identify the problem of chronic diseases, the challenges that patients and health professionals face and how to build educational projects, exploring the use of educational tools, including digital technology.

A charity’s core purpose is legally mandated and delivery thereof is not a corporate social responsibility (CSR) activity which, by definition, is voluntary in nature. Any CSR activity not required by law should be “incidental” and be an outcome of a core purpose/object and not a focus of activity. The purpose of this study, therefore, is to address the lack of research into voluntary CSR activities conducted by charities so that charities might have a clearer operating platform and do not involuntarily contravene legislation.

This was an exploratory investigation using purposive sampling of senior leaders in UK charities. This study uses a case study approach to identify pragmatic areas of concern and also identify practical actions.

The conventional hierarchical ordering of Carroll’s CSR pyramid (1991) for profit-focussed organisations were found to be inconsistent with those for charitable organisations which were: ethical, legal, economic and philanthropic/voluntary/incidental.

This was an exploratory study and would benefit from further investigation.

Corporate social responsibility actions undertaken by charities need to be carefully evaluated to ensure that they comply with the core charitable purpose or are incidental.

Many employees in charities are motivated by social justice; however, they need to be cautious that they do not exceed the core purpose of the charity.

To the best of the authors’ knowledge, no research was identified which has addressed the fundamental issue of charities’ core purposes and the extent to which charities might legally undertake CSR activities.

Women are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines.

The study used a mixed-method design with pre and post-program surveys used to measure changes in participants’ recovery capital. Focused group discussions elicited participants’ context, their reactions, perceived outcomes and suggestions on the program.

Women in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities.

A limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program.

Given punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience.

This study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.

This study aims to examine the effects of coworker incivility on employees' behaviors using a moderated mediation model that conceptualizes coworker exchange (CWX) as a mediator and servant leadership as a moderator.

The data were collected using a multi-temporal research design. The hypotheses were tested on a sample of 1,272 participants using confirmatory factor analysis (CFA), hierarchical regression analysis and moderated path analysis. In addition, supervisor incivility was added as a control variable to partial out the potential influence on employees' behaviors.

The results of CFA ensured that all measures had discriminant and convergent validity. In addition, the results of hierarchical regression analysis and moderated path analysis indicated that CWX mediates the relationship between coworker incivility and employees' behaviors. Furthermore, servant leadership exacerbates the negative relationship between coworker incivility and CWX.

Leaders and practitioners should invest in communication training programs for developing employees' communication skills to avoid incivility. In addition to viewing incivility as inappropriate behavior, leaders and practitioners should understand the meaning beyond those incivilities.

This study utilized incivility spiral theory to examine how coworker incivility affects employees' behaviors. The mediated path analysis found that CWX mediates the relationship between these variables, which has been ignored by previous research. Furthermore, this study introduced servant leadership as a moderator to account for the “when” in incivility spiral theory, i.e. what kind of social context facilitates or inhibits the influence of coworker incivility on CWX.

The purpose of this research is to delve into the scientific literature on hotel housekeepers in family hotel businesses to suggest new research directions in this field.

This paper is based on a concise literature review to discuss the past and future of research on family hotel business.

Research on family hotel businesses and the relationships and working conditions of their employees is limited. Most studies are focused on family businesses in general, without specific emphasis on a particular sector, or a specific job within each sector, or the type of company within a sector.

This paper synthesizes existing research on family businesses, particularly family hotel businesses, to delve into work conditions in both fields. It seeks to establish connections with the job conditions of hotel housekeepers as a means of addressing some of the challenges they face in their working environment.

The most recent wave of the opioid epidemic in the USA has been complicated by a sharp increase in methamphetamine use. In addition, many people classified with opioid use disorder (OUD) and methamphetamine use disorder (MUD) present indications of psychiatric conditions. These diagnoses are also highly prevalent among people who are admitted to jails, but research conducted with this population is limited, due in part to the challenges associated with gaining access to local detention centers. This paper aims to examine the patterns of psychiatric conditions, OUD, and MUD among an understudied population to help inform the development of service delivery systems.

The present study was designed to assess the prevalence of OUD, MUD and common psychiatric conditions in a large sample of adults (n = 846) collected from four local jails. Diagnostic patterns were evaluated according to the current criteria established in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; American Psychiatric Association, 2013).

More than half (57.3%) of the sample met criteria for MUD, one-third (37.2%) exceeded the threshold for an OUD diagnosis and 15.7% were classified with both conditions. Participants who met criteria for both MUD and OUD were significantly more likely to experience symptoms of major depression [adjusted odd ratios (aOR) = 1.76, 9, confidence intervals (CI) = 1.16–2.67], post-traumatic stress disorder (aOR = 2.51, 1.64–3.83), panic attacks (aOR = 3.24, 95% CI = 2.05–5.13), obsessive compulsive disorder (aOR = 2.74, 95% CI = 1.66–4.51) and antisocial personality (aOR = 3.03, 95% CI = 1.97–4.64).

These results, which were derived from an understudied population of adults detained in local jails, indicate the co-–occurrence of MUD and OUD are associated with certain psychiatric conditions.