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In the global world we live in, organizations have become progressively complex. “C” organizations have been replaced by “I” organizations, implying that we have moved from organizations permeated by a command, control, and compartmentalization orientation, to organizations distinguished by cultural signifiers such as interaction, information, and innovation. Effective teamwork will be essential to make these complex, highly diverse, increasingly virtual structures work.

Given the complexity of teamwork, this chapter discusses some of its benefits and drawbacks. Particular attention is given to possible team killers. Given the darker side of teams, a group coaching intervention technique is presented to resolve this daunting challenge. Taking this approach will help the members of a team to take control of their key team functions: setting direction, creating alignment throughout the organization, and building the commitment of everyone needed to accomplish organizational objectives.

To explore this intervention technique, the notion of the clinical paradigm is introduced, meaning using a psychodynamic-systemic lens that focuses not only on what is directly observable, but also on out-of-awareness behavior. The five premises that characterize the paradigm are described. It is suggested that applying the clinical paradigm within group coaching setting helps to tease out the central interpersonal role in which executives consciously and unconsciously cast themselves. It also helps explore the complementary roles they take on in an executive role constellation, creating tipping points for change. In addition, a number of other intervention techniques are introduced that help foster change.

The new NHS White Paper (DoH, 1997) provides for a new legal duty of quality for chief executives in Trusts. Clinical governance is seen as a central tenant of this legal duty which is designed to raise clinical quality to the same level of importance as corporate governance.

Finance has begun to utilize clinical approach in its research. The extent of its appropriate use is a serious point for consideration. Any adequate use of a research methodology would highly benefit from a deep understanding of its underlying worldview. This paper, therefore, discusses how worldviews underlie methodologies in general, and those of finance, in particular. It starts with a discussion on how any worldview can be positioned on a continuum formed by four basic paradigms: functionalist, interpretive, radical humanist, and radical structuralist. Next, the paper focuses on methodologies implied by the functionalist and interpretive paradigms, namely: scientific and clinical, respectively. Then, it notes that mainstream finance adheres to the functionalist paradigm. It examines how mainstream functionalist finance intends to use the interpretive clinical approach in its research. While this step towards a more balanced approach to research in finance is appreciated, the paper points out that clinical approach can be appropriately used only if certain fundamental, contextual, paradigmatic assumptions are met.

The independent living (IL) movement is a social movement but also an analytic paradigm which can be used to inform and shape rehabilitation research and practice. The purpose of this paper is to describe how the principles of DeJong’s IL paradigm have been used to develop a guiding framework for the Burwood Academy, a rehabilitation and disability research organisation in New Zealand. The Burwood Academy drew on the consumer empowerment principles inherent in DeJong’s IL paradigm, whereby the person learns to take control of the rehabilitation process, on which to promote consumer empowerment in all of the Academy’s endeavours.

This paper reports on three investigative phases of work: a stakeholder dialogue, a narrative review and a benchmarking exercise that collectively enabled the development of a working framework based on DeJong’s IL paradigm.

This paper highlights pragmatic strategies that are used to better promote consumer inclusion in the research process, build researcher capacity among consumers and clinicians, and promote knowledge translation through a range of tertiary and clinical education forums.

The results of this study identified numerous ways to promote consumer empowerment in research. Future research is needed to explore the effectiveness of the proposed framework further.

This paper suggests potential avenues to address the complexities of promoting the role of the “expert consumer” imbedded in clinical environments where this is not usually a priority in training and practice of health professionals.

This paper fulfils an identified need to study more pragmatic ways to promote consumer empowerment in both clinical and research settings.

Evidence‐based medicine (EBM) is a technical and scientific paradigm in clinical practice that has delivered major improvements in the outcome of care in medicine and surgery. However, its value in psychiatry is much less clear. The purpose of the paper is thus to examine its value by subjecting empirical evidence from EBM to a conceptual analysis using the philosophy of Thomas Kuhn.

The authors examine evidence drawn from meta‐analyses of RCTs investigating the efficacy of specific treatments for depression in the form of antidepressant drugs and CBT. This shows that the non‐specific aspects of treatment, the placebo effect and the quality of the therapeutic alliance as seen by the patient, are more important in determining outcome than the specific elements (active drug, specific therapeutic elements of CBT).

Using the philosophy of Thomas Kuhn, it is shown that these non‐specific and non‐technical elements are anomalies that indicate that the technological paradigm in the treatment of depression is fundamentally flawed.

Non‐specific elements of mental health care are essential in fostering hope, trust and meaning. They constitute non‐technical factors that are central to the concept of caring, and vital for recovery, and which resonate strongly with the growth of survivor and user‐led systems of support for people who experience distress and madness. As such they pose a major challenge to scientific psychiatry and mental health services based in this. The analysis has major implications for the primacy of the natural sciences in the education and training of those involved in mental health work, and demonstrates the importance of an open debate about the value of the scientific imagination in mental health work.

This paper is important because it supports user‐led self‐defined notions and understandings of recovery, and does so using a philosophical conceptual analysis.

This conceptual analysis is highly original. To the authors' knowledge no one has subjected EBM to a detailed conceptual analysis using the ideas of Thomas Kuhn.

To see how educational philosophies that underlie lecture and case methods of teaching are related to how faculty perform their teaching, research, and service.

This paper is based on the premise that foundational philosophies, worldviews or paradigms underlie educational philosophies, and each educational philosophy favors a certain instructional methodology, which in turn implies a certain way or method of instruction.

The findings of this paper are that each educational philosophy favors a certain instructional methodology, which in turn determines not only the way that the instruction is performed but also how faculty perform their teaching, research, and service.

This paper implies that differences between the underlying world views of lecture and case methods of teaching similarly lead to differences in many other aspects of the teaching and learning process.

This paper implies that, in practice, faculty would perform their teaching, research, and service in a more consistent manner if they become consciously aware of the underlying philosophy of their teaching method.

The original contribution of this paper is that it shows how in a systematic manner the differences in teaching philosophy lead to differences in what faculty do in all areas of their activities: teaching, research, and service.

To examine the importance of appropriate education for health services managers and to identify what might be included in the curriculum for health services management education.

The paper approaches these two questions through an exploration of the distinctive characteristics of health services as a context for management, relating these to a less context‐specific literature on management education. The case for health services management and a description of the ideal curriculum are both developed from this analysis. The analysis is based on the UK but much of it will be applicable to other national settings.

Health services as a context for management practice are made distinctive by the circumstances of working in close proximity to clinical professionals and dominance of evidence‐based practice as a paradigm for the clinical professions. Professionalism is weak as a governing concept for managers and health is often a politicised context for management, especially in publicly owned systems like the UK National Health Service. Management education for health services managers is important for improving systems performance and should offer a broad curriculum that includes the context for practice; research awareness and skills of critical appraisal; a grounding in a range of disciplines and a reflective approach towards general management skills.

Greater value should be attached to health services management education and a systematic approach taken towards curriculum development.

The analysis presented leads to the conclusion that health services management requires a broad curriculum reflecting the rich experience that health services management can offer as an occupation. As the power and influence of managers and managerialism in health care continues to grow, so it becomes all the more important that what is required for their education is questioned and value attached to providing opportunities for that education.

A novel integrated staffing model for community-based residential rehabilitation services is described. The purpose of this paper is to achieve synergistic gains through meaningful integration of peer support and clinical workers within rehabilitation teams. Key features include the majority of roles within the team being held by persons with a lived experience of mental illness, the active collaboration between peer and clinical workers throughout all stages of a consumer’s rehabilitation journey, and an organizational structure that legitimizes and emphasizes the importance of peer work within public mental health service delivery. This staffing model is not anticipated to alter the core rehabilitation function and service models.

The emergence of the integrated staffing model is described with reference to the policy and planning context, the evidence base for peer support, and the organizational setting. A conceptual and contextualized description of the staffing model in practice as compared to a traditional clinical staffing model is provided.

There is a potential for synergistic benefits through the direct collaboration between horizontally integrated peer and clinical specialists within a unified team working toward a common goal. This staffing model is novel and untested, and will be subjected to ongoing evaluation.

The integrated staffing model may provide a pathway to achieving valued and valuable roles for peer workers working alongside clinical staff in providing rehabilitation support to people affected by serious mental illness.

This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital accounting and clinical medicine in Britain between the late 1960s and the early 2000s.

The paper draws on an analysis of professional journals, government reports and other documentary sources relating to accounting and medical developments. It is informed by Abbott's sociology of professions and Eyal's sociology of expertise.

The paper shows that not only accountants but also elements within the medical profession sought to make the practice of medicine more visible, calculable and standardized, and that accounting and medical attempts to make medicine calculable interacted in a mutually reinforcing manner. Consequently, it argues that a movement towards clinical forms of quantification within the medical profession made it more open to economic calculation, which underpinned hospital accounting reforms and the accountingization, colonization or hybridization of health services.

The paper demonstrates that a fuller understanding of the relationship between accounting and public sector professions can be developed if we examine their mutual interactions rather than restricting ourselves to analyzing accounting's effects on public sector professions. The paper moreover illustrates instances of intraprofessional conflict and inter-professional cooperation, and draws on the sociology of expertise to suggests that while hospital accounting reforms have curbed the power of medical professionals, they have also enhanced the power of clinical expertise.

The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.

The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.

The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.

Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.