‘Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home‐care services. The aim of this article is to analyse ‘client involvement’ in practise seen from the positions of healthcare professionals, an elderly person and his relative in a home‐care setting. A sociologically inspired single case study was conducted, consisting of three weeks of observations and interviews. The study has a focus (...) on the relational aspects of home care and the structural, political and administrative frames that rule home‐ care practice. Client involvement is shown within four constructed analytical categories: ‘Structural conditions of providing and receiving home care’; ‘Client involvement inside the home: performing a professional task and living an everyday life’; ‘Client involvement outside the home: liberal business and mutual goal setting’; and ‘Converting a home to a working place: refurnishing a life’. The meaning of involvement is depending on which position it is viewed from. On the basis of this analysis, we raise the question of the extent to which involvement of the client in public home‐care practice remains limited. (shrink)

This book focuses on the client issues which are now becoming an integral part of the work of all practising solicitors. It focuses on the pro-active way that will enable the practising solicitor. as well as the new entrant to the profession. to learn and apply techniques and work practices that will help to ensure that the needs and perceptions of clients are satisfied regularly and systematically. This is set out in simple. practical and realistic stages throughout the book. (...) The author suggests that solicitors and law firms adopt a new and exciting strategy which focuses everyone in the firm. from senior partner to office junior. on meeting and exceeding client expectations. (shrink)

Internet based process control usage has grown in the past years. Industry field demands were behind this, and it ranges from factory, office and home automation to tasks simplifications and cost reduction. In this book a hardware interface circuit and a software system used to control the temperature and level of a liquid tank is described. The advantage of the designed interface circuit is its simplicity and low cost. The same can be true for the software system in which we (...) used C and Java programs to accomplish the communication. Both C and Java can be obtained freely and the development cost could be small. C language has been used to communicate with the designed interface circuit due to its strength in low level operations and communication with ports and hardware. In Java we have used mainly the Servlet for communication between the Client and the Server, which is a new approach and more reliable approach than the CGI based method that has common problems of speed and data persistence. This book is useful for people and researchers working in the field of control, remote access and computer based control. (shrink)

An important part of the student nurse’s training involves reflection on practice, as expressed in written assignments and seminar discussions. In this, students make use of material drawn from their work with clients. A key ethical question is, therefore: should clients’ permission be sought by students for this use of case material in coursework assignments. This article examines in some detail the arguments both for and against seeking clients’ permission and concludes that, in view of the principle (...) of respect for autonomy, there is a moral obligation to gain consent. It is argued, however, that there may be legitimate exceptions to this. (shrink)

Since 2005, Dutch Youth Care has focused, amongst other things, on strengthening client participation and self-management. However, the evaluation of the Youth Act in 2018 showed that neither of these aspects is sufficiently guaranteed. Furthermore, professionals and clients reported encountering moral challenges when seeking to implement client participation and self-management. Therefore, an innovative participatory action research study was conducted to explore the contribution of Moral Case Deliberation (MCD) with clients to client participation and self-management. MCD is a conversational (...) method that supports joint reflection upon and a moral inquiry into moral issues. Three types of MCD with clients were evaluated: A) MCD with clients only, B) MCD with students and client representatives within educational settings, and C) MCD with professionals and clients in youth care institutions. The findings were generated through a mixed-methods approach and subsequently subjected to critical reflection within a focus group comprising 16 participants, who represented the different participating perspectives in the study. MCD with clients appears to foster client participation and self-management, insofar as clients feel heard, seen, involved and taken seriously. Moreover, it supports professionals and clients to learn from each other. Finally, it appears to be a suitable method through which to support the attentive relationship of both professionals and students towards clients. MCD with client participation is a suitable method for training students in how to foster client participation and self-management in close cooperation with them. The findings have generated points of interest for MCD facilitators, both prior to and during the deliberations. (shrink)

Background: Enhancing client autonomy requires close coordination of interactional practices between nurse and client, which can cause challenges when interaction takes place in video-mediated settings. While video-mediated services have become more common, it remains unclear how they shape client autonomy in telehomecare. Research aim: To analyse how video mediation shapes client autonomy when nurses guide medicine taking remotely through video-mediated home care. Research design: This is a conversation analytic case study using video recordings of telehomecare encounters. The theoretical approach draws (...) on ethnomethodology and empirical ethics. Participants and research context: Four home-dwelling older adults and three nurses participated in the data collection; data extracts include one client and two nurses. The study was conducted in Finland. Ethical considerations: Special attention was given to protect the rights of home care clients. An ethical statement for the study was given by the Ethics Committee of the Tampere Region Findings: Video mediation complicates interacting remotely with care-relevant artefacts because of nurses’ limited visual access to the medicine and client’s need to simultaneously engage in vocal interaction and medicine taking. This can be overcome by dividing the guidance into manageable steps which invite the client to explicate their readiness to take the medicine and situating the video-mediation equipment and medicine close together. Different interactional practices and ways of situating video-mediation equipment and medicine have consequences for client autonomy. Discussion: Understanding client autonomy in digitalised settings demands empirical examination that recognises the importance of different human and non-human aspects of care that shape client autonomy. Conclusions: To harness the benefits of video-mediated home care, communication technologies’ reliance on home space and interactional practices should be recognised. Empirical ethics research is needed in order to make normative suggestions that fit a wide variety of care situation. (shrink)

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be (...) made available early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded. (shrink)

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. This (...) article aims at describing the experiences and processes of two MCD groups with client participation in a mental healthcare institution. A responsive evaluation was conducted examining stakeholders’ issues concerning client participation. Findings demonstrate that participation initially creates uneasiness. As routine builds up and client participants meet certain criteria, both clients and professionals start thinking beyond ‘us-them’ distinctions, and become more equal partners in dialogue. Still, sentiments of distrust and feelings of not being safe may reoccur. Client participation in MCD thus requires continuous reflection and alertness on relational dynamics and the quality of and conditions for dialogue. Participation puts the essentials of MCD (i.e., dialogue) to the test. Yet, the methodology and features of MCD offer an appropriate platform to introduce client participation in healthcare institutions. (shrink)

(1984). Lawyer‐client confidences under the A.B.A. model rules: Ethical rules without ethical reason. Criminal Justice Ethics: Vol. 3, No. 2, pp. 3-8.

Workers with involuntary clients influence the behaviour of their clients. One of the methods by which workers influence their clients relates to the way they model, encourage or reinforce their comments and behaviours. Practitioners may be aware or unaware of this process and of the extent to which it can impact on clients. This paper describes the process of modelling and reinforcement and discusses some of the ethical issues it raises. It suggests some guidelines by which (...) the process may be undertaken in an ethical manner and recommends the use of the ethics of care and concept of human dignity as additional theoretical resources to assist in working with this client group. (shrink)

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. (...) Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population. (shrink)

Depuis plus de deux décennies, les gouvernements scandinaves expriment leur volonté d’augmenter le taux d’emploi des personnes handicapées. Malgré la réaffirmation ininterrompue de cette volonté politique, ce taux est resté jusqu’à ce jour nettement inférieur à celui des personnes non handicapées. Les centres municipaux pour l’emploi – et, par conséquent, les travailleurs sociaux qui y œuvrent – disposent d’une grande latitude pour classer les clients présentant des déficiences permanentes susceptibles d’entraîner un handicap dans la recherche d’un emploi. Jusqu’à maintenant, (...) les recherches se sont principalement concentrées sur le processus de classification des déficiences des personnes en recherche d’emploi. Par contraste, cette étude explore le processus par lequel les personnes souffrant de handicaps permanents sont catégorisées dans les centres d’emploi danois lors de leurs premières interactions avec les travailleurs sociaux. Les résultats d’un sondage (n=69) et d’entretiens qualitatifs (n=9) montrent un très faible degré de catégorisation formelle ainsi qu’un manque d’attention portée aux problématiques du handicap et de l’accès à l’emploi. Toutefois, ce manque d’attention ne signifie pas qu’aucune classification n’est effectuée, car les travailleurs sociaux utilisent des catégories issues de catégories politiques ou sociales adjacentes comme le système d’emploi flexible. L’une des conséquences de cette absence de classification pourrait être que les agences pour l’emploi n’identifient pas les défaillances des chômeurs, ce qui réduit la possibilité de les aider. Toutefois, un niveau de classification plus élevé comporte également des inconvénients tels que la stigmatisation. (shrink)

Summary Viewing psychotherapy conversations from an epistemic perspective involves analysing how psychotherapist and client manage their knowledge, insufficient knowledge (uncertainty) and lack of knowledge (unknowledge). This article focuses on the use of the epistemic disclaimer “I don’t know”, i.e., a linguistic expressions that speakers employ to indicate uncertainty or unknowledge, in a corpus of psychotherapy sessions. The main aims, both qualitative and quantitative, are to identify the syntactic and pragmatic manifestations of “I don’t know” in the corpus (linguistic analysis), which (...) of them express unknowledge or uncertainty and why (epistemic analisys), how many of them are used by client and psychotherapist respectively. The practical purpose of this study is to give psychotherapists, counselors, clients etc. a few easy criteria for establishing when and why I don’t know communicates uncertainty or unknowledge. (shrink)

Intermediaries are social agents who can be found in all types of different environments, cultures, and organizations. More often than enough, intermediaries are middlepersons between two power centers, yet their agency is precarious due to their position as brokers who gain from bridging otherwise unconnected parties, or marginalized vulnerable individuals who suffer from the invasion of the neighboring power holders. How can these two different perspectives of the intermediaries be reconciled? Under what conditions do they shift from one type of (...) agency to another? Previous scholarship attributes the agency of intermediaries to static positionality. This paper treats the position of the intermediary as an opportunity structure, which is shaped by multi-level relational dynamics. We show the changing agency of three intermediary tribal groups (i.e. the Tibetans in northwestern China, Uriyangqad Mongols, and Jurchens) who were situated between the sedentary Chinese and nomadic Mongols during the Ming dynasty (1368–1644) through a systematic study with horse trade data. The group-based and officially-regulated horse trade constituted the most important linkage between the intermediaries and these two power centers. We study the changes in the dynamics of their contact during trade, and explain why these intermediaries became client, client to two patrons, and broker in their trade with the Chinese and Mongols in different eras. We argue that the position of the intermediaries did not provide definite advantages for their exploitation, nor did it paralyze them with any concrete disadvantages. Rather, their position offered them unpredictable opportunities that arose from their relational dynamics with the power centers. Moreover, the self-serving and local interests of the intermediaries, and the strategies and tactics that they used, determined their capacity to respond to emerging and unpredictable opportunities and capitalize on them. (shrink)

One ethical issue that commonly comes up in clinical practice is the negotiation of fees with clients. Although the APA Ethics Code provides standards regarding clients who are unable to or do not pay, little guidance is given pertaining to fee limits for clients who want to pay more. This issue is explored using a real case example, including the relevant ethical codes to be considered. The necessary “gray” areas of ethical decision-making are demonstrated through my own (...) decision process. Implications for future scenarios are discussed. (shrink)

The purpose of this paper is to examine what heals and harms the client in the psychotherapeutic encounter, from the client's perspective. The experience of eight clients was explicated using a model based on Giorgi and Schweitzer. The counselling experienced as healing by clients has at its core a vibrantly warm and honest relationship where the client feels held in the safety of the good heart space of the counsellor. The counsellor is experienced as providing an intense beingness (...) for the client that embraces the client's suffering and provides solid ground created out of the crucible of the counsellor's own encounter with his or her shadow. The counsellor is emptied out of his/her own agenda and provides space for the client's experience. The counsellor can evoke the higher resources of the client. The counselling is experienced as renewing and reconnecting the clients to his/her sense of self, of other and the lifeworld. The counselling relationship experienced as harming is described as being drained of human presence and transforming power. There is no alive human connection. The counsellor is experienced as insubstantial, and has no ability to hold traumatic experience. The counsellor's cold reception to the client's vulnerabilities has the power to shatter, fragment and splinter the client. The counsellor is full of self. This fullness may be ego that manifests as dry intellectualising or playing manipulative games as a substitute for human presence. This may lead the client to terror, sickness and anxiety. The counsellor may be full of their own fears and are experienced by the client as chaotic, avoidant and overwhelmed. Their unavailability leads clients to experience emotional depletion, exhaustion and frustration. The counsellor's self-righteousness, judgement and critical disengagement are experienced by clients as being belittled, condemned and diminished. The therapeutic encounter results in a weakening of the human potential for recovery. Both client and counsellor emerge as lesser human beings, with weakened relationships to self, others and the world. Indo-Pacific Journal of Phenomenology , Volume 1, Edition 2 September 2001. (shrink)

Providing Single Sign-On (SSO) between service providers and enabling service providers to share user personal attributes are critical for both users to benefit from a seamless access to their services, and service providers to realize new business opportunities. Today, however, the users have several independent, partial identities spread over different service providers. Providing SSO and attribute sharing requires that links (federations) are established between (partial) identities. In SAML 2.0 (Maler et al. 2003), the links between identities are stored and managed (...) at the network side by the identity providers (network-side identity federation). This model prevents the service providers from mass-correlating the partial identities they have, but the users must fully trust the identity providers. In this paper, we propose a complementary approach where the users have a full control of the links between their partial identities. It is a client-side identity federation approach, which relies on the introduction of a new cryptographic tool, called invariable partially blind signature scheme, that may be of independent interest. (shrink)

An explicit linking of the minutiae of everyday parenting practices and the good of society as a whole has been a feature of government policy. The state has taken responsibility for instilling the right parenting skills to deal with what is said to be the societal fall-out of contemporary and family change. ?Knowledge? about parenting is seen as a resource that parents must access in order to fulfil their moral duty as good parents. In this policy portrait, caring for children (...) is posed as a classless and gender-neutral activity. A key theme of this article is that parents from different social class groups are positioned and understand themselves in quite distinct ways in relation to parenting skills advice and expert intervention into their family and home lives. We take a ?relational? perspective to show how mothers and fathers from different social class groups see themselves, and are located by policy and practice, as clients or consumers, and as commonplace or pioneers, in relation to parenting support for themselves and the education system for their children. We identify the lived gendered and classed disparities of power, and associated moral worth, attached to particular parenting practices. (shrink)

This comparative study shows biases relative to client age, gender and behaviour demon strated by 268 female nurse subjects. A repeated measures design was utilized. All three main effects were significant (p < 0.001) for how respondents predicted that they would react to various clients and also how they predicted that their colleagues would react. Most two-way and three-way interaction effects were significant. Subjects demonstrated more favourable reactions to nice, young, male clients and least favourable reactions to not (...) nice, old, male clients. Study subjects predicted more favourable self-reactions to simulated clients than for their colleagues. What should be important to every professional as a result of this study is the need to be aware of self-biases, which may cause errors in decision-making and nursing care interventions and lead to ethical violations with clients. (shrink)

Summary Criticism of the traditional institution?based system of teacher training for primary schools is reviewed and recent responses to GATE requirements summarised. It is argued that such criticisms, and any radical reforms involving the transfer of training responsibility to the schools, should take account of client opinion of its likely effects. Clients here are taken to refer to students in training and school teachers including headteachers. For this study an open?ended questionnaire on the advantages and disadvantages of traditional institution?based (...) and radical school?based systems was administered to all students at the end of a PGCE course, and to a part?opportunity and part?random sample of teachers and headteachers in local schools. Their responses are tabulated and discussed. The vast majority of these clients foresaw considerable problems with a radically reformed system and, balancing the gains and losses that such a reform might bring, they demonstrated a clear preference for the existing system. (shrink)

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for (...) cross-cultural psychotherapists to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients. (shrink)

This paper argues that independent auditors have lost sight of their obligation to be truly impartial, and have increasingly adopted an attitude of client advocacy. We argue that auditors have a professional obligation to go beyond merely passing judgment on whether client accounting methods are acceptable under GAAP, and to judge whether the principles adopted are the most appropriate under the circumstances. We then review recent evidence which suggests that auditors have abandoned this objective in favor of advocating client-preferred principles. (...) The results of a survey of public accountants employed by small CPA firms indicates that, in a scenario in which an auditor did not feel that the client's accounting treatment was the most appropriate under the circumstances but it was recognized as an acceptable alternative under GAAP, advocacy of the client-preferred approach is considered appropriate and is very likely to occur in practice. In less subtle cases (e.g., when the auditor did not feel that the client's treatment provided the best reflection of the economic substance of the underlying transactions), survey participants as a group were ambivalent regarding the appropriateness of client advocacy, and felt that subordination of judgment was likely to occur in practice. The results also indicate that engagement risk, or the risk that the firm will be harmed by aggressive behavior, affects judgments of both the appropriateness and likelihood of subordination of judgment. These findings suggest that auditors have adopted an ideology of client advocacy, within the constraints of engagement risk. (shrink)

This paper traces the recent debate over the legitimacy of maturity mismatching and fractional reserve banking. It shows that there is common ground between Bagus and Howden :399–406, 2009, 106:295–300, 2012) on the one hand and Evans on the other regarding contractual arrangements that lead to fractional reserve banking, while both agree that fractional reserve banking that arises out of a bailment or storage contract constitutes fraud. Block and Barnett :711–716, 2009, 100:229–238, 2011) stress the illegitimacy of fractional reserve banking (...) for creating more money substitutes than there is actual money. While it is true that fractional reserve banks are capable of creating money, this activity still cannot be regarded as fraudulent using a common law definition of fraud for it can only take place with requisite client collaboration that makes it impossible to identify a victim. (shrink)

Context: The decolonial turn in psychology criticizes conventional Western psychotherapeutic frameworks and seeks to decolonize therapeutic practices by considering diverse cultural perspectives. Indigenous healing has been increasingly used in the psychotherapy of ethnic communities, but also in the psychotherapy of Western clients. The research questions of the present study were focused on how Western clients experience the therapies inspired by Indigenous healing. Objective: The study aimed to explore the motivations, experiences, and mental health outcomes of participants of therapies (...) inspired by Indigenous healing with a focus on issues related to intercultural transfer of therapeutic practice. Design: Semi-structured qualitative interviews were used to gather narratives from 28 participants. Thematic analysis was used for data analysis. Results: Participants reported the following long-lasting outcomes of Indigenous therapies: increased well-being, calm, satisfaction with life, better emotion regulation, coping with stress, behavioral control, problem solving, decision making as well as a more sensitive and deeper experience of reality. Conventional Western psychotherapy was perceived as conversation-based, while Indigenous therapy was perceived as experience-based and more complex. The integration of experiences from Indigenous therapies was more difficult in the Western sociocultural environment compared to participation in the place of their origin, within the community of Indigenous people. Conclusion: Indigenous healing has beneficial outcomes for Western clients, but the integration of these experiences is quite difficult and requires systematic psychotherapeutic support in the Western cultural environment. (shrink)

John McKnight's The Careless Society tellingly exposes the ways the professionalized welfare state creates dependency. But McKnight is too quick to condemn this result as the product of professional self‐interest, and to posit as the alternative a selfless, republican model of community. He overlooks the more realistic possibility that the pursuit of their interests by social groups empowered to take care of themselves would better serve those interests, and would simultaneously create a feeling of interdependence and civic responsibility.

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Journalists seldom consider the layers of those affected by their actions; third parties such as families, children, and even people unlucky enough to be in the wrong place at the wrong time. This article argues for consideration of the broader group, considering a range of options available for doing their duty to inform the public while also minimizing harm to others. Journalists might compare themselves with other professions that have similar roles, such as anthropologists, on such issues as confidentiality and (...) disclosure. A broader lesson is the value of applying different views, theoretical frameworks, and starting points to the ethical issues in any profession. (shrink)

ABSTRACTFormal representations of lawyer–client relations are often characterised by their regulative aspects, including codes of ethics and practice. In this article I look inside the relationship by returning to the sociology of Georg Simmel, who closely examined the basic units of sociality, especially dyads and triads. Using examples drawn from empirical research on corporate lawyers and clients and banks, I open up the lawyer/client dyad and show that in most cases the practices of lawyers and banks add noise and (...) interference to the relationship. The reason is that in many situations the basic unit of analysis for lawyer–client relationships should be the triad rather than the dyad. Whereas dyads are fundamentally stable, triads are the reverse, as they allow for alliances and defections creating permanent uncertainty. I take a number of examples where clients suffered in the alliances formed between their lawyers and the banks, leaving them on the periphery. It is time to recast the lawyer–client re... (shrink)

BackgroundWhile most studies on HIV/AIDS often identify stigmatization and patients’ unwillingness to access health care as critical problems in the control of the pandemic, very few studies have focused on the possible consequences of accessing health care by sero-positives. This paper examines the socio-psychological trauma patients experience in their desire to access health care in two health facilities in the Ashanti Region of Ghana.MethodsThrough participant observation, informal conversation and in-depth interviews, data were collected from health workers and clients of (...) the voluntary counselling and antiretroviral therapy units in the two hospitals.The data gathered were analysed and categorized into themes and supported with illustrative quotes obtained from health workers and clients.ResultsThe study found that the mere presence of a person at the HIV counselling centre or clinic is enough for the person to be labelled as or suspected to be HIV patient. It demonstrates that stigmatization may occur not only in the community but also overtly or covertly, in the health facility itself. Consequently, for many HIV/AIDS patients, access to antiretroviral therapy and treatment of related nosocomial infections are problematic. Besides, the study found that many clients and potential users of services were uncomfortable with the quality of care given by some health workers, especially as they overtly and covertly breached confidentiality about their clients’ health status. This has compelled many patients and potential users of the services to adopt a modus vivendi that provides them access to some care services while protecting their identity.ConclusionThe paper argues that by examining issues relating to privacy and confidentiality in the provision of care for and use of services by seropositives, more light will be shed on the whys of the limited uptake of HIV-related health care services in Ghana. (shrink)

The Revisions Task Force of the Ethics Committee of the American Psychological Association (APA) has proposed that prohibition of sexual intimacies with clients after termination of therapeutic relationships be made an explicit part of the new code. This decision was based on much careful deliberation and input from various individuals and groups. This article supports the proposed change and provides a rationale based on emerging theoretical positions and research findings regarding risks to clients, risks to professionals, and risks (...) to the various mental health professions. The revision would read, "Psychologists do not engage in sexual intimacies with current or former psychotherapy clients" (see "Ethical Principles Revised", 1990). (shrink)