Organisational effectiveness and personality disorder

2015 ◽  
Vol 20 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Jane Yeandle ◽  
Liz Fawkes ◽  
Clare Carter ◽  
Chris Gordon ◽  
Elizabeth Challis
Keyword(s):  
Personality Disorder ◽  
Service Delivery ◽  
Treatment Guidelines ◽  
Clinical Excellence ◽  
Emotional Reactions ◽  
Service Development ◽  
Content Type ◽  
Organisational Effectiveness ◽  
Client Group ◽  
Organisational Factors

Purpose – National treatment guidelines regarding Borderline Personality Disorder (BPD) (National Institute for Health and Clinical Excellence, 2009) make a number of recommendations relating to system and cultural treatment variables including: access to services, autonomy and choice, developing an optimistic and trusting relationship and managing endings and transitions. The purpose of this paper is to look at a model which could help organisational effectiveness across a range of service settings in relation to personality disorder. Design/methodology/approach – Explanation of why the McKinsey 7S organisational model (Waterman et al., 1980) may be useful in assessing organisational effectiveness in relation to personality disorder. Findings – Cultural and organisational factors across a range of levels need to be aligned to allow for effective service delivery. This is particularly important in working with this client group where strong emotional reactions and subsequent organisational splits are common. Practical implications – The application of this tool within clinical leadership and service development would be particularly important for coherence within generalist (as opposed to specialist) settings. Originality/value – To the authors’ knowledge this analysis is unique as a review of NHS culture across a range of settings and discussion of the implications for service delivery for patients with BPD.

Personality factors related to treatment discontinuation in a high secure personality disorder treatment service

2015 ◽  
Vol 1 (1) ◽  
pp. 29-36
Author(s):  
Alice L. Bennett
Keyword(s):  
Personality Disorder ◽  
Treatment Discontinuation ◽  
Narcissistic Personality Disorder ◽  
Personality Factors ◽  
Treatment Dropout ◽  
Treatment Unit ◽  
Content Type ◽  
Client Group ◽  
Narcissistic Personality ◽  
Disorder Treatment

Purpose – The purpose of this paper is to explore the range of personality disorder diagnoses and levels of psychopathy as assessed by the Psychopathy Checklist-Revised (PCL-R) associated with treatment discontinuation in a sample of adult male prisoners. Design/methodology/approach – Data from 92 male offenders in a high secure prison personality disorder treatment unit was analysed. PCL-R and personality disorder diagnoses were predicted as being related to increased treatment dropout. Findings – Having a diagnosis of narcissistic personality disorder was related to treatment dropout, but PCL-R total scores were not. There was a trend for a diagnosis of antisocial personality disorder being associated with remaining in treatment. Research limitations/implications – The current study highlights that narcissistic personality disorder can be associated with treatment dropout, warranting further exploration as to why this is the case. Practical implications – Managing responsivity issues for those presenting with a personality disorder diagnosis could be effective in maximising treatment engagement from this specific offender group. Originality/value – Although treatment dropout has been explored previously, this is the first study to explore treatment dropout at a specialised unit designed specifically to provide treatment for this client group.

Selecting business partner for service delivery co-innovation and competitive advantage

2015 ◽  
Vol 53 (9) ◽  
pp. 2107-2134 ◽  
Author(s):  
Hung-Tai Tsou ◽  
Colin C.J. Cheng ◽  
Hsuan-Yu Hsu
Keyword(s):  
Service Delivery ◽  
Competitive Advantage ◽  
Resource Dependence ◽  
Partner Selection ◽  
Resource Dependence Theory ◽  
Service Development ◽  
Service Firms ◽  
Business Partner ◽  
Content Type ◽  
Business Partners

Purpose – While co-innovation with third parties (e.g. customer or supplier) has been widely documented, the literature seems to pay scant attention on co-innovation with business partners. Building on the resource dependence theory (RDT) and the input-process-output model, the purpose of this paper is to examine how four criteria of business partner selection affect service delivery co-innovation, which, in turn, influences firms’ competitive advantage. Design/methodology/approach – A mail survey was sent to 600 IT service firms in Taiwan, the target respondents being senior marketing managers in charge of collaborative new service development. A total of 120 usable questionnaires were collected, for a response rate of 20 percent. Findings – The findings support the argument that all four criteria of business partner selection have positive relationships with service delivery co-innovation. Meanwhile, adopting these criteria, firms’ service delivery co-innovation is able to create superior competitive advantage. Research limitations/implications – The findings enrich the existing literature by proposing and empirically confirming that the use of appropriate criteria to select business partners enhances the effectiveness of firms’ service delivery co-innovation and competitive advantage. Practical implications – Managers must be aware of the criteria to select their business partners, in terms of developing service delivery co-innovation. Originality/value – This study adds to the service innovation literature by providing support for the RDT that partner reliability, partner complementarity, partner expertise, and partner compatibility are important business partner selection criteria to create service delivery co-innovation and achieve firms’ competitive advantage.

The impact of a co-produced personality disorder training on staff burnout, knowledge and attitudes

2020 ◽  
Vol 25 (3) ◽  
pp. 269-280
Author(s):  
Chloe Finamore ◽  
Fiammetta Rocca ◽  
Jennie Parker ◽  
Julia Blazdell ◽  
Oliver Dale
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Emotional Reactions ◽  
Production Model ◽  
Content Type ◽  
Knowledge And Attitudes ◽  
Mental Health Settings ◽  
The Impact

Purpose Mental health professionals working with patients with personality disorder are at risk of burnout. Burnout can adversely affect workforce retention and the delivery of high-quality care. The purpose of this paper is to investigate the impact of the three-day Knowledge and Understanding Framework (KUF) awareness-level personality disorder training on burnout, knowledge and attitudes in staff working in mental health settings. Design/methodology/approach A total of 253 mental health professionals attended the KUF training, delivered through a co-production model (i.e. co-delivered by a mental health professional and service user consultant with lived experience). Questionnaires were administered at pre- and post-training to assess changes in burnout symptoms and understanding, perceived capabilities and emotional reactions concerning personality disorder. Findings There were improvements in two burnout domains: decreases in emotional exhaustion (p = 0.009) and increases in personal accomplishment (p < 0.001) between pre-and post-training. Significant improvements were found in understanding, perceived capabilities and emotional reactions (p < 0.001). Research limitations/implications This evaluation is limited by a lack of a control group and long-term follow-up. Further research is required to investigate the sustainability of reductions in burnout for mental health professionals attending training and supervision structures. Originality/value KUF training may contribute to reductions in the high levels of burnout often experienced amongst staff working in mental health settings and could form a part of a broader strategy focussing on continued supervision and opportunities to integrate learning into practice.

Cultural adaptation of an evidence-based home visitation programme: Latino clients’ experiences of service delivery during implementation

2014 ◽  
Vol 9 (4) ◽  
pp. 280-294 ◽  
Author(s):  
Megan Finno-Velasquez ◽  
Danielle L. Fettes ◽  
Gregory A. Aarons ◽  
Michael S. Hurlburt
Keyword(s):  
Service Delivery ◽  
Cultural Adaptation ◽  
Home Visiting ◽  
Linear Models ◽  
Evidence Based ◽  
Cultural Issues ◽  
Content Type ◽  
Home Visitor ◽  
Client Group ◽  
Latino Clients

Purpose – The purpose of this paper is to examine the experiences of Latino clients following a naturalistic cultural adaptation made to SafeCare, an evidence-based home visiting intervention designed to address specific linguistic and cultural issues affecting the Latino community during implementation in San Diego County, California. Design/methodology/approach – Hierarchical linear models examined whether Latino clients experienced differences in perceptions of SafeCare delivery, working relationship with the home visitor and satisfaction with services when compared with non-Latino clients and whether language of service delivery and provider-client ethnic match were related to Latino clients’ experiences of the intervention. Findings – Overall, across several different dimensions, there was no decrement in experience with SafeCare for Latino clients compared to non-Latino ones, implying that adaptations made locally adequately engaged Latino and Spanish-speaking clients in services without compromising perceived adherence to the programme model. Research limitations/implications – Because this was a non-experimental study, conclusions could not be drawn as to whether the locally adapted SafeCare would fare better in Latino client ratings than SafeCare unadapted. However, the findings are important because they contradict concerns that EBPs may not be relevant to diverse client groups, and support the idea that when adaptations are made, it is possible to maintain adherence at the same level of adherence as when the programme is delivered in its non-adapted form. Originality/value – The study explicitly documents and generates knowledge around an organic adaptation made in a community to an evidence-based intervention for a client group about whom there has been documented concern regarding the relevance of and engagement in services.

Intellectual disability, personality disorder and offending: a systematic review

2015 ◽  
Vol 9 (2) ◽  
pp. 50-61 ◽  
Author(s):  
Kelly Rayner ◽  
Harry Wood ◽  
Nigel Beail ◽  
Maninder Kaur Nagra
Keyword(s):  
Systematic Review ◽  
Intellectual Disability ◽  
Personality Disorder ◽  
Predictive Factor ◽  
Design Methodology ◽  
Accurate Diagnosis ◽  
Inclusion Criteria ◽  
Content Type ◽  
Client Group ◽  
Offending Behaviour

Purpose – This review seeks to systematically review studies where personality disorder has been explored as a descriptive or possible predictive factor in offending behaviour in people with an intellectual disability. The papar aims to discuss this issue. Design/methodology/approach – A systematic search of several databases was conducted and 15 studies met the inclusion criteria and were included in this review. Findings – Methodological limitations and problems in accurate diagnosis within this client group preclude firm conclusions being reached. Originality/value – It is concluded that further research should be conducted, with particular attention paid to the conceptualisation and assessment of personality disorder.

scholarly journals Personality disorder: challenges in service development in the light of the new NICE guidelines

2011 ◽  
Vol 35 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Christopher Garrett ◽  
Tennyson Lee ◽  
Samantha Blackburn ◽  
Leanne Priestly ◽  
Kamaldeep Bhui
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Excellence ◽  
Borderline Personality ◽  
Service Development ◽  
Service Needs ◽  
Nice Guidelines ◽  
Prescribing Practice ◽  
Record Review

Aims and methodUsing the National Institute for Health and Clinical Excellence (NICE) guidelines on borderline personality disorder as a framework, we describe the profile of the first 100 individuals referred to a personality disorder service in London, captured through the use of record review and case study.ResultsThe referral population ethnic profile does not match the wider population of the borough; a third of the borough is Bangladeshi, but only 9% of those referred to the service are. Of those diagnosed with borderline personality disorder and on psychotropic medications, only one person had a clear current indication based on NICE guidelines. Of the 100 individuals who were referred to the service, a quarter were accepted to the programme; a third either did not want to proceed with the assessment or were unprepared for an intensive programme.Clinical implicationsThe under-representation of Black and minority ethnic individuals in referrals in the peresonality disorder service needs to be actively addressed. Interventions are required to support psychiatrists in reviewing their prescribing practice regarding individuals with borderline personality disorder. Access to the service needs to be improved.

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

An empirical investigation of tourist’s choice of service delivery options

2017 ◽  
Vol 29 (7) ◽  
pp. 1892-1913 ◽  
Author(s):  
Arun Kumar Kaushik ◽  
Zillur Rahman
Keyword(s):  
Service Delivery ◽  
Service Providers ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Technology Readiness ◽  
Extensive Literature ◽  
Perceived Ease Of Use ◽  
Content Type ◽  
Service Employees ◽  
Delivery Options

Purpose This paper aims to offer and examine a conceptual model of tourist innovativeness toward self-service technologies (SSTs) to confirm whether tourists prefer service delivery by SSTs over employees in an offline hospitality environment. Design/methodology/approach Tourists’ perceived usefulness (PU) of SSTs and need for interaction (NI) with service employees have been taken as crucial mediating variables to examine the effects of perceived ease of use and technology readiness index personality dimensions toward SST and employee-based service adoption. Findings Findings reveal that both “NI” and “PU” play significant roles in Technology Readiness and Acceptance Model (TRAM) when tourists select one of two service delivery options – SSTs and service employees. Research limitations/implications The foremost limitation of the study is its dependence on domestic tourist samples. However, such samples were chosen because tourists comprising these samples tend to use similar service delivery options more, in turn increasing their use of SSTs available in sample hotels. Practical implications The study gives a deeper understanding of TRAM with an extremely crucial mediating variable (NI) in an offline service context. It also provides useful insights to service providers and policy makers for developing new strategies and policies to enhance user experience. Social implications This study recommends the usage of numerous SSTs by tourists. Originality/value During extensive literature review carried out in this research, no study was found that proposed such an effective framework in an offline service context.

The moderating impact of emotions on customer equity drivers and loyalty intentions

2017 ◽  
Vol 29 (2) ◽  
pp. 239-264 ◽  
Author(s):  
Zohaib Razzaq ◽  
Salman Yousaf ◽  
Zhao Hong
Keyword(s):  
Service Delivery ◽  
Customer Service ◽  
Customer Loyalty ◽  
Positive Emotions ◽  
Survey Design ◽  
Emotional Responses ◽  
Point Of View ◽  
Customer Equity ◽  
Content Type ◽  
Loyalty Intentions

Purpose The purpose of this paper is to investigate the significant contribution of emotions along with other conventional loyalty drivers on the loyalty intentions. Design/methodology/approach The influence of three conventional loyalty drivers, i.e., value equity, brand equity, relationship equity on loyalty intentions was investigated by further exploring the moderating effects of negative and positive emotions. A sample of 834 Pakistani consumers in the supermarkets and banking industries was studied employing store-intercept survey design. Findings Consumer behavior is driven by emotions in both the supermarkets and banking context. Thus, in order to better predict customer loyalty intentions, the emotional component is crucial and should be included along with other cognitive components. Practical implications Since customers’ emotional responses throughout service delivery are strongly linked to loyalty, therefore supermarkets and bank service managers need to make sure that the customers experience with their services as pleasurable as possible and for this purpose, customer service employees need to be trained in order to better understand the customers’ emotional responses during the course of service delivery process. Originality/value The present study complements the existing literature regarding the role of emotions in service settings and offers a new point of view for the linkage among emotions, customer equity drivers and customer loyalty intentions.

Frozen child: schema therapy for a forensic patient in a service for men with a diagnosis of severe personality disorder

2016 ◽  
Vol 18 (4) ◽  
pp. 254-264 ◽  
Author(s):  
Asad Ul Lah ◽  
Jacqui Saradjian
Keyword(s):  
Personality Disorder ◽  
Service User ◽  
Single Case ◽  
Schema Therapy ◽  
Content Type ◽  
Protective Strategy ◽  
Personal Reflections ◽  
Participant Observer ◽  
Severe Personality Disorder

Purpose Schema therapy has gone through various adaptations, including the identification of various schema modes. The purpose of this paper is to suggest that there may be a further dissociative mode, the “frozen child” mode, which is active for some patients, particularly those that have experienced extreme childhood trauma. Design/methodology/approach The paper is participant observer case study which is based on the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy. Findings The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is proposed that patients develop this mode as a protective strategy and that unless recognised and worked with, can prevent successful completion of therapy. Research limitations/implications Based on a single case study, this concept is presented as a hypothesis that requires validation as the use of the case study makes generalisation difficult. Practical implications It is suggested that if validated, this may be one of the blocks therapists have previously encountered that has led to the view that people with severe personality disorder are “untreatable”. Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations as to the most appropriate processes to potentiate such therapy. Originality/value The suggestion of this potential “new schema mode” is based on service user initiative, arising from a collaborative enterprise between service user and clinician, as recommended in recent government policies.

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