Transforming the legal profession: an interview study of change managers in law

A lively debate progresses about change to the professions, including law, especially change in the form of managerialism. ‘Managerialism’ covers the methods and beliefs of managers within organisations, used to actively influence, evaluate, and ‘market’ professional work. But what about when that managerialism is change itself? How do we understand managerialism-as-change? This paper reports on an interview study with change managers, or ‘transformation leaders’ in the legal profession. Transformation leaders offer rich insights into the dynamics of professional change because they are incontrovertibly change agents. They are also themselves a form of managerial change as a new cadre of managers within the professions; managers with ‘hybrid’ identities whose legitimacy in professional settings is not assured. The findings presented include: the change leaders’ identities; the types of change being introduced; the constraints on and affordances for change in legal practices; and how change leaders secure, and sometimes struggle to secure, the authority needed to implement change. The concluding discussion highlights the study's contributions to our understanding of professional change and managerialism in the legal context – both what changes are being pursued and how they are materialising through certain ‘managerial’ goals, strategies, and the interactions of those with mixed identities and status.

The Experience of Participating in an Internet-Based Cognitive Behavioral Therapy Program Among Patients with Cardiovascular Disease and Depression: A Qualitative Interview Study

Background Depression in cardiovascular disease (CVD) is associated with poor outcomes and there is a treatment gap of depression in CVD patients. Recently we found that an Internet-based cognitive behavioral therapy (iCBT) tailored for CVD patients led to reduced symptoms of depression. However, we still have little knowledge about CVD patients’ experiences of working with iCBT. The aim of this study was therefore to explore CVD patients experience of engaging with a tailored iCBT program. Methods A qualitative interview study using inductive thematic analysis. Data was obtained from 20 patients with CVD and depressive symptoms who had participated in a randomized controlled trial (RCT) evaluating the impact of a nine-week iCBT program on depression. Results Three main themes emerged: (1) Taking control of the disease, (2) Not just a walk in the park, and (3) Feeling a personal engagement with the iCBT program. The first theme included comments that the tailored program gave the patients a feeling of being active in the treatment process and helped them achieve changes in thoughts and behaviors necessary to take control of their CVD. The second theme showed that patients also experienced the program as demanding and emotionally challenging. However, it was viewed as helpful to challenge negative thinking about living with CVD and to change depressive thoughts. In the third theme patients reported that the structure inherent in the program, in the form of organizing their own health and the scheduled feedback from the therapist created a feeling of being seen as an individual. The feeling of being acknowledged as a person also made it easier to continuously work with the changes necessary to improve their health. Conclusions Engaging in an iCBT program tailored for patients with CVD and depression was by the patients perceived as helpful in the treatment of depression. They experienced positive changes in emotions, thoughts, and behaviors which a result of learning to take control of their CVD, being confirmed and getting support. The patients considered working with the iCBT program as demanding and emotionally challenging, but necessary to achieve changes in emotions, thoughts, and behaviors.