A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Preliminary results and methodological issues

This article is an initial report from a review of alcohol and drug treatment studies with follow-ups of 2 years or more. The goals of the review are to examine the stability of substance use outcomes and the factors that moderate or mediate these outcomes. Results from 12 studies that generated multiple research reports are presented, and methodological problems encountered in the review are discussed. Substance use outcomes at the group level were generally stable, although moderate within-subject variation in substance use status over time was observed. Of factors assessed at baseline, psychiatric severity was a significant predictor of outcome in the highest percentage of reports, although the nature of the relationship varied. Stronger motivation and coping at baseline also consistently predicted better drinking outcomes. Better progress while in treatment, and the performance of pro-recovery behaviors and low problem severity in associated areas following treatment, consistently predicted better substance use outcomes.     

Editorial

Ohne Zusammenfassung

---

Editorial

     

Ein heuristisches Modell zur Work-Life-Balance: Vier Dimensionen des Tätigseins

The author picks up a model of the philosopher Martin Seel on the ?four dimensions of activity“ in human life, and he develops a pragmatic concept of work-life-balance. These dimensions are: (1) Work as purposeful activity, (2) interaction as dealing with a human other, (3) play as activity which has the purpose in itself, (3) contemplation as non-dialogical interaction with an object. After some considerations on the postmodern working culture and on the concept of work-life-balance, these dimensions are delineated in detail and explained in their relatedness. Successful life requires that all dimensions are available. A questionnaire may help a coachee to reconsider and eventually to modify his life style.     

Einsatz von Simulationspatienten im Kommunikations- und Interaktionstraining für Medizinerinnen und Mediziner (Medi-KIT): Bedarfsanalyse — Training — Perspektiven

Communication skills are of central importance within daily medical life providing effective treatment. In the modern high-tech field of medicine, trustful conversations play a prominent role. In order to help students of the Heidelberg Medical Faculty to be ready for their highly responsible role as communication partner, training is carried out in the framework of HeiCuMed (short for Heidelberger Curriculum Medicinale) using specially trained simulation patients. The communication and interaction training program (referred to as Medi-KIT) enables to practice conducting conversations with challenging communication partners and grave conversational content in difficult situations. Feedback from the standardized patients, as well as from peers and tutors represents a central didactic element.In order to secure knowledge transfer into daily clinic life and as well to build a relation to cognitive knowledge transfer, all medical students are assigned, alongside Medi-KIT lessons, to a ward, and training units are coordinated in terms of content to correspond with symptom-oriented lectures and parallel POL-groups (problem-oriented learning groups). In addition, communication learning objectives are examined at the end of the semester in the form of a clinical practical exam (OSCE: Objective Structured Clinical Examination) and at patient’s bedside (Mini-CEX: Mini Clinical Examination). The goal in imparting communication skills within medical education is that the longitudinal communication curriculum be maintained and continued in subsequent medical specialization studies.     

Where Does it Begin? A Comparative Perspective on the Professional Preferences of First-year Social Work Students

Correspondence to Dr John Gal, Paul Baerwald School of Social Work, The Hebrew University, Mt Scopus, Jerusalem 91905, Israel. Summary The goal of this paper is to contribute to a better understandingof international social work by examining the professional preferencesof students at the beginning of the social work training processin the United States, Great Britain and Israel. The study, uponwhich the paper is based, examined the preferences of the studentswith regard client groups, social services, types of sectorsand of practices, and sought to identify the similarities andthe differences between these preferences in different countries.The findings indicate that the students from the United Statesand Israeli universities prefer to work with social groups andto be employed in services, that can be defined as "less stigmatic",while these trends were not identifiable in the case of theBritish students. They expressed a greater readiness to workwith more needy social groups and to find employment in thestate sector. By contrast, the students in all the universitiesstudied expressed a similar unwillingness to work the unemployed,the chronically ill and to find employment in old-aged homes.In addition, casework with individuals was the most preferredtype of social work practice. Clearly, the findings indicatethat the preferences of students in different countries reflectvariations in the nature of social work in each of the specificnational settings.     

Charisma and organizational change: A multilevel study of perceived charisma,commitment to change,and team performance

What makes people perceive a leader as charismatic, and how do team leaders obtain performance outcomes from their followers? We examine leaders in times of organizational change and investigate the mechanisms through which leaders' change-promoting behaviors are associated with team performance. In a multilevel mediation model, we propose that the indirect relationship between change-promoting behaviors and team performance is sequentially transmitted through followers' perceptions of charisma and followers' commitment to change. A study of 33 leaders and 142 followers provides empirical support for the model, using multilevel structural equation modeling to analyze top-down relationships between leaders and followers and bottom-up relationships between followers and team outcomes. Results suggest that team leaders are perceived as more charismatic when they engage in change-promoting behaviors. These behaviors facilitate team performance through individual followers' perceived charisma and commitment to change.