Client Willingness Research Articles

Do Marketing Clients Really Get the Advertising They Deserve? The Trade-Off Between Strategy and Originality in Australian and New Zealand Agencies

This article replicates the role clients play in their agency's advertising development process, as investigated by Koslow, Sasser, and Riordan (2006), but with data from Australia and New Zealand agencies. The role of client willingness to explore ideas is again found to be a critical reason why some clients receive more creative campaigns that others. Although some of the complex interactions found by Koslow, Sasser, and Riordan (2006) were not replicated, additional analyses suggest other patterns in the data. Some marketer-related factors, such as client sophistication and the use of consumer research, improve how strategic campaigns are, but they do so at the cost of originality. The net effect on the total creativity of a campaign may be minimal, but the creative character may change dramatically. Again, marketers seeking accountability for their campaigns' creativity need look no further than themselves.

Supporting palliative care clients who live alone: Nurses’ perspectives on improving quality of care

Terminally ilL people who live alone at home are disadvantaged in terms of their places of care and death and health outcomes. There is a need to trial models of care that can extend the period of care at home for as long as possible for this group. The objective was to explore the experiences of nurses providing care to terminally ill clients who live at home alone and who were receiving either additional care aide support or a personal alarm through an RCT. Nine nurses in a home-based palliative care service in Western Australia completed a questionnaire (82% response rate). Client willingness to accept additional support from care aides, development of rapport between the client and care staff, and willingness to use the alarm appropriately all influenced the effectiveness of the models of care. These models of care may negate the need for frequent nurses' visits when nurses feeL confident that the care aide can pass on relevant information or that the client will use the alarm when required. Both models of care assisted in meeting the challenges to care provision; however, further larger trials are needed to test whether these might translate into granting clients their wishes regarding places of terminal care and death. This study is the first account of nurses' perspectives on service provision to support palliative care clients who live alone. It has prompted changes in practice and will inform service planning for this growing and challenging population group.

Finding those at risk: Acute HIV infection in Newark, NJ

BackgroundA screening strategy combining rapid HIV-1/2 (HIV) antibody testing with pooled HIV-1 RNA testing increases identification of HIV infections, but may have other limitations that restrict its usefulness to all but the highest incidence populations. ObjectiveBy combining rapid antibody detection and pooled nucleic acid amplification testing (NAAT) testing, we sought to improve detection of early HIV-1 infections in an urban Newark, NJ hospital setting. Study designPooled NAAT HIV-1 RNA testing was offered to emergency department patients and outpatients being screened for HIV antibodies by fingerstick-rapid HIV testing. For those negative by rapid HIV and agreeing to NAAT testing, pooled plasma samples were prepared and sent to the University of Washington where real-time reverse transcription-polymerase chain reaction (RT-PCR) amplification was performed. ResultsOf 13,226 individuals screened, 6381 had rapid antibody testing alone, and 6845 agreed to add NAAT HIV screening. Rapid testing identified 115 antibody positive individuals. Pooled NAAT increased HIV-1 case detection by 7.0% identifying 8 additional cases. Overall, acute HIV infection yield was 0.12%. While males represent only 48.1% of those tested by NAAT, all samples that screened positive for HIV-1 RNA were obtained from men. ConclusionHIV-1 RNA testing of pooled, HIV antibody-negative specimens permits identification of recent infections. In Newark, pooled NAAT increased HIV-1 case detection and provided an opportunity to focus on treatment and prevention messages for those most at risk of transmitting infection. Although constrained by client willingness to participate in testing associated with a need to return to receive further results, use of pooled NAAT improved early infection sensitivity.

Reflecting on Assessment Results to Inform Communication Center Tutor Training and Hiring

Abstract This study examines students' after-session survey data collected between fall 2010 and fall 2012 from a communication center (n = 1,100) to investigate four types of independent variables: (1) consultants' demographic variables such as female or male status and academic disciplines (language arts versus other disciplines), (2) length of consultation time and whether students received undivided attention, (3) suggestion categories (tapping suggestions on content, delivery, organization respectively), and (4) client willingness to return and client encouragement of others to use the center. Regression analyses provided new insight into predictors of student ratings of usefulness of suggestions and expertise of the consultant. Explanations for the results of the regression analyses are offered, and future directions for research are suggested. Further, implications of the findings on communication center staff hiring and training are suggested.

Reflecting on Assessment Results to Inform Communication Center Tutor Training and Hiring

Abstract This study examines students' after-session survey data collected between fall 2010 and fall 2012 from a communication center (n = 1,100) to investigate four types of independent variables: (1) consultants' demographic variables such as female or male status and academic disciplines (language arts versus other disciplines), (2) length of consultation time and whether students received undivided attention, (3) suggestion categories (tapping suggestions on content, delivery, organization respectively), and (4) client willingness to return and client encouragement of others to use the center. Regression analyses provided new insight into predictors of student ratings of usefulness of suggestions and expertise of the consultant. Explanations for the results of the regression analyses are offered, and future directions for research are suggested. Further, implications of the findings on communication center staff hiring and training are suggested.

Motivational Interviewing

As professional case managers seek to improve outcomes, including the health status of their clients, it becomes imperative to gather and assess as much relevant information as possible to identify and address the client's needs in a holistic manner. Motivational interviewing is a highly effective technique case managers employ for this purpose. They also rely on it to move their clients toward a course of successful, desirable, and sustainable change, such as healthier diet, exercise, self-care, and adherence to medications regime and follow-up care. Across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, and other settings in which case managers work with clients and their support systems. Motivational interviewing is a highly effective technique for gathering accurate and comprehensive information that is supportive of and additive to the assessment phase of the case management process. Using motivational interviewing, case managers can more readily uncover health and lifestyle needs of their clients. This results in building trusting relationships and developing rapport with clients, which can motivate them to move toward successful and desirable change. The design and implementation of a comprehensive and effective case management plan of care is facilitated by motivational interviewing, whereby professional case managers establish collaborative, respectful, trusting and individualized relationships with clients. Using the specific principles and techniques of motivational interviewing, case managers take a holistic approach to care to address a client's willingness and ability to change; addressing self-confidence and other emotional triggers that affect change and support the client's ability to embrace and sustain positive change.

Austin, D. (2008). The theory and practice of vocal psychotherapy: Songs of the self. Philadelphia: Jessica Kingsley Publishers. 223 pages. ISBN 978 1 84310 878 8

Austin, D. (2008). The theory and practice of vocal psychotherapy psychotherapy: Songs of the self. Philadelphia: Jessica Kingsley Publishers. 223 pages. ISBN 978 1 84310 878 8.The Theory and Practice of Vocal Psychotherapy: Songs of the Self is a comprehensive exploration of music therapy practice within a depth psychology framework. As succinctly presented in the introduction, Dr. Austin developed vocal psychotherapy based on her personal relationship with and use of music in her life journey. Her writing combines theory with clinical practice to illustrate how the voice can be used as a powerful and transformative psychotherapeutic medium. The book is divided into two parts. Part 1 provides the theoretical underpinnings of vocal psychotherapy whereas Part 2 gives an overview of the techniques that Austin has developed. Case material is used throughout the book to illustrate the theoretical constructs upon which vocal psychotherapy is built and to demonstrate the transformative nature of her work.Part I, Theoretical Foundations of Vocal Psychotherapy, begins with a chapter on the voice. It is here that Austin sets forth her rationale for using the voice in psychotherapy. Chapter 1 opens with a clinical vignette in which Austin describes how she works with the voice to meet the stated intentions of her client. She goes onto to discuss the value of singing on both a physiological and emotional level. The chapter ends with a focus on the importance of the breath in helping individuals re-discover their voice. Austin describes several breathing and vocal exercises that she has used in her work. These are given in enough detail so that the experienced music therapist could incorporate them into their work if deemed appropriate.The remaining chapters in Part I focus on the various theorists Austin has drawn from in developing her method, including Jungian (Chapter 2), Object Relations (Chapter 3), Trauma Theory (Chapter 4) and Intersubjectivity (Chapter 5). In each of these chapters, she gives the reader an overview of the constructs that have informed her clinical practice using language that is accessible for all music therapists, regardless of their familiarity of each of these theories. She augments her description of each theoretical construct with case material further demonstrating the link between theory and music therapy clinical practice.Part I concludes with a chapter devoted entirely to countertransference. Austin begins by giving the reader an overview of the myriad ways countertransference is understood in psychotherapeutic circles. She then moves into a detailed discussion about the importance of recognizing one's countertransference so as to be able to use these reactions in a way that will be helpful rather than harmful to the client. As in the previous chapters, Austin supplements didactic information with case material to help the reader better understand the concepts she is explaining. This chapter also underscores the importance of self-care and personal therapy for music therapists.There are seven chapters in Part II; each focusing on a different aspect of vocal psychotherapy. Chapter 7 sets the stage for the practice of vocal psychotherapy, although the guidelines and suggestions are hallmarks of ethical music therapy practice in general. Her discussion of the listening process is especially relevant for music therapists. Here Austin describes the importance of attending to one's self (one's thoughts, feelings, body sensations, etc.) and the client (his/her words, music, body posture, etc.). She then goes on to describe how she uses that information to inform her clinical decisions.Chapter 8 explores the concept of resistance and how it many manifest in the client or the therapist. Austin again draws from her clinical experience to demonstrate how this concept traditionally associated with traditional verbal psychotherapy, can manifest in the client or therapist's willingness or reticence to engage in vocalizing, toning, or singing. …

Enhancing Attitudes and Reducing Fears about Mental Health Counseling: An Analogue Study

This study examined the effects on 330 college students of addressing and validating negative client attitudes and fears associated with seeking counseling at a university counseling center, and client willingness to engage in counseling past the first session. Results suggest that addressing fears and negative beliefs about counseling during an intake interview influenced male students who had not previously sought counseling. Their image concerns were reduced and their tolerance for stigma associated with seeking counseling increased. Suggestions about how to address negative attitudes and fears about counseling are provided.

Impact of training for healthcare professionals on how to manage an opioid overdose with naloxone: Effective, but dissemination is challenging

Background Opioid overdose has a high mortality, but is often reversible with appropriate overdose management and naloxone (opioid antagonist). Training in these skills has been successfully trialled internationally with opioid users themselves. Healthcare professionals working in substance misuse are in a prime position to deliver overdose prevention training to drug users and may themselves witness opioid overdoses. The best method of training dissemination has not been identified. The study assessed post-training change in clinician knowledge for managing an opioid overdose and administering naloxone, evaluated the ‘cascade method’ for disseminating training, and identified barriers to implementation. Methods A repeated-measures design evaluated knowledge pre-and-post training. A sub-set of clinicians were interviewed to identify barriers to implementation. Clinicians from addiction services across England received training. Participants self-completed a structured questionnaire recording overdose knowledge, confidence and barriers to implementation. Results One hundred clinicians were trained initially, who trained a further 119 clinicians ( n = 219) and thereafter trained 239 drug users. The mean composite score for opioid overdose risk signs and actions to be taken was 18.3/26 (±3.8) which increased to 21.2/26 (±4.1) after training, demonstrating a significant improvement in knowledge ( Z = 9.2, p < 0.001). The proportion of clinicians willing to use naloxone in an opioid overdose rose from 77% to 99% after training. Barriers to implementing training were clinician time and confidence, service resources, client willingness and naloxone formulation. Conclusions Training clinicians how to manage an opioid overdose and administer naloxone was effective. However the ‘cascade method’ was only modestly successful for disseminating training to a large clinician workforce, with a range of clinician and service perceived obstacles. Drug policy changes and improvements to educational programmes for drug services would be important to ensure successful implementation of overdose training internationally.

Crawford Development Co. and Southeast Bank of Texas

In the early months of the 2007-08 financial crises, a loan manager faces a real estate financing decision. Should he approve a bullet structure three-year loan to a longstanding client, a legendary Texan developer? The developer, who near retirement downsized his business, is seeking financing for his only project: residential or commercial development on an attractive piece of land in suburban Houston. The loan manager considers the decision in light of the mortgage market turmoil, seeing commercial projects as safer, but also factoring that the residential market could bring higher returns if the market stabilizes soon. The manager collects the data and asks an analyst to assess the risks; that ultimately requires assessing the economics of both projects from both the bank's and the developer's perspectives. The bank could still change the interest rate on the loan to receive adequate compensation for the risk it carries, but the loan manager knows that doing so will change their long-term client willingness to take on the loan.

Adherence to Recovery Practices Prescribed by Alcoholics Anonymous: Benefits to Sustained Abstinence and Subjective Quality of Life

In a British cultural context, we tested the idea that physical abstinence and psycho-existential well-being during the aftercare period of recovery may be enhanced by higher levels of overall compliance with Alcoholics Anonymous (AA)-prescribed practices. We also examined whether enactment of certain types of AA-sanctioned practices might carry greater (or unique) therapeutic benefits relative to engagement in other ingredients of AA. Former residents (n = 76) of a Minnesota Model treatment program (in England) were assessed 2 years after being discharged. Higher levels of overall adherence tended also to be associated with greater abstinence, lower depression, and a stronger conviction that life has meaning and purpose. Microanalysis of discreet types of AA involvement showed formal completion of Steps 4 and 5 (done as a pair with a sponsor) had a robust salutary effect, being related to abstinence and better emotional and existential well-being. In addition, participation in Step 11 (praying/meditating) and having an AA sponsor were both associated with a broad spectrum of apparent benefits. Practitioners might consider implementing motivational interventions designed to facilitate greater client willingness to adhere more closely to the AA style of living. Results that identified especially potent facets of the AA lifestyle suggest counselors concerned with “high-quality abstinence” may wish to tailor such interventions so as to selectively target active ingredients.

Crawford Development Co. And Southeast Bank of Texas

In the early months of the 2007-08 financial crisis, a loan manager faces a real estate financing decision. Should he approve a bullet structure three-year loan to a longstanding client, a legendary Texan developer? The developer, who near retirement downsized his business, is seeking financing for his only project: residential or commercial development on an attractive piece of land in suburban Houston. The loan manager considers the decision in light of the mortgage market turmoil, seeing commercial projects as safer, but also factoring that the residential market could bring higher returns if the market stabilizes soon. The manager collects the data and asks an analyst to assess the risks; that ultimately requires assessing the economics of both projects from both the bank’s and the developer’s perspectives. The bank could still change the interest rate on the loan to receive adequate compensation for the risk it carries, but the loan manager knows that doing so will change their long-term client willingness to take on the loan.

Outreach-based drug treatment for sex trading women: The Cal-Pep risk-reduction demonstration project

Background California Prevention Education Program (Cal-Pep) provides street outreach services to injection drugs users and sex traders in Oakland and San Francisco, CA, to reduce their chances of contracting HIV/AIDS. Drug treatment is an effective barrier to HIV infections, but only clients who are ready for total abstinence from drug use can be referred to traditional treatment. Drug treatment readiness is currently defined by funding policies in the U.S. as a client's willingness to totally abstain from alcohol and illegal drug use. This policy and practice eliminates a major harm reduction opportunity to reach drug users who are just contemplating recovery with treatment. With a CSAT grant to demonstrate an effective innovation in treatment, Cal-Pep started a harm reduction outpatient program for women who were active drug users. Over the course of 1 year, actively drug-using clients came to the program house during the day for meals, for risk-reduction education sessions, group discussions, and one-on-one psychological counselling. Method From April 2001 to March 2006, 37 clients per year were interviewed at program entry and after 6 and 12 months to see if the intervention activities had an impact on their drug use and readiness for abstinence drug treatment. Results By the 6th and 12th month of clients’ progression through the risk-reduction program, they reported a statistically significant reduction in their poly-drug use (cocaine, cannabis, heroin, PCP) in the 30 days prior to their interviews ( p < .000). There were also significant reductions in poly-drug use with alcohol ( p < .000) and use of crack cocaine alone ( p < .003). There was also an added benefit: clients significantly improved their living circumstances from the streets and shelters to rooms and apartments while in the program ( p < .034). There was no significant improvement in employment. Conclusion This intervention shows that a harm reduction intermediate treatment program for actively using drug users can significantly reduce their drug use and improve readiness for full recovery.

Crawford Development Co. and Southeast Bank of Texas

In the early months of the 2007-08 financial crises, a loan manager faces a real estate financing decision. Should he approve a bullet structure three-year loan to a longstanding client, a legendary Texan developer? The developer, who near retirement downsized his business, is seeking financing for his only project: residential or commercial development on an attractive piece of land in suburban Houston. The loan manager considers the decision in light of the mortgage market turmoil, seeing commercial projects as safer, but also factoring that the residential market could bring higher returns if the market stabilizes soon. The manager collects the data and asks an analyst to assess the risks; that ultimately requires assessing the economics of both projects from both the bank’s and the developer’s perspectives. The bank could still change the interest rate on the loan to receive adequate compensation for the risk it carries, but the loan manager knows that doing so will change their long-term client willingness to take on the loan.

CDC and Progress toward Integration of HIV, STD, and Viral Hepatitis Prevention

This issue of Public Health Reports highlights approaches employed by state and local health programs to integrate viral hepatitis prevention services in correctional facilities, sexually transmitted disease (STD) and human immunodeficiency virus (HIV) prevention and treatment programs, and other settings serving high-risk clients. The reports presented in this issue demonstrate the feasibility of integrating viral hepatitis prevention services into a variety of settings; the ready acceptance of new interventions, such as hepatitis B vaccination and hepatitis C counseling and testing, by both providers and clients; and the positive impact the introduction of viral hepatitis prevention services can have on client willingness to consent to other interventions, such as HIV testing. These reports also illustrate the initiative of state and local health officials to craft integrated programs tailored to meet local needs.1–3 Although not representing formal evaluations, the data from these demonstration projects add to a body of evidence indicating that, given adequate guidance and resources, state and local health agencies can integrate services to enhance the prevention of HIV, STDs, and viral hepatitis.

Social Work Practice in Health Care: The Need to Use Brief Interventions

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2001), 14 million U.S. adults abuse alcohol and several million more are at risk of developing alcohol problems because of their drinking behaviors. Heavy drinking increases the risk of serious health problems, with the economic cost of problem drinking estimated to be $185 billion per year (NIAAA). Because individuals with alcohol problems are more likely to seek help from health care professionals than from alcohol treatment specialists (Bien, Miller, & Tonigan, 1993), it is imperative that social workers in health care settings be prepared to intervene. Although more than 7 percent of the U.S. population meets criteria for alcohol abuse or alcoholism (Grant et al., 1994), most people have problems that are considered mild to moderate (NIAAA, 2001), making it vital to intervene with individuals before the problems escalate to a level of alcohol abuse or alcoholism. Because traditional alcohol treatment approaches emphasize the need for abstinence, they are often inappropriate for and unsuccessful with people who have less severe alcohol difficulties (Zweben & Fleming, 1999). Therefore, alternative interventions that can be easily incorporated into social work practice in health care settings are needed. Findings from several meta-analyses have supported the success of brief interventions in helping clients reduce their level of drinking or as a means of facilitating treatment entry (Bien et al., 1993; Dunn, Deroo, & Rivara, 2001; Kahan, Wilson,& Becker, 1995; Poikolainen, 1999; Wilk, Jensen, & Havighurst, 1997). Brief interventions are now considered to have a valuable role in substance abuse treatment and the Consensus Panel of the Substance Abuse and Mental Health Services Administration has recognized them as an effective method for both treating some individuals and for motivating entry into more intensive treatment (Center for Substance Abuse Treatment [CSAT], 1999). In addition to representing a form of evidence-based practice, brief interventions are based on principles compatible with values of the social work profession and have the potential for use with diverse populations. Furthermore, brief interventions can be used to demonstrate the cost-effectiveness of social work services, which should be particularly appealing to those practicing in health care. DEFINITION OF BRIEF INTERVENTIONS Brief interventions are time-limited, self-help, and preventive strategies to promote reductions in substance use in nondependent clients and, in the case of dependent clients, to facilitate their referral to specialized treatment programs (Zweben & Fleming, 1999,p. 253). Interventions may be as short as five minutes, in which participants are given feedback regarding the consequences of heavy drinking and advised to reduce their consumption (Modesto-Lowe & Boornazian, 2000). Longer interventions may involve interviewing, which includes reflective listening on the part of the counselor, articulation of motivational statements by the client, full consideration of the client's ambivalence toward changing his or her risky behavior, and avoidance of client resistance (Dunn et al., 2001). The goal of any brief intervention is to motivate client change (CSAT, 1999; Fleming & Manwell, 1999) in a manner that recognizes the client's willingness to change, acknowledges the client as the expert, and demonstrates respect for client decision making. Core elements of brief interventions are identified by the FRAMES acronym (Miller & Sanchez, 1994): * Feedback is given to the individual about personal risk or impairment. * Responsibility for change is placed on the participant. * Advice to change is given by the clinician. * Menu of self-help or treatment options is offered to the participant. * Empathic style is used by the counselor. …

Service Quality and Competitiveness in the Hospitality Sector

This paper analyses and quantifies the main interrelationships between service quality and the competitiveness of hotels, distinguishing between external and internal effects. The external effects were evaluated according to customer satisfaction, its influence on the sales volume and the client's willingness to pay. The internal effects of quality on competitiveness were estimated using average direct costs. The sign and value of the estimated coefficients were used to examine a set of hypotheses for improving the competitiveness of hotels. The direct, positive effect of high service quality on competitiveness is a particularly important finding.

Consulting approaches with system dynamics: three case studies

Although the most obvious characteristic of system dynamics is often the computer simulation model, it is not always that way. From my experience, the valuable lessons from the methodology are obtained from crisp logic and sound reasoning supported by a simulation model. In this paper I discuss approaches to client issues and how to assess the client's capacity to solve problems with system dynamics. Three case studies illustrate how consultants assessed our client's willingness and preparedness and how we employed system dynamics based on that assessment. Here, the methodology's most obvious characteristic is desirable and lasting results. Copyright © 1999 John Wiley & Sons, Ltd.

The Impact of Health Beliefs on Adult Client Education

Quality health education is regarded as a right entitled to all clients within the health care system. Providing health education is the responsibility of all health care providers and an important role for professional nurses, social workers, and health educators. Assisting clients to make intelligent, informed decisions regarding their health needs facilitates continuity of care from hospital to home and supports a gradual return to health which helps to decrease spiraling health care costs. Client's health beliefs and health behaviors influence the adult teaching/ learning process, and it is important that health educators understand how the client's willingness, motivation, and desire to learn new skills and practices impact this learning process. This article will present principles of adult client education and explore how one process utilized by nurses can be adapted by all health educators to develop appropriate individual teaching plans.

Effects of therapist's gender, ethnicity, and verbal style on client's willingness to seek therapy.

Summary In a simulation of the initial therapeutic encounter, a self-disclosure questionnaire was administered to college students, and two dependent variables were analyzed: willingness to sign up for a meeting with the examiner to obtain individual results and reported self-disclosure. The effects of the administrator's (simulated therapist) gender, ethnicity (Anglo- or Mexican-American), and verbal style (nondirective, directive, or neutral) upon clients' willingness to seek therapy (as indicated by their signing up to learn their results) were assessed. Anglo- and Mexican-American females signed up at different rates according to the varied styles of male administrators but Mexican-American male Ss did not. Anglo-American males and females and Mexican-American female Ss were more likely to sign up for results when male administrators employed a directive verbal style. When the administrator was female, the only significant sign up difference was that Mexican-American female Ss were more likely to sign...