Distrust Of Professionals Research Articles

"You can't really have a relationship with them because they just ask you questions": understanding adolescent dropout - an empirical single case study.

High dropout rates are common in youth psychotherapy, including psychoanalytic psychotherapy, yet the reasons behind this trend remain obscure. A critical focus to enhance adolescent engagement could be the therapeutic alliance, particularly in resolving alliance ruptures. This study sought to clarify the complex relationships between the therapeutic alliance, encompassing alliance ruptures and resolutions, and dropout within the context of poor outcome. It investigated a single case of an adolescent with depression who dropped-out of Short-Term Psychoanalytic Psychotherapy, without showing clinical improvement. Data was garnered from diverse sources, including questionnaires, interviews, and session recordings, and analyzed through a mixed-method longitudinal framework. This encompassed views from the adolescent, therapist, parents, and external evaluators. The study identifies several factors impacting the decision to drop out, including initial profound distrust toward the therapist, a complex and difficult therapeutic relationship characterized by unresolved alliance ruptures, and sporadic attendance. External factors including minimal parental engagement with therapy were also seen as detrimental to the adolescent's involvement and progress. The research underscores the challenges in engaging adolescents, especially when there may be distrust of professionals, and in the absence of parental involvement with treatment.

Образовательные технологии: осознанная или навязанная необходимость?

The problem of effective and conscious use of modern educational technologies by university teachers as a means of improving the quality of education, the formation of different groups of skills (hard skills, soft skills, self skills) is posed. Based on the problematic analysis of the reports of the heads of departments of one of the universities on the use of technology by teachers, the following effects are highlighted: the “effect of false recognition” of specific technologies, the effect of “professional distrust” of educational and developmental capabilities of technologies, the effect of a contradiction between the subject content and the teacher’s choice between a special teaching method or an educational technology. The problematic points in the organization of joint educational activities at the university due to these effects are highlighted: distortion of the technological chain, the use of technology only at the final stages of studying the topic, the weak influence of the developing capabilities of technology on students, a low level of teaching culture and methodological activity. The inability of a teacher to choose, analyze and reconstruct educational technologies for their professional and personal tasks is, according to the authors, a manifestation of the anthropological deficit of education, which is characterized by the “exclusion” of a person from their education. Educational technology is interpreted as a didactically culturally designed way of organizing joint educational activities, which allows the teacher to achieve subject, meta-subject and personal learning outcomes. It is concluded that it is the teacher that must come to the need to use it: technologies imposed from above consolidate the “educational alienation” of a person from their educational reality and do not allow them to influence their own educational and professional activities.

Using attribution theory to explore the reasons adults with hearing loss do not use their hearing aids.

Hearing aids are an effective treatment for individuals with hearing loss that have been shown to dampen (and sometime ameliorate) the negative effects of hearing loss. Despite the devices' efficacy, many reject hearing aids as a form of treatment. In the present qualitative study, we explored the reasons for hearing aid non-use in the United States that emerged from the stories of adults with hearing loss who do not to utilize hearing aids. We specifically used thematic analysis in concert with an attribution theory framework to identify and analyze recurring themes and reasons throughout these individuals' narratives. A total of nine themes describing reasons of hearing aid non-use emerged. Four reasons were internally motivated: (1) non-necessity, (2) stigmatization, (3) lack of integration into daily living, and (4) unreadiness due to lack of education; five reasons were externally motivated: (5) discomfort, (6) financial setback, (7) burden, (8) professional distrust, and (9) priority setting. These findings contribute to the field of hearing healthcare by providing professionals with insight into reasons that people across the provided when recounting their experiences following the diagnosis of hearing loss, prescription for hearing aids, and their hearing aid non-use. These findings are an important step toward the development of more effective, person-centered hearing healthcare that can best address these individuals' concerns and expectations surrounding hearing loss and hearing aids.

“A Bridge Over Troubled Water”: Nurses' Leadership in Establishing Young Adults' Trust Upon the Transition to Adult Renal-Care - A Dual-Perspective Qualitative Study

PurposePatient trust is strongly related to adherence, but has not been tested in transitional care. Low adherence post-transitions of young adults from pediatrics to adult renal care jeopardizes transplanted kidneys and quality of life. We aimed at identifying barriers to trust of young adults in nurses and trust-building elements upon and post transition. Design and methodsFollowing IRB approval, we recruited 21 young adults who underwent kidney transplants before the transition to adult renal care and eleven nurses from adult care in two Israeli tertiary hospitals that perform kidney transplants. We conducted 42 in-depth narrative interviews with young adults and one interview with each nurse. We used thematic analysis guided by Meleis's framework of effective transitions. ResultsMost young adults' attributed negative meanings to the transition to adult care which did not enhance their well-being. Young adults were not provided with resources to promote their autonomy and role-sufficiency; despite preparation processes pre-transition, they were not aware of expectations from them. Their own unmet expectations of clinicians made them feel unsafe, objectified, and helpless and resulted in distrust in professionals, low adherence, and in some cases, dropping out of care and lower quality of life. ConclusionsNurses who focused on building a relationship with young adults rather than on operational tasks established trust and led young adults towards role-sufficiency, satisfaction with care, adherence, and optimized quality of life. Practice implicationsThe proposed recommendations for nurses and clinicians structure the trust-building process using elements to improve transitional care.

Revisiting Rittel and Webber’s Dilemmas: Designerly Thinking Against the Background of New Societal Distrust

In this article, we posit designerly thinking as a family of design approaches that some believe are able to effectively respond to wicked problems. We will scrutinize this premise by revisiting Horst Rittel and Melvin Webber’s 1973 article in which the notion of wicked problems was originally introduced. In it, Rittel and Webber note the emergence of a general sense of distrust in professionals in the 1960s and interpret it as a loss of confidence in the then leading approach to addressing societal problems: systems-based planning. Rittel and Webber formulated three dilemmas that societal problems pose, of which the second is their wickedness, and argued that planning does not resolve these dilemmas. In the 2010s, an emerging distrust in professionals has arisen once more, raising the question of whether designerly thinking is equipped to address societal issues. Our review and discussion of Rittel and Webber’s three dilemmas reveals that designerly thinking currently does not resolve any of them, as there can always be groups that will oppose certain solutions. We argue that designerly thinking cannot overcome societal pluralism, but that designers can and should interpret social distrust as an invitation to discuss the consequences and their societal equity.

The oil crisis, risk and evidence-based practice.

Evidence-based practice has risen to prominence over the last 20 years. Different professions have taken it up in different ways and for different purposes. It has been seen as holding both threats and advantages to professionalising endeavours and professional identity. It has engendered controversy but some criticisms of it have been unconvincing. It is possible to account for its rise as a response to tightening financial constraints on state spending in the west, as a sign of a culture increasingly concerned with risk, distrust of professionals and experts, as well as a way for professionals themselves to maintain control over their activity in the face of growing managerialism. This paper reviews the literature of some of the movement's proponents as well as criticism from various professional groups. It concludes that more useful than either arguing for or against it, is to understand the policy background and sociological reasons for its emergence and spread.