Shared Plan Research Articles

Collaboration Between Child Protection and Domestic and Family Violence: A Case File Review

ABSTRACT Collaboration across child protection and domestic and family violence sectors has been identified as central to responding to complexities experienced by families within these practice fields. However, there is little research that explores how collaboration happens and what outcomes are produced. This paper reports on a study that reviewed 21 case files between 2015 and 2019 to identify the indicators of collaboration when domestic and family violence are present along with child protection concerns, and what activities and processes enable collaborative practice at these intersections. The study found that collaboration is visible in case files through activities such as information sharing, referral, planning, and case conferencing. However, analysis of case notes and discussions with practitioners revealed that these indicators do not necessarily lead to collaboration consistently. The implication for practice is that effective collaboration is fundamentally relational. It is through relationship building between agencies, practitioners, and families that collaboration is enacted. IMPLICATIONS Collaboration between child protection and domestic and family violence practitioners can be identified through indictors such as information sharing, referral, shared case planning, and shared case conferencing. The democratising of practice can be seen most clearly at case conferences where information is shared for decision making to support victims of domestic and family violence. Collaboration becomes compromised when information is shared without purposeful and meaningful linkages between agencies, or without the goals of responsive service pathways for women and children and a common risk assessment of the perpetrator.

Palliative care in emergency care: invoking Kairos and rethinking health care systems.

Acute crises of decompensation of a chronic disease are, in most cases, handled in an Emergency Room setting. In these services, emergency care professionals face several challenges, such as incomplete information on the patient's disease, scarce resources, and the pressure of having to make decisions in a short time. In this context, what can be done to provide patient-centered care that is at the same time technically appropriate and aligned with their values? Understanding the patient's situation in relation to their disease; talking to the patient about their clinical condition, comprehending their values and feelings; and understanding time as Kairos - that is, the time of the consultation as an opportunity to understand the patient's needs and build a shared therapeutic plan - are possible solutions to this challenge. Proper handling of patients with severe diseases requires that all links of health care systems are functional and coordinated from primary health care to hospital and home care, starting with the education of health care professionals and the strengthening of work settings that foster the expression of Kairos. This is a long and fundamental path for health care systems such as the Brazilian Unified National Health System (SUS) and that health managers and professionals should not afford to ignore.

Cuidados paliativos na emergência: invocando Kairós e repensando os sistemas de saúde

Acute crises of decompensation of a chronic disease are, in most cases, handled in an Emergency Room setting. In these services, emergency care professionals face several challenges, such as incomplete information on the patient’s disease, scarce resources, and the pressure of having to make decisions in a short time. In this context, what can be done to provide patient-centered care that is at the same time technically appropriate and aligned with their values? Understanding the patient's situation in relation to their disease; talking to the patient about their clinical condition, comprehending their values and feelings; and understanding time as Kairos - that is, the time of the consultation as an opportunity to understand the patient’s needs and build a shared therapeutic plan - are possible solutions to this challenge. Proper handling of patients with severe diseases requires that all links of health care systems are functional and coordinated from primary health care to hospital and home care, starting with the education of health care professionals and the strengthening of work settings that foster the expression of Kairos. This is a long and fundamental path for health care systems such as the Brazilian Unified National Health System (SUS) and that health managers and professionals should not afford to ignore.

A Lightweight Secure Information Sharing Plan for Portable Cloud Registering

A Lightweight Secure Information Sharing Plan for Portable Cloud Registering

Altruism or Self-Interest? ESG and Participation in Employee Share Plans

Altruism or Self-Interest? ESG and Participation in Employee Share Plans

Cardiac stereotactic ablative radiotherapy for control of refractory ventricular tachycardia: initial UK multicentre experience

BackgroundOptions for patients with ventricular tachycardia (VT) refractory to antiarrhythmic drugs and/or catheter ablation remain limited. Stereotactic radiotherapy has been described as a novel treatment option.MethodsSeven patients with recurrent refractory...

Footsie, yeah! Share prices and worker wellbeing

PurposeA small literature has shown that individual wellbeing varies with the price of company stock, but it is unclear whether this is due to wealth effects amongst those holding stock, or more general effects on sentiment, with individuals taking rising stock prices as an indicator of improvements in the economy. The authors contribute to this literature by using two data sets to establish the relationship between share prices on the one hand and worker wellbeing on the other.Design/methodology/approachFirst, the authors use over 20 years of British panel data to show that employee happiness and job satisfaction moves with share prices among those whose pay is partly determined by company fortunes. The authors then examine share price movements and employee stock holding in a single corporation and provide suggestive evidence that an increase in the firm’s stock price increases the well-being of those who belong to its employee share purchase plan (ESPP). These effects are greatest among those making the largest monthly contributions to the program who have the most to gain (or lose) from stock price fluctuations. There is also tentative evidence that the well-being effects of a higher share price are larger for those who hold more shares. Taken together these results suggest that, although stock price movements have little effect on well-being in the population at large, the well-being of those holding stock in their own company rises when the price of that stock is higher, suggesting the effects of share prices work at least partly via changes in wealth.FindingsTaken together these results suggest that the wellbeing effects of share prices work at least partly via changes in wealth.Research limitations/implicationsThe authors cannot be certain that the job satisfaction movements they see are causally linked to share plan participation and bonus receipt. Future research might fruitfully examine the mechanisms at play, and whether the effects identified here are linked to differences in employee motivation and effort over the business cycle.Practical implicationsFirms may wish to consider the appropriateness of linking their workers’ pay to firm performance through share plans or profit shares to establish whether this improves worker wellbeing.Social implicationsThe utility of workers may increase where firms offer some compensation via a share plan or profit share.Originality/valueThe literature suggests a link between share price movements and worker wellbeing, but the reasons for the link are contested. Using two very different data sources, the authors are able to show that share price increases induce higher worker wellbeing, at least in part, through wealth effects.

Treatment development, implementation, and participant baseline characteristics: A randomized pilot study of a tailored quitline intervention for individuals who smoke and vape

BackgroundApproximately 57,000 dual users of cigarettes and e-cigarettes call state tobacco quitlines in the U.S. each year. MethodsThis paper describes a behavioral intervention for dual users of cigarettes and e-cigarettes designed to increase cigarette abstinence. It also presents baseline data from a randomized pilot comparing the Enhanced E-cigarette Coaching (EEC) intervention with quitline treatment as usual (TAU). Oklahoma Tobacco Helpline callers were recruited at registration and randomized to EEC (n = 46) or TAU (n = 50). Treatment included 5 coaching calls and free nicotine replacement therapy (NRT). EEC treatment included enhanced e-cigarette assessment, education, a shared decision-making quit plan development approach, and tailored behavioral support. ResultsParticipants averaged 40.6 years of age and 19.2 cigarettes per day; 85% smoked daily, 48% vaped daily, and 53% reported medium to high e-cigarette dependence. Most reported using e-cigarettes to quit (43%) or to cut down (26%) on smoking. Most had previously tried to quit smoking (91%) and had tried FDA-approved cessation medications (79%). Beliefs about vaping, NRT, and smoking included misinformation. After discussing the relative risks of NRT, vaping, and smoking, most EEC participants (89%) selected a quit plan that incorporated both NRT and vaping. ConclusionsAt baseline, most participants reported a history of failed quit attempts with NRT and were vaping to quit or cut down on smoking, but they may need more support to completely quit smoking. If the EEC improves smoking outcomes, it would provide needed guidance on behavioral support best practices for individuals who vape and want to quit smoking.

The Moving Mapper

Problem, research strategy, and findings Big data promises new insights for planning but threatens to exclude community expertise from knowledge creation and decision-making processes. Participatory methods are needed to ensure that big data is marshaled to address problems of importance to communities, that hypotheses and interpretations are shaped by evidence from lived experience, and that results are ultimately useful to residents. In this study we used a participatory action research (PAR) framework to engage Boston (MA)–area residents in leveraging a longitudinal consumer credit database to understand shared planning challenges. We describe how residents, community organizations, and academic researchers collaborated to co-design an interactive map of residential moves across Massachusetts. The resulting estimates were largely consistent with residents’ understandings of local moving patterns, providing a case of big data analysis confirming, and further specifying, phenomena identified through centering lived experience. Collaborative data analysis also generated new insights; for example, showing misalignment between regional planning boundaries and low-credit movers’ moving patterns. This work shows how sustained PAR partnerships can combine the strengths of community expertise and big data analyses to inform planning. Takeaway for practice PAR with big data is feasible, combines the power of lived experience and large-scale quantitative analysis, and can mitigate the risks of exclusion that threaten emerging uses of big data.

Exploring healthcare students\u2019 interprofessional teamwork in primary care simulation scenarios: collaboration to create a shared treatment plan

BackgroundPrimary care providers assume responsibility for patients with increasingly complex problems requiring interprofessional collaboration. Introducing interprofessional education in healthcare curricula prepares healthcare students for this reality. Solving simulation scenarios as an educational strategy is promoted to support interprofessional education in health care, and is mostly used in acute clinical situations. This paper aims to explore how healthcare students’ actions influence interprofessional collaboration and treatment plan identification when they solve common, sub-acute patient scenarios in primary care situations.MethodsInteraction analysis of video recordings from the simulation scenarios was performed with a focus on the students’ joint actions; specifically how these actions unfold and how productive the students were in terms of developing treatment plans.ResultsWe found variation in the groups’ interactions, the paths they followed, and the quality of their knowledge output in their shared treatment plan. The groups with the capacity to collaborate and engage in sharing information, and explain and elaborate on concepts, were more successful in developing comprehensive treatment plans. Furthermore, these groups managed the duality of defining and solving the immediate problem and collaboratively preparing for future care.ConclusionsAnalysis of the activities in our scenarios showed the students’ potential to practice interprofessional collaboration. Our study illustrates that simulation of sub-acute scenarios in primary care is an underexplored but suitable arena to train communication and teamwork in complex situations. The simulation scenarios are also feasible for use on-site in an educational facility or in practice with minimal equipment and resources.

Arizona Hospitals and Health Systems’ Statewide Collaboration Producing a Triage Protocol During the COVID-19 Pandemic

We describe the process by which all hospitals and health systems in Arizona, normally competitors, rapidly cooperated to develop a statewide protocol (“Addendum”) delineating how to allocate scarce resources during the COVID-19 pandemic should triage be required anywhere in the state. Eight physician ethicists from seven different health systems created the Addendum, which was accepted by all hospitals and health systems, approved by the State Disaster Medical Advisory Committee (SDMAC), and then formally adopted by the Arizona Department of Health Services (ADHS). In addition, the entire state developed a plan to “stick together” such that no facility would be forced to triage unless all were overwhelmed. Because we are unaware of any other state’s hospitals and health systems producing and committing to a shared triage protocol and plan, we believe this experience can serve as a model for other locales during the absence of sufficient state or federal guidance.

An expansion of practice: special education and Montessori public school

ABSTRACT The choices for public school education in the United States have evolved to include Montessori programmes. As a result, special education practices have become visible in Montessori, making collaboration essential. The exploration of how Montessori and special education teachers collaborate through the identified constructs of (a) shared planning, (b) frequent communication, (c) shared vision, (d) mutual respect, and (e) joint trust despite the evident philosophical differences is important for students in inclusion. Data sources included in-depth interviews with teachers to identify patterns related to collaboration in Montessori public schools. Findings indicated that there is a need to establish a clear plan for connecting philosophies and for collaboration for students in inclusion, not only in the context of United States public Montessori programmes, but for Montessori practitioners in other regions and school settings. Recommendations include using a terminology comparison activity in teacher professional development and implementing an Inclusion Professional Learning Community to address the barrier of time to proactively create deep collaborative relationships built upon the established collaborative constructs.

Clinicians’ perspectives on strategies to improve cross-institutional collaboration and coordination of pancreatic cancer care for rural patients.

e13532 Background: Rural pancreatic cancer patients often lack access to high-volume pancreatic cancer specialists. This lack of access can result in fragmented cancer care—when patients receive care at multiple institutions—and necessitates that specialists engage in cross-institutional collaboration. In the context of fragmented pancreatic cancer care, the strategies specialists use to facilitate collaboration across institutions are poorly understood. Methods: We conducted semi-structured interviews with cancer specialists (medical, surgical, and radiation oncologists) from a high-volume pancreas cancer center (n = 9) and rural community cancer centers (n = 11) to examine specialists’ coordination practices related to treating and co-managing pancreatic cancer patients across their respective institutions. Using qualitative methods, two of the co-authors independently coded the interview transcripts to identify themes related to cross-institutional coordination practices, noting improvement opportunities and facilitative strategies. Results: Cancer specialists described multiple practices to coordinate cross-institutional care including one-on-one phone calls and using a shared electronic medical record or secure email to exchange clinical notes. In recognizing the limitations of these practices, specialists acknowledged the need to develop and implement communication systems that could facilitate real-time discussions and information sharing between high-volume and rural specialists to coordinate diagnostic and treatment plans. Cross-institutional virtual tumor boards were viewed as a potentially useful approach to foster shared clinical decision-making and treatment plan development across institutions, but specialists perceived that logistical, institutional, and technological challenges could limit the use of this approach. Regardless, specialists indicated that cross-institutional virtual tumor boards could help disseminate treatment recommendations as well as identify barriers to care for mutually-shared rural cancer patients. Specialists also indicated that a dedicated patient navigator could help facilitate cross-institutional coordination by bridging communication between specialists while also assisting cancer patients with issues related to housing, transportation, scheduling, and treatment finances. Conclusions: It is important for cancer specialists treating rural cancer patients to have strategies that support efficient communication and decision-making. Cross-institutional virtual tumor boards and dedicated patient navigators are two such strategies that may help facilitate collaboration between high-volume and rural cancer specialists. Future research should examine the impact of these strategies on patients receiving cancer care at multiple institutions.

Study on the Intention of Private Parking Space Owners of Different Levels of Cities to Participate in Shared Parking in China

The implementation of shared parking program can effectively increase the utilization rate of existing parking space resources. At present, shared parking program has not been widely practiced in China, and the prerequisite for this prospect to be implemented is whether the private parking space owner group can quickly and widely accept shared parking program. In this study, considering the differences in the economic development, urban planning, and parking pressure in cities of different levels, the theory of planned behavior and the benefit-risk perception model (C-TPB-BRA) are combined as the theoretical framework to explore the intention to share parking space from the perspective of the owners of private parking spaces in cities of different levels. Based on China’s empirical data, structural equation models are built to verify the hypotheses proposed. Our results show that (a) the intention of private parking space owners in different levels of cities to participate in shared parking and the mechanism of action of the psychological factors are different, and not all psychological factors have a direct impact on the intention to share. In first-tier, second-tier, and third-tier cities, Subjective Norm (SN) and Perceived Behavioral Control (PBC) indirectly affect Behavior Intention (BI) through Attitude (ATT), Perceived Benefit (PB), and Perceived Risk (PR). In the fourth-tier cities, SN and PBC directly affect BI. Except for BI, other psychological factors influence each other significantly; (b) the psychological factors affecting the intention to supply shared parking spaces in first-tier, second-tier, third-tier, and fourth-tier cities, respectively, are PB > ATT > PR, PB > PR > ATT, PB > PR > ATT, and PB > SN > PBC > ATT > PR. Our research results could help determine the internal factors that affect the intention of parking space suppliers and their mechanisms of action to participate in shared parking, and on that basis, our findings could also help governments and platform operators to promote shared parking development plans.

An investigation into decision-making and delivery activities following design-led events in collaborative planning

PurposeThis paper is concerned with what should happen after design-led events have been held to promote co-decision-making, between professionals and local stakeholders, in collaborative planning of the built environment. Rather than being standalone, such events form one single step in a multi-stage collaborative planning process. What comes before and after them has to be acknowledged as important to their effective contribution to collaborative planning. This paper aims to make a case for giving more attention to the post-event stages of collaborative planning, to ensure that the involvement of the public produces real and tangible benefits.Design/methodology/approachContent analysis of both academic and grey literatures was undertaken to examine emerging advice on how to conduct decision-making, the implementation of outputs and the delivery of desired outcomes, after design-led events. A critical review of the post-event decision-making and delivery activities is offered, which aims to add to the current academic literature on the deployment of design-led events. An attempt is made to sketch out the characteristics of post-event stages, drawn from the literature and collated specific examples of collaborative planning investigated in Scotland.FindingsThree key factors are identified as affecting the successful implementation of decisions reached at design-led events: (1) a shared follow-on plan, (2) an agreed action programme for delivering this and (3) a properly constituted and resourced delivery vehicle that can monitor and evaluate progress. A research agenda to address questions raised but left unanswered is suggested dealing with how the decision-making and delivery activities following design-led events in collaborative planning might be improved.Originality/valueA research agenda to address questions raised but left unanswered is suggested dealing with how the decision-making and delivery activities following design-led events in collaborative planning might be improved.

Quels outils thérapeutiques en faveur du rétablissement dans la schizophrénie ?

Recovery is a multidimensional construct that encompasses both subjective (e.g. well-being, satisfaction with life, self-esteem) and objective outcomes (e.g. independent living, interpersonal and intimate relationships, work). Recovery can be defined either from a clinical perspective (i.e. clinical and functional remission) or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. Recovery-oriented practices imply to create pro-recovery environment seeking to enhance hope, control, strengths, goal striving and self-management. Their implementation in mental health services has shown effectiveness in improving personal recovery. Psychiatric rehabilitation brings together a wide range of recovery-oriented interventions. A comprehensive clinical, functional and cognitive assessment is performed to establish the individual's strengths and weaknesses, autonomy, and occupational level. Therapeutic tools are selected based on the participant's personal life goals as part of an individualized psychiatric rehabilitation action plan. The action plan can include strengths-based case management, psychoeducation, improvements in physical and mental health, peer-support interventions, joint crisis plans, cognitive remediation (CR), cognitive behavior therapy (CBT), social skills training (SST), self-stigma reduction, making empowered decisions about disclosure, family support, recovery-oriented interventions from preconception to post-partum care and supported housing and supported employment. Psychiatric rehabilitation interventions improve patient's outcomes after one year of follow-up (i.e. symptom reduction, improvements in insight, treatment adherence and cognitive and psychosocial function). The access to psychiatric rehabilitation interventions remains however limited (1/3 of the participants with SSD included in the FondaMental Advanced Centers of Expertise for SSD) and should be further developed. Supported housing and supported employment improve the access to stable housing and sustained competitive employment. They have been associated to improved patient's outcomes and have shown to be cost-effective. Recovery-oriented interventions from preconception to post-partum care (reproductive health counseling, strength-based case management by a trained midwife, shared action plan, self-stigma reduction, cognitive remediation, gender-sensitive CBT and SST) could reduce the risk of psychiatric, obstetrical and neonatal complications. They could reduce the risks of parent-infant separation and custody loss and could prevent the development of psychosis in family high-risk children. These interventions should be further developed and evaluated. Recovery-oriented practices and psychiatric rehabilitation support recovery in people with SSD. The access to a comprehensive standardized evaluation and to a personalized recovery-oriented care including psychosocial treatment remains limited. Their implementation in mental health services figures among the priorities under the French decree on the territory national mental health plan for recovery-focused care.

Improving Primary Care Medication Processes by Using Shared Electronic Medication Plans in Switzerland: Lessons Learned From a Participatory Action Research Study.

BackgroundSeveral countries have launched health information technology (HIT) systems for shared electronic medication plans. These systems enable patients and health care professionals to use and manage a common list of current medications across sectors and settings. Shared electronic medication plans have great potential to improve medication management and patient safety, but their integration into complex medication-related processes has proven difficult, and there is little scientific evidence to guide their implementation.ObjectiveThe objective of this paper is to summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the systemwide implementation of shared electronic medication plans. We collected experiences, assessed the influences of the local context, and analyzed underlying mechanisms influencing the implementation.MethodsIn this formative action research study, we followed 5 clusters of health care professionals during 6 months. The clusters represented rural and urban primary care settings. A total of 18 health care professionals (primary care physicians, pharmacists, and nurses) used the pilot version of a shared electronic medication plan on a secure web platform, the precursor of Switzerland’s electronic patient record infrastructure. We undertook 3 group interviews with each of the 5 clusters, analyzed the content longitudinally and across clusters, and summarized it into lessons learned.ResultsParticipants considered medication plan management, digitalized or not, a core element of good clinical practice. Requirements for the successful implementation of a shared electronic medication plan were the integration into and simplification of clinical routines. Participants underlined the importance of an enabling setting with designated reference professionals and regular high-quality interactions with patients. Such a setting should foster trusting relationships and nurture a culture of safety and data privacy. For participants, the HIT was a necessary but insufficient building block toward better interprofessional communication, especially in transitions. Despite oral and written information, the availability of shared electronic medication plans did not generate spontaneous demand from patients or foster more engagement in their medication management. The variable settings illustrated the diversity of medication management and the need for local adaptations.ConclusionsThe results of our study present a unique and comprehensive description of the sociotechnical challenges of implementing shared electronic medication plans in primary care. The shared ownership among multiple stakeholders is a core challenge for implementers. No single stakeholder can build and maintain a safe, usable HIT system with up-to-date medication information. Buy-in from all involved health care professionals is necessary for consistent medication reconciliation along the entire care pathway. Implementers must balance the need to change clinical processes to achieve improvements with the need to integrate the shared electronic medication plan into existing routines to facilitate adoption. The lack of patient involvement warrants further study.

Transitioning patients from outpatient mental health services to primary care: A rapid literature review.

A lack of access to mental health services is a critical barrier to obtaining evidence-based care. One strategy to improve access is to transition stable patients out of mental health specialty services and into primary care, thus opening availability for new patients and those with acute mental health needs. To support these transitions, organizations might explore a range of new practices and implementation strategies. We conducted a rapid literature review to summarize descriptions from the research literature about practices for transitioning stable patients from outpatient mental health services to primary care, as well as implementation strategies to enhance the adoption and sustainment of these practices. We searched PsycINFO and Cumulated Index to Nursing and Allied Health Literature (CINAHL) for articles published between January 2000 and August 2019. For articles meeting inclusion criteria, we abstracted data on study characteristics, transition practices, and implementation strategies. We included 11 articles representing diverse study designs, settings, and health care organizations. Across these articles, we identified six categories of commonly described transition practices, with patient engagement appearing the most frequently (10 articles), followed by shared treatment planning (eight articles), assessment of recovery and stability, care coordination, follow up and support, and medication management (seven articles each). Less frequently, articles included descriptions of implementation strategies, with five articles describing efforts to train and educate stakeholders and four articles describing the use of evaluative and iterative strategies. We identified descriptions of several common practices to help patients transition from mental health specialty services to primary care, but there are opportunities for an increased focus on implementation strategies to enhance the adoption and sustainment of these transition practices. More research is needed to better understand the effectiveness of specific transition interventions and the feasibility of deploying these interventions in heterogeneous health care settings.

P231 Patient experience of accessing a virtual cystic fibrosis service during the 2020 SARS-CoV-2 pandemic in Blackpool, North West of England

In 2015 Regional Specialist Commissioners awarded Blackpool Teaching Hospitals the commission of a new regional cystic fibrosis centre in the North West of England. The Blackpool Adult Cystic Fibrosis Service (BACFS) opened in February 2017 and was the first entirely new UK adult CF centre in three decades. Objective: To explore patient experiences of accessing a virtual adult cystic fibrosis service during the SARS-CoV-2 pandemic, to inform future practice and service development. Method: Between December 2020 and January 2021, 44 patients, accessing a blended approach to care through both virtual and face-to-face appointments, where necessary, were offered a CF-related adaptation of our hospital's Friends and Family Test. The questionnaire provided the mechanism to explore patient satisfaction and experience of BACFS during the pandemic (March 2020–December 2020) giving opportunity to critically appraise the service and their virtual experience. Results: Response rate was 18%. 100% of patients rated the service as either good or excellent, demonstrating care and compassion, being listened to, developing autonomy over their healthcare with shared action plans and improving confidence in the management of their condition. 50% of patients reported their virtual experience was ‘very good’ and 50% ‘good’, with 100% of patients reporting the frequency of their appointments was ‘just right’. Further qualitative themes of the virtual experience are presented, including convenience of appointments and feeling connected with the team during the pandemic. Conclusion: The data presented demonstrates that patients value the service provided by BACFS. Patients have been supportive of the virtual service provision with a suggestion that the offering may continue as we consider service delivery post SARS-CoV-2. The adapted patient experience questionnaire continues to drive service development and inform our approaches in alternative ways to engage our patients.

Are friends electric? The benefits and risks of human-robot relationships.

SummarySocial robots that can interact and communicate with people are growing in popularity for use at home and in customer-service, education, and healthcare settings. Although growing evidence suggests that co-operative and emotionally aligned social robots could benefit users across the lifespan, controversy continues about the ethical implications of these devices and their potential harms. In this perspective, we explore this balance between benefit and risk through the lens of human-robot relationships. We review the definitions and purposes of social robots, explore their philosophical and psychological status, and relate research on human-human and human-animal relationships to the emerging literature on human-robot relationships. Advocating a relational rather than essentialist view, we consider the balance of benefits and harms that can arise from different types of relationship with social robots and conclude by considering the role of researchers in understanding the ethical and societal impacts of social robotics.