Trained Interviewers Research Articles

Compliance to the tobacco-free educational institution policy (ToFEI study) in urban areas of selected districts of Karnataka: A situational analysis

BackgroundYouth smoking is a major concern as the average age at which people start smoking has been declining in recent years. Strengthening tobacco control policies at educational institutions (EI) will prevent the access to tobacco products for minors. The current study aims to assess teacher’s knowledge and compliance to tobacco-free-educational-institution (ToFEI) policy. MethodsFour districts of a south Indian state were chosen for the study. A face-to-face interview with approximately 50 head teachers from respective districts was carried out by a trained interviewer to assess the compliance to ToFEI guidelines. The shops within 100 yards of EI were visited to confirm the sale of tobacco using geographic information system. ResultsA total of 234 EI were surveyed, of which 79 (33.8%) institutions had ‘tobacco-free institution’ board. A display board prohibiting tobacco sale within 100 yards of school was present in 175 (74.8%) institutions. A total of 733 shops were found around 195 EI and of them, 9.7% (71/733) shops were selling tobacco products. ConclusionDespite the existence of tobacco-free school guidelines in India, there was a lacunae in compliance with provisions of guidelines among various EIs across Karnataka state. With nearly one-fifth of institutions having shops that sell tobacco within 100-yard of institutions, further laxity in implementation of tobacco control activities can be a threat and can lead to easy availability of tobacco products and attract more students to use the lethal products.

Peak Flow Feedback Intervention Improves Under-Perception of Airflow Limitation in Pediatric Asthma: A Randomized Clinical Trial.

Under-perception of asthma symptoms is associated with poor asthma outcomes. We assessed the effects of a behavioral intervention for improving perception of airflow limitation and asthma outcomes. A two-arm randomized controlled trial compared peak expiratory flow (PEF) feedback versus supportive counseling. Latino and Black adolescents with asthma ages 10-17 years old and caregivers were recruited from hospitals in the Bronx, NY. PEF feedback sessions reviewed accuracy of PEF guesses and medication adherence data, and targeted behavior change using motivational interviewing and problem-solving skills training. Supportive counseling received emotional support related to asthma. Both groups received 3 sessions across 6 weeks. All participants were blinded to PEF while guessing PEF during pre-intervention, 1, 6, and 12-month follow-up. Children in PEF feedback saw actual PEF after guesses were locked in during the 6-week intervention. Participants and assessors were blinded to group assignment. The primary outcome was under-perception of airflow limitation (divergence between actual PEF and guesses) on home spirometers. Secondary outcomes included daily PEF and forced expiratory volume in 1 second (FEV1), inhaled corticosteroid adherence measured by electronic monitors, Asthma Control Test, and emergency healthcare use for asthma. The sample comprised 354 children (M = 13.2±2.2 years; 62% Latino, 38% Black) and caregivers. PEF feedback (N = 153 analyzed) demonstrated greater improvements at 1-month follow-up on under-perception of airflow limitation (difference-in-differences, -12.64; 95% CI, -17.54 to -7.74), % personal best PEF (9.89; 95% CI, 7.13 to 12.65), % predicted FEV1 (4.93; 95% CI, 0.95 to 8.90) and ICS adherence (16.02; 95% CI, 7.15 to 24.89) compared with supportive counseling (N = 152 analyzed). At 12-month follow-up PEF feedback maintained improvements on under-perception of airflow limitation (-13.87; 95% CI, -19.03 to -8.71), higher PEF (14.23; 95% CI, 11.37 to 17.08) and %FEV1 (5.62; 95% CI, 1.56 to 9.67), and had smaller declines in ICS adherence (17.51; 95% CI, 7.12 to 27.89) versus pre-intervention than supportive counseling. No between-group differences existed for asthma control or healthcare use. The efficacy and sustainability of PEF feedback was established in improving children's perception of airflow limitation, pulmonary function, and medication adherence. Clinical trial registration available at www. gov, ID: NCT02702687.

Design and evaluation of a visual genomic explainer: a mixed-methods study

ObjectiveTo design and assess a visual genomic explainer focusing on plain language and engaging imagery. The explainer aimed to support doctors’ comprehension of complex genomic concepts and results and act...

A type 1 hybrid multi-site randomized controlled trial protocol for evaluating virtual interview training among autistic transition-age youth

A number of policies mandate that autistic transition-age youth receive employment services to prepare for the workforce before high school graduation. A key limitation to these services is the job interview component, which relies on non-standardized, resource-intensive, staff-led role-plays to help autistic transition-age youth improve their interview skills. The autism community has called for better job interview preparation. To address this gap in services, our team, collaborated with the autism community to adapt the intervention, Virtual Reality Job Interview Training (VR-JIT; effective among adults with serious mental illness), into Virtual Interview Training for Transition Age Youth (VIT-TAY). This adapted intervention was tailored to meet the needs of autistic transition age youth while maintaining the core components of VR-JIT (i.e., an online job interview simulator with four levels of automated feedback and e-learning content). A pilot randomized controlled trial (RCT) demonstrated VIT-TAY's feasibility and initial effectiveness at improving job interview skills, reducing anxiety, and increasing employment rates within six months when added to transition services or pre-employment transition services (Pre-ETS). Thus, the overarching goal of this Hybrid Type 1 effectiveness-implementation study protocol is to conduct a fully-powered RCT of VIT-TAY across 16 schools in various geographical locations. Our specific aims are to 1) Evaluate whether Pre-ETS (or transition services) with VIT-TAY, as compared to Pre-ETS (or transition services) with an active control intervention (i.e., job interview didactics/e-learning with a series of 3–5 min videos of employed autistic adults talking about their career pathways) enhances employment outcomes; 2) Evaluate mechanisms of employment by nine months post-randomization; and 3) Conduct a multilevel, mixed-method process evaluation of the initial implementation of VIT-TAY across settings (e.g., acceptability, feasibility, and barriers and facilitators of implementation).

Eyewitness memory for person, object and action information is mediated by interview environment and the presence or absence of rapport

Purpose Obtaining accurate and reliable information from witnesses and victims of crime is essential for guiding criminal investigations and for the successful prosecution of offenders and beyond. Here, the purpose of this study is to investigate the impact of prosocial rapport behaviours and retrieval environment on mock eyewitness memory with an emphasis on the qualitative nature of information recalled in terms of persons, actions, objects and surroundings. Design/methodology/approach One hundred participants from the general population took part in mock witness research using a 2 (Environment: face-to-face; virtual) × 2 (Rapport: present; absent) design. Participants individually viewed an event depicting a fight in a bar and were then interviewed 48 h later according to condition. Findings Rapport and environment variously emerged as impactful, resulting in significant improvements in correct recall of persons, actions and object information when rapport was present and in virtual environments (VEs) when communicating via avatars. In many instances, the benefits of rapport and environment were additive, but not always. Surroundings information remained consistent across all conditions. Erroneous recall was extremely susceptible to inflation in face-to-face interviews when rapport was absent, in some instances increasing by over 100%. However, virtual interview spaces appeared to dilute the negative effects on retrieval when rapport was absent. Research limitations/implications This study concurs with others who have argued that comfortable witnesses are “better” witnesses; however, understanding what “comfort” looks and feels like remains a challenge. Practical implications The results, alongside the findings of others, have implications for applied and social cognition and reveal avenues for future research centred on widening access to justice and professional interview training. Originality/value This study reveals that prosocial rapport behaviours and VEs significantly enhance the accuracy of eyewitness recall. The findings suggest that virtual interviews can mitigate errors in the absence of rapport, offering valuable insights for criminal investigators and legal professionals. This research is crucial for improving witness interviewing techniques, thereby aiding in the accurate prosecution of offenders and broadening access to justice. The paper is valuable for criminal investigators, legal professionals, forensic psychologists and researchers focused on improving the reliability of eyewitness testimonies and interview methodologies.

Development and evaluation of a questionnaire to capture environmental and occupational inhalational exposures in adults with fibrotic interstitial lung disease

BackgroundIdentification of exposures in patients with interstitial lung diseases (ILDs) is essential for diagnosis and management and can be facilitated through the use of exposure questionnaires. However, for most ILDs, a patient-focused questionnaire is lacking. Cognitive interviewing is a methodology used to evaluate sources of understanding and misunderstanding in a questionnaire and to provide evidence of content validity. We developed and refined a new exposure questionnaire for patients with fibrotic ILDs by using cognitive interviewing to establish its understandability and content validity.MethodsAn exposure assessment questionnaire was developed by a multidisciplinary team. Cognitive interviews with 24 patients with fibrosing ILDs were conducted by trained interviewers over the phone or Zoom using a semi-structured interview guide. The questionnaire was amended based on the interviewers’ interpretation of sources of misunderstanding. The revised questionnaire was tested in a second round of cognitive interviews with a different group of 24 patients.ResultsAmong the 48 patients who completed interviews, mean age was 61 years, 58.3% were male and 75.0% were white. Based on the first round of cognitive interviews, the multidisciplinary team modified the questions, organization, and instructions of the questionnaire to facilitate recall, adjust for exposures that were frequently misunderstood or required clarification, and focus on clinically relevant exposures. The revised questionnaire performed well in the second round of interviews.ConclusionAn exposure questionnaire, developed with input from patients, can be used to assess clinically relevant exposures in adults with fibrosing ILDs. This is the first questionnaire for all types of fibrosing ILD to have undergone content validation.

High vs. Low Intensity Behavior Therapy Delivered to Adolescents with ADHD: Potential Adverse Long-Term Effects on Substance Use Outcomes.

Individuals with ADHD are at risk for substance use initiation in adolescence and escalation to problematic use in adulthood. Little is known about the impact of psychosocial ADHD treatment on substance use. Based on existing theory, both therapeutic (i.e., through reducing symptoms and impairments) and iatrogenic effects (i.e., through improved social functioning) of psychosocial treatment for ADHD on adolescent substance use initiation are plausible. A primarily ethnic/racial minority sample (~ 95% Latinx or Black) of rising ninth grade students with ADHD (n = 106) were randomly assigned to receive high intensity (i.e., Summer Treatment Program-Adolescent, parent training, and school consultation) or lower intensity (parent training, organization skills training, and school consultation) intervention the summer before entering high school. Participants were followed four-years post-baseline and substance use was documented. Analyses tested treatment effects on substance use initiation (alcohol and/or marijuana) and mediators of main effects. After controlling for covariates, participants assigned to HI (37.5%) were significantly more likely than LI (18.6%) to initiate substance use by end of high school, indicating an iatrogenic effect of HI treatment. No significant mediators were detected. Post-hoc exploration of moderators suggested that youth with elevated Posttraumatic Stress Disorder (PTSD) symptoms may have experienced a benefit of HI treatment on substance use whereas youth without elevated PTSD symptoms experienced iatrogenic effects. Large, well-powered, samples should examine moderated mediational models to better understand who is most risk for iatrogenic effects of ADHD psychosocial treatment and why. Clinicians delivering psychosocial treatment to adolescents with ADHD should monitor for potential iatrogenic effects.

Training young co‐researchers to interview their parents: The transformative potential of intergenerational interviews

AbstractThe turn to co‐production in geographical research is underpinned by the social justice aim to democratise academic practice, and in recent years this has extended to training young people as co‐researchers. However, discussions of intergenerational dynamics in co‐produced research are limited, and there are no accounts of family members interviewing one another. This paper responds to this oversight by presenting a reflective account of a research project centring on intergenerational family discussions and negotiations of climate change knowledge, in which young co‐researchers interviewed parents. We share key considerations for developing bespoke interview training and preparing co‐researchers to undertake interviewing, and we highlight the strengths and opportunities of intergenerational interviews in families. Our core contention is that, when planned and supported with tact and consideration, intergenerational interviews can boost young people's confidence in their skills and generate rich dialogues that may lead to decisions and outcomes that will outlive the research. However, engaging co‐researchers and their pre‐existing familial relationships in research requires careful consideration, practical training, and ongoing reflection, because these relationships are defined by intergenerational dynamics that precede and outlast the research.

A survey of practicum training practices in clinical neuropsychology

Objective: While previous survey research has focused on various training constituencies such as trainees, and postdoctoral/internship supervisors, no previous survey research has examined the needs and perspectives of practicum level supervisors and training programs. This study was designed to address this limitation. These results were used in forming the North American Association of Practicum Sites in Neuropsychology (NAPSN). Method: A 41-item survey was developed and distributed to practicum supervisors across the United States and Canada via listserv. A total of 142 supervisors completed the survey; the majority were employed at academic medical centers (62%) and located in the U.S. (93%). Most participants evaluated adults (61%), while a minority evaluated children (27%), or patients across the lifespan (12%). Results: Most respondents supervise one (44%) or two (26%) students per year and prefer advanced trainees (>90%). The majority (78%) indicated students see one case per week. The number of clinical contact hours and reports varied based on location (U.S. vs. Canada) and population (adult vs. pediatric). Supervisors found professional papers and publicly available didactics to be the most helpful resources. Commonly endorsed needs included help with policies and procedures (53%), supervising trainees from underrepresented groups (49%) and nontraditional backgrounds (44%), and access to didactics (49%). Conclusions: The survey provided insights into current practices and the needs of practicum supervisors. These findings will inform NAPSN’s development of materials and policies to support trainees and supervisors and can guide other professionals in supporting their practicum trainees as they navigate training in neuropsychology.

Development of an application for training management of the maintenance team in a metallurgical industry in the suape industrial complex – cabo de Santo Agostinho

This work presents the development of an application designed to complement traditional training management methods within an organization. The application, developed on the PowerApps platform using a Low-Code approach, aims to facilitate the monitoring and management of employee training in the maintenance department of a company located in the Suape industrial complex, Cabo de Santo Agostinho. Its main objective is to provide a digital platform that allows for the verification of the training status of maintenance technicians, identifying which are in "Attention," "Expired," and/or "OK" status. Traditionally, this data is managed manually, in a time-consuming and error-prone process. The transition to a digital system ensures data accuracy, reduces the time required to access and update information, and improves the overall efficiency of the department's activity scheduling process. During the testing phase, conducted between January and August 2024, comparative data was collected on the training consultation process, before and after the implementation of the application. Preliminary results indicated a significant improvement in the efficiency and productivity of the maintenance department, comparable to other works that used PowerApps as a quick and low-cost solution.

Baseline financial distress and cost-related social risks among participants in the Cancer Financial Experience (CAFÉ) trial.

172 Background: Cancer Financial Experience (CAFÉ) is a multi-site, three-arm randomized controlled trial to test the impact of a novel financial navigation intervention on financial distress among cancer patients. We compared the baseline prevalence of financial distress among CAFÉ trial participants, using two instruments (InCharge and COST), and assessed cost-related social risks. Methods: Three hundred seventy one (n=371) participants were consented and randomized between August 2021-March 2023. Eligible participants (n=2033) included adults (18+ years of age), diagnosed with invasive cancer within 120 prior to a recent visit to a CAFÉ study clinic/site, members of Kaiser Permanente Northwest or Kaiser Permanente Washington, and spoke English or Spanish. Following consent, participants were randomized to one of three trial arms: enhanced usual care; brief intervention; enhanced intervention. The two primary trial outcomes were: financial distress, measured using the InCharge Financial Distress/Financial Well-Being scale, and cancer-specific health-related quality of life, measured by the FACT-G7 scale. Additionally, we collected the COST measure and cost-related social risks. All participant-reported outcomes, demographic, and socioeconomic data were collected via telephone survey at baseline and 12 months by trained interviewers. Survey data was stored in REDCap. Descriptive statistics were used to assess participant demographic, socioeconomic, and outcome data at baseline. Results: Among randomized participants (n=371), mean age was 61 years (standard deviation=14 years), 63% were female, 11% Hispanic, 9% Asian, 8% Black , 61% married or living with partner, 31% were employed full-time, 37% retired, 44% had annual income of $20000-$74999, 45% had Medicare, and 38% had breast cancer. At baseline, InCharge scores showed 31% (n=113) of participants had high, 19% had moderate, and 50% had low financial distress. Based on COST scores, 2.2% (n=16) of participants had high, 63% had moderate, and 39% had low financial distress. Forty percent (n=148) of participants reported any cost-related social risk, including heat and electricity (15%) and housing (15%). Conclusions: Baseline findings from the CAFÉ trial indicate that nearly one-third of patients with cancer may have high financial distress around the time of diagnosis, though this may vary by screening tool. The ideal screening tool for use at diagnosis is worthy of further study. Assessing and assisting patients with social risks, including financial distress, is essential to advancing cancer health equity. Clinical trial information: NCT05018000 .

SHARE Corona Surveys: study profile

At the onset of the COVID-19 pandemic, the Survey of Health, Ageing, and Retirement in Europe (SHARE) was in a unique position to respond to the need for high quality survey data on people’s changing living situations. Implemented as two telephone interviews in the summer of 2020 and 2021 in 27 European countries and Israel, the SHARE Corona Surveys present a great advantage by their integration into the longitudinal, multidisciplinary and ex-ante harmonised design of the SHARE study. This allows researchers to trace changes from the pre-pandemic period, through the different stages of the pandemic, and the post-pandemic situation. This article lays out the research aims and how the two Corona Surveys fit in the general design of SHARE. It presents the main design features of the SHARE Corona Surveys following the survey life cycle. It starts with information on procurement, contracting, funding, ethics, and data protection and sampling, followed by information on instrument design, translations, questionnaire content and interviewer training. Last, fieldwork, panel care and data processing are described. Focused on topics of health behaviour, health care, economics and social relationships, the balanced panel sample of the two SHARE Corona Surveys comprises more than 48,000 interviews and provides valuable information on how the 50+ population coped with the COVID-19 pandemic. The experience of implementing the SHARE Corona Surveys also offers insights into use of agile project management methods for large survey infrastructures and moving towards a multi-mode design in an ongoing panel data collection project.

Skills and knowledge therapists need to work with foster youth and families: According to key stakeholders in child welfare.

The current study relied on community-based participatory action research and qualitative methodology to explore the necessary skills and knowledge psychotherapists need to work effectively with foster youth and their families. In this study, the research team conducted interviews and focus groups with stakeholders (n = 48) in child welfare to learn how to support therapeutic relationships with foster youth clients. Using qualitative content analysis, the research team identified eight categories for needed knowledge and/or skills, such as collaboration with and inclusion of others in a client's system; flexibility and open-mindedness to individualize care follow the client's lead; and a solid understanding of trauma and attachment supported by therapist training and regular consultation specifically around foster care. These findings offer tangible suggestions for skills that psychotherapists can learn and practice in order to support beneficial mental health services for foster youth.

General emergency physician perceptions of caring for children: A qualitative interview study.

Emergency physicians care for most children presenting to U.S. emergency departments (EDs). Pediatric exposure during emergency medicine (EM) residency can be variable and critically ill children are rarely encountered. A recent needs assessment revealed that emergency physicians feel less prepared to manage various conditions in children and that infants, regardless of presenting complaint, pose particular challenges. Emergency physician perceptions of the experience of caring for pediatric patients have not been widely examined through a qualitative lens. We designed an interview-based qualitative study to explore emergency physician perspectives on pediatric patient care. We recruited emergency physicians who graduated from residency in 2015-2019 and all rotated through the same large tertiary children's hospital. Four trained interviewers conducted in-depth, one-on-one virtual interviews. An interdisciplinary team transcribed and then coded the interviews. The team performed a conventional content analysis for themes. Recruitment continued until thematic saturation was achieved. Twelve participants completed interviews. These participants trained in five diverse residency programs. Likewise, the participants now practice in a variety of settings. Three major themes emerged from the data: (1) experience and exposure are key to establishing comfort caring for children; (2) simulation, pathways, and the pediatric anesthesia rotation are educationally useful; and (3) caring for children poses unique emotional challenges. Participants shared many recommendations for future pediatric education for EM trainees, including increasing autonomy and exposure to neonates and considering how care might differ in a community setting. This interview-based qualitative study elucidates key themes in recently graduated emergency physicians' perceived experience of caring for children. Our findings have important educational implications for this group of emergency physicians and those who share similar experiences in training and practice.

Inclusive and Equity Training Needs of a Lactation Consultant Training Certificate Program

Inclusive and Equity Training Needs of a Lactation Consultant Training Certificate Program

PENGUATAN KAPABILITAS DIGITAL UKM BATIK CANTING KHAS GEMPOL KABUPATEN PASURUAN MELALUI PEMBINAAN DAN PENDAMPINGAN TRANSFORMASI BISNIS DIGITAL

The Batik Canting Khas Gempol SMEs in Pasuruan Regency face challenges in adopting digital technology to expand their market and enhance competitiveness. Low digital literacy is the main barrier. This program is designed to provide training and assistance for digital business transformation. The aim of this activity is to increase digital capabilities and motivate SME members to more actively utilize digital technology. This program uses a participatory action research model involving training, workshops, seminars, and individual consultation sessions to enhance participants' digital skills. As a result, 20 participants attended the training and workshops, with an average attendance rate of 97%. Significant improvements were observed in the participants' digital understanding, with an average post-test score of 90% compared to a pre-test score of 50%. About 95% of participants successfully created digital content, and 90% were able to use social media platforms for promotion. Within 2 months after the training, 70% of participants reported an average online sales increase of 30%. This program successfully improved the digital capabilities of Batik Canting Khas Gempol SMEs, demonstrating that external support and guidance are effective in empowering SMEs to undergo digital transformation.

Are "Global Measures" of Psychological Intimate Partner Violence Against Women Really Comparable? A Measurement Invariance Analysis of Controlling Behaviors in 19 Low- and Middle- Income Countries.

Background One third of adult women report lifetime psychological intimate partner violence (IPV). Controlling behavior is a common dimension of psychological IPV; however, evidence is mixed on its cross-national and cross-time measurement invariance, limiting its use to monitor Sustainable Development Goal (SDG) 5.2.1, to eliminate all forms of violence against women. We explored easier-to-modify survey-design features and harder-to-modify individual-level and national-level characteristics that may account for non-invariance of these controlling-behavior items. Methods We analyzed data on five controlling behaviors administered to 373,167 ever-partnered women 15-49 years in 19 low- or middle-income countries in which at least two national Demographic and Health Surveys were administered during 2005-2019. We performed multiple-group confirmatory factor analysis (MGCFA) to test for exact forms of invariance and alignment optimization (AO) to test for approximate invariance across 7-9 survey-design groups, defined by the number of preceding questionnaire modules (to proxy respondent burden) and weeks of interviewer training (to proxy interviewer skills). Adjustment for covariates in the MGCFA assessed whether individual- and national-level characteristics could account for any observed non-invariance across survey-design groups. Results In MGCFA without covariates, configural invariance of the controlling-behavior items was observed across survey-design groups. Exact invariance, partial invariance (with 20% of parameter estimates freed), and approximate invariance were not observed across groups. In adjusted MGCFA, neither woman-level covariates (schooling, attitudes about IPV against women) nor national-level covariates (women's mean schooling, mean attitudes about IPV against women, gender-related legal environment) alone or combined accounted for the non-invariance of controlling-behavior items across survey-design groups. Conclusions Comparing estimates for controlling behavior across country, time, and survey design variations warrants caution. Standardizing questionnaire length and interviewer training may improve the invariance of these items. Other characteristics, like ethnicity and language, may account for the non-invariance of controlling-behavior items across survey-design groups and should be tested. Current controlling-behavior items should be refined to enhance their comparability, and new controlling-behavior items should be identified and tested to improve the item set's content validity. Given current evidence of the high prevalence and health impacts of psychological IPV against women, advancing this research agenda is needed to monitor SDG 5.2.1.

The role of the Interview Manager (IM) in UK policing: perceptions and experiences of the IM when deployed in high stakes crime investigations

ABSTRACT The last 30 years have seen a dramatic shift in investigative interview training in the United Kingdom (UK) as a result of miscarriages of justice cases featuring vulnerable suspects. In 2001, the UK Police adopted a five-tiered approach to investigative interviewing, with Tier 1 for new recruits through to Tier 5 for interview managers (IMs). The IM is responsible for overseeing strategic decisions with regard to the investigative interviewing process. Even though the role of an IM has been in existence for over twenty years, it is one of the most under-researched aspects of investigative interviewing. The aim of the current paper is to present an oversight of the role of an IM in UK policing using a self-report questionnaire, presenting the responses of 53 UK police IMs’ perceptions of their role in high-stakes crime investigations. Content analysis was carried out on the responses and revealed that IMs are most frequently deployed to murder investigations, followed by serious assaults, then sexual offences. However, not all of the respondents had received the pre-requisite training for the role. Nevertheless, the IMs broadly agreed that the senior investigating officer respected the advice provided by the IM, though without fully understanding what the role entailed. IMs unanimously said the role was crucial to high-stakes investigations and presented their perceptions of the skills, qualities and knowledge that IMs require to perform the role. Finally, future directions of research in this area are outlined.

Theoretical foundations of clinical ethics consultation in psychiatry

Clinical ethics consultants support mental health professionals in identifying and analyzing moral problems in clinical practice. Presentation of key ethical concepts and normative theories that are relevant for clinical ethics consultation in mental healthcare. Conceptual and ethical analyses. After distinguishing between morality, ethics and law, moral problems are differentiated from other types of problems encountered in clinical practice. Subsequently, key ethical concepts and the concept of moral distress are clarified. In relation to the normative framework a distinction is made between philosophical ethical theories and medical ethical theories, such as principlism and the ethics of care. Finally, justification tests for ethical decision-making in situations of danger to self or others based on the harm principle and soft paternalism are proposed. Knowledge of key ethical concepts and normative theories is important for the identification and analysis of moral problems in mental healthcare and should be given greater weight in the training of clinical ethics consultants.

Consultation Training to Develop Change Agents: Introduction to the Special Issue

ABSTRACT The competent practice of school consultation, including at a systems level, is presumably predicated on effective consultation training. This article overviews the rationale for a special issue on consultation training to develop change agents in schools, and briefly previews the articles published within the issue. Taken together, the articles in the issue provide directions that can guide future research and practice in this area.