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The paper sets out to explore the leadership processes and dynamics of change management in a fragmented, and resource‐poor, health service in an impoverished rural region in South Africa.

The paper outlines an action research process aimed at assisting the stakeholders of two rural clinics to integrate psychiatric care into the Primary Health Care service that they offer their respective communities. This involved the transformation of existing practices through a form of praxis that involved learning from action and acting on learning.

The findings of the paper relate to the role of leadership in the facilitation of transformational learning in team‐based social action. Four areas of leadership responsibility are highlighted: the transformation of inappropriate mental models; the development of strategic resilience; the shifting of the locus of control of stakeholders to a more internal position; and the creation of a social environment in which intangible capital resources are generated and leveraged in the collective interest.

This paper is subject to the limitations of potential bias and distortion in action research. Although the “objective” evidence of the integration of psychiatric services at Pelsrus and Kwanomzamo clinics exists, the portrayal of the learning processes through which this was achieved could have been influenced unwittingly by the authors' own knowledge and other interests.

The paper endorses the educational importance of work‐based projects through which strong tacit leadership knowledge bases can be developed in health sector personnel.

This paper has attempted to share the effectiveness of work‐ and project‐based learning in district health teams in South Africa. In particular, it has outlined how the learning strategy of the module leverages the team structure of the district health management units in order to create and exploit the social and morale capital resources that are potentially available through such a structure and the covenantal culture that it spawns. Furthermore, an attempt has been made to show how these resources are leveraged in the generation of mission‐pertinent tacit knowledge that is then converted by project stakeholders into explicit knowledge forms that can be used more effectively in framing subsequent strategic action.

This chapter explores the parental experiences of 21 mothers of young and/or adult children who have been diagnosed with developmental disabilities (DD). Specific attention is paid to mothers’ reflections on marginalization, stress, and resiliency. Intersectionality of marginalization was explored with a select number of participants who identified with minority racial groups, with the LGBTQ community, and/or as a single or young mother. Data were collected via semi-structured interviews and analyzed using the constant comparative method. Eighteen mothers reported experiencing elevated levels of stress specifically related to challenges associated with DD; the need for greater investments of time and money was emphasized. However, nearly every participant highlighted stories of resilience and acclimation to these challenges associated with raising a child with DD. Thirteen mothers overtly discussed experiences of discrimination and marginalization. Some of these scenarios included being stared at or criticized in public, being excluded from social events, and facing discrimination within school settings. Select participants from marginalized backgrounds (being as a young parent, or as Black, single, lesbian, bisexual, and/or transgender) provided insight into how layers of marginalization negatively impacted their parental experiences. These personal accounts provide additional evidence that mothers of children with DD experience courtesy stigma. In addition, they provide a holistic illustration of motherhood experiences that does not center on only negative or positive aspects. Finally, the reports of mothers who identified with multiple marginalized identities strengthen the call for additional empirical focus on intersectionality as it concerns mothers of children with DD.

Upon completion of the case discussion, students will be able to: identify the enablers of a mental skills coaching process and the broad outcomes as a result of a coaching intervention; understand the contributing factors towards creating greater psychological safety in a team and the impact this has on team performance; and identify positive leadership strategies to create an environment in which meaningful work and goal achievement increase engagement.

Leanne Redding was the mental skills coach for Maccabi, a professional league soccer club in Johannesburg, South Africa. Redding had worked with the club’s players using mental techniques, the ultimate aim being to improve performance. Redding’s work was based on the premise of trust, lived values, self-respect and reflection. She believed that a strengths-based approach grounded in sports psychology and aligned with mental contrasting enabled resilience. Her process of holding individual and team sessions helped with sustaining motivation, overcoming limiting fears and encouraging focus on the greater good of the team. The result was Maccabi’s promotion to the professional league of soccer. However, not all of her broad stakeholder group had bought into the value of sports psychology coaching. The case explores Redding’s process and her belief of the importance and buy-in from all players of the team values which should inform behaviour. The case concludes with Redding contemplating what she should do to gain greater acceptance from the rest of the coaching staff for her work.

This case can be used in graduate and postgraduate level courses such as an MBA, in management development programmes or in short executive education courses focusing on organisational behaviour, leadership and human capital development and sports management.

Teaching notes are available for educators only.

CSS 7: Management Science.

During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD.

A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories?

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable.

The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD.

There is growing evidence examining mindfulness-based interventions (MI) for people with intellectual disabilities (IDs). As discussed in this paper, MI may be particularly suited for people with ID given high rates of difficulties in identifying and regulating emotions and as this approach may rely less on cognitive ability compared to other therapies. This study aims to assess the acceptability and preliminary effectiveness of a six-session MI group [the Coping Well Group (CWG)] delivered within routine clinical practice.

Six separate cohorts (n = 25) of adults with ID attended CWG. Quantitative data were collected from service users, including a pre- and post-quality of life (QoL) measure and qualitative data from group facilitators.

Roughly one-half (53%) of service users invited to the group attended at least one session, with low levels of dropout observed among group attendees. A significant improvement in QoL was reported demonstrating a small effect (d = 0.46, p = 0.022) after attending the group. Most service users (72%) were referred to the CWG for help managing difficult emotions. One-half (44%) of attendees required individual therapy after attending the group. Limitations of the evaluation and potential future research are discussed.

The current evaluation contributes a practice-based service evaluation of an MI group for people with ID and mental health difficulties to the currently limited evidence base. To the best of the authors’ knowledge, this is one of the first studies to investigate the impact of group psychological interventions collecting data across cohorts and assessing QoL, a more general measure of well-being than has been used previously.