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The purpose of this paper is to explore the relationship of two distinct variants of dispositional shame (internal and external shame) with collaborative, purpose-driven aspects of the patient–provider relationship (working alliance) and patient satisfaction. The aim of this research was to conduct a preliminary investigation into the relevance of dispositional shame in a general healthcare population.

In total, 127 community members (mean age 25.9 years) who reported that they had regularly seen a GP over the past year were recruited at an Australian university. Participants were asked to reflect on their relationship with their GP, and completed instruments assessing various domains of shame, as well as working alliance and patient satisfaction.

Non-parametric correlations were examined to determine the direction and strength of relationships, as well as conducting mediation analyses where applicable. Small, negative correlations were evident between external shame and working alliance. Both external and internal shame measures were also negatively correlated with patient satisfaction. Finally, the relationship of external shame to patient satisfaction was partially mediated by working alliance.

Both the reported quality of patient–provider working alliance, and level of patient satisfaction are related to levels of dispositional shame in patients, and working alliance may act as a mediator for this relationship.

The findings from this preliminary study suggest that internal and external shame are important factors to consider in the provision of medical care to maximise the quality of patient experience and working alliance.

The purpose of this paper is to examine the psychometric characteristics of male offenders who joined a democratic therapeutic community and their relationship to attrition.

Residents who left therapy prematurely during the assessment phase (N = 46) and residents who left therapy prematurely during core therapy (N = 202) were compared to residents who completed therapy (N = 52) on two psychometric measures: Raven’s Standard Progressive Matrices and The Blame Attribution Inventory.

A multinomial logistic regression analysis showed higher levels of external blame can predict attrition during therapy; those with higher levels of external attribution are significantly more likely to leave therapy prematurely, including both during the assessment phase and during core therapy. Raven's Standard Progressive Matrices score did not significantly predict whether an individual left therapy prematurely.

Support was found for existing research within the academic evidence base. The findings have both empirical and clinical utility, suggesting during the assessment phase of therapy, practitioners can identify residents that may require additional support to maintain engagement, minimising the potential for premature departure. The implications of the findings are discussed, with suggestions made for future research.

The editorial for this issue sets out the context of increasing awareness of the need for better services for children and adults with autism spectrum disorders, and highlights the importance of policy to maintain awareness and provide incentives while recognising that more would be needed to ensure that people with autism have a good quality of life and reach their full potential. There are two sections to this paper. The first is a case study written from a parent's perspective and highlighting the need for good joint working and supporting families, as well as the importance of understanding how autism affects a child and his/her family. The second part considers good practice in supporting children and adults with autism to increase social inclusion, independence, choice and autonomy.

The purpose of this paper is to discuss the issue of social inclusion for people with autism spectrum conditions.

Drawing on current policy and good practice guidelines as well as the experience of people with autism and those who support them, this paper considers how well legislation, policy, and good practice are currently implemented with regard to improving the social inclusion of children and adults with autism spectrum conditions.

International and UK policy sets out the rights of children and adults with disabilities to live a good life in the community, with reasonable adjustment to be made by society to ensure this is possible. However, the practical and strategic implementations of policies to ensure these rights for people with autism are still not fully in place.

This discussion takes into consideration the views of carers and support professionals and the direct experiences of those with autism as well as policy and published guidance.

The treatment of substance use amongst mentally disordered offenders (MDOs) remains a challenge for secure forensic mental health services. The purpose of this paper is to present an integrated three-stage substance use treatment programme (SUTP) for male and female MDO’s in medium security.

In total, 45 (72.6 per cent) MDO’s were referred (39 males/6 females). Standardised outcome measures were administered pre-SUTP, post-SUTP and at one year follow-up. Abstinence rates and location was determined via case notes at three year follow-up.

All MDO’s had a past history of substance use, approximately three-quarters reporting problematic use prior to admission. Over half completed all three SUTP stages, less than 5 per cent dropping out during active treatment. The SUTP supported abstinence throughout the one year follow-up period and significantly improved MDO’s adaptive beliefs about substances and craving by one year follow-up amongst attendees. At three years, most MDO’s were in the community and almost three-quarters were abstinent. There was no significant difference in abstinent rates between community and hospital. There was a non-significant trend suggesting SUTP attendance supported abstinence. Both male and female participants appear to have benefited from treatment and satisfaction was high, reflecting the specific aims and objectives of treatment.

The small non-randomised sample from one area limits the generalisability of findings and statistical power.

Findings indicate further support for the limited evidence base that small but clinically meaningful and maintained changes to problematic substance use are possible following integrated substance use treatment for male and female MDO’s.

This paper aims to engage with the cinematic history of Australian education by examining the historical representation of secondary schools in two Australian feature films of the 1970s: Picnic at Hanging Rock (Weir, 1975) and The Getting of Wisdom (Beresford, 1977). By what narrative strategies, metaphors and understandings were Australian high schools encoded into images and how might these interpretations differ from written accounts of the secondary schools? The discussion focuses on the social and material worlds of the schools. It reflects on the types of education depicted and the characterisations of teachers and students, including consideration of gender, class, and sexualities. The paper asks: what was the historical understanding of secondary schools that made them so attractive for cinematic explorations of Australian national identity in the 1970s?

Japanese lesson study (LS) is a professional development (PD) approach in which teachers collaboratively plan a lesson, observe it being taught and then discuss what they have learned. LS's popularity as an approach to teacher PD in the UK is growing, and it is used in both special and mainstream settings. This study explores whether LS is perceived and operationalized in the same way across special and mainstream settings.

This study arose as a result of collaboration between UCL Institute of Education academics (principle investigators) and three special school leaders using LS in their own schools (practitioner co-investigators), who together formed the research team. The team first explored the literature base for LS in special education. They then investigated special and mainstream schools using LS for teacher PD. Research tools included semi-structured interviews and an online survey. Participants were obtained through opportunistic sampling via the networks of schools available to the researchers.

There were several key differences between LS in special and mainstream settings. Special teachers felt LS had a more positive impact on subject knowledge than mainstream teachers, and this impact extended to support staff. Special teachers were more likely to carry out multiple research cycles than mainstream colleagues and to quickly build LS into the existing timetable. Mainstream teachers focused on individual pupils in LS to seek learning about pedagogy more generally, whereas general learning about pedagogy was seen as a secondary benefit to special teachers.

One of the limitations of the research is that participants are more positively inclined toward LS than the general population of their school, since those not interested in LS would be unlikely to take the time to engage with the research. It will be important to conduct more research into the use of LS in mainstream schools, as this study is one of very few exploring LS in this special context.

The ease with which special schools can align LS to current practice due to greater flexibility of timetables and larger staff teams seems to result in a greater appreciation and “valuing” of the process in mainstream schools, where teachers seemed to feel their senior leadership teams had gone to extra lengths to enable LS to happen. LS seems to offer a framework within which senior leaders can prioritize such learning experiences for teachers, leading to positive benefits for pupils, teachers and the school, and is therefore a process worth considering both for special and mainstream school leaders.

The literature review found a limited number of studies of LS in a special educational needs and disability (SEND) context, all of which took place in the UK and focused on the impact of teacher participation in LS on teacher practice and pupil learning. All three studies show a positive impact and suggest that LS might have wider applications for both special schools and mainstream schools supporting SEND pupils. There has been no exploration of the different ways in which mainstream and special school teachers and pupils might experience or construct LS in their own contexts.

The purpose of this study explores the perspective of key informants (educators, preceptors and former students) of the Kintampo Project, on the perceived effectiveness, gains and challenges in delivering this large-scale training innovation in Ghana. The problem of mental health care neglect in Ghana is gradually improving. The Kintampo Project which trained mental health workers in Ghana has played a critical role in increasing access to mental health care.

This qualitative study explored participants' perspectives on the Kintampo Project in three broad areas: perceived effectiveness, gains and challenges. In all, 17 interviews were conducted with former students, preceptors and educators from the project. The interviews were digitally audio-recorded, transcribed, coded and analysed using deductive and thematic methods.

The participants perceived the project to have been successful in increasing the number of mental health workers in Ghana. The project provided a route for career progression for those involved. However, the Kintampo Project faced accreditation issues, low recognition, improper integration and remuneration of trained staff in the Ghana Health Service. This study points to the fact that the sustainability of mental health training in Ghana can be obstructed, because of this career path being less attractive. Further research is needed to explore how best to achieve sustainability of similar mental health innovations.

This paper shares the views of participants in the Kintampo Project.