Patrick O'Neill

Expectation and burnout in the developmental disabilities field

Psychological burnout was assessed in staff members at workshops and community residences for the developmentally disabled. Participants also rated expectations for client progress and for their own contribution to clients. They reported on change in expectation since they entered the field. High expectations were related to low burnout; workers who reported experiencing large negative expectation change were most burned out. Burnout seemed to be prevented when staff members made an expectation shift from reliance on client progress to a sense of personal efficacy. This finding is discussed in terms of personal causation, internal control of reinforcement, and adaptation-level theory. There was little evidence of client depersonalization, a usual component of burnout. Such a burnout pattern may be a function of the ethic of community care for the developmentally disabled.

Responsible to whom? Responsible for what? Some ethical issues in community intervention

ConclusionEach ethical decision is a blend of general principles and contextual features. Many require compromises between competing values, must be made in the absence of perfect information, and require the courage to confront mistakes.In community intervention, we have seen that adopting a collaborative paradigm imposes the freedom to determine to whom we are responsible for our actions. A rationale was offered for giving priority to the most vulnerable group, even though this strategy leaves us with an accountability gap in which the group to whom we owe primary loyality is least likely to be able to call us to account.When we reject the professional-client paradigm in community psychology, we lose the formal contract as a device for setting the terms and limiting the scope of our responsibility. We do the best reconnaissance we can, but even with careful data-gathering we are condemned to act on the basis of imperfect information. We must follow through on unforseen consequences even when we have no formal role to mandate our perseverence.The community as a setting for psychological intervention faces us, then, with ethical challenges: we work for the well-being of groups too broad to give informed consent to our interventions; we act in collaboration with others, but collaborative action does not free us from professional obligation; we reconnoiter, but reconnaissance does not provide us with perfect information; we may advise while others act, but we cannot walk away from the consequences of their actions. Ethical decision making, in the community as elsewhere, is a creative act in which we invent our profession choice by choice.

Health professionals' perceptions of the psychological consequences of abortion

Measures of depression, guilt, and state and trait anxiety were administered to doctors, nurses, and social workers under two conditions, self-report and role play. In the role-play condition, they were asked to complete the questions as would a woman who had undergone an abortion the previous day. Half of the subjects in each group were experienced with abortion patients, and half were inexperienced students. All three professional groups expected extreme depression, guilt, and anxiety on the part of the abortion patient, when compared with their own scores. These expectations do not match the experience reported by abortion patients in this and other studies. As previously found, nurses were more extreme in their attitudes; but this is explained in terms of their self-report data, which were also more extreme on all measures.