Learning Dynamics Of Workplace Development Programmes
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Learning Dynamics of Workplace Development Programmes
Author: Agneta Halvarsson Lundkvist
language: en
Publisher: Linköping University Electronic Press
Release Date: 2019-02-13
The thesis focuses on workplace development programmes (WPDPs) that operationalize national policies on workplace development. WPDPs are time-limited and they provide support to organizations that aim to improve their operational performance or employees’ work conditions. The support that such programmes provide to organizations consists of competence-development activities provided through networks, courses or hands-on coaching. The supported organizations aimed at changing work practices to increase their operational performance. Departing from a workplace-learning perspective, the overall aim of the thesis was to contribute to knowledge about learning in workplace development programmes and the supported organizations when realizing policies on workplace development. A qualitative multiple-case study design was used and a total of 115 interviews and notes from meetings are included in the data material. Four substudies made up the empirical base. The findings revealed that realizing policies on workplace development required continuous learning among stakeholders at different levels of the WPDPs. Thus, conditions that enabled learning were important throughout the whole WPDP, which was seen as a large, complex social learning system. Learning between different levels of the WPDP was especially important, which required stakeholder representatives with the appropriate qualifications or characteristics that enabled them to take on roles as brokers between the stakeholders involved in realizing the policy. The overall conclusion pointed towards the dynamics of realizing policies of workplace learning, which cannot be achieved by a one-size-fitsall model for learning. The findings imply that funders and other authorities that make policies on workplace development through WPDPs should scrutinize how learning among stakeholders that enter into partnership to operate WPDPs is to be facilitated. Linear plans that are not complemented with careful explanations of how such learning is to be facilitated may constitute warning signs. Furthermore, the findings imply that organizations looking for external support to develop the innovative capabilities of employees must be careful in choosing their support. A WPDP may consume the resources of an organization without providing any benefit, if it does not provide the appropriate support. On the other hand, a WPDP may be a great source for learning, particularly if it includes support in designing the change effort, and help in developing an internal support infrastructure that will continue supporting workplace development after the programme ends. I denna avhandling ligger fokus på tre nationella utvecklingsprogram vars avsikt är att stödja arbetsplatser och organisationer för att realisera beslutsfattares policyer. Med utgångspunkt från ett arbetsplatslärandeperspektiv är syftet med avhandlingen att bidra med kunskap om lärande i arbetsplatsutvecklingsprogram och organisationer som dessa stödjer för att realisera policyer för utveckling av arbetsplatser. Studien har en multipel fallstudiedesign och totalt 115 intervjuer och anteckningar från möten ingår i datamaterialet. Resultaten visar att kontinuerligt lärande mellan intressenter på olika nivåer i programmen var en nödvändig förutsättning när en policy skulle realiseras. Särskilt viktigt var att de som representerade intressenterna tog rollen som mäklare vilket krävde rätt kvalifikationer och karaktärer för att kunna knyta samman de olika intressenterna som realiserade policyn. Den övergripande slutsatsen är att dynamiken i realiserande av policyer av detta slag visar på orimligheten i att hitta en modell för lärande som passar alla arbetsplatsutvecklingsprogram. Vidare kan ett utvecklingsprogram skapa goda förutsättningar för lärande i deltagande organisationer om programmet ger stöd vid utformning av förändringsinsatsen och vid utveckling av en intern infrastruktur som fortsätter att stödja utveckling av arbetsplatsen efter det att programmet avslutas.
Just know it
Author: Matilda Berg
language: en
Publisher: Linköping University Electronic Press
Release Date: 2021-02-23
The role of explicit, declarative knowledge in general health care and in psychotherapy is a growing field of research. In many areas of healthcare, knowledge is regarded as an important factor for successful interventions. Participants within mental-health interventions should ideally gain knowledge about their specific conditions and strategies to improve, in order to manage their problems in more helpful ways. In Cognitive Behaviour Therapy (CBT), explicit knowledge is a core feature when treating clients and educating them about their symptoms, problems and potential solutions. Still, the role of knowledge and its relation to treatment outcome within CBT treatments is unclear. CBT administered over the internet (ICBT), is mainly based on psychoeducative texts and thus provides a suitable format for an initial evaluation of explicit knowledge within a clinical research context. The role of explicit knowledge could be of particular importance in the study of younger target groups, who probably have their first treatment experience. Their knowledge gain and its use could be of importance both as separate constructs but also in relation to symptom reduction following treatment. The overarching aim of this thesis was to explore the role of explicit knowledge in internet-delivered CBT for adolescents with depression and anxiety. Study I explored the role of explicit knowledge in a randomised controlled trial with adolescents suffering from primary depression. A knowledge test was constructed and administered at pre- and post-treatment. Results showed that explicit knowledge and certainty of knowledge about depression, anxiety and CBT increased during treatment, but that these variables were unrelated to treatment outcome. Lower pre-treatment knowledge levels (certainty) however predicted greater improvement in depressive symptoms. Study II describes the procedure of developing a new knowledge test in the context of ICBT for adolescents with depression and anxiety. An explorative factor analysis was performed and resulted in a three-factor solution with the following factors: Act in aversive states, Using positive reinforcement, and Shifting attention. The procedure presented could illustrate one way of creating a test for knowledge evaluation in ICBT, but its clinical use needs to be evaluated further. In Study III, participants from a randomised controlled trial of ICBT for adolescent depression were asked about their acquired knowledge and knowledge use six months later. Qualitative methodology (thematic analysis) was used. The results showed two overarching ways that clients can remember and relate to CBT-principles after treatment; one more explicit way related to the active application of CBT principles, and another vague way of recalling treatment content and the passive usage of CBT. Both ways of recalling CBT principles were related to experiencing the treatment as helpful. Study IV evaluated the role of learning strategies and chat-sessions in ICBT for adolescents with anxiety and depression. A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 factorial design with the two factors: with or without learning support and/or chat-sessions. Overall, the results showed general reductions of anxiety and depressive symptoms, and increased knowledge levels. Participants receiving learning strategies during treatment obtained more immediate benefits in treatment outcome and knowledge levels, but at six months follow-up participants without learning support had reached equal amounts of knowledge and symptom reduction. Chat-sessions did not add any effect on treatment outcome or knowledge levels. In conclusion, this thesis suggests that explicit knowledge is a construct that is independent of symptom reduction and increases during ICBT treatments for adolescents with depression and anxiety. Increased knowledge, and increased certainty of knowledge, are valuable outcomes since CBT emphasises educating clients about symptoms, therapeutic principles, and strategies that they can remember and use later on. The lack of association between explicit knowledge gain and symptom reduction could indicate that explicit knowledge is a necessary but insufficient factor for symptom reduction. Adding learning strategies within a treatment programme could be of importance for enhancing short-term treatment effects. There is a continued need for more research on the role of knowledge in ICBT, both as an outcome and as a way to improve treatment effects. The findings in this thesis however suggest that research on explicit knowledge is important to understand what makes ICBT work. Explicit kunskap och dess roll i psykoterapi är ett växande forskningsområde. I kognitiv beteendeterapi (KBT) har explicit kunskap en kärnfunktion då man behandlar klienter och utbildar dem om deras symptom, problemområden och potentiella lösningar. Trots detta är kunskapens roll och dess relation till behandlingsresultat vid KBT oklar. KBT som administreras via internet (IKBT) baseras huvudsakligen på psykoedukativa texter, och kan således vara ett lämpligt format för en initial utvärdering av explicit kunskap. Syftet med denna avhandling var att undersöka om kunskap ökar under IKBT för tonåringar med depression och ångest, dess relation till behandlingsutfall, och om lärandestöd kan öka effekten av behandling. De fyra inkluderade studierna visar att explicit kunskap är ett unikt konstrukt som, oberoende av symtomminskning, ökar under behandling. Deltagare kan komma ihåg behandlingsinnehåll och uppleva KBT kunskap som användbart i deras vardag. Detta är ett värdefullt resultat då KBT betonar vikten av att utbilda klienter om symtom, principer och strategier som de kan komma ihåg och använda. Ett nytt kunskapstest utvecklades och validerades initialt för potentiell användning i framtida kliniska studier. En av studierna visade, via experimentell design, att lärandestöd i behandlingsmoduler kan förbättra kortvariga behandlingseffekter. Sammanfattningsvis är forskning om explicit kunskap viktigt för att förstå vad som får IKBT att fungera.
Looking into the Future
Author: Carl-Johan Uckelstam
language: en
Publisher: Linköping University Electronic Press
Release Date: 2021-01-21
Psychotherapy research has shifted from mainly focusing on the average effects of different treatments to concentrating more on questions related to the individual patient. When research attention shifts, it can give rise to the implementation of new statistical methods that, in turn, can illuminate new challenges that must be addressed. The aim of the thesis was to study how traditional methods for predicting certain psychotherapy outcomes have been conducted in the past, and how more advanced statistical methods might be used to enhance knowledge of how to predict these outcomes today. Three studies were performed: Paper I focused on how Multi Level Modeling (MLM) can be used to study certain aspects of the relationship between working alliance and treatment outcome. In Paper II, Latent Profile Analysis (LPA) and item-level analysis were used to give nuance to the relationship between psychological distress at baseline and change rate during treatment. Finally, in Paper III, Machine Learning (ML) was used to detect dropout patients in the early phase of treatment by exploring complex patterns of symptom distress during the early phase of treatment. The thesis showed how different goals of scientific exploration can be studied in the context of routine care with the use of these statistical frameworks and discussed some of the challenges and opportunities worth noting when entering this line of research. Psykoterapiforskning har på senare tid gått från att fokusera på genomsnittliga effekter av olika behandlingsinriktningar, till att inrikta sig mer mot den enskilda patienten. När fokus förflyttas på det här sättet kan det leda till att nya statistiska metoder behöver tillämpas vilket i sin tur kan leda till nya utmaningar för psykoterapiforskaren. Syftet med avhandlingen var att undersöka hur traditionella statistiska metoder har använts för att studera olika typer av psykoterapiutfall i rutinmässig vård, och hur mer avancerade statistiska metoder kan tillämpas för att öka kunskapen om hur dessa utfall kan prediceras. Tre studier genomfördes. Studie I fokuserade på hur flernivåanalys kan användas för att studera relationen mellan arbetsallians och behandlingsutfall. I studie II användes latent profilanalys för att studera sambandet mellan psykologiska besvär vid det första besöket och symptomförändring under behandlingens gång. Slutligen, I studie III, tillämpades maskininlärning för att upptäcka patienter med risk att hoppa av behandlingen i förtid. Sammanfattningsvis belystes i avhandlingen hur olika typer av vetenskapliga frågeställningar kan studeras i en klinisk kontext med hjälp av dessa statistiska ramverk samt några av de fördelar och begräsningar som är viktiga att notera när de tillämpas.