Suchergebnisse

This article presents a five-step clinical approach that describes a process for child sexual abuse survivors, who are now adults, to initiate a statement with their abuser, whereby the survivor can explain the abuse and its impact on their lives. This method may also have applicability for survivors of general child maltreatment. The timing of this intervention needs to be carefully assessed in a partnership between the survivor and clinician. Clinicians might consider this approach if they are conducting long-term psychotherapy with adult survivors of child maltreatment and child sexual abuse, in particular. In addition to delineating steps to be taken, the authors suggest a measurement path. This closure process provides a unique and unduplicated opportunity for personal and professional growth.

Given persistent barriers to effective electronic health record (EHR) system implementation and use, the authors investigated implementation training practices in six organizations reputed to have ambulatory care EHR system implementation "best practices." Using the lenses of social cognitive and adult learning theories, they explored themes related to EHR implementation training using qualitative data collected through 43 key informant interviews and 6 physician focus groups conducted between February 2009 and December 2010. The authors found consistent evidence that training practices across the six organizations known for exemplary implementations were congruent with the tenets of these theoretical frameworks and highlight seven best practices for training. The authors' analyses suggest that effective training programs must move beyond technical approaches and incorporate social and cultural factors to make a difference in implementation success. Taking these findings into account may increase the likelihood of successful EHR implementation, thereby helping organizations meet "meaningful use" requirements for EHR systems.