Towards a context-specific approach to understanding lawyers' well-being: a synthesis review and future research agenda.

Legal sector organisations face mounting pressure to protect and promote lawyers' well-being. However, knowledge is fragmented, hindering research and practice development. Our review investigated current conceptual understanding and empirical evidence of contextual influences. We systematically mapped the global scholarly and grey literature published since 1970, reviewing 145 relevant publications. Lawyers' well-being is conceptualised primarily as ill-being, despite well-being's positive facets. Empirical consideration of work context is mostly absent, though we deduce a focus on large commercial law firm practice and public service/legal aid. Our explanatory synthesis is abductive, coalescing Bourdieu's concepts of field and habitus with Hobfoll's conservation of resources theory to explain how context influences lawyers' well-being via distinct resource losses. We urge theoretical development to elucidate the role of context and theory-driven research on the cumulative effects of resource loss and gain. Recommendations for practice include a renewed focus on job design and line management upskilling.

A systematic review of interventions to support adults with ADHD at work-Implications from the paucity of context-specific research for theory and practice.

Attention Deficit Hyperactivity Disorder (ADHD) is estimated to affect 3.5% of the global workforce. Despite the high prevalence rate, little is known about how best to support adults with ADHD (ADHDers) at work. Relevant research is dispersed across different disciplines such as medicine, health studies and psychology. Therefore, it is important to synthesize interventions aimed at ADHDers to examine what learning can be gleaned for effective workplace support. We conducted a systematic review of relevant interventions framed by realist evaluation and the Context-Intervention-Mechanism-Outcome classification to identify key mechanisms of effectiveness for workplace interventions. We searched 10 databases including a range of journals from medical science to business management applying predetermined inclusion criteria and quality appraisal through a risk of bias assessment for quantitative and qualitative methods. We synthesized 143 studies with realist evaluation. Most studies evaluated the effectiveness of pharmacological interventions highlighting the dominance of the medical approach to supporting ADHDers. Key mechanisms of effectiveness were identified from psychosocial interventions including group therapy, involvement of people in the ADHDers network, and the importance of the client-patient relationship. Overall, there is limited research that examines the effectiveness of workplace interventions for ADHDers. Furthermore, much of the existing research evaluates pharmacological interventions which is difficult to transfer to the workplace context. It is recommended that future research and practice consider the key mechanisms identified in this review when designing interventions as well as barriers to accessing support such as disclosure and self-awareness.

Does it work? Using a Meta-Impact score to examine global effects in quasi-experimental intervention studies.

The evaluation of applied psychological interventions in the workplace or elsewhere is challenging. Randomisation and matching are difficult to achieve and this often results in substantial heterogeneity within intervention and control groups. As a result, traditional comparison of group means using null hypothesis significance testing may mask effects experienced by some participants. Using longitudinal studies of coaching interventions designed to provide support for dyslexic employees, this study describes and evaluates a different approach using a Meta-Impact score. We offer a conceptual rationale for our method, illustrate how this score is calculated and analysed, and show how it highlights person-specific variations in how participants react and respond to interventions. We argue that Meta-Impact is an incremental supplement to traditional variable-centric group-wise comparisons and can more accurately demonstrate in practice the extent to which an intervention worked. Such methods are needed for applied research, where personalized intervention protocols may require impact analysis for policy, legal and ethical purposes, despite modest sample sizes.

The professional resilience of mid-career GPs in the UK: a qualitative study.

BACKGROUND: With a continued crisis of increasing workload and reduced workforce in general practice, supporting resilience is a key strategy for sustaining the profession into the future. AIM: How do GPs perceive professional resilience, and what workplace factors influence it? DESIGN AND SETTING: A UK-based qualitative study of the perspectives of GPs currently practicing in mainly urban locations across the UK with ≥5 years' experience after completion of GP training. METHOD: Participants were recruited using convenience sampling, which included social media forums, and underwent semi-structured interviews undertaken in May and June 2020 (n = 27). Data were analysed using thematic analysis. RESULTS: Participants offered definitions of and influences on resilience that largely fit with existing research, but in addition, may result in the perception that GPs are obstructive, or that resilience may be a 'surface act'. GPs agree that the current focus on methods of improving resilience does support them, but there is significantly more to be done in this field. Social media activity aiming at GP support may be counterproductive. Reduction of clinical working hours is a common strategy to improve resilience. CONCLUSION: That GPs feel to improve resilience they need to work fewer clinical hours may have huge implications for a workforce already in crisis, and ultimately, for the health care of the UK population. Urgent research is needed to formulate a bespoke assessment for measuring GP resilience to assess potential interventions, and to identify GPs at risk of mental ill-health or leaving the profession.

Intersectional Stigma for Autistic People at Work: A Compound Adverse Impact Effect on Labor Force Participation and Experiences of Belonging.

Background: Little research addresses the experiences of autistic people at work, yet employment prospects remain bleak. The extant literature takes a largely remedial perspective and does not focus on harnessing this population's considerable talents. In global organizational practice, several programs purposefully target autistic people for their abilities. However, preliminary evidence suggests that such programs are inadvertently attracting mainly White males, to the exclusion of other demographics. Therefore, stigma surrounding autism at work remains, creating potential compound adverse impacts by marginalizing identities, including gender, race, ethnicity, sexuality, and socioeconomic status. We explored the intersection of autism with other marginalizing identities in the context of work. The research focused on labor force participation for autistic people and, for those in employment, perceptions of exclusion and inclusion. We compared the aforementioned variables by gender identity, racial identity, sexuality, socioeconomic background, and geographic origin. Methods: We undertook a global cross-sectional survey, advertised through various social media platforms and promoted directly to relevant organizations. The survey included a range of validated measures as well as demographic information. We analyzed the data with frequencies, cross tabulations, chi-square tests, and non-parametric, group-wise comparisons. Results: We found preliminary evidence of reduced rates of employment participation by race and geographic location. Females and non-binary people had lower perceptions of inclusion and belonging at work. The perception of accommodation provision had a strong association with inclusion and belonging; more so than incidental provision of flexibility in environment and scheduling not framed as a specific accommodation. Conclusions: The findings highlight the relational aspects of accommodation and a more universal inclusion perspective. We urge practitioners and researchers to monitor employment participation and levels of inclusion/exclusion using intersectional demographic identification. We appeal for cross-cultural collaboration with academic institutions outside the anglosphere to improve our knowledge of global programs and their impact.

Why is this an important issue?: Employment data show that autistic people find it harder to get and keep work. This study focuses on understanding whether multiple identities and people's background make a difference. What is the purpose of this study?: We asked a group of Autistic people about gender and race, as well as being gay lesbian, bisexual, transgender or queer (LGBTQ). We asked where people live, their education, parents' education and whether they had any diagnoses in addition to autism. We predicted that these things would have a negative effect on autistic employment rates. We thought they would also affect how autistic people felt at work. What we did?: An online survey was completed by 576 autistic people. We analyzed whether their identities and backgrounds made it more or less likely that they were in work. We then asked the 387 employed people within this group about their experiences at work. We compared their experiences by identity and background to see whether these made a positive or negative difference. What we found?: We found that White Autistic people living in western countries such as the United States and Europe were more likely to have jobs. They were also more likely to have jobs specifically designed for Autistic people. We found that women, non-binary, and transgender autistic people felt less included at work. We also found that feeling that someone cares is more important than any adjustments to work scheduling such as flexible working to support people. What do these findings add to what was already known?: It is already known that autistic people are less likely to be in work than non-autistic people. This study shows that these overall numbers are masking important differences arising from gender, race, and ethnicity. What are the potential weaknesses in the study?: The survey was taken at one point in time, which does not explain how these differences happened. Most people who completed the study were highly educated. We did not have enough people from the non-western countries or communities of color. Therefore, the sample is not large or diverse enough to draw firm conclusions. How will the study help Autistic people now or in the future?: We hope that the study inspires people to think about different identities and additional stigma for autism at work programs. We have provided a sample of baseline data from all over the world that shows a difference by location. Even though this is just a trend, it might spark more research looking at the crossover between autism, identities, and backgrounds. It provides a starting point to help researchers who want to do longer studies that test interventions to improve autistic participation and experiences in work.

Context matters: A review to formulate a conceptual framework for coaching as a disability accommodation.

Although dyslexia affects 5-8% of the workforce this developmental disorder has not been sufficiently researched in adult populations. Yet a diagnosis confers legal protections as employers must provide disability 'accommodations' to assist work functioning and performance. The implementation of such accommodations, including coaching, lacks theoretical framing and evaluations of impact in practice. Recognizing a need for conceptual work, we undertook a narrative, systematic scoping review from a realist pragmatic epistemology, taking an iterative approach to define and address the review question: 'to what extent, and under what conditions, can face-to-face learning interventions improve Working Memory (WM) and Self-Efficacy (SE) and can these lead to functional improvements related to work performance?' Informed by expert and stakeholder consultation and user data, our review extracted and synthesized 25 studies from eleven countries to identify potentially applicable learning intervention theories, their effects upon WM and SE but also functional outcomes such as comprehension. We suggest that intervention protocols informed by Social Cognitive Learning Theory can improve SE, as would be expected, and more surprisingly also WM. The development of metacognition, stress management and fidelity to Goal Setting Theory were identified as valuable intervention features. We propose that coaching activities may provide a more contextualized environment for transfer of learning from WM to functional skills such as comprehension, when compared to computerized training interventions. We call for theoretically underpinned, primary studies to evaluate interventions with adult dyslexic populations to further our understanding of disability accommodations.