The Civilizing Process of Trust: Developing Quality Mechanisms which are Local,Professional‐led and thus Legitimate

‘Quality’ and ‘performance’ have become defining concepts for policymakers and health‐care systems alike. Yet whilst these principles are of fundamental importance, their practical implementation and assurance are far from straightforward. This commentary analyses the difficulties faced in enhancing quality and performance in the English NHS. Many recent initiatives have been driven through incentives and external auditing of the professionals providing health care on the frontline. Drawing on recent literature and research findings, we argue that this checking‐based ‘audit culture’ is fundamentally flawed in driving quality and performance. Many targets and measures are too crude to reflect important aspects affecting patient outcomes and therefore these frameworks lack legitimacy amongst professionals. An alternative, trust‐based model is proposed – one more capable of acknowledging the meaning, complexity and specificities inherent to professional work. Quality mechanisms developed locally by professionals are able to produce the legitimacy crucial for their effectiveness. It is argued that the normative obligation of approaches based on conditional trust is a more compelling incentive towards good practice than targets and sanctions. This governance by ‘the social’ is able to motivate a more holistically enlightened and consistent reflexivity towards practice, though it is only able to flourish in the absence of purposive‐rational systems.     

Redefining “Old Age” and “Dependency” in East Asia: Is “Prospective Aging” A More Helpful Concept?

East Asian societies are currently some of the most rapidly aging in the world. Projections of the traditional old‐age dependency ratios (OADR) present a daunting future of the size of the aged population both in absolute terms and, in the context of low fertility, relative to the future workforce. Recently scholars, especially Sanderson and Scherbov, have argued that OADR is inadequate as a guide to future levels of dependency based, as it is, on past scenarios of “old age” and “dependency” rather than current and future notions. Indeed, in the context of rapidly aging settings in East Asia with developmental welfare states, the OADR has probably never been truly relevant, is profoundly unhelpful and could lead to policy paralysis. As such, Sanderson and Scherbov suggested a new method to measure aging prospectively to take into account both improved life expectancy and health across the life‐course. We introduce these new measurements as a possible new, more radical and optimistic way to think about aging in East Asia. These measurements more accurately demonstrate the “boundaries” to “dependency” and, hence, demonstrate the potential room for social policy interventions to maximize “active aging” for the population currently, perhaps incorrectly, defined as “old” and “dependent”.     

Family and community support among older Chilean adults: the importance of heterogeneous social support sources for quality of life

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.     

Expanding Discrimination Research: Beyond Ethnicity and to the Web*

Objective. This article aims to expand research about perceptions of discrimination both substantively and methodologically beyond the domains of race and ethnicity, relying partly on web‐based surveys. Methods. We conducted parallel surveys over the telephone and the World‐Wide Web, using standard random‐digit dial (RDD) techniques for the former, and a large volunteer panel for the latter. Results. Both modes, phone and web, revealed that respondents consider discrimination based on physical appearance and economic status to be more prevalent than discrimination based on ethnicity. Respondents also reported that they themselves have been victimized more by physical appearance and economic‐status discrimination than by ethnic discrimination. Significant differences emerged between the phone and web respondent pools, even after controlling for such independent variables as age, race, education level, and gender. Conclusions. People perceive discrimination across many aspects of social life, and appear more willing to reveal knowledge about controversial social phenomena on the web than on the phone.     

An alternative measure of social wellbeing: analysing the key conceptual and statistical components of quality of life

Statisticians, policy makers and social researchers widely accept that there is a need to consider a more nuanced range of measures of quality of life that move beyond the economic domain and that take into account key aspects of an individual's life circumstances. Using data from an Australian household survey, a composite Wellbeing Index was created that covered objective circumstances, with known associations to wellbeing, evaluated from the individual's subjective viewpoint. The robustness of the measure comes from the fact that while covering a broad range of key dimensions, the index only includes the items deemed important components of wellbeing by a majority of respondents. The index was then used to explore the extent to which wellbeing is associated with other dimensions of quality of life that have currency in the contemporary literature. The study contributes to the contemporary debate on social wellbeing and adds new Australian evidence to a body of research that has been mainly based on European and American data.     

Social development and the status quo: professionalisation and Third Way co‐optation

Gray M. Social development and the status quo: professionalisation and Third Way co‐optation Int J Soc Welfare 2010: 19: 463–470 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Social development is a massive undertaking that has spawned a multitude of organisational forms. It nevertheless remains an ambiguous term and ill‐defined area of work, though some social development practitioners have succeeded in making small‐scale local differences in particular situations. While largely a tool of the status quo, some believe that social development has transformative potential and provides valuable space to confront inequalities and deprivation. In this article, I argue that in contemporary neoliberal environments social development is being co‐opted by Third Way politics and professionalisation processes. As it professionalises through the creation of professional structures and educational systems, it is becoming increasingly like social work, despite arguments that it is as an alternative approach to poverty and social exclusion. In the process, it is losing its transformative, critical edge, and morphing into a neoliberal, social investment approach that absolves government of its responsibility for the welfare of citizens.     

The implications of dialogicality for ‘giving voice’ in social representations research

Social representations research is often undertaken by scholars who seek to ‘give voice’ to knowledge(s) that are held by socially disenfranchised individuals and groups. However, this endeavour poses a number of problems in practice, not least because it assumes that the ‘voices’ voiced by individuals and/or groups in social research will be unambiguous and uniform, and unchanged by the research encounter. Despite the growth of attention to the critical potential of social representations theory, there remains a lack of scholarship on the relationship between the theory's emphasis on the relational, or dialogical, nature of social life (the Ego‐Alter‐Object relation) and the implications of this for critical research. In this article, I argue that the dialogical epistemology from which social representations research must depart incites reflection upon (i) the design of empirical studies, which must equally attend to both ‘Ego’ and ‘Alter’, and (ii) the researcher‐researched relationship, which may itself be best viewed as an Ego‐Alter interaction. I make the case for adopting dialogical epistemology in critical social psychology, and argue that this is essential to undertaking ethical social research. I conclude by suggesting that claims to ‘giving voice’ have little place in critical social psychology in general, and social representations scholarship in particular.     

Sources of social support,job satisfaction,and quality of life among childcare teachers

Although literature has suggested a link between social support and well-being, relatively little research has examined the association of social support with job satisfaction and quality of life for employees. This study aimed to investigate whether and how different sources of social support influenced quality of life in conjunction with job satisfaction among teachers. Two-hundred and eighty-one childcare teachers in Korea completed measures of social support, job satisfaction, and quality of life. The results revealed that while director and colleague support predicted job satisfaction, director and family support predicted quality of life after controlling for age and marital status. Furthermore, results showed that job satisfaction mediated the relationship between director support and quality of life. The findings suggest the protecting role of different sources of social support in teachers’ job experience and evaluation of life domains. Suggestions for future research and implications for improving childcare teachers’ quality of life are discussed.     

SOCIAL ENTREPRENEURSHIP — FALSE PREMISES AND DANGEROUS FOREBODINGS

As a reaction against neo‐liberalism, Social Entrepreneurship has been promoted as the solution to welfare problems brought about by social change and persistent unemployment. The Social Entrepreneurship Movement (SEM) proposes the reconstruction of welfare by building social partnerships between the public, social and business sectors. Major aspects of this agenda include non‐profit organisations undertaking entrepreneurial ventures and the pooling of government welfare funding under the control of local communities. In this paper we argue that the SEM literature is based on two false premises: the failure to understand the true causes of mass unemployment, and the assumption that the government faces financial constraints in the provision of welfare services. We also argue that implementation of the SEM proposals would erode the rights‐based eligibility to universal welfare services based on the principle of social justice. We also conclude that the SEM is indistinguishable from neo‐liberalism and as such does not represent a viable solution to unemployment and the welfare needs that accompany it.     

From “Either‐Or” to “When and How”: A Context‐Dependent Model of Culture in Action

In this article, I outline a framework for the sociological study of culture that connects three intertwined elements of human culture (cultural motivations, resources, and meanings) and demonstrates the concrete contexts under which each most critically influences actions and their subsequent outcomes. In contrast to models that cast motivations, resources, and meanings as competing explanations of how culture affects action, I argue that these are fundamental constituent elements of culture that are inseparable, interdependent, and simultaneously operative. Which element provides the strongest link to action, and how this link operates, must be understood as a function of the actor's position within wider social contexts. I argue that on average motivations have the most discernable link to action within a social strata, cultural resources provide the strongest link across strata, and meanings have the greatest direct influence when codified and sanctioned. I then offer a reframing and synthesis that reintegrates previously “competing” theories of culture into a more holistic context‐dependent model of culture in action. Finally, I use evidence from prior empirical research, as well as new data from an ongoing ethnographic study of health behaviors among the aged, to show how various elements of culture are concretely linked to action in eight different social contexts. In doing so, I provide a roadmap for the transition out of the “either‐or” logic underlying much of cultural theory and reemphasize the importance of the classical sociological concern for “when” and “how” various aspects of culture influence action and outcomes in concrete social contexts.     

Racial and ethnic diversity in senior centers: comparing participant characteristics in more and less multicultural settings

The 2008 Health Indicators Project surveyed a probability sample (N = 1,870) of New York City senior center participants. Attendees of racially and ethnically diverse and nondiverse senior centers were compared across 5 domains: demographics; health and quality of life; social support networks; neighborhood perceptions and engagement; health service access/utilization. Although homogeneous and diverse center participants demonstrate similar health and quality-of-life outcomes, those from diverse centers demonstrate greater risk of social isolation, receive less family support, and more likely seek medical care from hospitals or community clinics. Implications and future directions for research, practice and policy are discussed.     

Rhetoric vs. reality in social work supervision: the experiences of a group of child care social workers in England

Whilst the contribution of good supervision to high‐quality social work practice is widely recognized, research exploring practitioners' experiences of supervision is surprisingly limited. Set within the context of the supervision framework for employers of social workers in England, this small‐scale survey, using an extended questionnaire, examined the experiences of supervision of a group of child care social workers. The aim was to find out what aspects of supervision worked well and where there was room for improvement. The findings suggest that whilst the majority of employers had appropriate supervision policies in place, day‐to‐day practice varied enormously, frequently falling well short of national standards, with the quality of supervision often depending more on the characteristics of the supervisor and the agency context than the needs of the worker. Supervision sessions typically focused predominantly on case management, with much less attention paid to the worker and opportunities for them to reflect on their practice. Only a quarter of the social workers in this survey could be considered to be satisfied with their current supervision, with a much higher proportion clearly dissatisfied.     

Does social capital always raise life satisfaction? A comparison of South Korea and Taiwan

This study examined the relationship between social capital and life satisfaction in an Asian context, focusing on South Korea and Taiwan. We considered two components of social capital – networks and trust – and argue that the ability of social capital to increase life satisfaction depends on the context. Using the national Life and Society survey data from South Korea (N = 978) and Taiwan (N = 1,200), our analysis found that, when several control variables, such as subjective social status, self‐reported health condition, sex and belief in individualism, were considered, social capital was positively related to life satisfaction in Taiwan, while there was no significant association between social capital and life satisfaction in South Korea. The South Korean case revealed that social capital is not a good predictor of life satisfaction in a context in which being successful is overwhelmingly emphasised.     

A new preventive intervention for children of substance‐abusing parents: Results of a randomized controlled trial

Children of substance‐abusing parents (COS) are at risk for developing psychosocial problems. We evaluated the effectiveness of the manualized, 9‐session psycho‐educational preventive intervention “TRAMPOLINE” (PE) for 8–12‐year‐old COS compared with a non‐educational “fun and play” group (NE) of equal length delivered by social workers in 27 German counselling centres. A randomized controlled trial was conducted to compare PE (n = 130) and NE (n = 88) outcomes at baseline, post intervention, and 6‐month follow‐up. Primary outcomes were related to stress and coping; secondary were also examined. Analyses were conducted using baseline‐adjusted repeated measures linear mixed models. Five outcomes revealed improvements both in PE and NE, four of which were more pronounced in PE, and one more pronounced in NE. Small but significant group differences in favour of PE were found in “social isolation” and “addiction‐related knowledge.” Children from both groups reported reduced mental distress, reduced avoidance in coping with family stress, improved self‐perceived autonomy, and a better parent–child relationship. No changes were observed in self‐efficacy, physical stress symptoms, and in other health‐related quality of life aspects. TRAMPOLINE can instill positive changes in COS by reducing mental distress and social isolation.     

Racial and Ethnic Diversity in Senior Centers: Comparing Participant Characteristics in More and Less Multicultural Settings

The 2008 Health Indicators Project surveyed a probability sample (N = 1,870) of New York City senior center participants. Attendees of racially and ethnically diverse and nondiverse senior centers were compared across 5 domains: demographics; health and quality of life; social support networks; neighborhood perceptions and engagement; health service access/utilization. Although homogeneous and diverse center participants demonstrate similar health and quality-of-life outcomes, those from diverse centers demonstrate greater risk of social isolation, receive less family support, and more likely seek medical care from hospitals or community clinics. Implications and future directions for research, practice and policy are discussed.     

Raising the Quality of Home Care: A Study of Service Users' Views

Raising standards is one of the key objectives of the British government's Modernizing Agenda. The quality of life of vulnerable older people who are being maintained at home is fundamentally dependent on the quality of the home‐care services they receive, so raising standards of home care is clearly central to this agenda. This paper draws on a small‐scale study of service users and providers to examine the aspects of quality of home care of importance to older people, their experiences and barriers to improvement. Six key aspects of quality were investigated: reliability, continuity, flexibility, communication, staff attitudes and skills and knowledge. If performance indicators are to have the desired effect, more work needs to be done to ensure they reflect key aspects of quality from the user perspective. We identify potential areas for improvement in commissioning and organization but these all have resource implications that will need to be met if home care is to realize its full potential in maintaining and improving quality of life for older people.     

Mental health practice in primary care: Some perspectives concerning the future of social work in organized delivery systems

Abstract

The rise of managed care as the dominant form of healthcare delivery in the U.S. clearly has dramatic implications for the profession of social work. Thus far and for good reasons, the professional dialog about managed care has largely focused on . the threats posed to the professional agenda of social work by managed care in its various forms. This article considers some of the more positive aspects of the transformation from fee‐based to population‐based healthcare systems, in particular the vigorous trend toward multidisciplinary primary care and collaborative mental health practice in primary care settings. It is argued that the market forces behind this trend also promote the emergence of models of social work practice that better integrate historically dichotomized aspects of health and mental health practice. Also considered are implications for social work education and the division of labor among the healthcare professions.     

The social inclusion policy agenda in Australia: a case of old wine,new bottles?

The election of an Australian Labor Government in Australia in 2007 saw ‘social inclusion’ emerge as the official and overarching social policy agenda. Being ‘included’ was subsequently defined by the ALP Government as being able to ‘have the resources, opportunities and capabilities needed to learn, work, engage and have a voice‘. Various researchers in Australia demonstrated an interest in social inclusion, as it enabled them to construct a multi‐dimensional framework for measuring disadvantage. This research program resulted in various forms of statistical modelling based on some agreement about what it means to be included in society. The multi‐dimensional approach taken by academic researchers, however, did not necessarily translate to a new model of social policy development or implementation. We argue that, similar to the experience of the UK, Australia's social inclusion policy agenda was for the most part narrowly and individually defined by politicians and policy makers, particularly in terms of equating being employed with being included. We conclude with discussion about the need to strengthen the social inclusion framework by adopting an understanding of social inequality and social justice that is more relational and less categorical.