Introspection as intra-professionalism in social and health care

This article analyses two cases from health and social care, adopting a psycho-societal approach. The analysis highlights how professionalism evolves and develops through an introspection of the relational and scenic processes between professionals, as well as between the professional and the client or patient. As a phenomenon at the core of professional practice, it will be argued that introspection needs to recognize and encompass the intra- and inter-psychic responses and understandings of professionals and their clients and patients. The first case places supervision as a learning space, where framing and complex exchanges of loss and confirmation, and of denial and displacement take place between a group of social workers and their supervisor. In the second case, it becomes apparent how the research interview opens up an opportunity for processing the emotions and socially critical experiences involved in hospital work.     

High‐frequency family contact: a road to nowhere for infants

Understanding the practices which support the best interests of infants when placed in out‐of‐home care in the first year of life is a significant challenge. A study based in Victoria, Australia, explored the practice by the Children's Court of ordering high‐frequency contact (4–7 days a week) with the infant's mother and father when they are placed in care in the first year of life. A literature review revealed little attention to the issue of frequency of family contact for infants. An audit of case files of all infants in care in mid‐2007 showed that at 1 year follow‐up, there was no difference in the reunification rate for children with a period of high‐frequency contact and those with less contact with their mothers and fathers. Focus groups revealed deep divisions of opinion about high‐frequency family contact which are played out in the adversarial Children's Court system in Victoria. The study highlights the complexity of understanding and supporting the attachment relationships at this critical period in the infant's life.     

Evaluating the Impact of Trauma-Informed Care (TIC) Perspective in Social Work Curriculum

A trauma-informed care (TIC) curriculum was integrated into a school of social work master’s level program. Measures assessed the impact of the curriculum on first and advanced-year students’ knowledge, attitude, self-efficacy, and behavioral intention at the beginning and end of a semester. Initial comparisons show advanced-year students as having more knowledge about TIC, more positive attitudes toward TIC, higher levels of self-efficacy to use TIC approaches, and greater likelihood to engage in TIC behaviors than first-year students. However, by the end of the semester, the latter were equivalent with advanced students on all measures. Results suggest the first-year curriculum provides sufficient background in TIC approaches to allow for significant gains across all areas assessed. However, integration of the TIC perspective within advanced courses needs further assessment.     

Predicting adoption dissolutions for children involved in the child welfare system

While the majority of foster care adoptions are stable and secure, some dissolve, resulting in the return of children to the system. The purpose of this study was to identify factors associated with children’s reentry into the foster care system after adoptions are formally finalized. Using case records from the Los Angeles Department of Children and Family Services’ (DCFS) Bureau of Information Systems (BIS), we compared 123 dissolved adoptions to 74 successful ones. We found that children’s gender, history of physical abuse, exposure to drug use, and the number of foster care placements prior to adoption are associated with greater odds of dissolution. Furthermore, the odds of dissolution were higher for relative adoptive parents and for adoptive parents with prior substantiated Child Welfare cases. Implications for practice include ongoing targeted training and supportive services for families and improved screening procedures that address the unique needs of adoptive parents.     

‘I shouldn’t be living there because I am a sponger’: negotiating everyday geographies by people with learning disabilities

Learning disability policy has for some time been framed by the goal of inclusion which purports to enable people with learning disabilities to lead a ‘life like any other’ person. This article examines the extent to which this is the case in England, by tracing the lived experiences of people with learning disabilities within their communities. The article draws on two interlinked qualitative studies involving interviews that examined their local place-based experiences of inclusion and exclusion. The findings reveal ‘moments of inclusion’ and opportunities for social encounter from peer support, but these were situated amidst wider experiences of exclusion and harassment.     

An examination of the views of young people in the Romanian residential care system regarding their relationship with biological family members and the option of reintegration

This paper reports findings from research conducted in six Romanian residential care homes. The aim of the paper is to examine the views held by young people, currently living in residential care, about the importance of their biological families and the option and challenge of reintegration. The data reflect the ideas and perspectives of 44 young people captured through a narrative interview approach using social mapping activities. The results indicate that most children and young people know at least one birth parent and maintain contact on their own initiative; most do not place a high level of importance on such relationships which are generally characterised by lack of confidence, low security and a presumed limited capacity on the part of the biological family to meet their needs. Family reintegration is considered to be a viable option for a small number of young people; others do not see it as realistic because of the impact of long-term separation and the likelihood of experiencing poorer living conditions.     

A Test of a Model with Reciprocal Effects Between Religiosity and Various Forms of Delinquency Using 2-Stage Least Squares Regression

ABSTRACT

This was a study of 1,093 adolescents from six different public high schools, where the same integrated theoretical model of control and social learning theories fit the data on alcohol use, heavy alcohol consumption, use of marijuana, criminal behavior, sexual exploration, and suicidal thoughts. It was observed that the model explained significantly more variance in some of these forms of delinquency than in others, indicating only equivocal support for the deviance syndrome argument in the literature. This study also found that religiosity was a significant influence only on criminal behavior, whereas the feedback eifect of delinquency on religiosity was significant for all forms of delinquent behavior studied. The importance of this particular finding was discussed in relation to previous studies, since almost all prior research has used statistics that do not consider reciprocal eifects. In the present study, the reciprocal effects between religiosity and various forms of delinquency were analyzed with two-stage least squares regression.     

Mental Health Care for American Indians in Prison

Abstract

Based on an earlier finding that as many Native Americans in upstate New York received mental health care in prison as outside of prison during a 10-month period, this study was designed to investigate if prisons had become an alternative treatment option for Native Americans with a mental illness in New York State. The study was not able to answer this question due to the limited number of cases and to outside constraints. However, it is possible from the results to provide a picture of mental health needs and attitudes among Native American inmates which is surprising and instructive for those who provide psychiatric care to American Indians, either within or outside of prison walls. A noteworthy finding was the importance placed by these inmates on the use of culturally appropriate ceremonies to assist in their rehabilitation. Low rates of serious mental illness among the American Indian sample highlight the need for further study in this area.     

Dementia Special Care Units

Abstract

Despite continued interest and growth in special care units in the United States, there is no uniform agreement on characteristics for these units, specific outcomes, or satisfaction with them. This study examined family satisfaction with Dementia Special Care Units (SCUs) using a modified standardized instrument and follow-up interviews. The study included five SCUs in one state, three participating in a dementia SCU demonstration project. Family outcomes were evaluated using surveys and interviews. The only significant difference between facilities in the demonstration project and the comparison facilities was one variable noting family with residents in the demonstration project had more positive perceptions regarding resident safety. The study illustrates a need for policy makers to more clearly identify and regulate special aspects of SCUs, taking family perceptions into consideration.     

The Effects of Nursing Home Placement on the Perceived Levels of Caregiver Burden

Providing care for an aging parent can be one of the most fulfilling life experiences for an adult child. It can also be one of the most exhausting physically, emotionally, and financially. A caregiver experiences psychological and emotional changes when their dependent parent or spouse is placed into formal care. This research project uses the Montgomery Borgatta Caregiver Burden Scale, amended with a questionnaire, in a self-administered, anonymous survey to explore perceptions of caregiving burden before and after the nursing home placement periods. This research showed that numerous factors influence caregivers' perceptions of burden and the quality of relationships among family members.