Impact of Computerized Rapid Assessment Instruments on Counselors and Client Outcome

Abstract

The effect of the availability of Rapid Assessment Instrument (RAI) (1) computer scoring, and (2) computer administration on: (3) counselor behavior, and (4) client outcome was inspected. Counselors without computer assistance employed fewest RAIs with their clients; those with computer scoring available employed more RAIs, and those with computer administration available employed RAIs most frequently. When more RAis were employed, clients improved more in counseling, terminated against medical advice less frequently, and were also more satisfied with their counseling experience.     

Factors in Acceptance of Advanced Information Technology Among Social Workers

Summary

Advanced information technology such as diagnostic programs, decision support systems or therapeutic computer games are likely to have far-reaching effects on the nature of social work practice, on the condition that they can be accepted by rank and file workers in human services organizations. This exploratory study was designed to develop a valid instrument that can test the extent to which social workers are willing to use the three most common types of advanced information technology: (1) computerized assessment package (CA), (2) decision support system (DSS), and (3) therapeutic computer games (TG). The instrument was field-tested with 74 Israeli social workers. Social workers clearly differentiated between the types of information technology with preference for therapeutic computer games (TG, DDS, CA, mean acceptance = 4.14, 3.91, 3.47, respectively). The differences between TG and CA, and between DDS and CA were statistically significant in paired t-tests (p = .000 and .003 respectively).     

The Application of Artificial Neural Networks for Outcome Prediction in a Cohort of Severely Mentally Ill Outpatients

SUMMARY

Social workers and other mental health workers lack clinical decision support tools to predict which clients are at greatest risk of psychiatric rehospitalization. Artificial neural networks (ANNs), are computer decision support tools that make prediction and classification decisions based on accumulated experience and information contained in successfully solved cases (correct decisions). This study evaluates the use of ANNs in predicting rehospitalization of severely mentally ill outpatients. Eight Bayesian ANN models achieved correct prediction rates ranging from 75% to 93% for two prediction conditions. These results support the utility of Bayesian ANN models in the development of clinical decision support tools.     

Agency Practices Affecting Social Workers Who Treat Substance-Abusing Clients

Abstract

This study interviewed 115 MSWs with substance abuse training working in general social service agencies to determine if they viewed their settings as facilitating or hindering their work with substance-abusing clients. This study builds on the work of Lightfoot and Orford (1986) who found that social workers were more hindered than helped by their agencies' practices regarding substance-abusing clients.

Results: A majority of workers viewed their agencies as facilitating substance abuse-related work through support from supervisors and administrators, availability of substance abuse training, workers' freedom to choose clients, and opportunities to supervise others on substance abuse-related issues. Supervisor data corroborated these findings. This is a hopeful sign for the profession contrasting with considerable social work literature documenting the profession's historic ambivalence toward substance-abusing clients.     

Counselor Trainees' Assessment and Diagnosis of Lesbian Clients with Dysthymic Disorder

SUMMARY

Graduate-level counselor trainees completed an Assessment and Diagnostic Inventory consisting of clinical vignettes and a series of questions pertaining to conceptualization of client problem, diagnosis, and assessment of overall level of psychopathology.We hypothesized that participants would assign different diagnoses to clients with lesbian versus heterosexual sexual orientation. Participants responded to vignettes in which clients were identified as either a lesbian or a heterosexual female, with all other content identical. Participants were significantly more likely to perceive lesbian clients' problems to be related to sexual orientation for the vignette corresponding to dysthymic disorder. However, they were not more likely to assign personality disorder diagnoses, nor did they attribute a greater degree of psychopathology to lesbian clients with dysthymic disorder.     

Experiential Exercises for the Development of Computer Literacy Among Social Work Undergraduates

Summary

This paper describes exercises and assignments used to promote computer literacy among social work undergraduates. These exercises were used as course assignments in an elective course for seniors, “Information Technology and Human Services.” Exercises met four criteria: (1) they assume no previous computer experience or knowledge, (2) they are directly related to human services practice, (3) they promote mutual support, (4) they are experiential. Exercises include use of word processing, database, spreadsheet, electronic mail, privacy invasion, shopping for a computer system, and impact of information technology on the larger society.

The potential placement of computer literacy exercises in the social work curriculum is discussed. It is suggested that a single experiential course best meets the need for promoting computer literacy among social work students.     

Exploratory study of the use of community treatment orders with clients of an Ontario ACT team

ABSTRACT

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining CTOs and ACT resulted in regular access to mental health supports, fewer hospitalizations and overall improvement of quality of life for their clients.     

The Worker Safety Advisor

SUMMARY

A performance support system (PSS) improves workplace performance by providing on-demand access to the integrated information needed to complete the task or solve the problem at hand. To test the feasibility of a human services PSS, the authors developed the Worker Safety Advisor (WSA), which presents several computer screens on which workers specify the situation they face. The WSA then searches a knowledge base and presents relevant worker safety information in an easy-to-read format. This article describes the development of the WSA, Including its background, rationale, objectives, resources required, and lessons learned. The PSS concepts and experiences presented can help others develop similar applications.     

Negative attitudes,nonverbal behavior and self-fulfilling prophecy in simulated therapy interviews

This research investigated if interpersonal expectancies in a psychotherapeutic context were mediated through nonverbal behavior. Beginning (male) therapists served as interviewers and interacted with (male) subjects who were introduced as clients (who were treated for psychological problems) or normal students. It was hypothesized that the therapists would have a more negative attitude toward the supposed clients than toward the nonclients and show more arm position symmetry and less forward lean toward the supposed clients. The interviewees were predicted to show more ah-filled pauses, speech disturbances, and less looking at the interviewers in the client condition than in the nonclient condition. The results demonstrated that therapists had more negative expectancies toward supposed clients than toward nonclients. Support was shown for the hypothesis that more arm position symmetry would be shown in the client condition than in the nonclient condition. The results also indicated that supposed clients used more ah-filled pauses and speech disturbances than nonclients. The therapists used this information when they attributed more discomfort to the supposed clients. It is suggested that the findings of this study have implications for understanding the process of self-fulfilling prophecy in a therapeutic context.     

Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

Inequality and Multiracial Gatekeeping

ABSTRACT

Theoretical propositions linking power and status relations are deeply rooted in classical sociological thought. Building on that tradition, this paper investigates the impact of racial status on a specific power relation, the relation between gatekeepers and their clients. Gatekeepers control access to “benefits” they do not own, benefits that are valued by “clients.” Seeking access to those benefits, clients assume obligations which may be discharged by a fee paid to the gatekeeper. The size of the fee paid is the amount of power exercised by the gatekeeper. Employment agents, car salesmen, real estate agents are gatekeepers because they control access to jobs, cars, and housing, respectively, as well as information about each. When clients are lower status, for example, African American, employment agents may steer them to lower-paid, less desirable jobs, car salesmen may ask for and receive higher prices, and real estate agents may show only segregated housing. Research reported here extends previous work on gatekeeping to multiracial (black-white) gatekeeping relations by jointly applying two theories. Network Exchange Theory (NET) models the gatekeeper–client relation, and Status Characteristics Theory (SCT) models the impact of racial status on that relation. The result is three theoretical predictions that are experimentally tested in the well-understood context of exchange networks. As a first replication of previous work on gatekeeping, a key finding is that gatekeeping does produce power differences, as theoretically predicted. Two new additional findings are that 1) whereas race does indeed undermine the effects of blacks’ gatekeeping of whites, 2) it does not amplify (significantly) the effect of whites’ gatekeeping of blacks. Theoretical and practical implications of these findings are discussed.     

Responsibilisation,social work and inclusive social security in Finland

ABSTRACT

In this article responsibilisation in social work is studied by analysing two Finnish state-level policy documents (called final report and research report) which concern a current activation initiative called inclusive social security (ISS). It is asked how social workers and clients are constructed as responsible subjects in these documents. Responsibilisation refers to the advanced liberal mode of governmentality, which aims to strengthen citizens’ abilities to self-governance through various techniques that include the intertwined elements of surveillance and empowerment. It is demonstrated that the policy documents construct the social workers’ and the clients’ responsibilities partly in different ways. The final report leads activation to be based on shared responsibility and social work to be more community-based, whereas the research report strengthens more individual-based responsibility of clients and social workers. For the clients, the interpretation of ISS based on shared responsibility would probably be less stigmatising and paternalistic than the one based on individual responsibilities, i.e. approaching long-term unemployed citizens as being personally ‘at risk’ and thus a justified target group of individualised techniques for activation. For social workers and clients, future activation appears to be a wide mix of different techniques, moral expectations and possible ways of being a responsible subject.     

A Program Evaluation of Los Angeles ACORN's Welfare Case Advocacy

SUMMARY

Bureaucratic confusion and client dissatisfaction since the 1996 changes in welfare policy opened opportunities for third party advocacy on behalf of welfare clients. This paper evaluates Los Angeles ACORN's case advocacy program for welfare clients. Outcomes analyzed include client satisfaction with ACORN's advocacy and effects of the program on welfare clients who later became ACORN members. Ninety-one percent of clients surveyed (N = 99) stated they were satisfied with the resolution of their welfare case complaint. Eighty-eight percent of respondents stated ACORN did a better job resolving their problem compared to the welfare department. Unique aspects of the program include peer advocacy and opportunities for welfare recipients to join ACORN and work on welfare policy changes among other issues.     

A Nonclinical Comparison of Transgender Identity and Sexual Orientation

Abstract

Multicultural counseling has emerged as the fourth force in American Psychology. To provide a nonclinical, multicultural framework with which to facilitate assessment and treatment of transgender (TG) clients, 73 North American TG respondents were compared to six groups. The comparison groups included 1,083 heterosexual females, 1,077 heterosexual males, 73 psychosocially matched females, 73 psycho-socially matched males, 256 homosexual females, and 356 homosexual males. Comparisons were made on psychosocial characteristics, past and present psychotherapy, past and present medication for a psychiatric condition, and past or present difficulties controlling potentially problematic behaviors. The TG respondents were more similar than different relative to lesbians and more different than similar in comparison to every other group. The similarities between TG respondents and lesbians suggest the dual influences of gender and sexual orientation minority status significantly compound the burden of adaptative functioning.     

Accredited Mental Health Social Work in Australia: A Reality Check

Abstract

Accredited mental health social workers (AMHSWs) have a great deal to offer the clients they see in their private practices, many of whom have complex needs. However, they are constrained by the inflated expectations Government has about evidence-based psychological interventions. The restrictions placed on the professional private practice of AMHSWs by Federal Government Medicare funding of a narrow set of psychological interventions ultimately limits the services received by clients. In this article, the findings of a survey of AMHSWs are presented, highlighting the tensions between individualised responses promoted by Medicare payments, and those premised on principles of social justice and social inclusion.     

College Counselors’ Perceptions and Practices Regarding Anticipatory Guidance on Firearms

Abstract

Objectives: This study assessed college counselors’ anticipatory guidance on firearms for student clients. Participants: The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey. Methods: In the winter of 2008, a 3-wave mailing procedure was used to maximize the response rate. Completed surveys served as consent (as approved by the University Human Subjects Committee). Results: A total of 213 counselors (59%) responded. They were unlikely to provide anticipatory guidance (6%), chart/keep records on client ownership/access to firearms (17%), or to counsel the majority of clients from various diagnostic categories on firearms. Conclusions: University personnel are likely to refer students with suspected mental health problems to university counseling centers. The findings indicate that few counseling centers will address firearm issues with students.     

A National Study of Involuntary Protective Services to Adult Protective Services Clients

ABSTRACT

A questionnaire was sent to state administrators of Adult Protective Services Programs (APS) to learn about involuntary protective services provided by APS to vulnerable adults at risk of abuse, neglect, or exploitation. Data were obtained on criteria used to assess the need for involuntary services, types of services provided, sources of authority for involuntary intervention, the nature and extent of public concern about involuntary services, and the protection of the rights of incapacitated clients. Based on responses from 43 states, less than 10 percent of APS recipients receive services without their consent; and all states providing services involuntarily take steps to ensure the protection of rights. Available information from the study does not support the general belief that adults who self-neglect are more likely than other APS clients to have protective services imposed.     

A novel way of responding to dissonance evoked by belief disconfirmation: making the wrongdoing of an opponent salient

ABSTRACT

Based on dissonance theory, we predicted that individuals who supported a political figure (Donald Trump), were exposed to information about his wrongdoings, and believed the veracity of this information would be most likely to share social media that points to incidents in which opponents also engaged in wrongdoing. Participants (N = 409) varying in their support for Trump were exposed to information concerning his alleged wrongdoings (or a neutral article). They viewed a meme of a political rival (Hilary Clinton) that alluded to her alleged wrongdoings, and reported how likely they would be to share the meme (and indicated how accurate they believed the Trump article was). Results supported the prediction, suggesting that dissonance may cause individuals to emphasize the wrongdoings of opponents.     

Mental Health Professionals' Exposure to Clients with Problematic Internet Experiences

ABSTRACT

This paper examines clients' exposure to problematic Internet experiences among a national sample of 2,098 social workers, psychologists, marriage and family therapists, and other mental health professionals. This analysis finds that mental health professionals are working with clients experiencing a range of problems related to Internet use. However, these professionals have generally not been exposed to training or information in the professional literature on the topic of working with clients with problematic Internet experiences. We identify several areas in which additional training is needed and review practical implications for mental health professionals.     

Computer Games and Simulations as Tools to Reach and Engage Adolescents in Health Promotion Activities

Summary

Computer games and simulations were used extensively in a comprehensive health promotion for adolescents. These strategies were used to attract adolescents to BARN (Body Awareness Resource Network), as well as helping to hold interest. In each of the six topic areas (AIDS, Alcohol and Other Drags, Body Management, Human Sexuality, Smoking and Stress Management) quiz games challenged users to test their knowledge on a topic. Simulations challenges users to apply health information in hypothetical situations. Games were a more important factor in selection of BARN for younger users than for older users. BARN game users were not more likely than non-game users to be isers of other computer or video games, nor did game users engage in more risk taking behaviors (e.g., alcohol and other drugs) than non-game users.