One-year outcomes from the CASAWORKS for Families intervention for substance-abusing women on welfare

AIM: To evaluate the effectiveness of a multiservice intervention designed to move substance-abusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. DESIGN: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women conducted in 11 selected sites across the country. There were significant improvements shown in substance use and family and social functioning by the 6-month point, and additional improvements in employment by the 12-month point. By 12 months, more than 46% were abstinent from alcohol and other drugs, and 30% were employed at least part-time. There were only modest improvements shown in the medical and psychiatric status of these women. These preliminary findings suggest that site-level interagency coordination and program-level case management were associated with improvements in the targeted areas as predicted by the model. Future work will require a more closely specified, manual-guided form of the intervention plus the inclusion of control groups and cost measures to fully evaluate the cost benefits from the final form of the intervention.     

Characteristics of substance-abusing women on welfare. Findings from the evaluation of CASAWORKS for Families pilot demonstration

AIM: To describe and compare the characteristics and needs of substance-abusing women on Temporary Assistance to Needy Families (TANF) who enroll in a multi-service "welfare to work" program (n = 673) with two other relevant groups: (a) women from the general TANF population in the same locales (n = 157) and (b) a sample of substance-abusing women on TANF who entered standard outpatient substance-abuse treatment programs (n = 520). DESIGN: A field study with repeated measures and intent-to-treat sampling. INTERVENTION: The CASAWORKS for Families (CWF) program was delivered in 11 sites in 9 states across the country. The CWF intervention featured integration of substance-abuse treatment and employment-work readiness services, using case management to tailor needed services (parenting, victimization, mental health, physical health, legal, and basic needs). MEASUREMENT: The Addiction Severity Index, supplemented with subject-appropriate questions, was used at treatment admission. FINDINGS: The CWF sample exhibited multiple serious problems in the areas of substance abuse, victimization, medical and psychiatric health, and basic needs. The severity of their lifetime problems and their recent service needs were significantly higher in all these areas, except physical health, than were those of the general welfare sample of women in the same locales. Compared with women on TANF from standard addiction-treatment programs, CWF women exhibited similar substance-use problems but generally more severe co-occurring problems.     

Potential barriers to work for substance-abusing women on welfare. Findings from the CASAWORKS for Families pilot demonstration

AIM: To assess the prevalence and relationship to later employment of potential barriers to work for substance-abusing women on Temporary Assistance to Needy Families (TANF) enrolled in a multiservice welfare-to-work program. DESIGN: A field study with repeated measures and intent-to-treat sampling. INTERVENTION: The CASAWORKS for Families (CWF) was delivered in 11 sites in nine states across the nation and featured integration of substance-abuse treatment and employment and work readiness services. MEASUREMENT: The Addiction Severity Index, supplemented with subject-appropriate questions. SAMPLE: A total of 366 CWF women who completed interviews at program enrollment, and at 6 and 12 months later. FINDINGS: Substance-abusing women on TANF in the CWF program exhibited multiple potential barriers to work at enrollment, averaging 6 out of 14 potential barriers assessed. They reported significantly more obstacles than a general welfare sample of women from the same locales. Few single barriers were significantly related to employment at 12 months. However, the total number of potential barriers to work experienced, particularly at 6 months, was related to employment at 12 months.     

Treatment services received in the CASAWORKS for Families program

This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients also had frequent contact with their case managers and were retained in the program for an average of 222 days. Considerable variation was observed across sites in the percentage of clients who received various services and the number of sessions they received. In Cox regressions, shorter retention in the program was predicted by referral to program from Child Protective Services or parole/probation, social conflicts, employment, and marijuana use at baseline, whereas a history of suicide attempts was associated with longer retention. Longer retention was associated with better alcohol use outcomes but was unrelated to employment or drug use outcomes.     

The impact of welfare reform on the parenting role of women in rural communities

Current family policy suggests that in order to restore family values we, as a society, need to focus on reviving a child-centered household. Full-time mothering is lauded as an honorable choice that will advance this goal and ultimately strengthen traditional family values. However, current welfare policy is contrary to this notion in that mandatory welfare-to-work programs deny women receiving public assistance the choice to be full-time mothers. Based on in-depth interviews with female welfare recipients in four rural Appalachian counties, this paper evaluates the problems women face as they confront the difficult choices of being either a “good mother” or a “good recipient.” From a feminist perspective, findings suggest that welfare reform programs in rural communities have put poor women in a proverbial “catch-22” with regard to effective parenting. Although many of the women strive to be ideal mothers as defined by societal standards, they often find that they cannot carry out the role effectively because of welfare reform regulations.     

The role of interagency collaboration for substance-abusing families involved with child welfare

Meeting the needs of families involved with the child welfare system because of a substance abuse issue remains a challenge for child welfare practitioners. In order to improve services to these families, there has been an increasing focus on improving collaboration between child welfare, treatment providers, and the court systems. This paper presents the results from qualitative interviews with 104 representatives of these three systems that explore how the collaborative process works to benefit families, as well as the barriers and supports for building successful collaborations. Results indicate that collaboration has at least three major functions: building shared value systems, improving communication, and providing a "team" of support. Each of these leads to different kinds of benefits for families as well as providers and has different implications for building successful collaborative interventions. Despite these putative benefits, providers within each system, however, continue to struggle to build effective collaborations, and they face such issues as deeply ingrained mistrust and continued lack of understanding of other systems' values, goals, and perspectives. Challenges that remain for successful collaborations are discussed.     

Foster parenting: A developmental model

This paper proposes a developmental framework for foster parents and outlines four distinct growth stages. Such a framework can be of value to program administrators who are required to assess foster parent development during the crucial matching process. To draw a distinction between each developmental stage, specific instrumental tasks and indicators are outlined.     

A clinical consultation model for child welfare supervisors

This article presents findings from a consultation project conducted by faculty from six schools of social work with approximately 150 child welfare supervisors over a two-year period. The purpose of the program was to assist supervisors with their roles as educators, mentors, and coaches for casework staff, specifically in relationship to case practice decisions. The consultation model, the development of the curriculum, the project implementation, and the results of the initial assessment are described.     

Temporary employment experiences of women on welfare

Females with recent participation in public welfare are a disproportionate and growing share of temporary help services firm employees. Research documenting low earnings, frequent job transitions, and low benefit rates among temporary workers has raised concerns that welfare recipients taking these jobs might have poorer labor market outcomes than those entering permanent positions. My findings show that a majority of welfare recipients working in temporary jobs were satisfied with their pay and working conditions and did not earn much less than those in other jobs. They did report, however, high levels of dissatisfaction with the lack of employment benefits received, and their annual earnings were still very low, reflecting chronic job instability that is endemic to the welfare population.     

A model of culture-centered child welfare practice

This article presents a framework for culture-centered child welfare practice, including child-family-system interactions, service provision, recruitment and retention of homes, and culturally responsive legislation. There should be no one-size-fits-all approach to child welfare practice. In a diverse society, child welfare practice must be responsive to the particularities of various cultures. A culture-centered framework allows for a holistic system of child permanence, with consideration of a child's mental, physical, and emotional growth. This framework cherishes the distinctiveness of America's cultures.     

A culturally responsive practice model for urban Indian child welfare services

This article describes collaboration among a university, a state child welfare agency, and a Native American community organization to develop a culturally driven practice model for urban, Native American child welfare. The approach includes a strategy to build resources to serve Native American clients, a training program for child welfare and court personnel using a culturally responsive curriculum, and an advocacy program that monitors for Indian Child Welfare Act compliance and provides assistance to child welfare workers and the court. The discussion identifies challenges and opportunities in addressing the needs of urban Native American communities. The article concludes with principles for culturally responsive practice for urban Native American child welfare practice.     

Child welfare management: a model curriculum.

A social work school curriculum designed especially to train persons to manage child welfare program is in its second year of operation. It may provide a model for training personnel in this area.     

Carbamazepine treatment of psychosis. Implications for patient welfare and nursing practice

1. The antiseizure medication carbamazepine, when used to treat psychosis, does not produce the same side effects that appear as problematic in neuroleptic treatment, most notably tardive dyskinesia. 2. Carbamazepine has useful sedating, antianxiety, and antidepressant properties that make it an effective treatment for manic psychosis. 3. Nursing actions include assisting psychiatry in establishing and maintaining effective carbamazepine treatment, ensuring safe treatment, enhancing the patient's self-care agency, and facilitating research regarding the effects of carbamazepine treatment.     

Social security, employment and Incapacity Benefit: critical reflections on A new deal for welfare

In January 2006 New Labour published a Green Paper on welfare reform, A new deal for welfare: empowering people to work. Following a consultation period the 2006 Welfare Reform Bill was published in July 2006. The main concern of the Green Paper was with Incapacity Benefit and the people who claim it. This paper critically engages with the proposals outlined in the Green Paper and the subsequent Bill. Focusing upon the social security and labour market interventions of the proposals, the paper argues that rather than empowering disabled people to work, the relationships held to exist between welfare reform and paid employment in A new deal for welfare are likely to have a limited impact. The paper discusses why this is likely to be the case by examining assumptions contained in the proposals related to the reasons why people claim Incapacity Benefit, the model of disability that structures the proposals and the relationships between disability, paid work and models of family structure that the proposals presuppose.     

Policy challenges for child welfare in the new century

Recent changes in public policy reflect increased efforts to scapegoat poor women and children and to polarize the objectives of child protection and family preservation. This article challenges various stakeholders in the child welfare field to move beyond the quick-fix solutions and bureaucratic overregulation precipitated by horror stories of child abuse in the media. The new century presents an opportunity to pursue differential intervention strategies that protect children while empowering poor families and communities.     

The effect of cross-cultural dialogue on child welfare parenting classes: anecdotal evidence in black and white

The child welfare system indicates that evidence of successful completion of parenting classes is instrumental in determining whether parents are actively engaged in the process of permanency planning. Such classes vary in length and intensity with topics ranging from "How to Raise Healthy Families" to "How to Discipline Your Child." Two social workers (one white and one black), who initially disagreed about the format of a parenting class, chronicle their efforts to collaborate and create a class format that recognizes the psychosocial and, more specifically, the cultural influences inherent in facilitating these classes. The juxtaposition of the clinical concepts of projection and projective identification are evaluated against the backdrop of the social concepts of empowerment and diversity.