Pathways to Service for Older Persons

Abstract

As services for older persons continue to shift from hospital and nursing home care to greater reliance on support for care at home, the need to understand the ways older persons obtain services becomes more important. This study examines the use of home-delivered meals as a case study to gain insight into the process of service use from the recipients' point of view. It explores the research question: What are the pathways by which older persons acquire home delivered meals? Narrative analyses of structured and unstructured questions asked of thirty frail older persons suggested that the process of acquiring home delivered meals was accompanied by patterns of adjustment in shifting between independence and dependence in managing loss of physical function, and themes of isolation, loss, and abandonment. The results provide insights for social workers in providing the support needed for the role transition that service acceptance symbolizes for older adults.     

Addressing the Vision Challenges of Residents at a Retirement Community: Collaborative Research with a Community Partner

ABSTRACT

Staff members at a community retirement village were concerned about the demise of a support group for residents with vision loss, and requested help developing effective services for residents with vision challenges. This study explored past barriers to support group participation, as they were perceived by residents, family members, and employees. The community partner worked collaboratively with the researcher in all phases of the study. Questionnaires were designed to elicit demographic data, diagnosed vision problems, level of adjustment to vision loss, well-being, and motivation for attending institutional programs about vision challenges. Residents responded to standardized vision and depression scales; qualitative questions were posed to all 3 groups concerning motivations for resident participation in program activities. Results indicated that, although many residents had diagnosed vision conditions, they were, in general, coping well with vision loss and did not report depressive symptoms. Participants considered ongoing personal contact and follow-up, a group design that offered the choice of educational presentations and/or process discussions, and individualized assistance with practical challenges to be critical to an effective program. This case study, utilizing a collaborative research process, generated requests for expanded social work services and an increased valuing of the social work role.     

Cool Pose: Black Male Homicide and the Social Implications of Manhood

ABSTRACT

Black male homicide has reached crisis proportions. This study investigated homicidal incidents to assess associations of Cool Pose with Black male homicides. Cool Pose is a tradition of manhood originating in Africa. The relationship of Cool Pose and homicide was examined by analyzing with multivariate statistical techniques 721 homicide incidents that occurred in the city of Newark, New Jersey. Findings suggest that Cool Pose is linked to homicides involving Black males. Society is not irrelevant to Cool Pose homicides and therefore relevant to their resolution. Social services may contribute to said resolution by informing the social work profession.     

Strengths-based creative mindfulness-based group work with youth aging out of the child welfare system

ABSTRACT

This article describes the outcomes of a doctoral study exploring the facilitation of an arts and mindfulness-based group for youth aging out of the child welfare system. Although there has been an upsurge in attention to the use of mindfulness-based interventions (MBIs) with children, there are still significant knowledge gaps regarding the use of MBIs with older youth who have experienced trauma, loss, and marginalization. At the same time, there is increasing attention to the importance of relationships to successful transitions in the lives of youth aging out of child welfare system. This research is qualitative and sought to explore how an innovative MBI was experienced by these youth. Data from semistructured interviews revealed key themes related to the unique challenges of being involved in the child welfare system and the aging-out process, the participants’ understanding and benefits of learning mindfulness, as well as their experience of social support through a collaborative group participation. The benefits of group participation, including meaningful engagement in the group process, are considered.     

Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis

ABSTRACT

Increasingly, social workers and behavioral health practitioners use assessment instruments to support service planning and to monitor progress. Following statewide implementation of the Adult Needs and Strengths Assessment (ANSA) to identify behavioral health symptoms, related functional challenges, risks, and strengths, this validation study explored the underlying structure of the instrument. An exploratory factor analysis used routinely collected information for Midwestern adults with diagnosed behavioral health disorders who participated in community-based services (N = 46,013). Five factors with adequate to good internal consistency (α = 0.733?0.880) emerged: personal recovery, trauma and stress related problems, substance use risks, self-sufficiency, and cultural-linguistic considerations. Validation of the ANSA supports use of the instrument to engage individuals and families, to plan services, to monitor progress, and to conduct research. Implications for social work education, supervision, and practice include the importance of understanding culture, holistic assessment, and services supporting personal recovery for individuals living with mental illness or substance use disorders. Confirmation of findings requires additional research.     

Lessons learned implementing community‐based comprehensive case management for families surviving homicide

Family members of homicide victims often experience a wide range of adverse reactions to the homicide. This study reports on the Traumatic Loss Response Team, a project conducted by a community‐based, mental‐health agency to provide comprehensive case‐management services to meet homicide survivors' complex needs. To conduct the study, we abstracted service/process data from open client cases in 2013 (most recent year with available data) and conducted interviews with the project's implementing agencies. Interviews revealed both initial challenges and factors facilitating successful implementation. Main challenges to overcome included gaining credibility and trust from police and issues around overlap of services provided to families by numerous agencies that may become involved in a homicide. Partners view the project providing a range of important services to families, including intermediary/buffer between families and police. Concerning service data, of the 131 cases open in 2013, most were referred directly by police and involved community violence, an adult victim and a firearm. Most of the 164 clients receiving services were female, adult, African‐American and parents of the deceased. Grief support was the most common of numerous services provided. We hope that this study will catalyse sharing of similar data and experiences among organizations providing services to homicide survivors.     

The Impact of Religiousness,Spirituality, and Social Support on Psychological Well-Being Among Older Adults in Rural Areas

Summary

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious/spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas.     

Bilingual Validation of the Family Responsibility Scale

Abstract

In the context of the HIV pandemic, infected persons in the United States are increasingly poor women of color, many of whom are single parent heads of household with responsibilities for caring for another ill family member. A significant proportion of such persons are recent immigrants, and many do not speak English as a primary language. Responding to the lack of cross-cultural instruments suitable for assessment and research in such populations, the present study describes the bilingual (Spanish and English) validation of the Family Responsibility Scale. Based on a sample of 161 persons receiving HIV-related service in family agencies in two major urban centers, the findings support a unidimensional rapid assessment instrument with substantial equivalence across language groups. Results indicate very good reliability, and evidence of strong content, factorial, and construct validity. Implications for bilingual validation and applications in health and social service settings are discussed.     

Youth Experiences Survey (YES): Exploring the Scope and Complexity of Sex Trafficking in a Sample of Youth Experiencing Homelessness

ABSTRACT

In the United States, sex trafficking victims have been identified at ages across the lifespan but young persons (under age 25) have been found to have unique vulnerabilities. At-risk youth, such as those who run away from home or those experiencing homelessness, are also at an increased risk of sexual exploitation. To better understand the scope and complexity of sex trafficking among these at-risk youth, a convenience sample of 131 homeless youth aged 12 to 25 years old experiencing homelessness recruited from Kentuckiana youth service providers completed an enhanced version of the Youth Experiences Survey (YES). Univariate and bivariate analyses were conducted. Results indicated that 41.2% of the homeless youth were victims of sex trafficking. The sex trafficked youth were more likely to report previous self-harm behaviors, suicide attempts, and substance use. This study not only provides support for improved service delivery, but also provides essential statistics that should inform internal policy and procedures for youth serving agencies in Kentucky and Indiana. Findings highlight a need for trauma-informed interventions designed to treat not only females but also males and LGBTQ youth. Additionally, service providers should consider partnering with victim providers and clinicians to offer therapeutic groups, individual therapy, and supportive services that increase prevention, education, and wraparound care for clients. In regards to future research, findings point towards a need to better understand the role that trauma and adverse childhood experiences may play in making young people vulnerable to sex trafficking, and encourage the need for testing prevention and early intervention practices among vulnerable youth.     

September 10, 2001

Abstract

This essay chronicles the impact of a patient's suicide on the therapist, reflecting on the initial trauma, the therapist's repeated attempts to deal with the loss, and her ultimate physical collapse. Time off from work began the healing of her physical symptoms, and the spontaneous writing and immediate sharing of her raw and unformulated feelings with a writing group she had just joined, began the process of grieving which, until this point, had only been known physically. Working and re-working this essay kept her safely, but affectively connected to the loss and gave her experiential understanding of the adaptive function of somatization, leading finally to the acceptance of the limitations of both patient and therapist.     

Addressing the vision challenges of residents at a retirement community: collaborative research with a community partner

Staff members at a community retirement village were concerned about the demise of a support group for residents with vision loss, and requested help developing effective services for residents with vision challenges. This study explored past barriers to support group participation, as they were perceived by residents, family members, and employees. The community partner worked collaboratively with the researcher in all phases of the study. Questionnaires were designed to elicit demographic data, diagnosed vision problems, level of adjustment to vision loss, well-being, and motivation for attending institutional programs about vision challenges. Residents responded to standardized vision and depression scales; qualitative questions were posed to all 3 groups concerning motivations for resident participation in program activities. Results indicated that, although many residents had diagnosed vision conditions, they were, in general, coping well with vision loss and did not report depressive symptoms. Participants considered ongoing personal contact and follow-up, a group design that offered the choice of educational presentations and/or process discussions, and individualized assistance with practical challenges to be critical to an effective program. This case study, utilizing a collaborative research process, generated requests for expanded social work services and an increased valuing of the social work role.     

I'm Gone When You're Gone: How a Group Can Survive When Its Leader Takes a Leave of Absence

SUMMARY

As the roles and demands on social workers increase in their agencies and their personal lives, there is a greater chance that they will need to take a leave of absence. This is also true for social workers who lead groups. This article presents a process to allow the primary worker to take a leave of absence while the group continues with an interim worker. The author's personal experience of a leave of absence from a HIV+ adolescent support group will be used to illustrate this transfer process. In providing ample time and a thoughtful process of transfer, this leave of absence was successful in maintaining group attendance and participation.     

Challenging the Myths of Black Women—A Short-Term,Structured, Art Experience Group: Exploring the Intersections of Race,Gender, and Intergenerational Trauma

ABSTRACT

The authors describe a short-term structured group process for African American women in the suburbs of Washington, DC, highlighting the perspective of the group leaders. The group was started to address the unique needs of African American women who are also survivors of childhood abuse and neglect. The group leaders used discussion and art in the group to explore the intersections of race, gender, and intergenerational trauma. Having shared experiences with the participants of the group, the authors explore the ways the group leaders were changed and challenged in the process.     

A Worker's Personal Grief and Its Impact on Processing a Group's Termination

SUMMARY

This article deals with a worker struggling with a personal loss while simultaneously helping her group with the termination of a valued long term member. The focus is on the parallel grieving process and the resistance to mourning.     

Barriers to the Use of Mental Health Services by African-American and Hispanic Elderly Persons

Abstract

This study discusses barriers to the utilization of community-based mental health services by African-American and Hispanic elderly persons. The study sample consists of “key Informants,” chosen because they were knowledgeable about the mental health needs and use of mental health services by African-American or Hispanic elderly persons. Principal component analysis using orthogonal rotation was conducted on the 23 item barrier scale and identified three levels of service barriers for the entire sample and for each subsample of African-American and Hispanic informants. Based upon the study findings, a number of strategies are offered to improve Utilization and overcome service delivery barriers.     

Assessing Transfer-of-Learning Potential With Human Services Professionals

ABSTRACT

Transfer of learning (TOL) from training to the job was examined in two different populations of human services workers using the Transfer Potential Questionnaire (TPQ). A cross-validation study was conducted to explore commonalities and differences between public welfare (PW) professionals in California (n = 459) and Child Protective Services (CPS) social workers in Ohio (n = 598). The TPQ significantly correlated with perceived TOL for both training populations and added to the amount of TOL variance explained after controlling for participant satisfaction and perceived learning. Important TOL factors identified for both groups included perceived learning and application planning. Findings suggest TPQ is a valid predictor of TOL for both PW professionals and CPS social workers, supporting a shared construct relative to TOL across human services practice areas. Future research should explore additional TOL assessment methods and seek to further validate the TPQ with other populations of human services professionals.     

Serving Former Foster Youth and Homeless Students in College

ABSTRACT

Many universities have developed campus support programs for former foster youth and homeless college students; however, there are no studies focusing on long-term programs in the college-setting with a mentoring component that focuses on developing relationships with supportive adults. To address the gap, this study examined both mentors' and program staff's experience with providing services to students in a campus support program. The authors collected qualitative data from one success coach (i.e. program staff) and eight mentors through focus group meetings and interviews. Results indicated that the success coach reported the students in the program improved their overall academic performance, while most mentors did not know their mentees' grades. The success coach coordinated most services of the program, assigned financial and academic support, and made service referrals. Mentors helped their mentees to improve academic and independent living skills. However, mentors reported that they received limited support, especially when working with mentees with mental health problems. Recommendations to improve the program include: using a multidisciplinary team for students with mental health problems and adopting systematic approaches to better support mentors' services. Future studies should go beyond program staff and mentors to include students' perspectives regarding their experiences with receiving mentoring services.     

Perceived social support among adolescents in Residential Youth Care

Social support may be of particular importance for vulnerable adolescents' development and health and can help them to cope with stressful life events. However, knowledge of perceived social support among adolescents in Residential Youth Care (RYC) is sparse. The present study therefore aimed to investigate perceived social support among adolescents in Norwegian RYC (N = 304, mean age 16.3 years, girls 57.2%), using a short form of the Social Support Questionnaire. The results were compared with adolescents in the general population. The findings revealed that adolescents in RYC reported a lower number of support persons compared with the general population. Both populations reported a decreasing number of support persons as they aged, except for girls in RYC. The adolescents in both populations were satisfied with the support perceived, especially those with the highest number of support persons. However, social support providers differed between the two populations; RYC adolescents reported their extended family, other sources of support, and the institutional staff more often and their parents less. The findings are important for adolescents living in RYC, as knowledge of their social support network could influence the current practices and ensure contact with important support persons, affecting their development and health.     

The serene student: Evaluating a group-based mindfulness training program for MSW students

ABSTRACT

Social work educators are exploring the benefits of mindfulness training for social work pedagogy. The authors evaluate the outcomes of a mindfulness program for MSW students. The authors assessed changes in mindfulness, self-compassion, affect, mood, and impairment due to emotional distress before and after the program, and at 4-month follow-up. The authors examine how the group process may facilitate the development of mindfulness and consider how mindfulness practices can support group development and student learning. Results demonstrate that mindfulness training supports student self-regulation and well-being and suggest that the active ingredients of the group process may play a role in mindfulness training outcomes.     

A New Grandparenting

Summary

The author explores the social identity of older persons and their potential for taking leadership roles in their families and communities as mentors to young persons with disability. Dealt with is the powerlessness of both these groups within society and the way in which they may be able to empower each other. It is posited that serious and active grandparenting and mentoring have the potential of filling a large gap in the continuum of meaningful and productive activities for older adults and provide highly valuable support and human resource to young persons with disabilities.