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.     

Future expectations of adolescents in residential care in Israel

The study examines the future expectations of adolescents in residential care facilities in Israel and their worries about the pending transition to independent living. The study examines the hypotheses that personal variables (e.g., gender, a personality trait of optimism) and social support variables (the support of family, peers and staff) predict their future expectations. 277 adolescents participated in the study. The self report questionnaire covered several areas including demographic background, optimism, family, peer and staff support, readiness to leave care and future expectations. Results indicate that most adolescents perceived their future positively. The most positive expectations were in the family and friends domains. About a third of the adolescents were worried or very worried about leaving care. Worries were not related to gender. Optimism, social support by mother and peers (but not staff) was positively correlated with future expectations. The findings suggest that there are areas of concern that should be addressed through programs to prepare youth for leaving care. Follow up and longitudinal studies are suggested.     

Fostering employability among youth at-risk in a multi-cultural context: Insights from a pilot intervention program

Recent studies indicate that the transition from school to work is a critical juncture in shaping the professional future of youth at risk. This period may thus serve as a window of opportunities for fostering employability among these youths and, thereby, for promoting their social mobility. However, systematic evaluations of intervention programs aimed at fostering employability among at-risk adolescents—and especially in a multi-cultural context—are relatively few. The current study describes the strengths and weaknesses of a pilot, nation-wide, multi-cultural, holistic intervention program, aimed at fostering employability among at-risk adolescents before they actually enter the labor market. The program integrated efforts in three main domains: cultivating work-related skills, fostering personal and interpersonal skills, and providing a supportive personal and group climate. During the years 2011–2013, the program was operated in 40 localities in Israel and in three culturally different sectors: The Jewish-Israeli majority sector in the periphery, the Ultra-Orthodox Jewish minority sector, and the Israeli-Arab (Muslim) minority sector. The current study describes the results of an evaluation study that accompanied the implementation of the program in nine representative localities (117 adolescents, ages 14–19) during 2012.Overall, the functioning of the adolescents (as evaluated by the professional program instructors) improved in all examined work-related domains: personal-emotional functioning, work-related functioning, CV writing ability, and future education prospects. Regression analyses highlighted several factors as predictive of improvement in the different employability-related domains, most notably, having a working father, being active in group meetings, having no Internet connection at home, helping other participants in the program, and being involved in selecting the topics of a professional course. Importantly, this improvement was linked with the cultural affiliation of the participants, and participants from the different sectors indicated different factors as contributing to their advancement.The results of this evaluation study suggest that intervention programs for promoting employability among at-risk adolescents should integrate a holistic and flexible national model with adaptations by local steering committees, whose members are from the same cultural group as the participating adolescents. Such a strategy will enable each unique community to tailor the local operation of the program to the culturespecific needs of—and to maximally utilize the resources available for—the different sectors in a multi-cultural society, while establishing a dialogue and reciprocal learning in national forums. A dilemma has been identified, however, with respect to increasing the local involvement of the national committee to provide the local committees with different viewpoints.     

Severity of impairment in dually addicted gamblers

While much information about pathological gamblers has been gathered from clinical observations, few data exist from systematic, objective studies. Furthermore, still less is known about that subset of pathological gamblers who are also chemically dependent and/or substance abusers. Previous studies (e.g., McCormick et al., 1984) report that up to 45% pathological gamblers are substance abusers. The present study hypothesizes that inpatient chemically dependent pathological gamblers will exhibit greater impairment on a variety of life-functioning measures than a comparable group of chemically dependent psychiatric inpatient. Twelve chemically dependent pathological gamblers were matched on the basis of age, sex, alcohol/drug history and occupational status with twelve chemically dependent persons with no pathological gambling history. All study members were inpatients in an addictions program at a private psychiatric hospital. Each patient was administered the Addiction Severity Index (ASI) to assess impairment in seven problem areas: medical, employment/support, alcohol, drug, legal, family/social, and psychological/psychiatric functioning. The following findings emerged: 1) Chemically dependent (CD) gamblers report more chronic medical problems than CD psychiatric patients; 2) CD gamblers report more frequent conflicts with relatives and family members than CD psychiatric patients; 3) CD gamblers report more psychiatric symptoms both in amount and duration; Although not reaching statistical significance, 42% of the CD gamblers had made a previous suicide attempt as compared to 8% of the CD psychiatric patients; 4) CD gamblers and CD psychiatric patients appear comparable with regard to employment functioning and amount of legal problems. The clinical and theoretical implications of these findings are discussed further.     

Getting to Know the Piece of Fluff in Our Ears: Expanding Practitioners' Cultural Self-Awareness

Israel being a multicultural society with a variety of ethnic groups, the delivery of culturally competent services is a crucial issue in social work practice. This paper describes the outcomes of a training model for cultural competence applied with social work graduate students in Israel. The model, based on work with immigrants' narratives, increased the cultural self-awareness of the trainees. Presented are conceptual and technical aspects of the training model as well as outcomes of an evaluation study. Fifty-one trainees submitted a short account of their personal experiences following the training. The reports indicated expansion in the trainees' cultural self-awareness: awareness of their own and their families' immigration experiences as well as of other transitions in their lives. Training elements that made this outcome possible are discussed.     

Coping Resources and Stress Reactions Among Three Cultural Groups One Year After a Natural Disaster

The aim of this study was to examine patterns of personal and community coping resources in explaining stress reactions among three cultural groups: Jews, Muslims and Druze, 1 year after the massive forest fire on Mount Carmel, Israel. We first compared the three cultures in their levels of personal and community resources as well as their stress reactions: anxiety, anger and psychological distress. Data on demographics, personal and community sense of coherence (SOC), as well as stress reactions of state anxiety, state anger and psychological distress, were gathered a year after the fire in northern Israel, among adolescents aged 12–18 belonging to three cultural groups. Results indicate that the personal coping resource of SOC was the strongest predictor of ‘stress reactions’ in all cultures. Community SOC, however, played a significant role especially for the collectivistic culture of the Druze. We will discuss the results in the framework of Antonovsky’s salutogenic model and his conviction that the personal resource of SOC functions as a protective or resiliency mechanism in all cultures whose members are in a chronic state of stress. Implementation of the findings for establishing interventions for social workers to promote sense of coherence and increase resiliency of adolescents will be presented as well.     

An exploratory investigation of family functioning for child inpatients: Implications for practice

This paper presents the results of an empirical investigation of family functioning for a sample of child and adolescent psychiatric inpatients. The McMaster Family Assessment Device, completed by patients and other family members at the time of the child's admission, provides an assessment of family competence in six areas; problem solving, communication, roles, affective communication, affective involvement, and behavior control. Results indicate that families of child and adolescent inpatients experience significant problems across all dimensions of family functioning. Further, patients report that family problems are more severe than do other family members. Implications of the study findings for social work practice are discussed.     

Environmental assessment and evaluation research: examples from mental health and substance abuse programs.

Evaluation researchers have been broadening the traditional client input--"black box" treatment--client outcome paradigm that has guided many evaluations of mental health, substance abuse treatment, and other intervention programs. The points of expansion are in the areas of treatment implementation and treatment processes, as well as "extratreatment" influences on treatment selection, duration, and, especially, outcome. This review illustrates the application of environmental assessment procedures--particularly social climate measures--in four aspects of evaluation research suggested by the more comprehensive model: (a) evaluating treatment implementation; (b) exploring treatment processes; (c) identifying extratreatment influences on client posttreatment functioning; and (d) operationalizing outcome variables. Conceptual and methodological issues raised by these applications are discussed, and the benefits to be derived from an expanded model of evaluation research--especially the greater potential for program improvement--are considered.     

How can context and discourse affect teachers’ and mental health professionals’ interactions with adults with mental illness?

Patients with severe mental illness may have needs different from those of patients with more limited illnesses and might benefit from other types of intervention than traditional treatment. We interviewed health care professionals from two open, short-term psychiatric wards and teachers from two schools for adults with psychiatric diagnoses. The focus was to explore how differences in contextual factors such as time, tasks, and organizational demands might affect the actions and attitudes of health care professionals and teachers, as well as the potential consequences for patients and students. Data were collected through qualitative interviews. Participants included 14 health care professionals and 14 teachers. The informants worked with patients and students with similar diagnoses and illness durations. All interviews were conducted during the informants’ work time. Findings and interpretations showed that both teachers and health care professionals were engaged in their work and in the wellbeing of students and patients. However, they described marked differences in practice, including the amount of time spent with students/patients, the organization of their work, main tasks, amount of control over their tasks, and social structure. These differences seemed to affect relationships with students/patients, attitudes toward students/patients, norms and values, and opportunities for patient empowerment. Our findings suggest that while existing psychiatric health care might be appropriate for limited short-term problems such as single-episode depression, a model with a supportive environment, based on stable relations and possibility for learning, may improve personal development and mental health for persons with severe mental illness and disturbances in self-experience.     

Psychiatric supervision for social work?

There are increasing efforts by psychiatrists and insurance companies to maintain psychiatric control in mental health settings and thus limit the autonomous functioning of clinical social workers. This paper presents facts indicating that psychiatrists actually are only peripherally involved in mental health facilities. Clinical social workers as autonomous professionals diagnose and treat mental disorders and often hold key positions in administration and in program and staff development. The attempt to maintain a facade of psychiatric control amounts to a distortion of the reality of professional roles and results in inefficiency, increased costs, and a lowering of the quality of care.     

Chronic factitious disorders. Helping those who hurt themselves

A chronic factitious disorder is a complex psychiatric illness that generally manifests itself in the medical/surgical setting. The immediate need for psychiatric intervention is generally overshadowed by the need for intense medical treatment. The psychiatric liaison nurse is in a key position to manage emotional nursing care during acute hospitalization. Assisting staff to recognize behavioral manifestations can help to prevent further self-destruction and promote future psychiatric followup. The prevalence of factitious disorders is probably higher than misconceptions about the disorder. The potential to save health care cost as well as needless human misery makes this a professional nursing concern. The high incidence of factitious disorders in the nursing profession may make profession may make it a personal issue for nurses as well.     

A Therapeutic Summer Weekend Camp for Grieving Children: Supporting Clinical Practice Through Empirical Evaluation

Through collaborative action-oriented community research, agency-based clinicians, and university-based researchers engaged in a two-year theory-driven evaluation of a therapeutic summer camp for grieving children. The evaluation examined the camp practice model and children’s engagement in therapeutic camp activities and psychosocial functioning based on the camp staff and parental caregivers’ assessments. The first year findings led to a synergistic decision-making process that strengthened one of camp therapeutic activities. The overall results reveal a high consistency among staff on assessments of engagement and psychosocial functioning, and parental caregivers’ satisfaction with the camp. Limitations of research evaluation and implications for practice are considered.     

Explaining Satisfaction with Volunteering in Emergencies: Comparison Between Organized and Spontaneous Volunteers in Operation Protective Edge

The study aimed to identify factors that explain general satisfaction with volunteering among volunteers in Operation Protective Edge, in Israel, through a comparison between organized volunteers affiliated with volunteer organizations and spontaneous volunteers who arrived at the scene independently. Based on the social exchange theory as the theoretical framework, the contribution of several variables to explaining general satisfaction with volunteering was examined: satisfaction with the intrinsic and extrinsic rewards of volunteering, personal sacrifice in volunteering, and motives for volunteering (social solidarity, personal empowerment, and escape from reality). The findings revealed that among organized volunteers, satisfaction with the intrinsic and extrinsic rewards of volunteering mediated between motives for volunteering and general satisfaction with volunteering. Among spontaneous volunteers, the motives of social solidarity and personal empowerment as well as satisfaction with intrinsic and extrinsic rewards were the main variables that explained general satisfaction with volunteering. In contradistinction, the main variables that explained general satisfaction with volunteering among organized volunteers were the motive of personal empowerment and satisfaction with the extrinsic rewards of volunteering.     

Predictors of parenting among African American single mothers: Personal and contextual factors

Guided by family stress theory, relations among neighborhood stress, maternal psychological functioning, and parenting were examined among 123 low‐income, urban‐dwelling, African American single mothers. Using a longitudinal design, structural equation modeling was employed to test the hypothesis that neighborhood stress results in poorer parenting over time through its detrimental effect on maternal psychological functioning. Social support from family and friends was examined as a potential moderator of the association between neighborhood stress and parenting behavior. Results indicated that higher levels of neighborhood stress were related to greater psychological distress among mothers, which in turn, was significantly related to less engagement in positive parenting practices approximately 15 months later. A moderating effect emerged for social support, however, such that the proposed model provided a better fit for mothers reporting low levels of perceived social support than for mothers reporting high levels. Implications of the findings for prevention and intervention are discussed.     

Policy-practice in social work and social work education in Israel

Policy-practice is a form of social work intervention that is intended to influence social policy. It is linked to an understanding of the role of social workers which places the struggle for social justice at the forefront of social work activity. However, this form of social work intervention has remained on the sidelines of social work practice and education in most welfare states. This paper seeks to understand the role that policy-practice and social policy play, and have played, in social work and social work education in Israel. The findings indicate that, despite a growth in interest in the political role of social workers in Israel during the 1970s, policy-practice has remained a mode of practice adopted by a minority of members of the profession in Israel. An empirical study of the curriculums of the schools of social work in Israel indicates that this is the case for the study program in most of the schools. The reasons for this can be linked primarily to the overwhelming influence of American social work upon the development of the Israeli profession and to the process of liberalization and privatization of the Israeli welfare state in the last two decades.     

Psychological and Social Adjustment of Russian-Born and Israeli-Born Jewish Adolescents

This study compares the social, school, behavioral and psychological functioning of high school students who immigrated from the Commonwealth Independent States (CIS) to that of Israeli-born children whose parents emigrated from the former Union of Soviet Socialist Republics (USSR) during the sixties and the seventies. In most areas of life, no significant differences were found between the two groups. The majority of the Israeli-born and immigrant adolescents functioned well in terms of social and educational functioning and tended to avoid involvement in dangerous behavior, such as drug use and delinquency. Concerning psychological functioning, the results pointed to an interesting phenomenon: even though no significant differences were found between the two research groups, the adolescents in both groups expressed higher emotional distress when compared to norms of Israeli adolescents who are not of Russian origin. In addition, the results showed that among the immigrant adolescents, the longer they resided in Israel the more the economic status of their parents improved, their self-esteem rose, the more likely it was that their levels of somatization, paranoia and general emotional stress decreased. At the same time, however, the frequency of alcoholic consumption increased, the longer they lived in Israel. A discussion of the results sums up the article.     

Kindergarten teachers promote the participation experience of African Asylum-Seeker families

African asylum seekers live in Israel in the realities of poverty, racism, and personal insecurity. From a sociological point of view, Participation is taking part in social processes, interacting with people, texts and technologies and it may affect all areas of life. This is a qualitative-interpretive study that examines through interviews the participation experience from the perspective of eight African couples and six Israeli kindergarten teachers. The findings indicate: (1) Increasing the parents' sense of belonging, (2) Increasing the cultural participation, (3) Increasing community cohesion. Findings reveal a tension between the parents' desire to be involved and my reality of poverty and working around the clock that prevents their presence in educational activities. Under such complex conditions, kindergarten teachers worked to establish a positive personal relationship, strengthen the parents' sense of ability, overcome language barriers, and cultivate a sense of belonging from a perception that increasing participation would help them deal with integration challenges and livelihoods social rejection. The study has a theoretical and practical contribution, and its findings may be used by educators and policymakers regarding principles for action to promote the experience of participation and involvement of parents in educational settings.