An Intersectional Model

Abstract

Although there is a growing literature on the experiences and service needs of ethnically and culturally diverse individuals, families and communities, the interaction of gender with other diversities has not been widely explored. This paper examines data collected from six affinity-based focus groups of women: refugees, older women, African American women, lesbians, girls, and women with disabilities to explore the interaction of gender with other diversities. All of the groups reported an interaction between gender and their affinity group, and the ways in which that interaction contributed to their subordinate position in society and within their population group was described. Implications for practice are discussed.     

Challenging implicit bias: preparing students to practice with African American families

ABSTRACT

The disparity of African American families in the foster care system is a concern in the field of child welfare services and the social work profession. African American families experience unique challenges related to discriminatory practices and implicit biases in the child welfare system and by mandated reporters. To address these inequalities, state and local agencies have implemented prevention and intervention services to support minority families. Additionally, child welfare agencies have invested in professional development training for their workers to alleviate possible intolerant practices. This article describes implicit biases and considers how they could contribute to the disparity of African American families involved in the child welfare system. Furthermore, the article presents approaches to help social work students to identify and challenge their implicit biases to support culturally sensitive practices while working with African American families. It concludes with implications for social work education.     

Culturally Competent Practice with African American Juvenile Sex Offenders

African American juveniles adjudicated for sexual offenses may struggle with the mistrust of both the judicial and treatment systems. Unlike general mental health services, juvenile sex offender treatment is often mandated by the court or child welfare services, thus these youths and their families must engage in the treatment process. Without clinicians and services that can acknowledge and respond to a minority youth’s experience in a sensitive, culturally competent manner, there could be significant resistance to treatment. Traditional treatment approaches fail to prioritize issues involving cultural competence. This article addresses the unique challenges of African American juvenile sex offenders and makes recommendations for creating culturally competent practice for these youth and their families.     

African American Men,Child Welfare,and Permanency Planning

Summary

Like social services generally, child welfare and permanency planning services have failed to incorporate African American men as significant and serious participants in the service delivery process. Child welfare and permanency planning services have marginalized African American men such that children fail to benefit from the inclusion of these men in the service delivery process. This incomplete and inappropriate approach to permanency planning specifically, and to child welfare services more generally, is a disservice to African American children. Corrective measures are proffered to promote greater inclusion of African American men in child welfare and permanency planning services.     

Substance Abuse Treatment with Adolescent African American Males

Abstract

The use of substances by adolescent African American males is of particular concern because of the damaging effect that drug abuse has not only on the individual and his family but also on the African American community. The literature is scant regarding treatment services and few therapeutic interventions have been specifically designed to holistically meet the needs of these youth. This article proposes the use of Afrocentricity and Reality Therapy as therapeutic bases for substance abuse treatment with this population.     

Methodological Issues in Conducting Community-Based Health and Social Services Research Among Urban Black and African American LGBT Populations

Abstract

Health and social service utilization experiences of disenfranchised groups have recently gained renewed public attention. Reducing and eliminating racial disparities in health care has become a major national agenda. While a fairly substantial literature on Black and African American health outcomes and social service utilization does exist, and may help to influence interventions to reduce disparities, there is no comparable literature for Black and African American lesbian, gay, bisexual, and transgender (LGBT) persons. In this article the author examines factors affecting research with urban Black and African American LGBT populations. A brief case study is included that demonstrates the viability of the recommended research methods and discusses the possible negative consequences of deviating from these methodological suggestions.     

A comprehensive health service evaluation and monitoring framework

ObjectiveTo develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services.MethodA targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders.ResultsThe framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable.ConclusionData collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle.     

Who is Kin?

Abstract

This article explores the ways in which African Americans, define family and kinship. Using data collected using ethnographic methods, issues such as the level of ongoing commitment to extended family structures, fictive kin status and obligations and pathways to kinship status are examined. This study has broad implications for the delivery of culturally appropriate services to African American individuals and families.     

The Social Environmental Elements of Resilience Among Vulnerable African American/Black Men Who Have Sex With Men

Resilience theory has been suggested as a strong framework for research on HIV prevention among men who have sex with men (MSM). Among this population, literature indicates that African American/Black MSM are particularly vulnerable to health and social disparities associated with HIV transmission risk. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates the specific elements of resilience, and the associated contexts and relationships, among a sample of 21 substance-using African American/Black MSM. Data indicate that (1) elements contributing to resilience are multiple and co-occurring, including inner strengths, social relationships, diversity of experience, religion/spirituality, altruism, and creativity; (2) as an element of resilience, social support was experienced differently among men who did and did not have supportive relationships with other gay and bisexual men, which has implications for social service provision and intervention approaches; and (3) diversity of experiences and relationships is an important influencing factor on expressions of resilience. Social services or interventions that facilitate the development of these elements of resilience will likely be especially beneficial for vulnerable African American/Black MSM.     

Barriers and Promoters of Mental Health Services Utilization in a Latino Context: A Literature Review and Recommendations from an Ecosystems Perspective

ABSTRACT

This article focuses on the problems of disparities in mental health service utilization in the Latino population in the United States. It begins with an overview of the Latino population within the United States, an exploration of the diversity within this group, and shared cultural values and traits with a particular focus on the problems of Latino poverty. A review of the literature follows, including identified barriers to and promoters of mental health services utilization. These are contextualized in a Latino perspective using an ecosystems framework. Recommendations are made for future practice, research, and policy regarding mental health and mental health services utilization in the Latino community.     

AsianWORKs

ABSTRACT

Achieving economic self-sufficiency through employment is the ultimate goal of recent changes to the welfare program. The Asian American and Pacific Islander (AAPI) population is most vulnerable to failing in this goal because of language difficulty, low education levels and lack of job skills in the labor market. Many AAPI immigrants, and Southeast Asian Americans in particular, suffer from adjustment and mental health problems due to their experiences as refugees. These are but a few of the obstacles for AAPI welfare recipients to become self-sufficient, making them one of the most “hard-to-serve” populations. The goal of self-sufficiency through employment can be reached if culturally appropriate and adequate support services are provided to meet the unique needs of the population. Few programs, however, are targeted at AAPIs. Using key-informant interviews and the case material review method, this article highlights the difficulties of AAPI welfare recipients and describes a unique program serving the Southeast Asian American, particularly the Cambodian, population. The article focuses on the program components of outreach and engagement, day socialization and job readiness, and family support services, and it discusses improvement to service access and lessons learned for the practice of cultural competence.     

Elder Abuse and Neglect in African American Families: Informing Practice Based on Ecological and Cultural Frameworks

Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.     

What Is Valued in Gay and Lesbian Specific Alcohol and Other Drug Treatment?

Little is known about what gay and lesbian clients value about culturally specific alcohol and other drug treatment programs. This study involves a sample of clinical staff and former clients (N = 40) of four culturally specific alcohol and other drug treatment programs to clarify what is addressed and deemed valuable for the specific needs of gay and lesbian clients. Through the lens of the recovery capital conceptual framework, this qualitative research emphasizes resiliency and the supports necessary for long-term recovery. Results indicate three major themes that make this type of treatment valuable: (1) a separate treatment unit or facility, (2) a safe and supportive therapeutic milieu, and (3) specific tailored treatment approaches. Findings are discussed to include implications for ways to improve services for this all too often understudied population of potentially vulnerable individuals who can benefit from culturally sensitive care.     

Cultural Factors in Collegiate Eating Disorder Pathology: When Family Culture Clashes With Individual Culture

Objective: The authors evaluated the validity of familial enmeshment (extreme proximity in family relationships) as a risk factor for eating disorders across cultural value orientations. They tested the hypothesis that although familial enmeshment may be a risk factor for eating disorder pathology for (1) participants of non-Asian descent or (2) culturally independent participants, enmeshment will not be a risk factor for (1) participants of Asian descent or (2) culturally interdependent participants. Participants: 255 undergraduate women participated. Methods: Participants completed questionnaires on cultural value orientations, enmeshment, and eating disorder pathology. Results: As hypothesized, enmeshment was related to eating disorder pathology in non-Asian American and culturally independent participants, but not in Asian American and culturally interdependent participants. Conclusions: Depending on cultural values, enmeshment may or may not be a risk factor for eating disorders. This study highlights the importance of examining risk factors in the appropriate cultural framework when considering college student mental health.     

Elder abuse and neglect in African American families: informing practice based on ecological and cultural frameworks

Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.     

Understanding African American Discipline Styles

ABSTRACT

Discipline styles among African American parents are closely scrutinized; yet, they may be among the most positive aspects of African American child rearing. Families headed by “hardline” disciplinarians often interface with human, service providers who may perceive them as dysfunctional.

The authors report the findings of an exploratory study which examined discipline styles among African American families from various socioeconomic backgrounds in a midwestem community In-depth interviews were conducted, using a naturalistic method of inquiry. Emergent themes were analyzed, using an interactive model to contrast elements of African American and perceived European American methods of discipline. Based on research findings, multilevel service suggestions are provided.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

Kinship Care: A Cultural Resource of African American and Latino Families Coping with Parental Substance Abuse

SUMMARY

This paper examines kinship care as a cultural resource used by African American and Latino families coping with substance abuse by a family member. Although there is a growing body of literature on kinship care, there are no conceptual or empirical studies that have drawn or built on cultural similarities between these two groups of ethnic minority families. A framework that prioritizes cultural assessment and relevance in using familial and cultural resources is proposed to assist practitioners confronted with the demographic realities of working with social, clinical and ethnocultural complexities when serving ethnic minority families. The framework is based on practice implications raised by recent studies on kinship care and from the perspective of pertinent cross-cultural and anthropological literature.     

A Psychosocial View of Mental Illness: An Introduction to Part II

Increasingly, grandmothers are parenting grandchildren in homes where parental presence is sporadic or nonexistent. A disproportionate percentage of African American grandparents fall in this category. The author reviews the literature on the African American grandmother in the context of the African American family and describes a practice model for service provision to those women who seek support as they “parent again.”     

Latino Immigrants in a New Destination State: A Qualitative Study of Provider Experiences

ABSTRACT

Latino immigrants are settling in new destination states that have fewer culturally and linguistically competent health and social service providers. Social workers are in an ideal position to serve Latino immigrants. Yet, limited literature is available on the strengths and needs of this population specific to new destination states. To help fill this gap, qualitative data were gathered in individual interviews with providers serving Latino immigrants in one new destination state. Key themes emerged from the data, suggesting the importance of family and community, the challenges of immigration-related stressors, and the strengths and gaps in service provision. Implications for practice and social work education are presented.