ADAPTING THE MODEL: THERAPEUTIC WORK WITH CHILDREN FROM ARMY FAMILIES

This paper describes the development of a specialised therapeutic service for parents and their young children in an inner city social services family centre. The Under five's counselling service, based on the Tavistock Model, offers brief psychoanalytic interventions to parents who are worried about their young child's development e.g. crying, eating, persistent crying etc. The premise behind setting up such a service was to provide therapeutic intervention to the parent-child relationship at the earliest possible stage, preventing further ongoing difficulties. The paper draws upon observations and interventions with families I have seen in the first year the service was opened. Particular themes which emerged in the work with these families will be highlighted. In particular a link is made between early childhood difficulties and unresolved loss in the mother's lives. Furthermore, the impact of the service upon the rest of the social services family support services is commented upon.     

Social Service Research and Religion

Abstract

Development of accountability standards to demonstrate cause and effect relationships are gaining rapid advancement in the field of social sciences. Many governmental agencies, foundations, and other funders have developed approaches that require organizations to utilize science-based programs and incorporate evaluative methods to show improved outcomes and cost benefits to society. This article will examine the need for increased accountability in developing effective interventions by faith-based organizations in the delivery of social service interventions. Recently, there has been a strong movement toward governmental funding for faith-based institutions to provide social services, although there has been inadequate scientific data to demonstrate that approaches implemented are effective in meeting needs or yielding favorable outcomes. Similarly, many faith-based organizations provide innovative and effective programs that could serve as model programs if there was appropriate empirical evidence. This article will discuss how rigorous evaluative approaches such as randomized clinical control trials can produce scientific data on program effectiveness. We will use a case example in the field of drug and alcohol treatment to illustrate these points.     

Need-service matching in substance abuse treatment: Racial/ethnic differences

This study examines the impact of ancillary health and social services matched to client needs in substance abuse treatment for African Americans, Latinos and Whites. The study uses data collected from 1992 to 1997 for the National Treatment Improvement Evaluation Study, a prospective cohort study of substance abuse treatment programs and their clients. The analytic sample consists of 3142 clients (1812 African Americans, 486 Latinos, 844 Whites) from 59 treatment facilities. Results show that racial/ethnic minorities are underserved compared to Whites in the substance abuse service system. Different racial/ethnic groups come into treatment with distinct needs and receive distinct services. Although groups respond differentially to service types, substance abuse counseling and matching services to needs is an effective strategy both for retaining clients in treatment and for reducing post-treatment substance use for African Americans and Whites. Receipt of access services was related to reduced post-treatment substance use for Latinos. Study findings are relevant to planning special services for African Americans and Latinos.     

The rise of market-based “choice” programs: 100 years of social sorting in social welfare services

Social service programs in the United States increasingly focus on giving individuals and families more “choices.” The approach is exemplified by “choice programs,” where people receive services through various forms of market participation. Examples of choice programs include defined contribution retirement plans, housing vouchers, charter schools, and health insurance marketplaces. Individuals across the socioeconomic spectrum have become accustomed to choice programs, and one's social status greatly affects the types, qualities, and prices of services people receive. The importance of the conversation around choice programs for providing access to resources is immense. Yet, despite contentious debate about their utility, we lack a comprehensive understanding of the institutionalization and widespread adoption of choice programs across a diverse range of social service domains. This article synthesizes stratification literature on retirement, healthcare, education, and housing to document the historical rise of choice programs. Particular attention is given to explaining how behavioral patterns and routines become second nature, altering who benefits, who is left out, and the overall effectiveness of the social welfare system.     

Evidence-based programs in children's services: A critical appraisal

Evidence-based programs (EBPs) are increasingly being implemented in children's services agencies in developed countries. However, this trend is meeting resistance from some researchers, policy makers and practitioners. In this article we appraise the main critiques, focusing on scientific, ideological, cultural, organizational and professional arguments. We contend that some of the resistance stems from misconceptions or an oversimplification of issues, while others represent valid concerns that need to be addressed by proponents of EBPs. We set out implications for the development and evaluation of programs and how they are introduced into service systems, and conclude with broader recommendations for children's services.     

USING SOCIAL NETWORK INTERVENTIONS TO IMPROVE MENTALLY ILL CLIENTS’ WELL-BEING

This paper reviews empirical evidence showing that the structures of the social networks of mentally ill clients influence both their well-being and their use of mental health services. Network interventions that might help clients better address network-related problems, and might help their families improve relationships and prevent caretaker’s burn-out are presented. A case illustration will demonstrate how practitioners can assess a client’s social network, involve the client’s family in treatment, evaluate that treatment, and select tailored interventions. This case will emphasize both how practitioners can help a client restructure her network, and the complementary roles of formal and informal networks. The author shows practitioners how to match clients’ initial network structures to interventions and desired outcomes. Practitioners can thus help clients modify their social networks, increase the use of preventive services, and improve their well-being. Dr. Pinto has been supported by a training grant from the National Institute of Mental Health (732MH19139, Behavioral Sciences Research in HIV Infection; Principal Investigator, Anke A. Ehrhardt, Ph.D.) at the HIV Center for Clinical Behavioral Studies for Clinical and Behavioral Studies.     

Interventions for Internationally Adopted Children and Families: A Review of the Literature

Internationally adopted (IA) children are at increased risk for health-related, developmental, and behavioral difficulties. This article reviews the literature on various interventions currently used with IA populations; including health-related interventions provided by medical specialists, preparation programs provided by adoption agencies and other social service organizations, treatments for attachment and behavioral disorders, psychoeducational services, programs designed to improve children’s care prior to adoption, and parent-based initiatives. Surprisingly, very little systematic information exists regarding the effectiveness of interventions designed to prevent and remediate these difficulties in IA children. Recommendations for future research activity and for best practice approaches to intervention are discussed.     

Hospital social work in Sweden and the UK: Access to chances of physical health and well-being

In Swedish and UK practice, interest is developing in social work's contribution to tackling service users' unequal chances and experience of physical health. This is through alleviating disadvantaged social conditions such as relative poverty which service users face and which are associated with health inequalities. Ready access to social work services is an essential preliminary if service users are to gain the material and social resources services can provide, to alleviate their adverse social circumstances and thereby improve their health prospects. However, despite hospital social work's well-established position, its significance as an access point for services has tended to be marginalized. Drawing on a comparative account of Swedish and UK practice featuring two action research projects, we explore how hospital social work is a key point of access to services for service users experiencing profound disadvantage. We analyse major barriers to such access, notably the underfunded nature of hospital social work, discriminatory procedures, and unequal professional service user power relations. Nevertheless, the action research projects show how these barriers may be breached to some degree, enabling service users as patients and carers to access resources which contribute to more equal chances of health and well-being in ill-health.     

The Clinical Aspects of Case Management and its Role in Graduate Field Education

In graduate social work education, faculty advisors together with practice instructors can improve social work students' skills to link the practical aspects of ‘work responsibilities’ to the clinical underpinnings of case management. Often students are taught the direct services (case management) with a view solely focused on the practical aspects of care, and this curtails the students' opportunity to learn the clinical interventions that exist in all components of social work: to identify, understand and apply clinical dynamics to presenting problems. The authors discuss their work in addressing case management from a clinical perspective with MSW students and recommendations for its inclusion in graduate social work programs.     

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.     

Computer-mediated parenting education: Digital family service provision

Computer-mediated family service provision holds the promise of equal efficacy, lower cost, and higher accessibility than traditional parent education groups that require parents to travel to a service venue, thereby alleviating often-cited pragmatic barriers to participation in parenting programs. Hence, examinations of which populations are attracted to particular service modalities are a necessary step in building a reliable evidence base. The scant computer-mediated parent education literature indicates that online parenting programs are beneficial to indicated or secondary prevention programs seeking to bolster specific parent, child, or dyadic outcomes; it is reasonable to ask, then, if this service provision mechanism would be equally effective for all parents, outside of targeted intervention designs. The current paper describes the provision of computer-mediated parenting services to a large sample of parents (N = 192, 89.6% female, average age 40 years; 27% racial/ethnic minority) with no shared prevention indicator through an employer-based program. Our research questions on service provision and utilization include: Who is served by primary prevention programs like this? Do participants report satisfaction with computer-mediated services commensurate with traditional face-to face services? In addition to significant differences in perceived social support by gender, marital status, and number of children younger than 18 living in the home, results from three measures of parenting attitudes and behaviors (e.g., discipline style, sense of competence, and locus of control), indicate that this sample has some confidence in their general abilities as parents, but struggle to feel an internal sense of control over their children's behavior, with the greatest number of parents tending towards overreactive discipline. Associations between these indicate a consistent pattern such that dysfunctional parenting practices tend to co-occur, and parents who do employ dysfunctional strategies feel less competent as parents. Participants report high satisfaction with these services, at equal or better rates than reported in the parent education literature. This work provides evidence that computer-mediated parenting services can attract and exceed expectations of participants with clinical and subclinical but moderate parenting needs, indicating that this service delivery mode has the potential to reach a wide number of individuals ideally situated for prevention services.     

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.     

The Status of Nutrition Education in ACHA College and University Health Centers

Abstract

An assessment of the prevalence and scope of nutrition services offered through 208 randomly selected American College Health Association member student health centers revealed that 79% of the 160 respondents provided some type of nutrition education for students. One-to-one counseling, available at 96% of the institutions, was the most common approach. The larger the school's enrollment, the more likely it was to provide programs in nutrition. All of the institutions with student populations of more than 35,000 offered some type of nutrition service, as did 52% of the 19 schools with enrollments between 2,000 and 5,000. Health educators, nurses, doctors, dietitians, and trained peer educators provided the services, with registered dietitians the most common providers and often coordinators of the programs. Costs to students for nutrition interventions were nominal; weightmanagement programs were the most expensive and showed the greatest variation in content.     

Effective relationship-based practice: A theoretical exploration

This paper looks at the importance of a relationship-based approach within social work. It explores past writings on the social worker-client relationship, why the relationship was seen to be central to effectiveness and good practice, and why this perspective fell out of favour. It revisits the importance of a relationship-based approach, within a psychosocial perspective, in relation to eight areas of practice. These include the assessment task and process; relationship difficulties; people who are vulnerable or reliant on others for their well-being; situations that require practitioners to be able to hold and contain anxiety; the relationship as a foundation for capacity building, empowerment and developing people's potential; and in relation to disadvantaged and marginalised sectors of the population, how social workers can use the 'front-line' knowledge they have gained through the relationships they have created in political ways--to bear witness and report on 'social ills' as they impact on the lives of service users. A final section looks briefly at how the service user-social worker relationship is perceived and described in the Benchmarking Statement, National Occupational Standards and the General Social Care Council's Rules and Requirements and their implications in terms of the new social work degree.     

Making it ‘APP’en: service user feedback: developing and implementing a service user APP: reflections from Northern Ireland,England and Scotland

Despite the advent of social media and increasing use of smart phone technology amongst global and UK populations, APP’s for social work remain in their infancy. Several have been developed which focus on the education of social workers and practitioners providing information on specific social work issues, and one we are aware of that explores ethics and values using a games-based approach. In this paper, we discuss the importance of service user perspective in social work practice and how this informed the development of the feedback App. We reflect on developing this instrument using digital technologies which social workers can use to gather anonymous feedback from service users about their experiences of social work interventions. This project, developed in response to demands placed on social work agencies to evidence the effectiveness of service interventions, provide robust data from service users for inspection regimes and sustain service user involvement in improving services. The evaluation model is designed to document the implementation process, exploring what works and what barriers, challenges and lessons were learned by the project team together with how some of the tensions in the process were addressed and resolved.     

Referrals and Resources for Chemically Dependent Gay and Lesbian Clients

The article investigates issues surrounding same-sex relationships in an African context. Many countries on the continent outlaw such partnerships, creating complex dimensions for people trapped in a no-man's land of socially unacceptable reality. Furthermore, criminalization of same-sex practices results in a lack of targeted health and welfare programs, creating a dangerous lacuna in service delivery. To address this, academic programs, field supervisors, and practitioners, particularly in the field of social work, must be sensitive to the needs of sexual minorities, and those behind whose acceptability they are forced to hide, especially in an alien environment.     

Policy Implications of a Statewide Survey on Elder Abuse

Effective policy interventions require an understanding of both the social problem itself and the support systems which deliver the proposed "solution." This paper reports on a study which blended research of the elder abuse problem with an evaluation of the social service network. Professionals from sixteen types of agencies in each of Pennsylvania's sixty-seven counties were surveyed on their perceptions of: (i) types of elder abuse cases encountered; (ii) gaps in support services for these cases; (iii) professional training needs; and (IV) current procedures for handling cases of, and keeping statistics on, suspected elder abuse. Survey findings and the resultant policy recommendations are discussed.     

How Do They Fit?

Abstract

Despite public policies that promote an increased role for faith-based organizations in the delivery of publicly supported services, insufficient attention has been paid to assessing how service delivery by faith-based and secular providers might differ. This study considers the issues involved in evaluating the role of faith-based organizations within the broad context of a community's social service offerings. Criteria are developed for assessing role differences by comparing the types of services, delivery approaches, and service locations offered by different types of providers. The approach is then illustrated using a large sample of social service providers in Los Angeles County. Important role differences are revealed. Faith-based organizations offer fewer and different types of services than their secular counterparts. The results suggest a modest and focused role for faith-based organizations in social service delivery, but one that is complementary to the efforts of secular providers. The methodological issues raised by such analyses are highlighted.     

Interventions that Foster Healing Among Sexually Exploited Children and Adolescents: A Systematic Review

Sexual exploitation of children and adolescents is a pressing, yet largely under-recognized form of child abuse. The goals of this review were to identify interventions that have been implemented with sexually exploited children and adolescents and to better understand their effectiveness for fostering healing with this population. Our systematic search generated 4,358 publications of which 21 met our inclusion criteria. Based on their objectives and delivery, we organized the interventions into five categories: (a) focused health and/or social services, (b) intensive case management models, (c) psychoeducational therapy groups, (d) residential programs, and (e) other. Most programs were gender-specific, targeting girls and young women with just one being for boys and young men only. Studies reported on a range of outcomes including psychosocial outcomes, risky behaviors, trauma responses, mental health, protective factors, and public health outcomes. Despite differences in delivery, most of the interventions did, to some degree, appear to foster healing among sexually exploited children and adolescents. Findings from this review have implications for researchers, policy and program developers, and frontline practitioners who, through partnerships with one another, can advocate for the creation of evidence-informed, purpose-built, and thoughtfully delivered interventions.