Prediction of outcome in coerced and voluntarily treated alcoholics

The study concerns multivariate prediction of the short-term outcome of alcoholism in a coercive treatment setting in Sweden. One hundred and twenty-one patients (87 men, 34 women) with a mean age of 41 (range 26–63) years attended a 5-week program. They were for the most part severely alcohol-dependent and socially unstable. Compulsorily committed patients ( n -32) were less socially stable but did not differ from the voluntary patients ( n =89) in the type of drugs abused. Nine months (mean) after treatment, a follow-up was performed by mailing questionnaires to the patients and to the referring social workers. The improvement data in the questionnaires were checked with other data. Data on alcohol abuse were available for 116 (96%) of the patients; 55% improved. Of these, 13% had remained entirely abstinent. Using multivariate logistic regression, participation in a self-help group and first-time admission were found to be significant factors for overall improvement, while having a family and more than primary education were significant for abstinence. Compulsory commitment to treatment was not related to the short-term drinking outcome. Undergoing voluntary treatment and having previous treatment experience were significant factors for participation in self-help groups.     

Trust as a Means of Bridging the Management of Risk and the Meeting of Need: A Case Study in Mental Health Service Provision

Shifts in public policy towards an increasing focus on risk have been deemed problematic at a number of levels, particularly the tendency for concerns over reputational risk to institutions to trump the interests and needs of service‐users. This article explores the tension between these two dimensions, of risk and need, in a case study of local mental health services – a setting where conflicting objectives to manage risk and meet need are apparent. Media‐driven pressure to ward against the ‘risk’ represented by service‐users tends towards more coercive policy which may obstruct the meeting of need, which in turn may undermine service‐user engagement and hinder risk management. Drawing on qualitative data from interviews with service‐users, professionals and managers, the article explores the process of trust and its facilitative role in meeting need and managing risk. Findings suggest that while existing foci on risk are at times counter‐productive, trust plays a significant role in service‐users' initial and ongoing engagement, communication and co‐operation with professionals. Yet inherent obstacles to trust within mental healthcare contexts remain, due to cultural pressures on professionals, the nature of the illness experience and negative past experiences of in‐patient care.     

Accumulated knowledge and experience in the treatment of substance abuse

This article summarizes the accumulated knowledge and experience of people engaged in the institutional treatment of substance abusers in Sweden. The views of the respondents were obtained by means of the Delphi method, which entails compiling several rounds of written dialogue between researcher and respondents. The study had three rounds. The arguments of experienced staff concerning the professionalization of substance abuse treatment are presented, with the main emphasis being on general trends. At the time of the study, the main dividing line, according to the respondents, lies between the 12-step program of Alcoholics Anonymous and psychotherapeutic programs. The majority of the respondents believe that knowledge of psychotherapy provides a better understanding of the treatment process. This finding is particularly evident among the staff of drug treatment institutions, two-thirds of whom are of the opinion that acquiring proficiency in psychotherapy is a way to professionalize treatment. An important aspect is the quality of the relationship between therapist and client. The majority of the respondents believe that it is possible to define the criteria for good treatment.     

The Effects of Computerization on Public Child Welfare Practice

ABSTRACT

This paper examines the impact of a new and promising case-based management information system on child welfare case management practices in two California counties. The objectives were to measure the extent to which computerization affected casework practices and to identify factors that influenced the effects of computerization. An exploratory longitudinal one-group pre-post design was used. Contrary to expectations, few differences were found, although workers spent more time alone after implementation of the system. A key finding is that the amount of time that caseworkers spent with clients was not reduced by the computer system.     

Family Size and the Gendered Division of Unpaid Work: Implications for Fertility Decisions in Australia

Low fertility in Australia has been attributed to social factors which encourage women to devote more time to market work and reduce the number of children they have. This paper explores whether women might have fewer children because they experience a gendered division of unpaid household and childcare work. It uses ABS time use data to analyse the time spent by men and women in unpaid household and childcare, and finds an unpaid workload for women that is greater with additional children, and a relatively consistent workload for men across all family sizes. Controlling for the amount of paid work also suggests that the additional time spent, and increased share of unpaid workload experienced by women, is independent of time spent in paid work. This is consistent with the suggestion that women might restrict the number of children they have in order to control their unpaid workload.     

Improving the Efficacy of Administrative Data for Evaluation of Holistic Defense

A college of social work developed a partnership with a state commission on indigent defense to examine existing data-collection procedures, potential case outcomes, and practical implications of implementing holistic defense programs. The holistic defense model responds to the complex challenges of justice-system-involved defendants by providing social services in public defense offices. Using chi-square and logistic regression analyses of administrative data for a sample of 15,994 public defendants from a single judicial circuit, this research study examined case outcomes before and after implementation of a holistic defense program. Results were mixed regarding effectiveness of holistic defense in mitigating the effect of justice involvement for indigent defendants. Implementation of holistic defense was associated with a decrease in case dismissals. However, defendants receiving holistic representation were less likely to be indicted than defendants prior to program implementation. Once indicted, there were no changes in levels of diversions, and more defendants were held on bond, convicted as guilty, and incarcerated. After program implementation, fewer defendants were sentenced to alternatives to incarceration; more defendants were sentenced to time served, avoiding further incarcerative penalty. These findings suggested the need for further research to determine whether holistic defense practices are producing desired legal and social service outcomes.     

Lessons Learned From the First-Year Evaluation of a Small-Scale Home Visitation Program

ABSTRACT

Home visitation programs to prevent child maltreatment are offered in many communities. Agencies in these communities want to help families in need while under increased pressure to provide effective services. Funding is limited and competitive; some agencies might choose to limit funds spent on supervision, training, and evaluation as a way to provide more direct service. In this article, we use an implementation science framework and the results of an evaluation of a small home visitation program to underscore the importance of ongoing training and supervision, attention to fidelity, and program evaluation. The evaluation included 17 families entering the program during 21 months. Evaluators visited families in their homes at the beginning of the program and again 10 months later. Like many other well-intended, small-scale programs, this one “borrowed” from evidence-based models and expanded enrollment criteria in an attempt to better serve families. Findings from the evaluation suggest that the program, as it was carried out, was not effective at reducing parenting behaviors known to be associated with child maltreatment. We offer advice to funding and community agencies based on these findings and implementation science. Future evaluation research must pay greater attention to fidelity and implementation.     

Why targeting matters: The apprenticeship program for youth in the Czech Republic

In this paper, we analyze the targeting and outcomes of the apprenticeship program implemented under the Youth Guarantee/YG scheme in the Czech Republic. We examine the outcomes and targeting using counterfactual impact evaluation (quasi-experimental design) of the apprenticeship program on the basis of administrative data from the Czech Employment Office. The implementation strategy is analyzed using various policy documents. The findings indicate that the program is apparently targeted at those groups of young people who are less disadvantaged as regards education level and previous unemployment experience. At the same time, paradoxically, the effects in terms of outflows from the unemployment register are weak for the short-term and medium-term unemployed, as well as for low-skilled and high-skilled youth, and stronger effects are evident in the case of long-term unemployed and medium-skilled youth. The failures in targeting and in adjusting the program to the needs of more vulnerable groups of youth are due to an inconsistent implementation strategy of Czech Public Employment Services.     

Age and gender differences in emotional and behavioural problems during the transition to residential treatment: the Odyssey Project

Utilising a national sample of 1,167 young people in residential treatment, this study explored whether the behav-ioural problems exhibited during the transition to residential treatment varied depending upon the age and gender of the youngsters. Specifically, we asked whether those who were admitted to residential treatment centres (RTCs) aged under 12 had a different set of behavioural problems from those who were 12 years and older when admitted, and whether boys had different characteristics than girls. The 11 scales of the Achenbach Child Behavior Checklist were examined. The results revealed statistically significant patterns of associations by age and gender. As populations shift within agencies and across time, knowledge of the behavioural problems associated with age and gender groups can be used to facilitate agency planning and staff training.     

Assessing the Effects of an Asset-Building Program in Resource-Constrained Households: The Case of Sub-Saharan Africa

ABSTRACT

Using a survey that was administered individually to respondents at set locations, this study examines the effects of participation in an asset-building program in resource-constrained households in rural Ghana (n = 120 in the experimental group and n = 120 in the comparison group). Results suggest the program is effective in reaching the most economically vulnerable households. We also learned that program participation was related to ownership of social assets, as well as psychosocial and financial well-being. Program characteristics, including trust among members and time spent on program-related activities, were related to enhanced social and financial assets, respectively. A number of implications emerge from this study. Given that the program, although effective in reaching the most economically vulnerable households, did not produce significant outcomes in such households, attention may be devoted to understanding ways to enhance the welfare of vulnerable program participants. A targeted approach may be a viable option. With respect to policy, consideration could be given to incorporating microfinance models in poverty alleviation strategies. Continued research using more rigorous design is needed to explore the relationship between microfinance and the welfare of vulnerable participants.     

强制结构理论及实验检验

学术界对强制关系的研究较少，尽管它无处不在。本文基于要素论探讨强制结构的含义、分类及模型，重点探讨了间接强制结构的效应。间接强制是涉及至少三个行动者的一类“不给钱就制裁,给钱就‘保护’你”的结构关系。实验研究结果表明，在边界条件内，间接强制结构与直接强制结构一样有效力，即有类似的强制幅度和力度，二者都使强制者获得最大的剥夺率。本文最后讨论了影响强制效果的因素，包括强制者的贪欲与策略、强-强联盟及受制者联盟的效应等。     

How unemployment duration affects social assistance receipt: evidence from Finland

This article reports on a study of the impact of unemployment duration on the probability of becoming a social assistance recipient and on the time spent on social assistance. The data are taken from a local Finnish labour market consisting of the cohort of unemployed people at a given date (n = 2,274). The data are linked to information about the number of months recipients received social assistance during the subsequent year. Count data regression models of the hurdle type are estimated. The results of the analysis suggest that the impact of unemployment duration on the probability of becoming a social assistance recipient is explained to a large extent by changes in the distribution of types of unemployment benefits between people with different lengths of time spent in unemployment. Unemployment assistance recipients are more likely to become social assistance recipients and to spend longer periods on social assistance than are recipients of unemployment insurance because the unemployment benefits for the latter are higher. Among social assistance recipients, time spent on the transfer increases with unemployment duration only for those who are in frequent need of assistance.     

Australia saved from the financial crisis by policy or by exports?

There is general agreement that Australia weathered the Global Financial Crisis (GFC) better than many other advanced countries. There is less agreement as to why. In popular discussion, fiscal policy and continued strong export demand have been championed, with less support for monetary policy. But there is little formal empirical work which disentangles the relative contributions of these three factors. It is the purpose of this paper to make a start in this direction. It does so within the framework of a small vector-autoregressive model. The main finding is that the three factors together actually exacerbated the effects of the GFC on average over the 2009–2011 period, with most of the blame falling on fiscal policy. This seemingly anomalous finding is further explored and explained by households’ response to cash hand-outs which were saved and not spent; indeed, it is conjectured that they took cash hand-outs and government predictions of doom as indicators that bad times were ahead and saved rather than spent in response.     

Rural mountain natives,in-migrants,and the cultural divide

Conventional wisdom suggests that different views held by native and in-migrant rural residents lead to a division that ultimately damages community. Using a sample of rural residents in the Southern Appalachian Mountains, we seek to (1) determine whether these groups differ and, if they do, (2) explain the predictors of the difference. Our results suggest that there are demographic and attitudinal differences between natives and in-migrants, although a significant number of in-migrants share native attitudes. Proportion of lifetime spent in the region and perception of threat to cultural heritage play important roles in determining shared attitudes among the groups, implying that natives and in-migrants may not be as different as previously assumed and that in-migrant status by itself may not be sufficient to explain changes in rural community.     

Group Work: Theories and Practices by Siddiqui,H. Y.

This paper describes the use of structured board games as the sole program activity for a small group of maladap- tive Israeli adolescent boys in attendance at a socio-educational community center. The extensive use of groups by non-social work center staff necessitated intensive pre-group planning which included consideration of the setting, the social worker's role, the abilities of otential group members and the classifica- tion and selection orgames. The group met for ten weeks with the social worker actively participating in the games. Positive changes were reported and both emotional growth and behavior change were vistble to the boys and the staff.     

The Experience of Respite

Abstract

Interviews were conducted with 228 African American and white caregivers seeking respite care. The two groups were compared in terms of their own functioning, that of their relative and their needs for assistance at the time of their requests for respite. After six months of use, a comparison of the effects of the program on the two groups was made. The findings indicate that although patients were comparable at the time of application, white caregivers were more anxious, depressed, felt less competent, and experienced less gain that the African-American group. Needs for assistance and the effects of the program on the two groups also varied.     

Quality of Life Enhancement Research Program: Lessons Learned

The attempted Quality of Life Enhancement program appeared to be a novel method for creating a symbiotic and sustainable relationship between a large Southeastern university and local nursing home and assisted living facilities (ALF), through which ALF residents would attend university arts and sporting events. During implementation, it was discovered that this project was unsustainable, undesired, unneeded by many care centers, difficult to implement, and required a dedicated and specialized staff. After attempting to enroll 14 local care facilities, only 2 were interested in becoming involved and produced 5 eligible participants. During the program itself, coordination with facilities and residents was difficult to maintain and unique transportation and accommodation needs were challenging to overcome. Finally, data collection was time consuming and generally unfruitful. Ultimately the project was discontinued after a year of attempted recruitment and implementation of inclusive changes to protocol. While creating an ongoing relationship with local care facilities and local universities may enhance opportunities for residents and research into important areas, such relationships take time, effort, and specialized staff to maintain.     

Lessons Learned from the Kinship Education and Support Program (KEPS): Developing Effective Support Groups for Formal Kinship Caregivers

This qualitative study examines the effectiveness of the Kinship Education Preparation and Support (KEPS) program, a group-work program designed specifically to address the varied support needs of formal kinship caregivers. There were a total of 43 participants in this study, including relative caregivers, child welfare workers, and community leaders, all of whom participated in one of six focus groups. Themes emergent from the focus groups were: the need for, and benefits of, support programs for formal kinship caregivers, implementation challenges, and improvements for KEPS. Recommendations for planning supportive and educational groups for relative foster parents will be discussed using components of Kurland's planning model.     

From policy to practice: the implementation of a new framework for social work assessments of children and families

This paper describes a two‐year study conducted in 24 English councils to evaluate the implementation of the Framework for the Assessment of Children in Need and their Families. The Framework promotes a holistic, multi‐agency approach towards the assessment of children in need. The study was carried out in two phases. Phase one explored how councils implemented the Framework and accompanying assessment records. Phase two used a variety of methods to assess the impact of the Framework on practice, including an audit of completed assessment records, postal questionnaires to practitioners and managers in social services and partner agencies, and a qualitative study of 52 cases which included interviews with parents, children over 10 and social workers. A time record was used to gather information on the time social workers spent on the various elements of the core assessment process. The study suggests that councils had to overcome a number of organizational and other barriers in order to implement the Framework. However, the Framework and supporting materials appear to have provided the foundations to improve the quality of social work recording and promote interagency working, and have strengthened the involvement of children and families in the assessment process.     

Psychosocial Intervention and Clinical/Educational Outcomes for Students with Emotional and Behavioral Disorders: An Evaluation of the Astor Transitions Program

The Astor Transitions Program (ATP) was developed to assist youth with emotional and behavioral disorders moving into a new educational environment where the services would often be less integrated. A research/evaluation consultant was hired to conduct a program evaluation of the ATP. The study sample consists of the charts of 150 consecutive students admitted to ATP between April 2010 and March 2013. The following hypothesis was tested: the ATP service in terms of caseworkers’ contacts will be associated with better clinical and educational outcomes. The major findings were the impact of caseworker contacts on clinical outcomes was indirect and greatest on type of placement; caseworker contacts had no effect on school attendance, yet ATP students were present about 85% of the time; and casework activity increased for chronic cases in placement but decreased after hospitalization. Recommendations were made to program staff on how to improve ATP services.