Assessing client satisfaction among Hispanics

Data from two studies using community health center clients are analyzed to assess how a measure of client satisfaction operates when used with different ethnic populations. The eight-item version of the Client Satisfaction Questionnaire (CSQ-8) is a measure of general satisfaction with services that was developed to provide a brief, standard assessment procedure suitable for use in a wide variety of service settings. Based on the results of this survey, the CSQ-8 seems to operate about the same, whether administered to Anglos, blacks, persons of Mexican descent, or persons of other Hispanic origin, or whether in English or Spanish. There were essentially no differences among the various ethnic groups across statistical criteria of internal consistency reliability, central tendency, dispersion, item intercorrelation, or missing values. These results suggest that the CSQ-8 is a measure of general satisfaction with services suitable for use with a variety of client populations, including Hispanics.     

Effects of anonymity and experimenter demand on client satisfaction with mental health services

Among the methodological issues associated with the measurement of client satisfaction are those concerning anonymity of response, experimenter demand effects, and reliability of instruments. In this study, 100 inpatients were randomly assigned in a 2 X 2 factorial design; subjects were asked or not asked to sign their names to the CSQ-8 questionnaire and were asked or not asked to "tell it like it is." The reported satisfaction of those given anonymity was significantly lower but there was no effect due to demand. Furthermore, subjects in the anonymity group had lower scores on all 8 items of the questionnaire. A factor analysis of the CSQ-8 revealed one major factor; the internal consistency of the scale was .93. The CSQ-8 was found to be a useful measure of overall client satisfaction but, because ceiling effects are a pervasive problem in client satisfaction research, anonymity should be assured whenever possible.     

The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome

An 18-item version of the Client Satisfaction Questionnaire (CSQ-18) was included in an experimental study of the effects of pretherapy orientation on psychotherapy outcome. The psychometric properties of the CSQ-18 in this study were compared with earlier findings. In addition, the correlations of the CSQ-18 with service utilization and psychotherapy outcome measures were examined. Results indicated that the CSQ-18 had high internal consistency (coefficient alpha = .91) and was substantially correlated with remainer-terminator status (rs = .61) and with number of therapy sessions attended in one month (r = .54). The CSQ-18 was also correlated with change in client-reported symptoms (r = -.35), indicating that greater satisfaction was associated with greater symptom reduction. Results also demonstrated that a subset of items from the scale (the CSQ-8) performed as well as the CSQ-18 and often better. The excellent performance of the CSQ-8, coupled with its brevity, suggests that it may be especially useful as a brief global measure of client satisfaction.     

Client satisfaction in a community crisis center

Variables determining client satisfaction with crisis intervention services were evaluated. The short version of the Client Satisfaction Questionnaire (CSQ-8), and open ended questions were used in telephone interviews of clients and significant others. Results showed that 40% of the total variance of client satisfaction was explained by clients' evaluation of workers. Low correlations were found between reports of clients and significant others, implying that different factors determine satisfaction for each group.     

Comparison of indirect and direct approaches to measuring patient satisfaction

One indirect (PSQ) and two direct (CSQ-18B and ERS) measures of patient satisfaction were compared across a series of psychometric, acceptability, and concurrent validity criteria. None of the three measures was significantly related to health status or demographic characteristics. Each measure performed as expected from prior research on their psychometric properties. The scales contrasted, however, in regard to acceptability, with the PSQ being much less acceptable to patients than the other two. The PSQ also produced more missing data. The results on the PSQ reflected patient inconsistency on cross-check items and patients tended to be uncertain in their responses to many items. In multivariate analyses the three measures were used as predictors of patient-rated indices of global service satisfaction. The CSQ-18B and the ERS were significant predictors of patient-rated indices of global service satisfaction, whereas the PSQ was unrelated to these indices. It was concluded that the direct and indirect approaches measure different satisfaction domains. The PSQ likely assesses more generalized attitudes about health services while the CSQ-18B and the ERS efficiently reflect opinions about the specific setting in which they are administered.     

Very Brief Interventions in College Mental Health

Abstract

Although short encounters account for one-half of college mental health practice, they're often viewed as an unavoidable evil rather than a desired outcome. In order to evaluate client satisfaction with very brief interventions the authors mailed questionaires to 215 clients who had mental health encounters lasting no more than three sessions. Seventy-two percent of respondents were satisfied with their treatment. Thirty-six percent reported that they terminated because they felt they satisfied the conditions of the consultation, as opposed to 16% who left dissatisfied and 29% who left because they were referred elsewhere. A chart review revealed that in 45% of cases the decision to terminate was made unilaterally by the client. These findings suggest that very brief interventions are more often associated with rapid goal achievement than with client dissatisfaction.     

A Desire to Return to the Country of Birth as a Function of Language Preference: An Empirical Study with Iranian Immigrants in the United States

It was hypothesized that bilingual Iranian immigrants in the United States who prefer to use the Persian language, compared to Iranians who prefer to use English, would be more likely to express a desire to return to Iran to live. Participants were 292 bilingual Iranian immigrants in the United States (128 men, 164 women) who completed a questionnaire with a similar content, prepared in Persian on one side and in English on the other side. Participants were given the option to either complete the Persian or English version of the questionnaire. Results confirmed the research hypothesis suggesting that the immigrants’ preference in using their native language serves as a “pull” factor that increases the probability of a desire to return to the country of birth. It was also found that women and younger respondents were less likely to express a desire to return to Iran. Level of education, marital status, years of living in the United States, and attitudes toward marriage and the family did not predict such a desire. Implications for acculturation research and for counseling culturally diverse clients are discussed. Policy implications to attract immigrants back to their country of birth were also discussed.     

Clients' views of live supervision and satisfaction with therapy

In this study we examined clients' perceptions of live supervision and their satisfaction with therapy in a university-based training clinic for marriage and family therapists. A total of 108 clients completed the Client Satisfaction Questionnaire-8 and a modified version of the Purdue Live Observation Satisfaction Scale. Clients' comments on the advantages and disadvantages of live supervision were also solicited through short-answer questions. Results indicated that clients were generally satisfied with therapy and found the live-supervision process satisfactory as long as the perceived helpfulness of live supervision outweighed its perceived intrusiveness. The challenge for training clinics is striking a balance between helpfulness and intrusiveness in an effort to both train competent therapists and provide quality treatment.     

Using Decision Analysis: Connecting Classroom and Field

This paper reports on the findings of a small‐scale research project investigating the views of social work students on the use of decision analysis. After giving the context of the research, the article reports on what was found when students, who had just completed a Decision Making and Risk module, were asked for their opinions on the component parts of decision analysis, its use as a practice tool and their attitudes to using it on placement. The research found that the respondents in general took a critical and supportive stance towards the use of decision analysis in social work and, with extra teaching and a positive approach from their practice assessor, would be happy to use decision analysis. When the same group of students completed a follow‐up questionnaire on a placement recall day, half of them had thought about using decision analysis but only three had gone on to discuss this with their practice assessors. Some issues in relation to connecting ‘classroom’ and ‘field’ are identified and the paper concludes that a number of further steps would be necessary to realise the potential of decision analysis to help students be more systematic and analytical in their approach to decision making.     

Child welfare clients and school satisfaction

Despite long-standing knowledge about child welfare clients' poor educational outcomes, we know less about these vulnerable young people's situation in school. This article addresses school satisfaction among upper secondary students who have been in contact with the child welfare services. These child welfare clients' school satisfaction is compared with their peers' satisfaction. The results from a survey indicated that the majority of child welfare clients were satisfied with school but that they were less satisfied with school than were their peers. The results showed that the association between school satisfaction and positive school experiences explains a large part of this difference. Among students who reported they were doing well in school, had supportive teachers and friends at school, the difference in school satisfaction between child welfare clients and others was small. Among students who did not report similar positive experiences in school, difference in school satisfaction between child welfare clients and their peers was more substantial. These results show that school can be a good place for child welfare clients, but that facilitating support from teachers, increasing opportunities for making friends at school, and working to develop the child welfare clients' academic performances are important as efforts to improve school satisfaction.     

Career Counseling From the Counselee Perspective: Analysis of Feedback Questionnaires

The effectiveness of career counseling as perceived by counselees was measured using evaluation questionnaires. The results showed that 75% of the respondents rated the career counseling they received as satisfactory. A systematic difference was found between satisfaction with counseling as a result of the enhancement of the counselees' personal understanding and satisfaction as a result of the assistance they perceived in decision making. Respondents were more positive concerning their gains in self-understanding than about the help they felt they were given in arriving at a career decision. On the average, counselees rated discussions with the counselor as more important in counseling than were objective tests, interest inventories or vocational information. Respondents who reported that counseling helped them in both their personal and career problems were more satisfied than those who reported being helped solely in either their personal problems or their career decisions. The theoretical and practical implications of these results for career counseling are discussed.     

Comparing the Decision Structures of Public Relations Agencies and Clients

In this study, I use K. R. Hammond's version of social judgment theory (Hammond, Stewart, Brehmer, & Steinmann, 1975) to examine the conscious and covert judgment patterns of a group of public relations agency consultants and their clients. Respondents assessed 30 hypothetical public relations proposals that combined different mixtures of five decision factors: cost effectiveness, measurability, image support, marketing support, and feasibility. Analysis based on the lens model equation revealed that both groups emphasized bottom-line considerations over less quantifiable ones; that clients, more than agency professionals, understood how they valued the decision factors and acted on that knowledge; that the two groups' subjectively specified judgment weights showed closer agreement than their actual decisions about public relations plans; and that flawed self-understanding and inconsistent decision making, particularly among agency professionals, accounted for most disagreement in practice.     

Reactive transnationalism: homeland involvement in the face of discrimination

In this article we examine whether migrants' perceived discrimination in the country of settlement leads to an increase of their transnational involvement. So far, this so‐called ‘reactive transnationalism’ has not been studied extensively. Based on literature on discrimination and transnationalism, reactive transnationalism is expected to be most prominent among socioeconomically successful migrants, particularly among males and those who consider themselves Muslims. Our research among middle‐class migrants in Rotterdam, the Netherlands, indeed shows that the more respondents experienced discrimination, the more transnationally involved they are, both regarding transnational identifications and transnational activities. While no gender difference was found regarding reactive transnational activities, for women perceived discrimination proves to lead to stronger instead of weaker transnational identifications than for men. The fact that no difference was found between Muslim and non‐Muslim respondents regarding reactive transnationalism suggests that, despite heated public debates about ‘Islam’, in the Netherlands, ethnic divides – being considered as ‘Dutch’ or ‘non‐Dutch’ – are even more prominent than religious ones.     

Equity and sexual satisfaction in recently married couples

This study was designed to determine whether or not equity considerations are important in couples' sexual relations. To answer this question, 53 newlywed couples were interviewed about their sexual relationships. Two main hypotheses were tested: (a) Men and women who feel their relationships are equitable will be more content (less distressed) than people who feel either overbenefited or underbenefited. (b) Men and women who feel equitably treated will have more satisfying sexual relations than those who feel either underbenefited or overbenefited. Some support for both hypotheses was obtained. Specifically, couples in equitable relationships were more content with their relationships and with their lives in general than other couples. In addition, equitably treated men and women were more satisfied with their sexual relationships overall than were other couples. They felt most loving and close after sex and assumed their partner felt that way too. While equitable couples did not say they felt more satisfied immediately after a sexual encounter than did other couples, they believed their partners were unusually satisfied. Reasons why these findings, though providing some support for the equity paradigm, must be interpreted with caution are discussed.     

Former welfare clients in prison: education and self-reported learning problems

The aim of this study is to investigate educational background, educational wishes, actual participation in prison education, and self-reported learning problems among former child welfare clients in prison. A significant concern is that prisoners' educational level is far lower than for the general population. The same concern has also been expressed regarding former child welfare clients. The question is whether prisoners with a background from the child welfare system are especially vulnerable. The survey reported in this paper addressed the entire Norwegian prison population. We distributed a questionnaire containing questions about whether the prisoner or their family had been in contact with the welfare system, educational issues such as educational background, whether they wanted to participate in prison education and actually participated, and to what extent the participants had self-reported learning problems. We also investigated whether such learning problems affected participation in prison education. The results showed that around one-third of the 2065 respondents were former child welfare clients. The mean age of the respondents in the child welfare group was 31 years and 7.9% were women. The results further revealed that those who had been child welfare clients had a lower educational level and more self-reported learning problems than the general prison population, but most of them still wished to start an education while incarcerated.     

Unique Characteristics of Cohabiters Seeking Therapy

There is limited information on cohabiters presenting for therapy. The authors examined the characteristics of 143 married and 54 cohabiting, young (m = 30.39), Caucasian, couples presenting for therapy. We hypothesized that cohabiters presenting for therapy would be more satisfied and committed than married couples and that they would be similarly emotionally differentiated. We conducted a repeated‐measures MANOVA to test the hypothesis. Significant effects between partners and between dyads were found, indicating a difference between clients based on relationship status. Cohabiting clients presented earlier in their relationship and were more satisfied and committed. Cohabiting male partners were less emotionally reactive. Without the institutionalized rules of marriage, cohabiting couples may perceive threats to their relationship earlier than married couples.     

The reporting and help‐seeking behaviors of domestic violence victims with criminal backgrounds

The decision to report domestic violence is often conditional on whether victims were satisfied with their prior treatment by the criminal justice system. One issue in reporting victimization is that victims of domestic violence may also be involved with the system as offenders. The current paper systematically reviews research on this overlap, finding that most research supports that victims who also have criminal backgrounds are significantly less likely to report subsequent experiences of domestic violence, and are less likely and able to seek out social services, particularly when they report prior negative experiences. The paper then identifies theoretical and policy‐based implications of the review findings.     

How is participation related to well-being of homeless people? An explorative qualitative study in a Dutch homeless shelter facility

The majority of homeless people is socially excluded which negatively affects their well-being. Therefore, participation-based programs are needed. The current research is conducted within a Dutch homeless shelter facility that offers educational, recreational, and labor activities to clients in an environment which is designed to feel safe (an enabling niche). The main aim of these activities is to facilitate social participation. We conducted two qualitative studies consisting of 16 semi-structured interviews, to explore clients’ experiences with participation in activities in relation to their well-being. The findings showed that clients experienced that participation had led to an improvement of physical, social, and mental well-being. In general, clients reported that due to participation in activities they have strengthened their social support network, improved their (mental and physical) health, self-esteem and personal growth. We concluded that in order to facilitate long-term positive outcomes of participation in practice, it is necessary to focus on group cohesion, and on the social worker’s behavior and attitude.     

An Examination of Mandated Versus Voluntary Referral as a Determinant of Clinical Outcome

A literature review was undertaken to examine evidence for the effectiveness of psychotherapy with mandated clients. The primary question addressed was whether or not clients mandated to therapy, whether by court order or by order of their employers, show poorer outcomes than clients who enter therapy voluntarily. To this end, research on client resistance and motivational readiness to change was reviewed. This was followed by an examination of research on the effectiveness of mandated treatment. The question of the potential influence of relationship factors such as the therapeutic alliance was also addressed. The literature review was followed by suggestions for future research on the effectiveness of treatment for clients with mandated or voluntary referral status.