A Comparative Study of the Management of Cases of Deliberate Self-Harm in a District General Hospital

Correspondence to Michael Bateson, Senior Psychiatric Social Worker, Lancaster Moor Hospital, Lancaster, Lanes. Summary A controlled study was undertaken of two services assessingand managing cases of deliberate self-harm admitted to a casualtydepartment. The first service featured psychiatrists only andthe second included psychiatric social workers as well as psychiatrists. A combination of standardized instruments, a structured questionnaire,a twelve month diary and medical and social work files wereused to collect information. Demographic factors, repetitionrates, types of help offered, client satisfaction, social circumstancesand general health were investigated. Few significant differences were found to have existed betweenthe client populations of the two services at initial assessment.Also, there were no apparent differences in factors interveningbetween initial assessment and follow-up. However, the analysisof outcome measures indicates that clients benefited substantiallyfrom the addition of a psychiatric social worker in the followingareas: help offered, client satisfaction, social circumstancesand general health. These results are discussed.     

Brief interviews: approaches, techniques, and effectiveness

A study of brief-contact interviews at a psychiatric hospital by social workers indicated that such interviews can reduce long client waiting lists and increase case loads without adding to cost. Their effectiveness requires skill and judgment by highly-trained and experienced workers.     

An exploratory study of different approaches between social work practice and correctional services in Hong Kong Special Administrative Region

This paper tries to explore the differences between social work and correctional services from the aspects of professional boundaries, concept, content, construct, context, approach, function, professional identity and relationship with service users. Through these, social workers will be informed what are the limitations of their service in a correctional environment, whilst for correctional officers, a better understanding of the philosophical stance of social services which may be helpful for them in discharging their dual role of law enforcer and social worker under the contemporary correctional policy stressing rehabilitation and reintegration of offenders.     

Contextualizing Performance of Coordinated Care Network of Veteran Services in Virginia

Abstract

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency measured as the amount of days a client’s case is open and effectiveness measured as the recorded outcome of a client’s case. However, performance was affected by both client’s characteristics and types of services requested. Therefore, performance was not uniform across the network of providers. Further, indicators could be enhanced to better capture areas of the network needing improvement. Future research may consider adding performance measures and track it over time and across contextual attributes to confirm the effectiveness and efficiency performance of a coordinated care network.     

Perceived Importance of Service Elements in Client Satisfaction Measures

ABSTRACT

Many evaluators or service providers develop their own client satisfaction measures using satisfaction rating items representing service elements specific to the service settings. Global satisfaction scores are then produced by summing these item scores while assuming an equal contribution of all items. One approach to overcome evidence against this assumption is importance weighting, which is achieved by considering both item satisfaction and item importance in measuring overall satisfaction. Unfortunately, the adequacy of importance weighting in client satisfaction measures is not well understood. This study assessed the adequacy of importance weighting. Analyzing data from a previous client satisfaction survey with 110 older adults, the current study found that the relationship between global client satisfaction and the sum of satisfaction scores across service elements was dependent upon the patterns of respondents’ perceived importance of service elements. These results provide support for importance weighting and suggest the need for incorporating perceived importance of service elements in measuring overall client satisfaction.     

Differences in inmate-inmate and inmate-staff altercations: Examples from a medium security prison

Inmate violence is a major concern for correctional organizations. Most research on violence lump together inmate-inmate and inmate-staff violence and attempt to understand them from a single perspective. This article posits that inmate-inmate and inmate-staff violence are different phenomenon. Data from a medium security prison is used to understand the relationship between inmate-inmate and inmate-staff violence and other variables. Inmate-inmate altercations are related to structural and interpersonal variables. Inmate-staff altercations are related to the extent to which inmates are involved in social relationship with other inmates and see the correctional staff as a physical threat to them. variables. Inmate-staff altercations are related to the extent to which inmates are involved in social relationship with other inmates and see the correctional staff as a physical threat to them. variables. Inmate-staff altercations are related to the extent to which inmates are involved in social relationship with other inmates and see the correctional staff as a physical threat to them.     

The association of affective and continuance commitment with correctional staff life satisfaction

Previous research suggests that life satisfaction is a stronger predictor of job performance than job satisfaction, and life satisfaction is negatively associated with absenteeism and a desire to retire early. Despite the fact that employees with high life satisfaction are essential for organizations’ optimal efficiency, little empirical research exists to determine the individual and workplace factors that shape and maintain high correctional staff life satisfaction levels. This study investigates the impact of two types of organizational commitment, continuance and affective, on correctional staff life satisfaction at two Midwestern prisons, one private and one public. Continuance commitment was negatively related and affective commitment was positively related with life satisfaction for staff in both prisons. Possible methods to increase affective commitment and life satisfaction for correctional staff are discussed.     

Building a people's home* for settled,conscientious Swedes

Social policy in Sweden has evolved along two lines, one marginal and the other institutional. A work ethic that stems from the pre-Christian era is a factor in both these traditions, above all in the marginal model. The marginal line, with social services aimed at the indivual, has traditionally focused on the coercion of deviants, a tendency that was manifest in the statutory provisions up to the reform of the social services in 1982. Rigorous regulations based on domiciliary right meant that poor relief and social assistance were largely reserved for the settled population. A primary aim of the social services reform of 1982 was to replace the existing social relief, with its heavy emphasis on control, by a system of social services that would be voluntary in principle and aimed at catering to the client. Coercive measures became less frequent initially, but the element of repression soon grew again at a time when the economic climate was becoming harsher. Since the beginning of the 1980s there has been a further increase in repression in both social welfare and correctional care. This has been accompanied by significant tendencies to move away from an institutional social policy towards a marginal line. The shifts in values in the 1980s and 1990s do not represent a traditional right-left dichotomy.     

中日制造业服务化测度及其对产业国际竞争力的影响——基于国际投入产出的分析

从生产性服务投入角度,借助世界投入产出数据库(WIOD)最新公布的2000-2014年世界投入产出表,测算中日两国制造业服务化水平,对比中日两国制造业服务化发展特征,并基于增加值贸易核算中日两国以增加值显示性比较优势指数表征的制造业国际竞争力水平。结果表明:(1)中国制造业服务化水平和国际竞争力整体上落后于日本,中国低技术、中低技术密集型制造业国际竞争力比较优势明显,日本高技术、中高技术密集型制造业国际竞争力更高;(2)从细分生产性服务投入行业类型看,中日两国服务化类型结构相似,批发零售和仓储运输服务化水平相对较高,其他类型服务化水平较低;(3)制造业服务化与国际竞争力水平之间并非简单的线性关系,而是存在显著的倒U型关系。此外,信息通讯服务投入对制造业国际竞争力的促进作用存在门槛效应,且产业国际竞争力的提升更多依赖专利科技服务要素的投入。     

Empowerment in social work practice with the psychiatrically disabled: Model and method

Empowerment of those clients disempowered by society is explored as both a philosophy to inform social work practice and as a continuing method of practice in itself. A three‐part model of empowerment at individual, interpersonal, and group levels is presented and is then illustrated by application to a case study of psychiatric disability. The generalist model of practice is seen as particularly suited to empowerment. New directions in serving mental health consumers are discussed, including participatory action research, the disability paradigm, and consciousness‐raising in relation to economic oppression. Egalitarian partnership between worker and client is seen as the future of social work practice.     

Citizen‐agency versus state‐agency at the frontline in prisons and probation services: A systematic literature review

Street‐level bureaucrats play a key role in the delivery of public services to the citizens with whom they interact. Using the Preferred Reporting Items for Systematic Review and Meta‐Analyses approach, we rely on a street‐level perspective to report a systematic review of 46 studies about officer–offender interactions in prisons and probation services. In doing so, we examine how correctional officers articulate state‐agency – whereby they focus on the implementation of rules and policies – and citizen‐agency – whereby their decisions regarding offenders are based on judgements of offenders' worth. Our results provide evidence that frontline work in prisons and probation services stems from a mix of citizen‐ and state‐agencies in which the former is prioritized over the latter: when rule enforcement allows it, correctional officers often make discretionary decisions based on professional judgements rooted in professional norms. In this respect, the managerial and actuarial approach to risk management and public protection involved by contemporary correctional reforms comes with new role expectations that conflict with correctional officers' rehabilitative ideals. At the same time, the literature provides many instances of officers coping with workload in order to meet policy objectives and organizational demands while maintaining satisfactory working conditions. In other words, there is an increasingly elaborate and fragile articulation of state‐ and citizen‐agencies at the frontline, in prisons and probations services. We conclude with some implications and an agenda for future research.     

Examining the Effect of Correctional Programming on Perceptions of Likelihood of Recidivism Among Incarcerated Prisoners

ABSTRACT

For many years, policymakers and criminal justice scholars have debated the impact of correctional programming on recidivism. This debate is currently unresolved. Using data from 1,234 currently incarcerated inmates in a mid-Southern state, this study examines whether inmates who participate in correctional programming while incarcerated are less likely to feel that they will recidivate upon release from prison. The findings from this research suggest that program participation while in prison has little impact on the inmates’ perceived recidivism, although important programming effects may still occur. Policy implications and directions for future research are discussed.     

The Use of Imprisonment on Groote Eylandt

The island of Groote Eylandt, in the Gulf of Carpentaria off the coast of East Arnhem Land, has a rate of imprisonment far higher than that prevailing in other local government areas of the Northern Territory and more than 25 times the national rate. Groote Eylandt prisoners are predominantly young, unmarried, Aboriginal males who are likely to be unemployed, have low levels of educational achievement, are highly likely to have been in prison previously, are dealt with by the Magistrates Court for offences involving property or alcohol and are likely to serve actual prison terms of under one year. This paper suggests that the use of correctional facilities in Darwin and elsewhere has little deterrent effect for these offenders and recommends the establishment of a small correctional facility on Groote Eylandt.     

A Case for Correction

Summary Current criticisms of the correctional approach to offendersare examined, viz. (a) that it is ineffective, (b) that it isoften unjust, (c) that it is deterministic and (d) that thereare other approaches to which these strictures do not apply.It is concluded that these arguments do not justify the abandonmentof correctional policies.     

Keeping the Probation Service Whole: The Case for Discretion

Summary The function of the probation service has been the discretionarymanagement of the tension between control and care. There wasa time when officers could make these discretionary decisionswith relative confidence, but structural pressures, togetherwith the decline of the correctional/treatment model have madethis more difficult. This has led to arguments for the separationof control and care functions. A recent attempt has been madeto re-instate the correctional/treatment model and this is discussedbut found to be unconvincing. The author presents his own argumentfor retaining discretion and describes how he believes it shouldbe managed.     

Therapeutic residential care in Spain. Population treated and therapeutic coverage

Therapeutic residential care (TRC) is the name given to specialized children's homes for treating cases with severe emotional and behavioural problems that have been placed in residential care. A recent international review has revealed great diversity in the referral criteria of cases and in the models of intervention carried out. The goal of this study is to describe the population treated in these types of facilities in Spain and the therapeutic coverage given. The sample is made up of 215 young people in children's homes, of whom 93 are in TRC. The cases referred to TRC have been in residential care for less time but have gone through a greater number of placements. These young people also exhibit more problems of drug use, and there is a larger percentage of clinical‐range cases in the Child Behaviour Checklist scales of attention problems and aggressive behaviour. Nevertheless, the results of logistic regression indicate that the only variables that significantly increase the probability of being referred to TRC are drug use and changes of care placements. With regard to therapeutic care, there is a higher percentage in the TRC group receiving psychiatric care, and the sessions are also more frequent.     

Using psychodrama for information gathering

Based on the results presented here, psychodrama has a definite place in the treatment of acute and chronic psychiatric clients. It works especially well with these clients on an information-gathering level to elicit information about a client's past unresolved conflicts and feeling relating to them. This data is not often available in the social and psychological history. An additional benefit of this exercise is the accelerated acceptance of the new client into the open-ended, ongoing group. It has also proved to make future group sessions more meaningful to the new member. The implementation of psychodrama at the information gathering level has benefited the therapists clinically and, at the same time, enhanced the client's total participation in group.     

Wearing Two Hats: Clinical and Ethical Implications of Combining Individual and Group Treatment

ABSTRACT

The purpose of this qualitative case discussion is to reflect on the practice of combined therapy where the group worker and the individual clinician are the same person. The authors find that in the complexity of today's practice environment this phenomenon may not be simply a matter of clinician, or even client choice, but may exist as a required component of program service offerings. Often, an ad hoc or haphazard approach to the combined treatment modality can submerge the worker into clinical and ethical quagmires potentially damaging to client and the group. This article examines how the judicious use of combined individual and group approaches can offer a viable model of intervention across varied theoretical domains and practice settings. Vignettes and practice examples are used to illustrate the discussion.     

Community-Based Long Term Care

Through the Living at Home Program (LAHP) 20 communities across the United States have developed cooperative networks involving multiple health and social services providers. The LAHP networks have sought to increase access to care, reduce duplication of services, and identify and fill service gaps. The LAHP national evaluation is examining the inter-organizational linkages that have been implemented by the networks and the characteristics of 1500 clients enrolled for care. Preliminary findings at the midpoint of the evaluation indicate that the networks have moved from a reliance on informal communication and coordination mechanisms at baseline to the use of more formal structural mechanisms over time. Despite the lack of formal targeting criteria, the networks have enrolled a quite frail elderly population. Future analyses will examine variability across the networks in client targeting and service utilization, In order to shed light on the need for utilization review of community based long term care.     

A Cross-Sectional Examination of the Association Between Dyspnea and Distress as Experienced by Palliative Home Care Clients and Their Informal Caregivers

This study examined the association between dyspnea and distress as experienced by both palliative home care clients and their informal caregivers as a unit of care. Cross-sectional analysis was conducted using the interRAI Palliative Care Assessment database. Responses from 6,655 individual palliative home care clients across six regional jurisdictions in Ontario, Canada were included. This study found that clients experiencing dyspnea were more likely to show overall signs of distress; report one or more signs of self-reported distress; and be at risk for depression when compared to clients who do not experience dyspnea. Caregivers of clients experiencing dyspnea were more likely to exhibit distress than caregivers of clients not reporting dyspnea. When indicators of caregiver distress and client distress were combined, 53% of the caregiver-client units exhibited distress. Social work practitioners should include a focus on distress within the care unit as a priority when care planning to meet the needs of persons nearing the end of life. Members of the care team should consider available treatment and management options tailored to meet both the client and their informal caregiver’s needs.