Spirituality and the Gay Latino Client

An essential element in providing social services to clients form diverse communities is an understanding of cultural norms and values. The importance of acknowledging the understanding the role of spiritual beliefs and practices in working with gay Latinos is paramount when one considers the strong influence that organized religion and alternate belief systems have had on the societal, cultural and familial lives of these clients. This article looks at the role of spirituality in working with gay Latino clients, and offers suggestions for enhanced service delivery.     

What is mixed in welfare mix? Welfare ideologies at stake in the Lithuanian case of social service delivery

The article deals with the development of social welfare and social services in Lithuania by describing cultural contexts and disclosing evaluations of social service providers and recipients and needs of social service delivery. The authors of the article discuss the changing role of the state, pose a question as to what the institutions and the actors are and to what extent should they participate in the creation of social welfare. One of the aims of this paper is to describe the development of the welfare mix in Lithuania, by showing that welfare is inevitably woven into the historical, economic, political and social context; the distinctive cultural configuration of the welfare mix in social services delivery in Lithuania is revealed. Empirical research (survey of social services recipients and providers) presented in the article discloses that actors of social services delivery experience tension and ambiguity between the demand of neoliberal policy to choose and be responsible and the expectation that the state will participate in the social service market. At the same time social services recipients and providers express a need for different actors to take an active part in the welfare system.     

Developing a community-based care system for seriously emotionally disabled children and youth

The needs of emotionally disabled children and their families are not optimally served within traditional mental health service delivery systems. Policies are inadequate, delivery systems are insufficient and underfunded, and supporting research is sparse. As communities begin addressing the needs of the seriously emotionally disabled child and family, planning should address community coordinated services. Such systems, however, are not easily established and maintained in communities accustomed to addressing children's needs in terms of existing fragmented categorical structures. National models exist but care and time are required to adapt critical elements from these models to local need. This article will review the rationale for integrated community-based, case management services for children and adolescents. A case example is offered illustrating issues affecting the development of one community support system.     

National consistency and provincial diversity in delivery of long-term care in Canada

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

Implementing the family preservation program: Feedback from focus groups with consumers and providers of services

There is a growing understanding that preventative child welfare efforts can be both more cost effective and are more desirable philosophically than strictly remedial programs. The Family Preservation Act provides funds to assist communities in strengthening and preserving at-risk families. In order to implement this program effectively, local communities must design new programs and procedures which will be both attractive to consumers and effective in meeting their needs. This study it identifies problems with contemporary child and family services and suggests solutions to those problems. This study uses a focus group format and presents ideas generated by those individuals who will be most directly affected by this legislation; front line service providers and service consumers. Several areas of weakness in the current service delivery system are identified, including bureaucratic barriers, limited resources, problematic consumer/provider relations and a range of collaborative issues, both within and between agencies and the communities they serve.     

The Revitalization of Community Practice: Characteristics,Competencies, and Curricula for Community-Based Services

Abstract

A recent move toward community-based services on the part of direct service agencies presents a major opportunity for the revitalization of community practice. Driven by funding from major philanthropic foundations and also by recent changes in federal entitlement legislation, these efforts at system reform are designed to make services for vulnerable populations more effective, accessible, integrated, and comprehensive in the context of the local community. Although this service reorganization requires the type of methods typically found in community practice, direct service workers employed in these agencies usually have not been trained in community work. To begin to address this concern, this article uses a computerized word search to review the community practice and community organization literature. A working definition of “community-based” practice is developed. The extensive literature review yields six characteristics of community-based service delivery: (1) neighborhood-based and family-focused; (2) strengths- and empowerment-oriented; (3) cultural sensitivity and multi-cultural competency; (4) comprehensive services; (5) access to integrated services and supports; and (6) teamwork and leadership skills. The article reviews what scholars have recommended in each of these areas as a way of understanding the characteristics of community-based service delivery and the skills needed by direct practitioners working in community-based programs. The article summarizes innovative curricula and specific courses which demonstrate ways of teaching community skills to direct practice workers. Future work for community practice scholars and educators is recommended.     

An Aging Workforce in an Increasingly Global World

Summary

The aim of this article is to demonstrate the diversity in delivery of long-term care at the provincial level, within a national legislative framework that provides universal health insurance and public administration. Not all provinces have legislated provision of long-term care, but mandates for provincial long-term care programs typically address the needs of those with chronic health needs and maintain them in the community for as long as possible. Eligibility is based on common criteria of residency, health need, facility, assessment, and consent. The three common components of the service delivery system are institutional care, community-based services, and home-based services; the kinds of services within each component and the mix among them vary from province to province. There are also five common features in provincial service delivery systems: single point of entry, assessment, client classification, case management, and single administration. Throughout the article, examples from different provinces show the varying ways in which these aspects of service delivery have been addressed, and recent innovations have furthered this diversity. A detailed account of quality management systems also shows that while all provinces have adopted a common set of principles, they use a range of methods to pursue quality of care and to promote good practice.     

Reshaping to serve evolving communities: Addressing immigrant needs in the library

Abstract

Libraries face evolving communities and must constantly reorient themselves to serve new needs. This article examines the impact of emerging immigrant communities on library services. It discusses the emergence of library services to immigrants and the diverse faces of these services, which may include foreign language collections, access to technology and connections with local services, as appropriately determined through community analysis. The Atwater Library and Computer Centre in Montréal, Québec is examined as a case study of community analysis informing service reorientation. This article will be useful for organizations working with immigrants or community service providers confronted with changing demographics.     

Partnering for Mental Health Promotion: Implementing Evidence Based Mental Health Services Within a Maternal and Child Home Health Visiting Program

This article details the clinical foundations of a social work focused community-based participatory research project promoting women’s mental health during and around the time of pregnancy. Specifically, we discuss the theoretical, empirical and organizational implementation of an enhanced engagement model of mental health service delivery that integrates evidenced based practices into the structure and services of an existing non-profit maternal and child health home visiting agency. The model is grounded in literature addressing barriers to accessing mental health care among minority women living in low-income communities. We discuss informing the intervention through direct consumer involvement, as well the rationale supporting the inclusion of Interpersonal Psychotherapy and Cognitive Behavioral Therapy into the design and implementation of the model which emphasizes adequate training of staff with varying levels of mental health experience. Finally, we describe typical client situations and responses reflected by the Enhanced Engagement model and discuss future implications of this approach as a way to offer meaningful intervention to women and families who may not have access or eligibility to utilize specialty mental health services.     

Urban and Indigenous: The Challenges of being a Native American in the City

The United States is home to more than 4 million Native Americans, the majority of whom live in urban areas. Urban Native Americans often experience significant social, health, and economic problems while having access to substantially fewer Native-specific resources than their reservation-based counterparts. They also face challenges with access to tribal services and political processes, as well as identity-sustaining cultural resources. This article describes the urban nature of many contemporary Native American communities. Examples from various urban Native American communities highlight the challenges faced by urban Native people, as well as creative initiatives developed to serve this population. This paper draws on and synthesizes the literature on contemporary urban Native communities, thus providing needed information for service providers and researchers working in these communities.     

Cultural diversity and the mistreatment of older people in black and minority ethnic communities: some implications for service provision

Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact.     

Program Design and Planning Strategies in the Delivery of Culturally Competent Health and Mental Health Prevention and Treatment Services to Latino Communities

SUMMARY

It is important that the delivery of health and mental health prevention and treatment services within Latino communities be culturally sensitive. This article outlines several ways in which agencies can develop programs that can meet the needs of Latino communities. The most important aspect of the provision of health prevention and treatment services is that the organization integrates itself into the community through outreach, recruitment, and inclusion in decision-making. In addition, the organization needs to be structured so communication and participation from the community and health professionals are open and mixed. Otherwise, the likelihood of success of the provision of services in the community will be diminished.     

Organizational structure,leadership and readiness for change and the implementation of organizational cultural competence in addiction health services

Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed.     

Coordinated Service Delivery and Children's Well-Being

ABSTRACT

Interagency collaborations are uniquely suited to meeting the increased needs of communities in today's environment of reduced federal funding and devolution of services to the state and local levels (Gore, 1993). In Texas, interagency collaborations take place through Community Resource Coordination Groups (CRCGs), which were created by the Texas Legislature to coordinate local service delivery for children and their families who often “fall through the cracks” due to having multiple needs. This article presents an evaluation of CRCG operations, with a focus on identified best practices, related obstacles, and suggestions for improvement. The researchers visited CRCG sites, and conducted semi-structured face-to-face interviews, as well as a mail survey, with CRCG staff. Overall, CRCGs appear to effectively enhance the delivery of coordinated services in an effort to meet the multiple needs of the children and families that they serve. Recommendations for policy and practice are discussed, such as spearheading community action structures (Poole, 1997) that may help CRCGs more effectively meet the needs of their respective local communities.     

Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system

While the gap between need for and access to mental health services is well documented among children of color in foster care, little is known about why they are sustained. To illuminate barriers of service delivery, thirty-six caseworkers participated in one of five focus group meetings in a large urban Mid-Atlantic City. Ground Theory Methods revealed that there are barriers and facilitators at the macro, meso, and micro practice orientations. At the macro-level, development of effective practice strategies and proximity to effective services are likely to influence dissemination of effective practices. Secondly, at the meso-level, job support is needed to facilitate awareness, but for case managers to feel supported, they need effective training and opportunities to facilitate interagency collaboration. Finally, at the micro-level, cultural competence largely impacts implementation of effective practices. However, increased awareness around the social ills of stigma and the salience of “insider work” are needed to increase cultural competence. A “downstream” effect in which there are numerous barriers identified at the macro level has a direct negative impact on organizational capacity and readiness to deliver and engage youth and families in mental health services served by the child welfare system. Findings underscore the need for child welfare agencies to build supports at the macro, meso, and micro practice levels to ameliorate mental health service disparities.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Adapting Social Work in Working with Muslim Clients

Current social work education programmes and textbooks often underestimate the hypothesis that providing effective services to different cultural groups requires cultural understanding. One approach that has been recommended is the localization of social work: using a fundamentally different social work knowledge base and approach with different cultural groups. To date, however, little scholarship considers how to localize social work in working with Muslim communities. On the basis of interviews with over 50 social service providers in Canada who work with Muslim clients, the present article provides insight into strategies and methods that involve localizing social work in Muslim communities, focusing on possible client characteristics, challenges, and needs from the perspective of the practising social worker. Issues of racism, spirituality, acculturation, help seeking, and client expectations of service are particularly relevant. Properly responding to these factors ultimately involves the coordinated efforts of educational institutions, agencies, and social workers, but none of this will be possible without a thorough understanding of cultural values meaningful to Muslim clients.     

Community Based Rural Health Care in India

SUMMARY

India is a large country, geographically as well as popula-tionwise. The majority of its population lives in rural areas, i.e., villages. Again, most of the villages are in remote areas. The State has been making sincere efforts to make the basic social services accessible to all in the rural area. Health being one of the vital services, it has been a challenging task before the State to extend it to the remote rural areas, many of which are not yet connected by motorable roads. As a result of various experiments carried out over the last five decades, the State has developed a fairly well-designed primary health care service, and it is in operation in rural areas. However, there appears to be a striking gap between the delivery of health services in rural areas and utilization of the services by the people. Attempts have been made in this article to apprise the readers of the health service system in India, and it discusses the issue of health service delivery at the village level. The discussion is based on a small study carried out in a rural area in the State of West Bengal (India) where students of social work of the University to which the author belongs are placed for field work. Following the inputs received through supervision of the students' work, the study was initiated and conducted.

This article based on the study seeks to focus on peoples' perception of the health services as provided by the State in rural areas, which in turn gets reflected in the extent to which they utilize the services. Social workers being an integral part of the health set up, their role bears special significance. Discussion, therefore, centres on scope for social work intervention at the community level as well as in institutional level of the health service delivery system to make the services meaningful and effective in rural areas. In fact, it has to take the leadership role in reforming the service delivery system when required.     

Exploring cultural economies of internationalization: the role of ‘iconic individuals’ and ‘brand leaders’ in the globalization of headhunting

Understanding the internationalization of professional services like advertising, architecture, accounting, consulting and legal services continues to attract considerable attention in academic and policy circles. Research in geography and management studies has emphasized the different organizational strategies adopted by firms as they seek to develop and maintain a competitive position within an increasingly global economy. In this article we develop a new strand in this literature by adopting a cultural economy approach to argue that an important, yet comparatively neglected, aspect of the internationalization strategies of transnational professional service firms is the role of certain ‘iconic individuals’ and ‘brand leaders’ in influencing the practice of internationalization. Drawing on empirical research into the burgeoning European executive search (headhunting) industry we identify a cadre of such individuals and brand leaders that act as resources other firms leverage when internationalizing. This highlights the importance of a cultural economy perspective in theories of the internationalization of professional services and its value in moving discussions beyond purely economic analyses of competitive advantage.