Resilience,mental health and Assertive Community Treatment

Clinicians try to promote resilience by building an effective therapeutic relationship with their clients. Assertive Community Treatment (ACT) is an established approach for providing services to individuals with severe mental illness who have not fared well in the regular mental health system. This work underscores the importance of a resilient therapeutic relationship in preventing relapse and assuring adherence to therapeutic outcomes. Persistent psychiatric illness takes a toll on the resilience of the client, while the relationship work takes a toll on the resilience of the clinician. This article explores the concept of relational resilience between clinician and client as a dynamic process of shared success and failure, progress and regression through cycles of crisis, stabilization, relapse, and partial recovery. This is a qualitative study exploring how ACT clinicians promote and sustain resilience and is based on interviews with social workers, nurses, occupational and recreational therapists, coordinators, and psychiatrists.     

Understanding the longer-term effects of family group conferences

Few studies estimate the longer-term effects of family group conferences (FGCs), as previous research has been mainly qualitative or has focused only on the shorter-term effects of FGCs. This study analyses, using a randomised controlled design, the longer-term effects of adult FGCs in terms of social support, mental health and re-employment. A total of 149 Norwegian longer-term social assistance recipients were randomly assigned to intervention and control groups. Participants were followed up 12 months after baseline. To gain in-depth knowledge of the FGC process, 15 participants were interviewed. Despite high shares of participant satisfaction and significant shorter-term effects, the one-year follow-up identified neutral effects of the intervention. Qualitative interviews demonstrated that lack of reciprocity in social relationships and lack of follow-up were the main reasons for the stagnation of an initially positive FGC process.     

Examining the Relationships Between Resilience,Mental Health,and Academic Persistence in Undergraduate College Students

Abstract

Objective: In this study, the relationships between measures of interpersonal resilience, intrapersonal resilience, and mental health were examined with respect to academic and social integration, key determinants of academic persistence. Participants: A sample (n = 605) of undergraduate students was recruited from 2 midwestern universities during the 2007–2008 academic year. Methods: Hierarchal (or sequential) regression analysis examined whether the inter- and intrapersonal resilience and mental health measures contributed to explaining variance in the response variables of university cumulative grade point average (GPA) and university sense of belonging. Results: The intrapersonal resilience factors contributed to explaining variance in cumulative GPA in addition to aptitude and achievement. Furthermore, there was a strong statistical correlation between the inter- and intrapersonal resilience factors and mental health. Conclusions: The demands in college are significant and there is a need for more research on the concept of resilience as it relates to college health and academic persistence.     

Examining the Incidence and Clients’ Experiences of Single Session Therapy in Italy: A Feasibility Study

Single session therapy (SST) postulates that one session can be sufficient for a client to take charge of the process and work toward their own solutions. Research has been conducted worldwide corroborating SST assumptions with several mental health conditions, but not in Italy. For the first time in Italy, this paper aims to explore: (1) if the most frequent number of sessions in traditional psychotherapy (not SST) is one (Study 1); and (2) the satisfaction of clients who attend SST services and the number who consider one session sufficient to address their presenting problem (Study 2). In Study 1, the records of 476 voluntary clients referred to three different traditional (not SST) psychological services in the west-central region of Latium, Italy, were retrospectively screened, and the number of sessions attended by each client recorded. In Study 2, 85 consecutive clients who voluntarily asked for SST with seven mental health professionals across Italy received a link to an online ad hoc survey, 1–3 weeks after the consultation, evaluating their experience. Study 1 found that the most frequent number of traditional psychotherapeutic (not intentionally SST) sessions was one (124 out of 476 clients (26%). Study 2 found that 44 out of 85 clients (52%) considered one session to be enough, as they felt better or much better and chose not to attend further sessions. Of those who asked for a second session (41 clients), 33 clients (80.5%) indicated that the first session was not enough and 8 clients (19.5%) wanted to address a new problem. These results converge with previous international studies and provide encouragement for the use of SST in both private and public psychological services to address the demand for timely mental health services in Italy. Further research is needed to support the efficacy of SST and to evaluate its cost-effectiveness.     

Improving mental health assessments in child protection through audit

Existing agency records, together with questionnaires completed by social services referrers and mental health providers, were used to identify problems in current arrangements for obtaining specialist mental health assessments in child protection cases. Standards were set and implemented through a multi‐agency steering group. The practice of referrers and providers was then reaudited. Sixty‐nine social workers, six mental health specialists and 27 child protection initial case conferences (involving 31 children) were involved in the reaudit over a 4‐month period. Initially, main problems concerned communications, unclear referral and access arrangements, waiting times and disagreements over prioritization. Standards concerned consultation and decision‐making arrangements within the child mental health service, the format of referral and reply letters, the sharing of information and the attendance of mental health professionals at child protection case conferences. There appeared to be improvements in all these areas at reaudit. In conclusion, some shared views of problems, additional support funding and the audit process appear to have helped to improve inter‐agency collaboration and develop more efficient referral and care arrangements. There is a need to maintain and further develop this work, and audit would again be a useful means. Copyright © 1999 John Wiley & Sons, Ltd.     

How Effective are Interventions to Enhance Adherence to Psychiatric Medications? Practice Implications for Social Workers Working With Adults Diagnosed With Severe Mental Illness

This study integrates eight systematic reviews of adherence enhancement interventions to develop practice guidelines for social workers who work with adults who do not adhere to prescribed psychiatric medications. Findings indicate that existing investigations are disparate in their adherence definitions, methodologies employed, and sampling strategies, rendering it difficult to construct overall guidelines for social work practice. However, themes associated consistently with increased adherence are collaboration between clients and providers regarding medication decisions, consistent follow-up care, and a comprehensive network of professionals and caregivers who support clients in their use of medication to facilitate stabilization of mental health symptoms.     

Police encounters among a community sample of children and youth accessing mental health services

Generally, within the Canadian context, scholarship on police encounters with persons living with mental illness has focused on the experiences of adults and not children and youth. In this article, we present preliminary work of a secondary data analysis of intake statistics collected over a 5-year period (2009–2014) and a thematic content analysis of qualitative intake notes collected over a 2-year period (2009–2011) about police involvement among a community sample of children and youth accessing mental health services. Of 8,920 intakes completed, 1,449 children and youth, birth to 24 years old, had had police involvement at the time of accessing mental health services. Over the 5 years, the average number of young people with police involvement at the time of accessing mental health services was 16%, or one in six children and youth. Analysis of the qualitative intake notes revealed two main reasons for police involvement: (1) support in the home for a distressed child, and (2) concerns about a child’s conduct and behaviors in the community. The implications for social work practice and future research are discussed.     

Reclaiming Self

In this article I use performance poetry pieces to reflect upon my experiences of living with a disability as a person of color, a woman, and an immigrant. It is my firm contention that, although listening to the stories of the clients we meet on our journeys is integral to creating individual and structural changes and raising awareness of mental health issues, as social workers it is just as important to share our own personal and collective stories of mental health, stigma, and recovery. As helpers and change makers, it is unlikely that we can influence mental health policy purely from behind the wall of positivism. Stories of clients as well as stories of our lived experiences are critical to challenging the strong divide that characterizes the social work academy: the us/them, service provider/service user, and the expert/client. Furthermore, my hope is that this article will add to the literature concerning the traumas experienced by immigrant women in their private domains.     

Mental Health Professionals' Exposure to Clients with Problematic Internet Experiences

ABSTRACT

This paper examines clients' exposure to problematic Internet experiences among a national sample of 2,098 social workers, psychologists, marriage and family therapists, and other mental health professionals. This analysis finds that mental health professionals are working with clients experiencing a range of problems related to Internet use. However, these professionals have generally not been exposed to training or information in the professional literature on the topic of working with clients with problematic Internet experiences. We identify several areas in which additional training is needed and review practical implications for mental health professionals.     

Outcomes Measurement

SUMMARY

Outcomes measurement in health and mental health should be of vital concern to social workers since public support and financing will follow evidence of effectiveness. Social work in health and mental health requires a framework for conceptualizing outcomes measurement so that the profession can focus clearly on the work to be done in outcomes measurement. This framework should distinguish among the various ways that outcomes measurement can be used to advance policy, program and practice. This article discusses two applications of outcomes measurement, namely for improving policies and programs, and, second, for conducting outcomes research. Other dimensions that could be included in an outcomes measurement framework for social work in health and mental health are identified but not elaborated. The author's objective is to make a strong case for the role that outcomes measurement can play in both the improvement of social work policies and programs in health care, through performance measurement, as well as in advancing the healthcare knowledge base, through outcomes research.     

Counseling with Muslim Refugees: Building Rapport

Recent social work literature has stressed the importance of considering culture when working with individuals with mental health problems. This paper presents my personal experience, journaling, reflections, and research as a mental health social work practitioner and researcher working with refugee clients with mental health problems from a Muslim background. It also draws on my research experience in cross-cultural mental health. The paper emphasizes the significance of building rapport especially in the earlier stages of the professional relationship.     

Psychological distress among mental health social workers

This study employs the General Health Questionnaire (GHQ-12) in order to examine psychological distress among Greek mental health social workers. The findings are examined in the light of the respondents' demographics, professional characteristics (educational background and work experience), work perspectives (job satisfaction and perceived work efficiency) and perceived financial strain. The study took place two years after austerity measures were imposed in the country. A self-addressed questionnaire employing 4-point Likert-type scale items was posted to 154 mental health social workers residing in an urban area in Greece. A statistical analysis of the 65 returned questionnaires identified frequencies and correlations in the corpus of the data. According to the findings, 15% of the practitioners were within the psychological distress range. When compared to their non-psychologically distressed counterparts, the psychologically distressed respondents were clearly differentiated according to their professional characteristics, work perspectives and perceived financial strain.     

Multidimensional Resilience: Predictive and Construct Validity of the Individual,Family, and Community Resilience Profile

Few measures parallel the robust depth offered in the existing multidimensional and ecologically informed theories of resilience. This study sought to evaluate the test–retest reliability, construct, and predictive validity of the individual, family, and community resilience resource profile (IFCR-R). The IFCR-R measures a family’s access to resilience resources and protective factors across multiple ecological levels. Confirmatory factor analysis was used with a sample of n?=?810 low-income families. And 159 families completed multiple time point measures for test–retest reliability and predictive validity evaluation. Results of this study support the proposed multidimensional ecological structure of the IFCR-R and found that the IFCR-R offers an acceptable test–retest reliability and predictive validity for outcomes of mental and physical health.     

Changes in the association between social housing tenure and child outcomes across cohorts: comparing the millennium and British cohort studies

ABSTRACT

In recent decades, social housing in the UK has increasingly become the preserve of the poorest in society. This paper is the first to investigate how the child outcome penalties associated with social housing tenure have changed over time across UK cohorts. I compare the differences in the cognitive, mental health, and physical health outcomes of children in social housing with children in non-social housing and evaluate whether these tenure differences have changed between the 1970 British Cohort Study (BCS) and the 2000 Millennium Cohort Study (MCS). I find that in both cohorts, children in social housing exhibit worse outcomes across all three dimensions (cognitive, mental health, and physical health) than children in non-social housing. For cognitive and physical health outcomes, however, the tenure difference has narrowed between the two cohorts, while for mental health outcomes, the tenure difference has widened. These results suggest that children have experienced a relative worsening in their mental health outcomes across cohorts, but also a relative improvement in both their cognitive and physical health outcomes. The findings suggest that policies aimed at reducing tenure inequalities in child outcomes should focus on mental health development in the early years.     

Value of Self-Disclosure to Parents and Peers During Adolescence

Self-disclosure is a crucial part of developing close interpersonal relationships during adolescence. In particular, sharing information with a greater depth of intimacy is thought to strengthen social bonds and thus support mental health. The current study investigated the value for different depths of self-disclosures to close others (mothers and best friends) during adolescence and its association with mental health and well-being. Fifty-four girls (11.0–15.9 years) completed a forced-choice monetary paradigm to assess value for self-disclosures and questionnaires on mental health. Participants significantly valued (i.e., forfeited monetary reward) for disclosures to both mothers and best friends, although intimate disclosures were more “costly” than superficial disclosures. Greater value for intimate self-disclosures to mothers was also associated with better mental health and well-being.     

Creation and evaluation of a maternal mental health course

Perinatal Mood and Anxiety Disorders (PMADs) engender significant and increasing personal, social, developmental, and economic burdens to women, children, families, and global public health. In the US, a Master of Social Work (MSW) elective course, Introduction to Maternal Mental Health, was created to prepare future social workers to better understand, detect, intervene, and advocate with women struggling with perinatal mental health concerns. A pilot study used pre–post-surveys (N = 10) and a focus group to examine students’ knowledge acquisition, course satisfaction, and perceived self-efficacy. A Wilcoxon signed-rank test showed a statistically significant difference between pre- and post-survey course content knowledge scores. Positive focus group feedback and survey outcomes suggest that students benefitted from the course in terms of increased learning and professional efficacy in maternal mental health; however, the study should be replicated using a larger sample and comparison group. The course outline provided may be used to develop a similar course or to infuse maternal mental health content into existing courses. The paper concludes with implications and recommendations for social work educators.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

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.     

Public attitudes toward disclosing mental health conditions

This study examined public perceptions about mental illness, specifically investigating individuals’ concerns about disclosing a mental condition and the potential outcomes of doing so. This survey asked 570 adults whether they would disclose a mental condition in four different scenarios: seeking health care, employment, academic or vocational counseling, and for background checks. Respondents were then asked to identify the reasons they would agree or refuse to disclose. Only in a health care situation were respondents very favorably inclined to disclose. A significant percentage of people in all scenarios were unwilling to disclose, citing privacy as a primary concern.