Making it ‘APP’en: service user feedback: developing and implementing a service user APP: reflections from Northern Ireland,England and Scotland

Despite the advent of social media and increasing use of smart phone technology amongst global and UK populations, APP’s for social work remain in their infancy. Several have been developed which focus on the education of social workers and practitioners providing information on specific social work issues, and one we are aware of that explores ethics and values using a games-based approach. In this paper, we discuss the importance of service user perspective in social work practice and how this informed the development of the feedback App. We reflect on developing this instrument using digital technologies which social workers can use to gather anonymous feedback from service users about their experiences of social work interventions. This project, developed in response to demands placed on social work agencies to evidence the effectiveness of service interventions, provide robust data from service users for inspection regimes and sustain service user involvement in improving services. The evaluation model is designed to document the implementation process, exploring what works and what barriers, challenges and lessons were learned by the project team together with how some of the tensions in the process were addressed and resolved.     

Engaging families in child welfare services: an evidence-based approach to best practice

Successfully engaging clients in the helping process is a critical task for child welfare practitioners. Drop-out and noncompliance rates in child welfare services are high and lead to high rates of removal of children from their families and to eventual termination of parental rights. Although no known interventions guarantee treatment compliance, this review of the empirical literature delineates critical components of engagement in child welfare services. Effective engagement strategies, including service components and caseworker qualities and behaviors, are identified as contributing to the positive case outcomes of treatment compliance, family preservation, and placement prevention. The unique needs of neglectful parents are also examined, with recommendations for practice.     

Computer-based Information Systems and Human Service Organisations: Emerging Problems and Future Possibilities

Abstract

Standardised case management systems were designed to address poor outcomes for abused or neglected children. Their introduction has been controversial, with some social workers identifying them as undermining the social worker–service user relationship, and professionalism. This paper reports on a qualitative study of service users of two widely used systems in Australia: “Looking After Children” (LAC) and “Supporting Children and Responding to Families” (SCARF) (both based on adaptations of United Kingdom systems). There has been relatively little evaluation of the long-term use of these systems relevant to Australian social work. The experiences of service users can contribute to debate because they provided lived experiences of these systems and family members' inclusion is a central goal. Children, young people, and parents reported positive experiences of case-managed interventions: the goals of the intervention were usually clear, processes productive, and relationships with social workers possible. However, service users did identify barriers to participation, limitations in assessment, and described diverse experiences of interventions. While these findings challenge critics, they also suggest that LAC and SCARF could be further developed to better meet expectations of families.     

The Perceptions of Welfare Reform by Michigan Families Whose Children Have Disabilities and Welfare Caseworkers

Abstract

This article examines family and caseworker perceptions of welfare reform and services as they relate to families who have a child with a disability. Interviews were conducted with 39 families and 77 caseworkers. Family questions addressed their perceptions of the welfare system, factors impacting their self-sufficiency, and their perceptions of needed program changes. Caseworker questions addressed their perceptions of welfare practices and policies and their education needs related to serving families who have children with disabilities. Familial perceptions of the welfare system were validated by caseworker reports. Implications for service improvement are discussed.     

Hospital social work in Sweden and the UK: Access to chances of physical health and well-being

In Swedish and UK practice, interest is developing in social work's contribution to tackling service users' unequal chances and experience of physical health. This is through alleviating disadvantaged social conditions such as relative poverty which service users face and which are associated with health inequalities. Ready access to social work services is an essential preliminary if service users are to gain the material and social resources services can provide, to alleviate their adverse social circumstances and thereby improve their health prospects. However, despite hospital social work's well-established position, its significance as an access point for services has tended to be marginalized. Drawing on a comparative account of Swedish and UK practice featuring two action research projects, we explore how hospital social work is a key point of access to services for service users experiencing profound disadvantage. We analyse major barriers to such access, notably the underfunded nature of hospital social work, discriminatory procedures, and unequal professional service user power relations. Nevertheless, the action research projects show how these barriers may be breached to some degree, enabling service users as patients and carers to access resources which contribute to more equal chances of health and well-being in ill-health.     

Internet-Based Interventions for Addictive Behaviours: A Systematic Review

Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.     

New Technology and the Human Services

Summary

Much has been written about the effects of new technology on the human services and about its possible implications for agencies, practitioners and service users. There is also an important and expanding literature on the implications of new technology for society as a whole, including much which addresses issues of social justice. Until recently, however, there have been only a few attempts to explore the range of issues specifically concerning the relationship between social justice and the human services. My main purpose here is to start to sketch out the parameters of the field of study relating new technology to social justice in the human services and to explore some of them in depth.

Three examples of different definitions of social justice are introduced, viz.; justice as equity; flexible individualised justice; and empowerment. Then normative and ethical considerations in relation to new technology in the human services are briefly reviewed. In the main body of this paper these issues are brought together in relation to three key areas (i) the manager/professional interface (ii) strategies for new technology implementation-top down or bottom up and (iii) the relationship between social worker and service user. Finally some conclusions are drawn about the possibilities for a synthesis between competing visions of social justice.     

Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.     

Examining needs of informal kinship families: Validating the family needs scale

Families who provide informal kinship care are a critical part of child welfare, yet our understanding of their needs is limited due to the challenges of identifying the population. The absence of validated and reliable instruments for kinship families is an additional barrier. This study tests the psychometric properties and construct validity of the Family Needs Scale. A sample of 303 informal kinship families recruited through local child welfare and social services completed the scale as part of a demonstration project. An eight-factor structure emerged from psychometric testing. The FNS is strongly associated with other predictors of the needs such as income and parenting stress, suggesting the instrument's potential as a need assessment tool for kinship families. Further replication and robust analyses of the FNS structure will build stronger support for the scale as a needs assessment for kinship families.     

After family treatment drug court: maternal, infant, and permanency outcomes

This study reports on maternal functioning, infant developmental, and permanency outcomes for 52 families following maternal participation in a family treatment drug court (FTDC) for perinatal substance users. Although the majority of families experienced positive child welfare outcomes, over time, maternal functioning deteriorated and infant developmental concerns were identified. Even when promising interventions like FTDC are used, long-term needs of families affected by perinatal substance use need to be considered and addressed.     

Communications Technology—empowerment or Disempowerment?

Developments in communication technology can reduce dependence on others and facilitate independent living for disabled people. Recently developed telephone-based services allow users to call up help quickly, as and when they need it. But the dominant model of provision emphasises vulnerability, assumes a need for protection and imposes rules about appropriate use. The article identifies the influence of manufacturers and providers of communication alarms in perpetuating paternalistic approaches to services for older disabled people and limiting the potential for user determination of need. Emergent models which aim to facilitate user-control face low expectations among users, the entrenched attitudes of providers and the dominance of the market in influencing practice. The mixed economy of social care is likely to increase the gap between providers' interests and users' needs.     

‘It's People's Whole Lives’: Gender,Class and the Emotion Work of User Involvement in Mental Health Services

The concept of emotion work has been widely applied to the study of service work. Yet its use in understanding the social dynamics of user involvement in public services remains under explored. Drawing on a study of user involvement in mental health service development, I show its utility for understanding this social and political realm. The article discusses findings from a critical discursive and contextual emotional labour perspective, taking into account organizational and institutional factors as well as social structural dimensions of gender and social class. It shows how discourses on emotion, constructed through articulation of personal experiences of service usage both reflected and constructed the ideological and structural positionings of women service users, while emotional discourse — displays of anger in user involvement forums — worked to constitute traditionally male and ideologically masculine elements of the field, as well as the working‐class identities of some participants. These forms of emotion work, and the ways in which they elicited further emotion management from service users and workers alike, are located in relation to the rules of engagement of user involvement and the bureaucratic institutional forms within which this took place. The article concludes that the emotion work of user involvement ultimately helped to reproduce the dominant institutional and social order, including its gender and class dimensions. Implications for policies and practices of user involvement in mental health services are provided.     

Social gradients and participant characteristics in child behavior problem interventions

A social gradient has been found in both children's behavior problems and among the users of services that treat such problems. If low-resource families are simultaneously at higher risk of having a child with behavior problems and less inclined to use services to address such problems, healthcare inequality and social inequity could be exacerbated. I focus on social gradients in participant characteristics in two evidence-based parent training interventions that target children who display behavior problems: Parent Management Training—Oregon Model (PMTO) and Brief Parent Training. This study extends the literature on social gradients in participant characteristics by focusing on family social and economic resources independently and in an additive cumulative risk index. I investigated potential social gradients overall in a pooled sample and in separate analyses relating social gradients to more intensive treatment. The results revealed inverse social gradients among the intervention participants compared with the Norwegian general population of families with children; intervention participants had fewer social and economic resources. The inverse social gradient was partially replicated through analyses that focused on treatment intensity. Families with fewer resources were more likely to receive high-intensity treatment; however, these associations disappeared for families with > 3 cumulative risks. These results indicate that these PMTO interventions do not exacerbate social inequality by serving a high-resource population.     

Accredited Mental Health Social Work in Australia: A Reality Check

Abstract

Accredited mental health social workers (AMHSWs) have a great deal to offer the clients they see in their private practices, many of whom have complex needs. However, they are constrained by the inflated expectations Government has about evidence-based psychological interventions. The restrictions placed on the professional private practice of AMHSWs by Federal Government Medicare funding of a narrow set of psychological interventions ultimately limits the services received by clients. In this article, the findings of a survey of AMHSWs are presented, highlighting the tensions between individualised responses promoted by Medicare payments, and those premised on principles of social justice and social inclusion.     

Building Social Inclusion for Rural Older People Using Information and Communication Technologies: Perspectives of Rural Practitioners

Abstract

The literature identifies rural, older people as at risk of social exclusion, as a result of rural disadvantage. In this context, improved access to information and communication technologies (ICTs) has potential to build social inclusion, yet current evidence shows that rural, older people are the lowest current users of technology. This paper draws on the practice and local knowledge of rural practitioners from one Victorian region in order to explore: (a) the practice issues associated with ICT use among rural, older people; and (b) the characteristics of effective practice models in the rural, social work context. An analysis of findings highlights the need to respond to the diverse skills, needs, and learning styles of older people, to demonstrate the benefits of ICTs, involve users, and build confidence. Major barriers include poor ICT usage by many rural agencies and low practitioner capacity, as well as access and resources.     

Involving Services Users in Social Work Training on the Reality of Family Poverty: A Case Study of a Collaborative Project

In the last five years there has been an increased drive to include the perspectives and contributions of service users in social work education in the United Kingdom. In this paper we discuss the experience of one project that attempted to bring together service users, academics and practitioners to jointly develop and deliver a module that sought to examine the perspectives of families living in poverty who were in receipt of children and families social work services. Through doing this it was hoped that it would be possible to raise practitioners’ awareness of how poverty impacts on parenting and how they could develop an approach that was non‐punitive and genuinely supportive. The paper starts by exploring the context of service user involvement in social work education and then describes the development and process of this collaborative project. The paper concludes with recommendations for both projects seeking to engage service users in empowering and meaningful ways, as well as social work practice within an anti‐oppressive framework.     

Sudanese and Somali Refugees in Canada: Social Support Needs and Preferences

The aim of the study was to identify the unique support needs and preferences of African refugees in Canada. In‐depth interviews were conducted with Sudanese and Somali refugees (n=68) living in two cities in central and western Canada. Refugees were interviewed individually to identify their support needs, current sources of support, available support programmes, barriers to access to support resources, and preferred support interventions. These refugees reported major support needs, depleted social networks, and barriers to accessing services and supports. They identified distinct preferences for support from peers from the same country of origin and professionals. Participants wanted group‐level support supplemented by one‐to‐one support. Transportation, child care, meals, and peers matched by language and gender were recommended to enhance accessibility to support programmes. These findings can inform the design of support intervention research and enhance the relevance and supportiveness of services and programmes for recent refugees.     

Parents' Perceptions of Services for Children and Youth with Emotional and Behavioral Disorders

Increased concern about the pervasive problems children and youth with emotional or behavioral disorders (EBD) experience has led to the planning and development of alternative approaches to serving these individuals and their families. One alternative approach includes the development of a comprehensive, community- based system of care. This study encouraged parent participation in a county-wide needs assessment designed to facilitate the development of a system of care. Parents were surveyed to gather their views regarding their experiences with various service agencies as well as their input into how comprehensive services could best be developed and implemented. The survey focused on (a) family needs, (b) existing barriers to comprehensive individualized care, and (c) specific service priorities for system development. Suggestions for future research and implications for developing such services are discussed.     

Building on users' knowledge as a basis for professional expertise? An example from Swedish social care services

Implementing new occupations in social care services as a solution to social problems challenges the knowledge base for social care. This has been particularly evident in services for persons with disabilities. Social policy has emphasized influence over services for persons with disabilities and hence has implemented personal assistance and case management services. Using these as examples, this article explores the professional logic developed, and the ways it relate to existing social professions. The results are presented in a typology defining two occupations as examples of a professional logic based on users’ knowledge. This logic, here called ‘user-mandated professionalism’, is denoted by wide discretion, relationships with users built on trust, and legitimacy mainly stemming from user organizations. The analysis then raises the challenge for social professionals in social care occupations based on users’ knowledge to be explicit about the knowledge base they build on in their arguments and in decision-making.     

An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research

Discussions about user involvement in the mental health services tend to throw up four major areas of concern: the capacity of service users to participate, their lack of participation skills, the need for a positive organisational culture and the need for arenas of participation. This article presents evidence from participatory action research with Irish mental health service users which explored how they could more equally participate in advisory committees. Participants identified barriers to their equal participation due to unequal cultural, physical, mental and economic resources, time, power, ‘stigma’(prejudice) and lack of respect for their experiential knowledge and emotional expression. These barriers fall within the ‘equality of condition framework’ developed by Baker and colleagues. Enabling equal user involvement in strategic decision‐making requires more than arenas of participation – it requires comprehensively addressing service users’ structural disadvantages throughout the process of involvement.