Preparing social workers for practice with LGBT populations affected by substance use: perceptions from students,alumni, and service providers

Trends in the field of service among those with alcohol and other drug addictions highlight the urgent need for schools of social work to effectively train students to serve clients with substance use disorders, and have cultural humility to effectively serve disproportionately affected LGBT consumers. Online surveys and interviews examined perceptions of graduate social work students and alumni in a certified alcohol and drug counselor program, along with several service providers within an urban setting in the US. Results indicated that students and alumni did not feel adequately prepared through coursework to practice with LGBT populations affected by substance use, while feeling more clinically competent to practice with LGB individuals, than with transgender consumers. Similar findings related to unique differences associated with perceptions of faculty support, along with field preparedness to practice with LGB individuals when compared to transgender individuals. Service providers noted an overall commitment and to serve LGBT consumers as well as positive perceptions of students and alumni to do the same. Implications examine the role of faculty in addressing challenges related to preparation of social work students to practice with LGBT consumers affected by substance use disorders, along with suggestions for curricular changes, and ongoing field trainings.     

Learning opportunities through camping for mental health nursing

1. To equip nurses with the skills necessary for working with disturbed people, nurse educators need to be mindful of not watering down the essential skills necessary for nurses to deal with difficult behaviour in all branches of nursing. 2. These components of a mental health clinical experience should equip the graduate to deal with the pressures of dealing with disturbed people in any environment, as the skills learned generalize to any branch of nursing. 3. Universities can combine with traditional hospital services and community mental health services to provide services to clients with mental illness. An additional benefit is in providing students with an intensive clinical learning experience that reinforces the theory taught in the classroom.     

Fear of people with mental illnesses: the role of personal and impersonal contact and exposure to threat or harm

Vignette and laboratory experiments suggest that negative reactions to people with mental illness are a direct consequence of their symptomatic behavior, but because of their poor external validity, these studies cannot tell us whether widespread negative public reactions to people with mental illness actually result from observation of symptomatic behavior. Focusing on perceived danger, we use a large national survey to test the "behavior hypothesis" in the general population. We reason that, if this hypothesis is correct, contact with people with mental illnesses should be associated with more perceived danger, and exposure to threat or harm should mediate this association. On the contrary, respondents with more personal and impersonal contact perceive people with mental illness to be less dangerous. Exposure to threat is more common among people with more contact, but this exposure explains very little of the variance in perceived danger. These findings do not support the conclusion that public fear of people with mental illness is due to the observation of violent behavior.     

Enough is enough: Grandmother caregivers' strategies for mitigating out-of-school suspensions for African–American youth

This qualitative study explores the strategies used by grandmothers caring for African–American grandchildren with out-of-school suspensions drawing from a larger study of caregivers. In-depth, semi-structured, individual interviews with 10 grandmothers who were caring for a total of 13 grandchildren with a range of 1 to 14 out-of-school suspensions (OSS) revealed that these grandmother caregivers took action with both their grandchildren and the grandchildren' s educators. Grandmothers became intensely involved with school and in-home educational activities. They structured their relationship with their grandchildren to attend to affection, provide incentives and respond with appropriate consequences. Additionally, grandmothers identified services and programs received and needed to enhance the grandchildren' s engagement with the learning process. Furthermore, based on strong opinions about changes needed in the schools, they provided concrete recommendations to educators. These recommendations call for professionals to support grandmothers' actions to reduce OSS and advocate to educators to revise policies and procedures that would promote a better understanding of grandchildren in the care of their grandmothers and the efforts that these grandmothers make to mitigate OSS.     

Approaches used by employee assistance programs to address perpetration of intimate partner violence

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.     

Prelinguistic Vocal Development in Infants with Typical Hearing and Infants with Severe-to-Profound Hearing Loss

Delays in the onset of canonical babbling with hearing loss are extensively documented. Relatively little is known about other aspects of prelinguistic vocal development and hearing loss. Eight infants with typical hearing and eight with severe-to-profound hearing loss were matched with regard to a significant vocal development milestone, the onset of canonical babbling, and were examined at three points in time: before, at, and after the onset of canonical babbling. No differences in volubility were noted between the two infant groups. Growth in canonical babbling appeared to be slower for infants with hearing loss than infants with typical hearing. Glottal and glide production was similar in both groups. The results add to a body of information delineating aspects of prelinguistic vocal development that seem to differ or to be similar in infants with hearing loss compared to infants with typical hearing.     

Refugee resettlement and the Convention on the Rights of Persons with Disabilities

The Convention on the Rights of Persons with Disabilities (CRPD) created pathways for people who are refugees with disabilities to resettle and build new lives. Resettlement country Australia, in response to its CRPD obligations, created greater access to the waiver of visa health requirements for humanitarian entrants. This article chronicles key documents demonstrating that the CRPD has been an effective instrument for improving access to resettlement for people with disabilities. The article also describes new challenges to Australia’s compliance with the CRPD as it fails to address multiple discrimination of people from refugee backgrounds with disabilities, an area of concern to the Committee on the Rights of Persons with Disabilities for which it has issued guidance. This article proposes creating a United Nations High Commissioner for Refugees Resettlement Submission Category for disability to improve resettlement programmes’ compliance with the CRPD.     

Prevalence and economic well-being of families raising multiple children with disabilities

This study estimates the prevalence of households raising more than one child with disabilities, and examines these families' economic well-being. Using pooled data from the 2004 and 2008 Survey of Income and Program Participation we compare households with multiple children with disabilities (n = 932) to households with one disable child (n = 3457) and to households with at least one child but none with disabilities (n = 21,378) on measures of material hardship. Three percent of U.S. households with children had more than one disabled child. Compared to other households with children, those with multiple children with disabilities were significantly more likely to have income below the federal poverty level and to report material hardships. The number of children with disabilities is an important contextual variable for studying the economic circumstances under which, care is provided to children with disabilities. Its implications for practice and policy are discussed.     

Collaborations with faith‐based social service coalitions

Based on the first national survey of faith‐based social service coalitions in the United States, this article presents data on the degree to which these nonprofit organizations collaborate with other specific organizational types, as well as the range and intensity of these collaborations. In general, faith‐based coalitions tend to collaborate most frequently with other faith‐based agencies, a pattern especially characteristic of the more religiously expressive ones. However, collaboration with non‐faith‐based organizations is also quite common. Based on seven organizational characteristics, we are able to predict which faith‐based coalitions are most likely to collaborate with different types of organizations: coalitions that have more explicitly religious policies and practices with reference to clients and staffs are less likely to participate in intense collaborations with some types of secular organizations, and consistently less likely to do so with all types of governmental agencies.     

Multisystemic Therapy for Disruptive Behavior Problems in Youths With Autism Spectrum Disorders: A Progress Report

Youths with autism spectrum disorders (ASD) often engage in serious disruptive behaviors that interfere with their ability to successfully manage day‐to‐day responsibilities and contribute to relationship problems with caregivers, peers, and teachers. Effective treatments are needed to address the factors linked with disruptive behavior problems in this population of youths. Multisystemic therapy (MST) is a comprehensive family‐ and community‐based treatment approach that has been effective with other difficult‐to‐treat populations of youths and holds promise for youths with ASD. In this article, we review the broad range of factors associated with disruptive behaviors among youths with ASD and discuss how MST interventions can be adapted to address those factors. We also present a framework for our adaptation of the MST model for youths with ASD. This framework includes a recently completed pilot study as well as an ongoing efficacy trial that together have served to identify key interventions for our adaptation of the MST model.     

Patronizing Speech to Older Adults

We measured the use of patronizing speech among young adults who were instructed to provide directions (via an internet connection) to a newcomer to campus described as 21 or 65?years old. As predicted, the acoustic properties used with older adults were moderated by the speakers?? history with older unrelated adults (no comparable effects were found for speakers?? history with grandparents). Participants with relatively low contact with unrelated older adults were more likely than those with high contact to be judged as sounding ??patronizing?? and to display acoustical properties associated with patronization (high vocal intensity, high pitch) with older newcomers. However, participants showed a shared tendency to speak more slowly to older than young adults. Findings inform our understanding of the circumstances under which ageist speech is amplified or attenuated.     

Social work with people with disabilities in Croatia: a qualitative study

In conducting this study, the authors aimed to gain insight into social work with people with disabilities. Due to the lack of research in this field, qualitative methodology was applied. Using semistructured interviews, data were collected about 30 respondents: 10 people with disabilities, 10 parents of people with disabilities, and 10 social workers who work in the public sector with people with disabilities. Analysis of the results revealed characteristics of approaches to social work, knowledge and skills used in working with people with disabilities, difficulties related to specific work with clients, and the position of the profession in society.     

Variations in provider capacity to offer accessible health care for people with disabilities

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Listening to Older Women with Dementia: relationships, voices and power

Four older women with dementia were interviewed about their experiences of their services. People with dementia are rarely asked for their opinions or judged to be fully legitimate persons. Gaps in previous research concerning people with dementia is presented, with respect to listening to people with dementia themselves and with respect to gender issues. The present study is described and the methodology for analysis, Brown and Gilligan's Voice Relational Method, is presented. This method was developed to listen to adolescent girls and has been used to listen to the voices of others who are disempowered in society. Its focus on relationships and issues of power was useful in this study. The methodology is presented in the context of debates within feminist and disability research. The results of the interviews are discussed, particularly with respect to power in the women's relationships, and particularly the relationships between the women with dementia and medical staff. Some implications of these power issues are presented and recommendations are made.     

Marital Quality and Spouses' Marriage Work With Close Friends and Each Other

Through in‐home interviews with 142 married couples, we explored how husbands' and wives' marriage work with close friends and one another was linked to their perceptions of marital quality. Results showed that husbands engaged in more marriage work with their wives than with close friends, whereas wives engaged in similar levels of marriage work with their close friends and husbands. For wives, marriage work with their spouses was found to moderate the relationship between marital quality and marriage work with friends. At low levels of marriage work with their spouses, wives' marriage work with friends was negatively related to their reports of marital love and positively related to reports of ineffective arguing. In contrast, at high levels of marriage work with their husbands, no significant relationship was found between wives' marriage work with friends and marital quality for wives. Findings underscore the role of spouses' friendships and suggest that the strength of spouses' ties to one another is linked to the social context they and their close friends create.     

Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Predictors of Change in Self-Reported Social Networks among Homeless Young People

This research investigates changes in social network size and composition of 351 homeless adolescents over three years. Findings show that network size decreases over time. Homeless youth with a conduct disorder begin street life with small networks that remain small over time. Caregiver abuse is associated with smaller emotional networks due to fewer home ties, especially to parents, and a more rapid loss of emotional home ties over time. Homeless youth with major depression start out with small networks, but are more likely to maintain network ties. Youth with substance abuse problems are more likely to maintain instrumental home ties. Finally, homeless adolescents tend to reconnect with their parents for instrumental aid and form romantic relationship that provide emotional support.     

Couples Therapy: Unravelling the Strands

Work with couples is one of the more widely practised forms of counselling or psychotherapy, yet seems to have found it difficult to establish its own identity and theoretical base. A theoretical tradition specific to work with the couple relationship has, however, developed over the past 40 years. Recently, this tradition has become more clearly demarcated and has begun to show signs of vigorous growth. It is important for therapists whose primary identification is with individual or family therapy, but who work with couples, to be familiar with this theoretical tradition, and with its practice implications. This paper selects six aspects of theory relating to couples therapy that the author has found useful in practice, and seeks to show how, separately and together, they can illuminate the nature and dynamics of the couple relationship.     

Therapeutic Communication with Psychotic Clients

With the current emphasis on evidence-based practice, the significance of the social worker–client relationship as a prerequisite to client goal attainment has been de-emphasized. This is particularly problematic with regard to practice with psychotic clients, with whom practitioners often have difficulty establishing therapeutic relationships. The purposes of this article are to examine the communication deficits of persons with psychotic disorders and, with an extended example, to describe five intervention guidelines for social workers toward the goal of developing positive working relationships with them.     

The sibling relationship as a housing alternative to institutionalization in later life

The nature of the sibling relationship in middle and later life and the potential of living with a sibling as an alternative to institutionalization when independent living may no longer be possible was assessed using interviews with a random sample of 41 persons 56 to 84 years of age. Forty-nine percent of the respondents had lived with a sibling in adulthood usually for more than one year and over one-half would consider living together again. Men were somewhat more likely to have lived with a sibling in adulthood than were women. When a sibling went to live with another sibling, it was to a sister's home in 90 % of the cases. Almost none had previously considered living with a sibling in later life but ranked living with a sibling second to living in a nursing home and ranked it comparably with living with children. When asked directly their willingness to live with a sibling in later life, respondents were almost equally divided. Age, number of children, educational level, and a feeling of closeness particularly in middle age were found to be moderately correlated with willingness to live with a sibling.Dolores Cabic Borland earned a Ph.D. from Texas Women's University in Sociology and is presently an Associate Professor in Family and Child Ecology at Michigan State University. Dr. Borland's current research interests include middle age and sibling relationships in middle age and later life.This research was supported in part by a grant from the Michigan State University Foundation, Grant # (ORD 26081) and parts were presented at the 1986 National Council on Family Relations Annual Conference. Requests for reprints should be sent to Dolores Cabic Borland, Ph.D., Department of Family and Child Ecology, Michigan State University, East Lansing, Michigan 48824-1030.