Health Care Reform and the Behavioral Health Workforce

Health care reform will increase the number of individuals who have access to substance abuse services. This impending influx of consumers has the potential of overwhelming the service capacity of providers within the field. Provisions included in the reform legislation might fall short of their intended goal to expand the number of service providers needed to deliver services. This article discusses unmet treatment need in the United States, the current numbers of service providers, and provisions within the reform legislation to increase the labor force. Recommendations are set forth that could help expand the number of providers in the field.     

An International Review of the Long-Term Care Workforce

Abstract

The developed world's population is aging, due to trends of increased life expectancies and decreased fertility rates. These trends are predicted to increase demand on long-term care services. At the same time, the long-term care workforce is in shortage in most of the developed world. Moreover, such shortages are expected to increase due to parallel socio-demographic factors. The increase in demand for long-term care, coupled with shortage in supply of care workers, has promoted some attention from policymakers. The current paper provides an international review of institutional arrangements for long-term care in different developed countries and in particular explores different strategies used or proposed to resolve the shortage in the long-term care workforce.     

TimeOut@UCLA: An Intergenerational Respite Care and Workforce Development Program

TimeOut@UCLA is an intergenerational program that recruits undergraduate college students to provide companionship to older adults with early Alzheimer’s or other forms of dementia in a community setting, providing respite for their caregivers. In the program, 86 students and 89 seniors participated from September 2015 to December 2016. This program appears to reinforce positive attitudes about working with older adults among undergraduate students and gives caregivers an innovative option for respite time.     

Training the Future Workforce: Social Workers in Integrated Health Care Settings

The current study explored social work skills and competencies required for work on integrated health care teams. Semi-structured, qualitative individual interviews were conducted with social workers employed in integrated health care settings. Key themes emerged around existing social work strengths, further training that is needed for this work, and fundamental skills for effective team-based collaboration. Incorporation of content, such as the social work role in integrated health care settings, advocacy in team-based treatment delivery, and incorporating medical knowledge into the social work curriculum are key to strengthening the future workforce. Education strategies can include not only infusion of integrated health care material into existing courses but also micro- and macro-specific elective courses and a range of interprofessional learning opportunities.     

Health Care and Disability NGOs in Croatia: State Relations,Privatization, and Professionalism in an Emerging Field

Although nongovernmental organizations (NGOs) in post-socialist countries have been under a microscope since their inception, their relations with the state are only beginning to come into focus and to be the subject of comparative and theoretical assessment. What these relationships mean to different stakeholders, whether they take trajectories similar to those in the West, and how they will be shaped by socialist legacies, are important questions to address before such relations are naturalized as “the way things are.” This paper examines NGO/state relations in the development of health care and disability services in Croatia, a nation newly admitted to membership in the European Union. The paper explores policy and institutional legacies, health care privatization, and relations with health professionals as forces affecting the financing, structure, and experience of relationships between NGOs and the post-socialist state.     

Incremental Change: The Pace of Progress in Health

Abstract

In a prospective study of acute diarrheal illness among college students, during one academic year, the incidence of Campylobacter enteritis was 5.57 per 1,000. Approximately 17% of all patients with acute diarrheal illness had Campylobacter enteritis. Campylobacter enteritis is briefly discussed. The value of the stool wet-mount examination is emphasized. It can serve as a guide to which stools to culture and often can lead to a presumptive diagnosis of Campylobacter enteritis. Student health center labs are urged to perform stool wet-mount exams and to provide cultures for isolating the Campylobacter organism.     

EAP Service Use in a Managed Behavioral Health Care Organization: From the Employee Perspective

Contemporary employee assistance program (EAP) services are typically provided in broad-brush programs delivered by large external vendors in a network model. Yet research has not kept pace with EAP evolution, including in terms of how EAP clients themselves view services. We surveyed a random sample of EAP service users from a national provider (361 respondents). About one-third of respondents reported getting help for workplace issues. Most learned about the EAP through employer communications such as the company website. The large majority reported that the EAP helped them "a lot" or "some," suggesting they valued this benefit.     

College and University Health Care Professionals: An Expanding Team

Abstract

Factors contributing to students' compliance with mass vaccination programs during meningococcal outbreaks have not been well described. A 1997 mass vaccination campaign at Michigan State University provided an opportunity to study such factors. Of 34 024 students in the target population, 17 538 (51.5%) were vaccinated in 5 days. Vaccination rates were higher for women (47.9%) than for men (43.1 %) and higher for on-campus residents (65.3%) than for off-campus residents (35.6%). For each year of students' age beyond 19, the adjusted odds of vaccination were reduced by 0.82. Adjusted odds ratios for vaccination, with White students as the reference group at 1.0, were 1.33 for Asian American students, 0.97 (not significant) for Hispanic students, 0.82 for African American students, and 0.80 for Native American students. Students from the Colleges of Business, Engineering, Communication, and Natural Science had the highest vaccination rates; those from the College of Arts and Letters had the lowest rates.     

Health care innovations for homeless families: Emerging opportunities under Medicaid and the Affordable Care Act

Prior to the Patient Protection and Affordable Care Act of 2010 (the ACA), the US health care system left many low-income families facing limited access to medical care, struggling with high-health costs, or lacking health insurance altogether. The ACA aims to increase access to care, improve the quality of care, and lower total health care costs. While the ACA can benefit all individuals and families, it has significant potential for expanding and improving services for those experiencing homelessness. This paper describes specific opportunities under the ACA and Medicaid that can be used to strengthen services for homeless families and provides examples of efforts under way. It also offers guidance for how homeless service agencies can effect change in their respective states. The examples described here are promising approaches to strengthening homeless services. Pursuing these ideas for homeless families will require initiative, creativity, and perseverance, but recent progress is encouraging.     

The Aesclepain: An Ancient Model for Health Maintenance

No abstract available for this article.     

Innovative Moments in Career Construction Counseling: Proposal for an Integrative Model

This article advances understanding of career construction counseling (CCC) by viewing it through the lens of the innovative moments model (IMM) of how clients construct change. The IMM conceives clients’ narrative transformations as resulting from counselors prompting and clients reflecting on exceptions to a problematic self‐narrative (i.e., innovative moments; IMs) that emerges in counseling dialogues. On the basis of intensive IMM analysis of CCC case studies, the authors propose an integration of the 2 models that describes the sequence of client change in IMs across the 3 phases of CCC. This proposal provides both conceptual and assessment tools that make it possible to describe and analyze the process of client change through life‐designing dialogues. The authors illustrate the integrated framework with vignettes from case studies and conclude by suggesting research to examine the validity and usefulness of the client change sequence and interventions for using this pattern of change to foster client transformation.     

Japanese Education in an Era of Internationalization: A Case Study of an Emerging Multicultural Coexistence Model

Abstract: Responding to the pressure of internal internationalization, some local communities and schools in Japan started to generate and practice a new philosophy known as “multicultural coexistence” (tabunka kyousei). Based on a long‐term ethnographic research in one of the most progressive multicultural communities and elementary schools in Japan, this paper elucidates the shape of an emerging “multicultural coexistence” education model in Japan and provides some implications for its further development. By focusing on returnee and newcomer students enrolled, the paper argues the transformation of school culture, which will be delineated as an interaction among different agencies at the school: “the margin”, “the top”, “the outside” and “the inner core”. From these ethnographic findings, the paper draws five main features of the emerging model—three that are positive and two that are potentially problematic:

• 1 community‐based school reform movement,
• 2 teachers as decision makers, learners, and cooperators,
• 3 students’ knowledge and experience as a shared resource,
• 4 country‐oriented approach in difference/similarity framework,
• 5 treating all differences equally same.

Referring to the critiques of multicultural education in the United States of America, the discussion suggests that the issue of social justice should be addressed more in the model by highlighting the issue of ethnicity in Japanese society. Changing teachers’ attitudes toward such direction is vital and the paper proposes that coherent set of institutional changes, which centre around social justice, are necessary to raise teachers motivation.     

A Nonrecursive Causal Model of the Health Care Delivery System*

The phrase “health care delivery system” is often used in both the popular and scientific literature. However, most research only examines one aspect of the system. We specify a causal system that links client characteristics and the structure, process, and outcomes of medical care. We also specify reciprocal effects among three outcomes of medical care: health status, client satisfaction, and visiting the docior. For each effect, we test a medical model hypothesis and two critiques of the medical model; a moderate critique and a radical critique.     

The Clubhouse Model of Community Support for Adults with Mental Illness: An Emerging Opportunity for Social Work Education

The Clubhouse Model of community support is enjoying renewed interest among social workers and social work educators concerned with alternatives to traditional forms of community mental health treatment and rehabilitation. This article describes the model and its underlying congruence with social work theory and practice. Findings of the National Task Analysis Study of Social Work Practice are presented that suggest an increasingly important role for social workers and social work educators in the continued growth of this practice model.     

An introduction to methodological challenges in the evaluation of eHealth research: Perspectives from the Health e-Technologies Initiative

In February 2002 the Health e-Technologies Initiative (HETI), a program office of the Robert Wood Johnson Foundation^®, was created to advance discovery of scientific knowledge regarding the effectiveness of interactive eHealth applications. This article is the introduction to a series of seven articles written by grantees of HETI which address challenges, lessons learned, and proposed solutions as researchers implement eHealth projects. From this body of work it is clear that the overall process of conducting evaluation research in eHealth requires careful and detailed planning, recognition of the heightened sensitivity of IRBs, and institutions around the electronic collection and communication of personal health information, and a combination of tenacity and creativity to address the inevitable thorny methodological challenges to eHealth research. Use of established guidelines to help standardize the evaluation process, where feasible, is recommended.