Social Work Assessment of Adaptive Functioning Using the Vineland Adaptive Behavior Scales

Abstract

The assessment of client adaptive functioning is often an important component of a comprehensive social work evaluation. The Vineland Adaptive Behavior Scales (VABS) are the most commonly used quantitative measures of adaptive functioning for clients meeting the criteria for a wide range of disorders. We review the development of the VABS and current knowledge pertaining to the instrument's reliability and validity. We conclude that the ability to administer and interpret the VABS is an important skill for clinical social workers to acquire.     

Individualized Career Counseling Outcome Assessment: A Case Study Using the Personal Questionnaire

Career counseling has evolved to include practices that attribute a central importance to context variables and meaning‐making processes. Accordingly, there is a need for client assessment tools that consider the subjectivity and cultural specificity of clients and the interface between their work and life concerns. The idiographic assessment of outcomes, which uses individualized measures that involve clients in the definition of person‐specific items, is a promising approach. This article explores the use of the Personal Questionnaire (PQ) as an individualized outcome measure that complements standardized outcome career measures. The authors identify the factors leading to the emergence of idiographic assessment in career counseling, review existing research relevant to the need for the PQ, and present a case study of career construction counseling that illustrates how the PQ helps counselors to obtain sensitive and contextualized assessments of career counseling outcomes, guides interventions, and facilitates meaning making.     

An empirically derived typology of mentally ill group home residents.

The classification of clients in terms of psychiatric diagnosis or level of functioning is a logical prerequisite to the conduct of quality of care assessments in mental health care. This article reports on efforts to create a typology of mentally ill group home residents based on a variety of measures of functioning. Subjects for the study come from a probability sample of 253 group home residents in Michigan. A three group typology, derived through cluster analytic procedures, is presented along with-evidence supporting its validity. Implications of the typology for program evaluators and service system planners are briefly addressed.     

The need for explicit argumentation in ethical decision-making in social work

This article addresses the need for social workers' explicit argumentation in ethical decision-making, i.e. the justification offered in adopting a particular course of action with their clients. It is the main assumption of this article that social workers need to be aware and explicit of the personal and professional ideas, concepts, values, and assumptions that guide their practice. In the following sections we clarify central concepts such as argumentation and its explicitness, present a conceptual framework for analyzing ethical decisions in social work, illustrate its applicability on social work dilemmas, and discuss possible implications for social work practice and education. Finally, we recommend that social work education put emphasis on: (1) developing more awareness for inner deliberations and making these explicit and amenable for evaluation; and (2) developing specific skills for explicit argumentation in ethical decision-making.     

The History of Interest Inventories and Career Assessments in Career Counseling

Interest inventories and career assessments continue to be used to support practitioners as they work to uncover client interests, abilities, skills, motivations, values, and other personal factors that help individuals self‐define and construct their career. The skilled use of career inventories and assessments remains a minimum competency of career service providers' ability to successfully partner with their clients. A history of the evolution of assessment from 1914 through 1974 and considerations for the future of assessment are highlighted to provide historical perspective to inform practitioners as they serve the diverse needs of complex client populations.     

Three dimensions mental health professionals emphasize when judging levels of functioning of the severely mentally disabled in the community

Ratings of the level of functioning of severely disabled clients collected from staff of mental health agencies, while attractive as outcome measures, lack specificity and, at times, consistency. Three multidimensional scaling (MDS) studies were conducted to identify the dimensions staff emphasize when they compare clients as to their level of functioning. Analogues of clients were created to serve as stimuli, dissimilarity judgments of pairs of stimuli were collected, and an individual differences MDS model was applied in each study to distinguish client variance from the judges' perspectives. Ratings along specified dimensions also were collected and compared to the MDS solutions. One dimension emerged as pre-eminent, but it corresponded to many of the pre-selected dimensions, such as competence with daily living tasks, clarity of thinking, appearance and manner, and overall functioning. The other two dimensions were belligerence and openness to psychological intervention or distress with one's problems. Differences among judges were sizable; nevertheless, considerable support for emphasizing these three dimensions was found upon reviewing the contents of other assessments of functioning. Concentrating on these three dimensions of functioning may promote greater agreement among raters, highlight where functional improvements occur, and expand the coverage of functional differences without markedly increasing the costs of assessment.     

Winnicott and clinical social work: A facilitating partnership

This article examines the applicability of D. W. Winnicott's theoretical concepts to clinical social work practice with clients whose psychosocial well-being has been compromised by environmental deprivation and related developmental vulnerabilities. This examination is organized around three questions: (1) Why is Winnicott relevant for social work? (2) Which of his concepts are most useful for social workers? (3) How can these concepts be put into practice with social work problems and populations? The translation of theory to practice is illustrated with case material.     

Developing a Rubric for Supervision of Students Counseling LGBTQ Clients

More than 100 pieces of anti-lesbian, gay, bisexual, transgender (LGBT) legislation are active in 2018. In this current political climate of “conscience clause” legislation, counselor educators and supervisors are poised to adopt more holistic practices in assessing and evaluating student and supervisee readiness to work with LGBT queer (Q) clients. The purpose of this article is to present a dispositional framework for assessment and evaluation and introduce the flexibility, integrity, awareness, stability, compassion, and openness (FIASCO) rubric of professional counseling dispositions. Two court cases, Keeton v. Anderson-Wiley and Ward v. Wilbanks, are used as case examples for applying the FIASCO rubric to situations involving LGBTQ clients.     

A Computer-Assisted Self-Interview (CASI) Assignment in the MSW Classroom

ABSTRACT

This article reviews the research regarding computer-assisted self-interviews and describes a specific program, the Addiction Severity Index-Multimedia Version (ASI-MV), a self-administered audio assessment of substance use as well as concurrent psychosocial problems. This program was integrated into a graduate substance abuse course through a simulated exercise intended to introduce students to computer-based assessments. Students (N = 21) later evaluated the exercise and their reactions to computerized assessment at the end of the semester. Overall, students reported increased assessment skills, more comfort with the use of computers to assess clients, and willingness to incorporate computers into social work practice.     

Repairing the nest: A psychodynamic developmental approach to clients with severe behavior disorders

In this article, the authors explicate concepts from psychodynamic developmental theory that can foster affirmative assessment and intervention with clients who have developmental disabilities and present severe behavior disorders. A case example illustrates how making bonding the primary goal of intervention appears to facilitate positive behavior change in these clients while reducing feelings of helplessness and discouragement in their caregivers.     

Methodological challenges in the implementation and evaluation of social welfare policies

As social reality is quite elusive, even regarding seemingly well-recognized everyday concepts and objects, there are always methodological challenges underlying assessments and evaluations of implementation policies. The present article addresses this area of concern by presenting the results of a rereading of an empirical study of elderly home care services. Our results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. We claim that this has methodological implications for evaluation of implementation policies in general.     

Construct validity of the instrument DOA: a dialogue about ability related to work

This study examined the construct validity of the newly developed instrument A Dialogue About Ability Related To Work (DOA). DOA [18] was developed using concepts from the Model of Human Occupation [20] as theoretical framework. The instrument assumes the assessment of work ability by both the client and the occupational therapist, and is followed by a dialogue which is expected to distinguish possible goal-setting for further rehabilitation [18,19]. Twenty-one professionals and 126 clients from three clinics in Sweden participated in the study. All clients were involved as outpatients in psychiatric work rehabilitation in county councils or community services. Results of a Rasch analysis test indicated that items are well separated and generally work together in five unidimensional continuums to measure work ability. Twenty-nine of 34 items showed goodness-of-fit statistics, which means acceptable infit MnSq values from > or = 0.6 to < or = 1.4 in association with Z values from -2 to 2. The five misfit items have to be revised. The study has indicated that DOA is a valid instrument in psychiatric work rehabilitation and ought to be useful in the dialogue between occupational therapists and clients about goalsetting and treatment planning.     

Therapy with Transsexual Youth and Their Families: A Clinical Tool for Assessing Youth’s Readiness for Gender Transition

The World Professional Association for Transgender Health’s Standards of Care suggests a letter of recommendation be provided from a mental health professional if a transsexual desires hormone therapy or surgery. Therefore, transsexual clients have a unique dependence on therapists to obtain medical treatments needed to live life in their affirmed gender. Despite this need for therapeutic services, most therapists lack the training that is necessary to sensitively serve transsexual clients, particularly transsexual youth. While a published clinical assessment tool exists for therapists to determine readiness of adult transsexual clients for medical gender transition, no similar tool is available for therapists working with transsexual youth. This article discusses therapeutic issues specific to transsexual youth and families and presents a clinical assessment tool for determining transsexual youth’s readiness for medical treatments.     

New Zealand Vietnam Veterans’ Family Programme,Nga Whanau a Tu (Families of War): Development and Outcome

This article reviews recent research concerned with the association between combat-related posttraumatic stress disorder (PTSD) and interpersonal functioning, before describing the development of a pilot program established to provide mental health services for Vietnam veteran family members. The results of a brief program evaluation are also presented. Sixty clients provided posttreatment and six-month follow-up data on a variety of outcome measures which were compared with independent ratings returned by 33 therapists. On average, clients reported that counselling had been beneficial and indicated satisfaction with services received. However, at posttest, therapists indicated that approximately 50% of clients were in need of continued treatment. There was a decrease in satisfaction with services over the posttest-follow-up period, but no change on most measures of psychotherapy outcome.     

Gender-Sensitive Social Work Practice: A Model for Education

Many social work educators are in search of ways to integrate course content on women while preserving time-tested models of assessment and intervention. Although women comprise the majority of social work clients, most psychological models of assessment and intervention are based on male psychological development. In contrast, feminist theories and therapies have turned attention to female psychological development and how this differs from male progression. This article describes and discusses a psychotherapeutic model for practice and education that allows for balanced gender sensitivity and that can be readily superimposed on existing models for more effective assessment and intervention.     

Building Culturally Sensitive Assessments for Transgender Clients: Best Practices for Instrument Development and the Adaptation Process

ABSTRACT

This article focuses on best practices for developing, adapting, and using assessments with transgender clients. The historical context of gender minorities in counseling is discussed, outlining the bias and stigma that has been attached to transgender identities. Due to this historical bias, most assessments use heteronormative language and were not developed for use with gender minorities. As such, we used the guidelines put forth by the American Counseling Association (ACA), the Council for Accreditation of Counseling and Related Educational Programs (CACREP), and the Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) to present a guide for developing and adapting assessments for the transgender population. Finally, the authors discuss the clinical application of using a trans-sensitive assessment process for counselor educators and clinicians.     

A principles-focused evaluation of community mental health short-term case management

Principles-focused evaluations allow evaluators to appraise each principle that guides an organization or program. This study completed a principles-focused evaluation of a new community mental health intervention called Short Term Case Management (STCM) in Toronto, Canada. STCM is a time limited intervention for clients to address unmet needs and personalized goals over 3 months. Findings showcase that a principles-focused evaluation, assessing whether program principles are guiding, useful, inspiring, developmental and/or evaluable (GUIDE), is a practical formative evaluation approach. Specifically, offering an understanding of a novel intervention, including its key components of assessment and planning, support plan implementation and evaluation and care transitions. Findings also highlight that STCM may work best for those clients ready to participate in achieving their own goals. Future research should explore how best to apply the GUIDE framework to complex interventions, including multiple principles, to increase evaluation feasibility and focus.     

Clinical family assessment: applying structured measurement procedures in treatment settings*

This article describes the use of a battery of structured family measurement procedures to conduct systematic, comprehensive assessments of families who enter treatment. The measures are derived from family research and include self-report questionnaires and structured observation of family interactions. The assessment is multimodal, and examines the entire family unit, the marital subsystem, the individual family members, and the larger social context affecting a family. Two case examples are presented which demonstrate how the structured assessment data are combined with clinical theory and other information about a family to generate initial hypotheses about the functioning of the family system and likely avenues for therapeutic intervention.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.