The Influence of Rural and Urban Substance Abuse Treatment Counselor Characteristics on Client Outcomes

Focus group data was collected from 28 substance abuse treatment counselors employed in rural and urban areas to examine their perceptions of factors influencing treatment outcomes. The influence of the counselor characteristics (i.e., education, experience, and recovery status) on client outcomes and geographic differences are explored. Focus group data was analyzed by three raters using line-by-line coding, focused coding, and memoing. This analytic approach revealed geographic differences in the counselors' perceptions of the effect of counselor education, experience, and recovery status on client outcomes. Recommendations for treatment planning and future research are provided.     

Client Improvement and Working Alliance: Case-Manager Factors

ABSTRACT

To investigate working alliance and other factors in case managers' perceptions of client improvement, data were collected from 95 case manager–adult client pairs from community-based agencies. Per the multiple regression results, client improvement as perceived by case manager increased with level of working alliance as perceived by case manager, and with manager age and social work education at the bachelor's level and master's level. Such improvement decreased with level of client substance abuse as perceived by manager. No association was found between client improvement as perceived by case manager and four further tested factors: level of working alliance as perceived by client; homogeneous gender and ethnicity of client and case manager; case manager work experience; duration of client working with the current case manager. Implications for practice and education are discussed.     

Student Perceptions of Financial Literacy: Relevance to Practice

ABSTRACT

The relevance of financial literacy to social work has been framed almost exclusively in the context of poverty relief, but this study expands this framework to the evidence linking financial stress, not merely poverty, to adverse client outcomes. Using a new 15-item, quantitative instrument, student (N= 1,506) perceptions were collected. Respondents demonstrated a moderate awareness of the relevance of financial literacy in 11 of 15 problem issues commonly encountered in practice, indicating a moderate receptivity to financial education. Future research should clarify the contours of financial knowledge that is required to assist clients.     

Utilizing a Required Documentation Course to Improve the Recording Skills of Undergraduate Social Work Students

ABSTRACT

Baccalaureate social workers respond to documentation and record-keeping demands of regulatory organizations that oversee or fund social service agencies. Learning to accurately document client needs, progress, and service delivery outcomes is important in ensuring that clients are receiving effective services. Despite the importance of documentation skills, many undergraduate social work programs do not provide sufficient curriculum content on client record keeping. The authors report the results of a study that examined changes in baccalaureate social work students’ perceptions of their documentation skills after completing a required documentation course. The sample size included 101 students at pretest and 97 students completing the post-test. Statistically significant findings show students perceived an increase in knowledge in three areas of documentation: 1) formats, 2) content, and 3) writing skills. The authors discuss implications for social work education and practice.     

Differences by Race in Social Work Students’ Social Distancing,Treatment Options,and Perceptions of Causes of Mental Illness

ABSTRACT

Research has shown that racial and cultural differences are related to the degree of social distancing associated with mental illness, beliefs about what causes mental illness, and what treatment options are best; however, there is little information on how this may manifest in social workers’ perceptions of these issues. This cross-sectional survey analyzed the differences in perceptions by race of 835 students enrolled in social work classes in the United States. Results indicated that individuals who self-identify as African American/Black expressed the greatest social distance concerning mental illness. Whites were most likely to endorse the use of medication and were least likely to normalize mental illness. The most frequently endorsed mental health provider varied according to racial/ethnic groups. Our findings show that future research may be needed to further investigate the conceptualization of the role of social work among different groups. The need for self-reflection and keeping biases in check are discussed as implications for social work practice and education. Suggestions for working with diverse clients, including religious diversity, are offered as well.     

A Primer for Social Worker Researchers on How to Conduct a Multinomial Logistic Regression

ABSTRACT

The purpose of this article is to explain how to conduct a multinomial logistic regression (MLR) to increase its usage among social work researchers. A challenge for social work researchers carrying out practice-based research is to incorporate statistical analyses that are comprehensible to clinicians. Another challenge is that categorical variables, as opposed to continuous, commonly occur in clinical settings, yet their usage is seldom taught in social work education. This article will discuss MLR, a categorical data analysis used when there are three or more unordered categories in the outcome variable. Multinomial logistic regression determines differences across client groups, and can be useful in assessment, case planning, and examination of outcomes.     

Defining Service Coordination: A Social Work Perspective

ABSTRACT

This pilot study explores the meaning of and factors that influence coordination as a first step toward conceptual refinement, theory development, and system interventions. Using data from treatment guidelines archived by the National Guideline Clearinghouse (n= 9) and semistructured interviews with social workers (n= 4), themes related to the definition, indicators, and perceptions of coordination were explored using a grounded theory approach. Data suggest the need for coordination is driven by complex client needs, but the quality of providers’ personal relationships influences coordination. Future research might examine the impact of standardization of roles, referral procedures, and treatment philosophies.     

Treatment Utilization Among Metropolitan and Nonmetropolitan Participants of Corrections-Based Substance Abuse Programs Reentering the Community

ABSTRACT

This study examines differences in drug use and recidivism outcomes at 12 months postrelease from jail or prison as a function of geographic location and treatment utilization. Participants (N= 700) were previously enrolled in drug treatment during the last 6 to 9 months of their incarceration and were released to the community on either parole or serve-out. Findings from this study indicated that offenders returning to metropolitan areas reported more use of community treatment services following release than offenders in nonmetropolitan areas. Although offenders in both metropolitan and nonmetropolitan areas who reported community treatment following release were less likely to be reincarcerated, community treatment utilization was not a significant correlate of relapse. Findings are discussed, and future directions include favorable outcomes when community treatment is utilized.     

Redefining Success: A Qualitative Investigation of Therapeutic Outcomes for Noncompleting Drug Court Clients

ABSTRACT

Utilizing a convenience sample from a drug court program, the authors investigated the benefits of treatment for noncompleting drug court clients (n = 30). Using an as-treated design, the qualitative investigation assessed whether noncompleters received any benefit from their drug court experience. In-depth interviews were conducted to determine both benefits gained and reductions in harm that occurred as a result of drug court participation. Data analysis was guided by the grounded theory method. Outcomes of coding indicated that participants' motivation and self-efficacy were enhanced through the intervention. Further, participants reported that their relationships with family, therapists, or peers were improved as a result of their involvement with drug court. Individuals in the study sample reported abstinence or decreased substance use, as well as improvements in employment and/or educational attainment. Participants’ perceptions of barriers to program completion were also noted. Study outcomes suggest that expansion of a harm reduction approach in social service practice may have utility for drug-abusing populations. Limitations of the research, including lack of generalizability, are discussed. Further research of harm reduction effects with a larger, heterogeneous sample size is recommended.     

Impact of an Infusion Model on Social Work Students' Aging Knowledge,Attitudes, and Interests

Abstract

This study sought to provide data regarding the use of infusion of gerontological materials throughout curriculums to enhance students' attitudes toward older adults, their knowledge of aging-related issues, and their perceptions of gerontological social work. A quasi-experimental design was used to compare outcomes for graduate social work students who were and those who were not exposed to gerontological infusion. Results indicated that exposed students experienced a greater improvement in their view of aging-related career opportunities and in their belief in the importance of gerontological social work. Treatment group students also showed greater gains in self-rated aging knowledge. Both treatment and control group students had significant gains in a test of aging-related knowledge. Pedagogical implications are discussed.     

Frame modifications with a dying client

Abstract

This paper explores the nature of the treatment frame with a client in extreme circumstances. A move is made, through frame alterations, from a more “pure” technical mode to a more humanistic one. The costs and gains of these frame modifications are evaluated and the therapist's internal experience of the process presented. The paper concludes that the traditional frame is inadequate in therapy with a dying client. Blending the customary frame with a more flexible one more fully meets the needs of the client who is in extremis, enhancing treatment and the treatment alliance.     

Wearing Two Hats: Clinical and Ethical Implications of Combining Individual and Group Treatment

ABSTRACT

The purpose of this qualitative case discussion is to reflect on the practice of combined therapy where the group worker and the individual clinician are the same person. The authors find that in the complexity of today's practice environment this phenomenon may not be simply a matter of clinician, or even client choice, but may exist as a required component of program service offerings. Often, an ad hoc or haphazard approach to the combined treatment modality can submerge the worker into clinical and ethical quagmires potentially damaging to client and the group. This article examines how the judicious use of combined individual and group approaches can offer a viable model of intervention across varied theoretical domains and practice settings. Vignettes and practice examples are used to illustrate the discussion.     

Primary Health Care Workers' Views about Social Work

Summary SUMMARY A comparison of the views about social work held by 188 primaryhealth care workers—118 GPs, 31 health visitors and 39district nurses—working in the same teams is presentedhere.^* The study focussed particularly on their perceptionsof social workers, their role and performance. The data indicatea general acceptance of the social work role, but a lack ofknowledge of or extensive criticism about, social work performance.Significant differences of view emerged about social work training,role and clients, indicating occupation is a significant factorin perceptions held. In particular, the client group predominantlydealt with appears to have had an impact on perceptions. However,views about social work performance did not differ greatly,suggesting the influence of occupation on perceptions shouldnot be overstated.     

Utilizing a Continuing Education Workshop to Increase Knowledge of Documentation Among Hospital Psychosocial Staff

ABSTRACT

Hospital-based psychosocial staff including social workers, mental health counselors, and marriage and family therapists utilize documentation skills to assess, treat, and manage patients admitted to inpatient settings. Little research exists that examines the impact of continuing education on documentation skills. This study examined changes in hospital-based psychosocial staff perceptions of their documentation skills after attending a two-part continuing education documentation workshop. The quantitative, pretest–posttest design utilized a convenience sample that included 32 staff members at pretest and 30 staff members completing the posttest. Results from the 51-item pretest and posttest survey indicate that the continuing education workshop statistically increased participants’ knowledge of progress notes and termination summaries. Findings did not indicate any differences when comparing knowledge, at the start of the workshop, for employees with prior documentation training, longer work experience, or different license groups. The authors discuss implications for practice, continuing education, and future research.     

Social Workers' Experiences of Virtual Psychotherapeutic Caregivers Groups for Alzheimer's,Parkinson's,Stroke, Frontotemporal Dementia,and Traumatic Brain Injury

ABSTRACT

The objective of this study was to examine the challenges for social workers who transition from facilitating face-to-face psychotherapeutic groups to online web-based video groups with family caregivers of persons with chronic disease. Study data consisted of survey responses of a group of therapists who had facilitated a series of web-based video-conferencing caregiver groups over a period of 4 years. All therapists were trained using an intervention training manual and weekly supervision. They received minimal training with regard to using technology (computers, Internet, web cams, and headsets). Despite reported challenges in how the technology affected the group process, therapists described overall positive experiences transitioning from face-to-face to working online. All therapists reported that group interactions and client outcomes in the Internet environment were overall comparable to those that occur in face-to-face groups.     

Home-Based Practice with Older Adults

Abstract

Social work with older adults frequently occurs in the client's home. Although practitioners and the professional literature acknowledge the existence of differences between agency-based and home-based practice, little attention has been given to the way the home environment impacts on the intervention process. This exploratory study examined practitioner-identified events that impact on the intervention process in home-based practice. The events elicited two general categories, the context and the process of interventions. Factors subsumed under intervention context are situational and geographic factors, such as practitioner and client comfort, and differences in urban and rural environments. Examples of intervention process categories include setting up home visits, assessment, boundaries, common distractions, and termination in home-based practice.     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.     

Being the Only One: Finding Connection through the Shared Experience of “Otherness”

ABSTRACT

There is a noticeable paucity of clinical resources that help clinicians of color to name and navigate the multitude of challenges in working through racial, cultural, and power differences in psychotherapy with White clients. African American therapists rarely receive adequate preparation for clinical practice in identifying, addressing, and working through transference and countertransference reactions in racially mixed dyads. The author highlights the challenges she faced early in her career with addressing racial and sociopolitical differences as an African American female clinical social worker providing individual psychotherapy to her older White male client whose traumatic experience focused on racial issues.     

Social Workers' Implementation of Client Participation: What Factors Make the Difference?

ABSTRACT

Client participation is both a value and a strategy in social work, involving clients in decisions influencing their lives. Nevertheless, the factors encouraging its use by social workers in social services have received little research attention. This article reports on a study drawing on Goal Commitment Theory to examine, for the first time, four categories of variables that might predict its implementation: background variables (intervention method, age, experience, education, supervision); personal resources (self-esteem, mastery); organizational variables (superiors' support, organizational commitment); and situational factors (previous client participation, perception of client participation).

A sample of 661 Israeli social workers completed questionnaires. Hierarchical regression analysis and t-tests revealed that intervention method, mastery, superiors' support, and both situational variables contributed significantly to explaining the variance in client participation. Moreover, social workers valued client participation significantly more than they used it. The implications for researchers and professionals in social services are discussed. Proper training could increase social workers' awareness of client participation and provide tools for implementation. Policy makers should set standards for its use and evaluation, and require its inclusion in all interventions. Further research investigating clients and managers of social services could provide a broader picture of the factors impacting client participation.     

Exploring African American and Latino Populations Perceptions of Parenting Education Programs: A Qualitative Assessment of Enablers and Barriers

Abstract

Parenting education programs aim to enhance the quality of parenting. Preferences vary between African American and Latino parents, but the context is not well known, and the ethnic/racial differences may have implications for parenting education programs. Focus groups were conducted with seven African American and eight Latino parents, and semi-structured interviews with eight key informants. This qualitative assessment provided information to identify barriers and enablers to participation in parenting education programs. Enablers included parental interest in learning about the developmental stages of their children, the convenience of locations and times, and incentives. Minority parents desired to obtain adequate parenting education. The scarcity of culturally sensitive programs, transportation, affordability, and childcare were significant barriers. There were both significant similarities and differences between the two parent groups. From the perspectives of African American, Latino parents and key informants, a range of resources are necessary to enable the participation and the delivery of high-quality parenting education. The findings from our research will help address the unmet parenting education needs of African American and Latino parents. Future research should work to develop a tailored and culturally sensitive parenting education programs to reduce the divergence between parents and service providers.