Youth and Provider Perspectives on Social Service Providers' Roles in Mental Health Services

ABSTRACT

In 1994 and 1996, the Youth Services Project interviewed 792 youths from St. Louis City. Although the youths showed a high need for mental health services (20% met diagnostic criteria), less than half of the youths with problems received services. Past contact with a social service provider, but not a teacher, physician, etc., significantly predicted care for mental health problems (odds ratio = 1.5). Social service professionals (largely social workers) served more youths than did any other profession. Of youths with persistent problems, 25% received services from social service professionals, 3% from MD/PhD level psychiatrists or psychologists, 7% from primary care medical doctors, 12% from teachers/coaches, 15% from other helpers, and 37% received no services at all.     

Parenting Style and Religiosity as Predictors of Antisocial Behavior Among Nigerian Undergraduates

Abstract

The relationship between parenting style, religiosity and antisocial behavior (ASB) was investigated in this study. Participants were 228 (120 males and 108 females) undergraduates. Participants’ age ranged from 16 to 20?years (M?=?18.9?years). They responded to the ASB scale, Parental authority questionnaire and centrality of religiosity scale. The study utilized a cross-sectional design and hierarchical regression was used for data analysis. Results showed that the model of the three dimensions of parenting styles (i.e., authoritarian, authoritative and permissive) predicted ASB and accounted for additional 11.2% variance in ASB over and above the control variables. However, only authoritarian (β?=?0.13, p?=?0.043) and permissive (β?=?0.32, p?β?=?0.25, p?相似文献   

Ability of the Behavioral Model to Predict Utilization of Five Services by Individuals Suffering from Severe Mental Illness and Homelessness

Abstract

This study examined the ability of the behavioral model to predict utilization of five specific services in a sample of individuals who suffered from severe mental illness and who were homeless at baseline. Nearly 4000 individuals from 18 sites provided data at baseline and 12 months later for this study. Hierarchical logistic regression was used to analyze the data. The behavioral model did not explain much of the variance of utilization of medical services, housing services, and public support. The behavioral model did explain a moderate amount of the variance of utilization of psychiatric services and substance abuse services. Enabling variables explained more of the variance of psychiatric services than either predisposing or need variables. In contrast, predisposing and need variables explained more of the variance of utilization of substance abuse services than enabling variables. Social support from professionals and self-perceived need for service were the most consistent predictors of all of the service utilization variables.     

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.     

Compassion Satisfaction,Compassion Fatigue,and Burnout: A Replication Study with Victim Advocates

Abstract

Past research has investigated the rates of compassion satisfaction (CS), compassion fatigue (CF), and burnout within health-care providers. Findings indicate higher levels of CS and lower levels of CF predict lower rates of burnout. The current study extended prior research by replicating past research findings, but with victim advocates. This study enrolled a national sample of 142 victim advocates. A hierarchal linear regression was run to test the research questions. In level 1, years of experience was not significant and only accounted for 1.1% of the variance in burnout. When adding CS, the model became significant (p?<?.001) and CS accounted for an additional 51.8% of the variance. When CF was added to the final model, it was significant (p?<?.001), and accounted for an additional 19.3% of the variance. When comparing the findings to past studies, our findings were similar; however, our study did find that CS and CF accounted for significantly more variance than past studies with health-care providers. Therefore, CS and CF might be greater predictors of burnout in victim advocates than in health-care providers. Future studies should aim to create interventions to increase CS and decrease CF, to reduce burnout.     

The Substance Abuse Treatment Self-Efficacy Scale

Abstract

Evaluating substance abuse services in ordinary treatment environments requires the use of instruments to measure various dimensions of the intervention process in order to link those processes with client outcomes. This paper reports on the further validation of the Alcohol and other Drug Self-Efficacy Scale (AODSES), designed to measure social workers' perceived self-efficacy with regard to the implementation of substance abuse services. In the first validation study, Kranz (2003) employed exploratory factor analysis to reduce the original 98 items to six factors (43 items) that accounted for 76% of the variance, and demonstrated excellent internal consistency. The current study is a reanalysis of the same data using confirmatory factor analysis, a more stringent test of construct validity. Results were strongly supportive of a 5-factor model with seven of eight indices showing excellent fit of the observed data to the model, and high internal consistency for all subscales. Potential practical applications for clinical evaluation in substance abuse environments and limitations of the study are discussed.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.     

Toward Client-Centered Service: Asking Clients for Their Views of TANF,Food Stamps,Child Care,and Medicaid Services

ABSTRACT

This article presents the results of a randomized study that asked Division of Family and Children Services' (DFCS) clients throughout the state of Georgia to rate their satisfaction with Temporary Assistance to Needy Families (TANF), food stamps, child care services, and Medicaid services, as well as their perspectives of the customer service they received through their county DFCS offices. Telephone interviews were conducted with 2,408 clients. Overall client satisfaction percentages are: TANF, 80%; food stamps, 88%; child care, 92%; and Medicaid, 94%. Satisfaction indices were also created from the data collected. Client suggestions for improvement are presented as well as practice and educational implications.     

Proactive Screening for Health Needs in United Way's 2-1-1 Information and Referral Service

ABSTRACT

Cancer disproportionately affects the underserved. United Way 2-1-1 is an information and referral system that links underserved populations to community services. This study explores the feasibility of integrating proactive screening and referral to health services into 2-1-1. A cancer risk assessment was administered to callers (n = 297), measuring their need for 6 cancer control services. A subset of respondents was randomized to receive generic or tailored referrals to needed services. Nearly all participants (85%) needed at least one of the services. Those who received tailored referrals were more likely to make appointments. Future research will explore approaches to address and eliminate health disparities through 2-1-1.     

Incremental Validity of Stressful Life Experiences in Predicting Psychiatric Comorbidity Among Women in Substance Abuse Treatment

ABSTRACT

The dynamic contribution of stressful life experiences in predicting psychiatric comorbidity continues to challenge clinical practice and research. This study tested incremental validity of stressful life experiences related to psychiatric comorbidity among 128 young women in a Midwestern substance abuse treatment facility. Respondents reported low income, homelessness, and health and mental health issues. Using the Addiction Severity Index (ASI), Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision, and Stressful Life Experience (SLE) Screen as correlates, hierarchical linear regression demonstrated support for incremental validity of SLE uniquely accounting for 6.5% of variance in ASI psychiatric scores. Findings support future use of SLE in clinical settings for assessment and intervention purposes.     

An Ecological Systems Comparison Between Homeless Sexual Minority Youths and Homeless Heterosexual Youths

ABSTRACT

This study examined risk and protective outcomes by comparing homeless sexual minority youths to heterosexual homeless youths regarding family, peer behaviors, school, mental health, stigma, discrimination, substance use, and sexual risk behaviors. Structured interviews (N = 147) were conducted with individuals aged 16 to 24 years old in Toronto. Bivariate analyses indicated statistically significant differences between homeless sexual minorities (n = 66) and their heterosexual counterparts (n = 81) regarding all variables: family, peer behaviors, stigma, discrimination, mental health, substance use, and sexual risk behaviors, with the exception of school belonging. Implications for future research are suggested.     

Predicting Retention in Three Substance Abuse Treatment Modalities Among Anglo,African American,and Mexican American Juvenile Offenders

Abstract

Many of the same factors that predict delinquent behavior also predict adolescent drug use. This study examined factors that predict, and interventions that maximize, substance abuse treatment retention in three modalities among high-risk Anglo, Mexican American, and African American juvenile offenders. The study sample includes youth (N = 211) who were discharged from probation supervision and who received substance abuse services through a CSAT-funded federal demonstration project. The key predictors examined included the stage-of-change (i.e., precontemplation, contemplation, preparation) in which a juvenile fell, various dimensions captured by the Comprehensive Addiction Severity Index for Adolescents, and other intervention status (probation, case management, and mental health treatment). The research questions were addressed using statistical models known as survival analysis that treated time from entry into substance abuse treatment to exit from substance abuse treatment as the outcomes. Among key findings were that females were 73% more likely to leave day treatment relative to males; for each additional family problem ever experienced, Mexican American adolescents were 15% more likely to leave residential treatment compared with African American adolescents; and African American and Mexican American adolescents in the contemplation stage-of-change were 50% less likely to leave day treatment compared with Anglo adolescents. Applications for practice and research with this population are discussed.     

Assessing Health Care Needs Among Street Homeless and Transitionally Housed Adults

ABSTRACT

This study examined the health services received and needed among homeless persons in Hillsborough County, FL (N = 823). Lifetime and current need and receipt of health services were assessed with a cross-sectional survey. Participants reported extensive lifetime and current needs for physical and behavioral health care services. Nearly a third of participants reported current unaddressed health problem(s); an inability to obtain needed health care; and feelings of unaddressed mental health issue(s) as well as substance abuse problem(s) in the past year. Future research on homelessness and health should focus on identifying different pathways to health and mental health services for this vulnerable population and the outcomes of these interventions.     

Disaster Outreach Service Provision

ABSTRACT

This article reports preliminary findings on the development of an index that measures outreach workers' perceptions of the provision of services to survivors of natural disasters. Data were collected from a sample of 64 outreach counselors who worked for Project Recovery during the Great Flood of 1993 along the Mississippi River in Illinois. Factor analyses were used to identify a 15 item index. The fifteen items represent five factors which explained 82.2% of the variance among the items. The resulting Disaster Outreach Service Provision (DOSP) Index has acceptable reliability estimates (Alpha = .83) and appears normally distributed. The index represents an important step in filling the need for measurement instruments designed specifically for use in natural disaster situations. Such instruments can be used in evaluating the provision of disaster relief services and in conducting disaster related research.     

Philanthropy and Government

Abstract

This study examines the effect of characteristics of the caregiving network on the likelihood of using supportive services by dependent older persons. Logistic regression analysis was conducted with a probability sample of community-dwelling elders cared for by their wives or daughters (n = 209). Results indicate that the specific composition of the caregiving networks, including the identity of the primary caregiver (wives vs. daughters), the availability and identity (kin or friends) of secondary helpers determines the likelihood of service use. The findings suggest that elders cared for by their wives alone may be quite isolated and should be the priority for community outreach services.     

Assessing Transfer-of-Learning Potential With Human Services Professionals

ABSTRACT

Transfer of learning (TOL) from training to the job was examined in two different populations of human services workers using the Transfer Potential Questionnaire (TPQ). A cross-validation study was conducted to explore commonalities and differences between public welfare (PW) professionals in California (n = 459) and Child Protective Services (CPS) social workers in Ohio (n = 598). The TPQ significantly correlated with perceived TOL for both training populations and added to the amount of TOL variance explained after controlling for participant satisfaction and perceived learning. Important TOL factors identified for both groups included perceived learning and application planning. Findings suggest TPQ is a valid predictor of TOL for both PW professionals and CPS social workers, supporting a shared construct relative to TOL across human services practice areas. Future research should explore additional TOL assessment methods and seek to further validate the TPQ with other populations of human services professionals.     

Mental Health Service Utilization Among Frail,Low-Income Elders

Abstract

This study was conducted to determine the extent to which service providers in a community-based care program accurately identified and referred elders with symptoms of depression. Interviews were conducted with 79 frail, low-income elders, with the CES-D used to gauge depressive symptomatology. Reviews of their case files were then conducted to determine first, the extent to which case managers recognized depressive symptoms and second, the extent to which respondents who screened with significant symptoms were referred for mental health services. Results suggest an imperfect association between CES-D scores and case managers' perceptions and referrals. Less than 1/3 (31%) of those who screened for depression received counseling.     

Assessing Statewide Need for Older Adult Health Promotion Services: The Oklahoma Experience

ABSTRACT

The growing senior population and persistent poor health status of seniors in Oklahoma compels a fresh look at what health promotion services would be well received. Surveys were distributed to a list of registered voters aged 65 and older in Oklahoma with a total of 1,248 surveys returned (19.8%). Survey items asked about interests in services, classes, and activities, plus current barriers to accessing and/or engaging in such programs. To account for survey weighting, Rao-Scott Chi-Square Tests were performed to determine differences by demographic characteristics. We identified services, classes, and activities that were (and were not) of interest to seniors in Oklahoma with legal assistance (52.1%), exercise classes (46.6%), internet classes (40.7%), and indoor exercise activities (45.5%) receiving the highest level of interest. Barriers to interest in participating in programs included not wanting to go and not knowing availability of such services. The results of this survey provide useful data on health promotion gaps for seniors, interests and barriers to engaging in such activities, and guidance for statewide program development. Future program development needs to be focused on areas of interest for older adults, including legal assistance, exercise classes, and internet classes.     

Association of Personal Distress With Burnout,Compassion Fatigue,and Compassion Satisfaction Among Clinical Social Workers

ABSTRACT

Studies of empathy and empathy-related responding show that while some people respond to observing the suffering of another with a prosocial concern and urge to help the suffering person, others have an aversive, avoidant response that is primarily self-focused and aimed toward relieving their own distress rather than helping the other person. This self-focused response, labeled personal distress, is associated with various social and psychological problems. This article discusses the concept of personal distress and describes a study of licensed clinical social workers (n = 171) that examines the relationship of personal distress and three other aspects of the empathy construct with compassion fatigue, burnout, and compassion satisfaction. Results of ordinary least squares multiple regression analyses indicate that the model of empathy components and control variables explain 20% to 23% of the variance in the dependent variables. Personal distress is the only component of the empathy construct with significant associations with the dependent variables. Higher personal distress is associated with higher compassion fatigue and burnout and lower compassion satisfaction among clinical social workers. Implications for future research and for social work education are discussed.