Appalachian Women: A Study of Resiliency Assets and Cultural Values

ABSTRACT

There is scant literature addressing Appalachian women, their resiliency, and their cultural values. The purpose of this phenomenological study was to explore what constitutes resiliency for Appalachian women. The following research questions were explored: (a) Are Appalachian values reflected in Appalachian women's perceived resiliency during their school-age years, ages 5–18; and (b) if so, which Appalachian values emerged in these women's external and internal developmental assets? Ten Appalachian women were interviewed and asked to reflect on developmental assets during their school-age years. The study results indicated a relationship between developmental resiliency assets during youth as they corresponded with nine Appalachian values. The results indicate that Appalachian women's cultural values foster their strengths and resilience. This study supports the significance of practitioners acknowledging the importance of cultural values in counseling strategy. Implications and suggestions for future research are suggested     

Six-Month Follow-Up Changes for TANF-Eligible Clients Involved in Kentucky's Targeted Assessment Program

ABSTRACT

Welfare reform has been successful in helping clients achieve self-sufficiency. However, some individuals experience problems associated with basic needs, physical health, mental health, substance abuse, and intimate partner violence (IPV) that can impede transitioning from welfare to work and/or interfere with parental responsibilities. The Targeted Assessment Program (TAP) was created more than a decade ago to identify and address these problems and help clients move off the welfare rolls in Kentucky. Self-reported interview data were used to examine changes and effect sizes between baseline assessment and 6-month follow-up from a sample (n = 322) of Temporary Assistance for Needy Families-eligible clients participating in Kentucky's TAP. Using McNemar's test for correlated proportions, paired-sample t-tests, and measures of effect size, significant changes with varied effect sizes were found for selected basic needs, as well as physical health, mental health, substance use, and IPV barriers. Findings suggest that social service practitioners could incorporate strengths-based case management and motivational interviewing into their practice. Further research is suggested utilizing longitudinal and controlled studies on evidence-based practice that address pretreatment and assessment strategies involving case management and motivational interviewing.     

‘We’re Civil Servants’: The Status of Trauma-Informed Care in the Community

ABSTRACT

Trauma-informed care (TIC) in social service organizations means that the organizations operate with the understanding that everyone involved has possibly experienced trauma in their lifetime. This qualitative study examined local service organizations’ usage of the 5 main principles of TIC: safety, trustworthiness, collaboration, empowerment, and choice (as developed by Fallot & Harris, 2006). Ten focus groups (n = 69) and 6 individual interviews (n = 6) with employees from administration through management were interviewed such that almost all facets of each agency were represented. The participants were asked about their agencies’ policies and practices for utilizing the 5 principles of TIC. The results suggest that the vast majority of organizations in this study implemented many of the principles of TIC with clients, though they had not labeled their practices as “trauma-informed.” However, although clients were receiving TIC, some of the principles were neglected as they pertain to staff, such as choice and empowerment. The findings of this study suggest that agencies are unaware of the relevance of TIC as it relates to staff. It is recommended that future research examine whether the use of TIC in agencies prevents “burnout,” high turnover rates, and vicarious traumatization of staff.     

Colorful Disclosures: Identifying Identity-Based Differences and Enhancing Critical Consciousness in Supervision

ABSTRACT

Managing microaggressions and marginalizing experiences while negotiating the ongoing oppression that occurs in micro, mezzo, and macro settings can be particularly challenging for clinicians of color. Thus, supervision with clinicians of color must include affirmation, empowerment, and exploration of the intracultural/intercultural dynamics inherent in the treatment-providing process and clinical supervision. Through case studies, autoethnographic studies of our supervision experiences, and interviews with supervisors and supervisees, we reflect on how axes of identity, including race, power, and privilege, inform practitioners’ clinical lenses and affect their vulnerability in treatment and the clinical supervision dyad. Special attention is placed on the clinical supervisor–clinician–client triad (the triple process) and the interpersonal dynamics of cultural sensitivity, cultural humility, and authentic responsiveness that supervisors aim to model and cultivate in the supervisory relationship. In addition to sustaining clinical growth for clinicians of color, adding this level of complexity to supervision supports equity in direct clinical practice, enhancing efficacy outcomes for clients and communities. Recommendations and pedagogical strategies are offered to support supervisors in initiating difficult dialogues and shifting the paradigm to promote this transformational perspective.     

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.     

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.     

Assessing the Participation of Women in Microfinance Institutions: Evidence From a Multinational Study

ABSTRACT

Microfinance institutions (MFIs) typically offer small credit services with no collateral to low-income clients, particularly women microentrepreneurs. Evidence suggests that microcredit services are an effective tool for the social and financial empowerment of women and have a significant impact on maternal health, children's education, and sustainable economic growth. With multiple financial institutions offering various microfinance services, women's participation as borrowers has changed. We examine the variation in women borrowers’ participation rates in 105 developing countries by analyzing participation rates using selected determinants such as legal status, outreach, external control, and target clients. Results indicate a preference for unregulated MFIs, particularly nongovernmental organizations (NGOs), which suggests that in spite of the advent of formal financial institutions, women in developing countries are more likely to seek loans from grassroots MFIs. However, with more commercial banks offering microcredit and microsavings with a preference for borrowers with assets, women could be left behind. This raises important questions regarding the objectives of microfinance services and empowerment of women. Future studies should examine the impact of transformations of NGO MFIs on low-income women clients.     

Research with Older Adult Methadone Clients: The Importance of Monitoring Suicide Ideation

ABSTRACT

This study reports on the importance of monitoring suicide ideation among older adult research participants. A recently completed randomized controlled trial of older adults who are current clients in methadone maintenance treatment (MMT) served as a case study to elucidate a suicide protocol that was designed to account for the potential instances of suicide ideation within the research project structure. As the numbers of older adult heroin users increases, this study’s findings seek to influence research protocols that involve older adults with addictions who may be particularly vulnerable to suicide risk due to comorbid psychiatric conditions and psychosocial adversities.     

Promoting Self-Efficacy and Self-Esteem for Multiethnic Sexual Minority Youth: An Evidence-Informed Intervention

ABSTRACT

Sexual minority youth face multiple challenges, yet research regarding evidence-informed practice strategies for this population is limited. This study describes the pilot efforts of Strengths First, the first strengths-based intervention created specifically to promote self-esteem and self-efficacy among multiethnic sexual minority youth. A pretest–posttest design was used to gather preliminary data from program participants (n = 162) about the potential effectiveness of the program during a 2-year period that ranged from the inception of the program in June 2008 to September 2010. Significant increases in self-esteem and self-efficacy were found. Implications for social service research and practice are discussed.     

Implementation of Active User Principle: Learning from the Czech Social Services Reform

ABSTRACT

The active user principle introduced in Czech social services by the new Act on Social Services (2007) was expected to induce change of the prevalent paternalistic nature of social service provision. This study examines the relationship between clients and social service workers in social service facilities designed for people without shelter. From 2001 to 2008, instrumental case studies were examined from three different shelter facilities using qualitative interviews (with 17 members of staff) and document analysis. The findings indicated that neither the frontline workers nor the managers could always understand how to implement this principle. Response patterns and the effect it had on recipients are examined. These findings imply that such a profound change needs to be supported with proper explanation, professional training, and practical application skills. Directions for further application and future research are suggested.     

An Evaluation of a Multifaceted Prenatal Program Serving a Diverse Inner-City Population

ABSTRACT

A multifaceted prenatal program incorporating social service and educational components as well as medical care has been operating in Cleveland, Ohio since 1966. We evaluate this program's effect on reducing infant mortality with data from linked birth, infant death and program files for 1985–87 resident birth cohorts. Adjusted for level of risk, participation in the prenatal program was associated with improved survival of newborns among African-Americans and possibly also Hispanics. However, Non-Hispanic White clients, some of whom may have been of Appalachian background, had an excessively high rate of postneonatal mortality. We discuss several hypotheses which might account for these findings.     

Caring for the Child Welfare Client: Am I Good Enough?

ABSTRACT

Given the demographics of youth served by the child welfare system, culturally responsive approaches are critical to effective social work practice and desperately needed. Like many adolescents who grow up in the child welfare system, Paul, a White adolescent male in foster care, was beset by a lack of adequate environmental resources and multiple stressors and had little hope or motivation to work on improving his situation. This article highlights the author's “use of self” as an African American male therapist who worked with Paul, using a Winnicottian and caring framework. Because child welfare workers are often overburdened by the demands of work, including large caseloads and clients with few to no resources, they find it difficult to consistently provide empathic and caring behaviors for their clients. The author highlights his therapeutic work and struggles with Paul and offers cultural insights and Winnicottian strategies when working with adolescents in the child welfare system who are ultimately in need of permanency and stability.     

Building a Bicultural Bridge

ABSTRACT

The balancing act of living between two cultures can have a significant impact on the development of adolescent Latinas living in the United States. Many adolescent Latinas, particularly second generation, live with two sets of cultural values that are often in conflict with one another. This case study illustrates the importance of understanding the impact of acculturation on the individual and the family. Issues of identity, biculturalism, and bilingualism—specifically the phenomenon of language switching—are dismantled in this case study to gain deeper insight into the unique experience that second-generation Latinas undergo when negotiating two cultural orientations. These findings are important to consider when working with the Latino population as they represent one of the largest immigrant groups and the most rapidly growing group in the United States.     

Addressing Unmet Needs in Incarcerated Women With Co-occurring Disorders

ABSTRACT

This article will present findings related to critical needs in a group of 281 incarcerated women with co-occurring disorders. The women completed interviews while incarcerated and again at various time points after community reentry. Findings revealed that the number of basic needs increased over time, and a low level of social support was related to negative outcomes. Recommendations for this population include holistic evaluation assessments and integrated treatment plans that encourage staff to comprehensively assess clients at intake and link them to support services during and after incarceration. Implications of this female empowerment model will be discussed.     

Measuring Support Provisions for People Living With Disabilities in South Asia: An Accessibility Index

ABSTRACT

The terms “empowerment,” “rights,” and “inclusiveness” are now commonly used in public policy, but little emphasis is placed on “accessibility” issues in the integration of disabled people. This article proposes a composite index to measure economic support provisions, such as employment, vocational training, microfinance, and safety nets. The index was tested in a case study (N= 245) of two districts in Pakistan. Results support a “cost/benefit”-based philosophy, rather than the “means–ends” goal, where the disabled poor are viewed as unproductive and risky payers, instead of giving them an opportunity to exercise their potential. Change for the disadvantaged poor can be brought about with the mandatory use of this index in local annual audits. Future research might examine the impact of the index and standardize it for global use.     

Spiritual Assessment and Latter-Day Saints: Establishing the Preliminary Validity of Spiritual Eco-Maps

ABSTRACT

Few spiritual assessment approaches have been validated with Latter-Day Saints (LDS), in spite of the importance of religion to this culturally distinct population and its burgeoning growth. Drawing on the concept of social validity, this mixed-method study validates a qualitative spiritual assessment approach—spiritual eco-maps—using a geographically diverse sample of social workers (N = 100), all of whom had at least 5 years of direct practice experience with LDS clients. These individuals were asked to identify: a) the degree of cultural consistency, strengths, and limitations of the spiritual eco-map at a conceptual level; and 2) how the questions designed to operationalize the approach might be improved to be more valid, relevant, and consistent with LDS culture. The results suggest that spiritual eco-maps are consistent with LDS culture as long as they are operationalized appropriately. Toward this end, a culturally valid question protocol is provided along with suggestions for administering the instrument in a culturally competent manner. Spiritual eco-maps may be particularly useful in settings where a quick, visually oriented assessment that focuses on clients’ present relationships is indicated. Future research might build upon the present study by assessing the validity of spiritual eco-maps with both community and client samples.     

“Koe wai hoki koe?!”, or “Who are you?!”: Issues of trust in cross‐cultural collaborative research

Abstract

Cross‐cultural research designs are increasingly employed in the New Zealand context to investigate a range of complex social and environmental issues. However, there is little guidance for researchers who work for mainstream organisations and hapū (subtribe(s)) and iwi (tribe(s)) on how to undertake cross‐cultural collaborative research. Trust is a key issue that makes cross‐cultural research possible and it is surprising that issues relating to trust have not featured widely in the literature. In this paper, we reflect on our experiences working cross‐culturally and collaboratively with a hapū in Northland, New Zealand. We discuss how a mainstream research organisation worked with a community health trust and developed a working relationship with a hapū, forming the basis of a community‐driven collaborative evaluation of a central government‐funded project. Key findings were the establishment of a tuākana‐tēina relationship (where teacher and learner are interchangeable) between the members of the collaborative research team and the employment of appropriate research methods to develop a research agenda that ensured everyone would benefit from the research.     

Spiritual Histories and Native Americans: A Mixed Method Validation Study

ABSTRACT

Although spirituality plays a central role in health and wellness for many Native Americans, surprisingly few spiritual assessment tools have been validated with this population. This mixed-method study modifies an existing spiritual assessment tool—spiritual histories—that may be particularly congruent with Native American culture. Using a sample of recognized experts in Native culture (N = 50), the study identifies: (a) the degree of cultural consistency, strengths, and limitations of the tool, conceptually, and (b) a culturally valid question protocol to operationalize the concept for use with Native clients. The findings are discussed in light of recent accrediting requirements mandating the administration of spiritual assessments in numerous settings and suggestions are provided to administer the assessment in a culturally competent manner.     

The Role of Empowerment in Home Care Work

ABSTRACT

The home care industry experiences similar problems with the recruitment and retention of direct care workers (DCWs) as those faced by institutions, and it is important to identify strategies to help retain and grow this important workforce. The empowerment of DCWs has been shown to be an effective strategy for increasing job satisfaction and decreasing turnover in nursing homes but has not been studied in home care. Using Kanter’s organizational theory of empowerment, including structural empowerment (structure of opportunity, access to resources, access to information, and access to support) and psychological empowerment (meaning, competence, self-determination or autonomy, and impact) this study examined whether home care workers (HCWs) feel empowered in carrying out their jobs. An exploratory, qualitative study of 12 HCWs, recruited from two states in the United States, found high levels of both structural and psychological empowerment among research participants, as well as a number of disempowering aspects of their job. Findings suggest ways to support elements of the work that HCWs find empowering and decrease elements that contribute to job dissatisfaction and turnover.     

Living with and Caring for Older Family Members

Abstract

Using the strengths-based Caregiver Well-Being Scale, this research provides social workers with strategies for assessing and promoting caregiver well-being. One hundred eighteen family caregivers (64 spouse and 54 adult child caregivers) are used to examine caregiver relationship to the care-recipient and 138 caregivers are included in the analyses for coresidential arrangement with the care-recipient. Predictors of well-being are highlighted for each group. Caregiver competence and depression predict well-being for spouse, adult child and non-co-resident caregivers. Depression is the only predictor for co-resident caregivers. Using the activities of living sub-scale, depression predicts wellbeing for all groups. Additionally, caregiver strain relates to spouse wellbeing. Implications for social work practice with family caregivers are highlighted.