Reconceptualizing Substance Abuse Treatment in Therapeutic Communities: Resiliency Theory and the Role of Social Work Practitioners

ABSTRACT

Although therapeutic communities (TC) have achieved promising results in the treatment of substance abusers, several areas have been identified which might further enhance TC treatment effectiveness. Two of these, resiliency theory and the role of social work practitioners, are discussed. Resiliency theory provides a framework for re-conceptualizing interventions as they apply to therapeutic communities. Resiliency is explicated and illustrated via a case study of a therapeutic community TROSA (Triangle Residential Options for Substance Abusers), a non-profit TC in Durham, North Carolina. A number of contributions that social work practitioners can make to TCs are described.     

Rural social workers and their jobs: An empirical study

Abstract

Results are reported from a national survey of 194 social workers commencing rural positions in Australia in 1994 and 1995. This paper focuses on: practitioner, position and community characteristics; which location the practitioners came from; their professional, rural practice and rural living experience; preparation for the positions by employers and educators; satisfaction with rural work and life; and anticipated length of stay. Results challenge myths about rural social workers and support key themes of rural practice literature. Respondents were mixed with respect to age and experience, scattered widely throughout Australia in different-sized communities, mostly living and working in the same communities and engaged predominantly in generic practice. There appears to be a pool of rural practitioners in Australia who are committed to living and working in rural places. Implications are developed for practice, employers, the profession, professional education, research and theory. Tentative explanations are offered for high rural staff turnover.     

Evaluation of the Stress Adjustment and Adaptation Model Among Families Reporting Economic Pressure

ABSTRACT

This research evaluates the Stress Adjustment and Adaptation Model (double ABCX model) examining the effects resiliency resources on family functioning when families experience economic pressure. Families (N = 128) with incomes at or below the poverty line from a rural area of a southern state completed measures of perceived economic pressure, family hardiness, social support, and the McMaster Family Assessment device. The family resiliency model was evaluated using regression and two path analyses. Results of the model evaluation indicate that when family resiliency resources are introduced economic pressure is not a significant stressor influencing family functioning. Family resiliency is a key to the healthy functioning of the family unit moderating distress and decreasing the negative effects associated with economic pressure. Implications for social work practice to enhance family resiliency using community and personal supports are discussed.     

Initiating Senior Co-Housing: People,Place, andLong-Term Security

Abstract

An increasing proportion of older people are unable to afford rental or purchase of age-appropriate residential accommodation in Australia. This article reports on a community-initiated research project investigating feasibility of affordable co-housing for older residents wishing to age in their community. Factors enabling successful co-housing for seniors were investigated through a systematic literature review. The multiphase participatory research approach drew on the knowledge of local seniors, community support workers, and planning and design professionals through workshops and interviews in a regional community in southeast Queensland. The findings demonstrate interest in and barriers to senior co-housing. The research engagement approach enables tailored solutions for individual long-term security, relevant to small communities in Australia.     

Making Continuing Professional Development Relevant and Accessible in Regional Social Work

ABSTRACT

Continuing professional development (CPD) is an integral component of quality social work practice (Australian Association of Social Workers, 2013). Despite this, there is a lack of knowledge around the perceived needs and challenges of accessing CPD for rural and regional social work practitioners. This research explored professional development education needs and challenges for rural social work practitioners. The findings revealed an increase in complex cases in practice leading to the need for more training in mental health, legal aspects, and therapeutic interventions. Strong demand for CPD was evident, with a preference for face-to-face training instead of online modules. In the face of persistent challenges some innovative solutions were possible from a partnership between service providers, higher education providers, and the professional body to better meet the needs of the rural social work practitioners.

IMPLICATIONS

• Increasing complexity in rural, regional, and remote social work practice has placed extra demands on the knowledge resources of social workers.

• Continuing professional development (CPD) must be relevant and readily accessible to meet the needs of those who practice in these areas.

• Partnerships between agencies, higher education providers, and professional bodies, along with the use of technology can increase accessibility for rural, regional, and remote social workers.

     

Practitioners’ Perspectives on Choice for Older Spousal Caregivers in Rural Areas

Recent shifts toward individual choice and consumer-directed practices largely conflict with traditional expectations of familial obligation and informal caregiving. The research reported on in this paper aimed to understand how practitioners’ perspectives of spousal caregiving obligations impact on choice in rural communities. Seven focus groups were conducted in rural and outer regional areas of North East Victoria, comprising 42 practitioners who work with older couples who reside in the community. Thematic analysis revealed practitioners’ personal values and constraints of the direct practice environment impact on the experience of choice for older Australians. This discussion considers the problematic nature of choice in policy and practice for older people and their caregivers in light of these findings.     

Working with Larger Systems

Abstract

To be productive citizens, lesbians and gay men must successfully work and live in communities and organizations. Definitions and structures of both gay communities and social communities are changing. In rural areas, gay people often remain socially and geographically isolated. The culture of organizations, which is played out through expected behaviors, makes it difficult for gay people to succeed. Social workers and other human service practitioners must work to empower gay people in order for them to be more socially engaged and successful in living and working in communities and organizations.     

Building from the Ground Up

SUMMARY

In an era of low crime rates and high imprisonment rates, the role of communities in producing safety and justice is open for critical reexamination. This article suggests that community resiliency is an unexplored factor in the recent drop in violent crime rates, and that community capacity is adversely affected by imprisonment policies, creating critical questions about the ability of community organizations to engage in partnerships on crime and justice topics. Drawing lessons from several community policing experiments, this article outlines a possible role for community engagement in reducing the current reliance on incarceration as a response to crime.     

Rural and Regional Developments in Social Work Higher Education

Abstract

Social work education has traditionally been taught in urban universities in on-campus programs. In the present paper, the author outlines the nature of social work education at Charles Sturt University, a regional Australian university. The author argues that social work education in a rural/regional university is shaped by rural social contextual issues, as well as by changes in the higher education sector. The author notes that social work education fills a significant gap in that it attracts students who are unable to access urban campuses, adds value to rural service delivery, supports rural/regional research, and highlights issues of rural disadvantage. Despite this, the paper argues that rural disadvantage and higher education sector pressures place the delivery of social work education shaped around and responsive to rural social justice issues in regional universities in jeopardy.     

Local Housing and Service Decisions

Abstract

The purpose of this research was to identify factors associated with local housing and service decisions that support aging adults in rural communities. These decisions represent de factostrategies that affect the quality of life of older residents and their ability to age in place. Data were collected from 951 informants in 134 Midwest rural communities. Analyses were undertaken to identify the role of community characteristics in predicting the availability of a group of housing options and support services. Findings support the notion that the community context is important to the delivery of key housing and service needs. Population size, proportion of community residents 65 years and older, and housing planning processes promoted gains in housing and services.     

Re-Uniting African American Scholars,Practitioners and the Community

ABSTRACT

That African American communities are too often desolate places where it seems, in Hurston's words, “life has been and gone,” argues for increasingly creative community development strategies. This paper presents an historically-based, corporate empowerment model designed to address the desolation, by re-uniting scholars, practitioners and other community stakeholders for collective benefit and empowerment. Through an African-centered evaluative discussion, the authors assume the professional risk of sharing an outcome that may be viewed as a failure. The efficacy of the model, juxtaposed against the continued powerlessness of African American scholars, practitioners and communities, is explored. Practice challenges and implications are discussed.     

Social Work and Disadvantage: Addressing the Roots of Stigma through Association

Abstract

This paper reports on a small-scale research study that explores the impact of climate change on rural women. Qualitative data were collected through interviews with 7 women, who came from a regional centre and were either employed by women's services or who had activist roles within the community pertaining to women's services. Outcomes of the study identified a range of areas of impact, including increased hardship for rural women, implications of household roles, and subsequent organisational responsibilities. A high level of concern, particularly for the vulnerability of women in crisis, was identified among participants. We contend that the effects of climate change are becoming increasingly relevant to the social work profession and that specific groups such as women are at risk of further disadvantage unless collective action is taken to circumvent the impact of climate change. Strategies for social work practice and policy initiatives are considered.     

Practitioner Research Capacity: A Survey of Social Workers in Northern Queensland

Abstract

Strategies to build practitioner research capacity need to be developed in order to increase the research base for social work. To be effective, strategies need to be informed by an understanding of the organisational context and the social work workforce. This paper reports the results of a cross-sectional survey of social workers conducted as part of a larger study of health practitioners in a public sector health organisation in northern Queensland. The survey demonstrates a high level of interest in research. Research methods congruent with social work's person in environment focus were favoured by participants. However, consistent with the literature, lack of confidence, limited knowledge and skills, and practical constraints impeded research activity. This study contributes to research capacity building initiatives by identifying research strengths and areas of research activity where support is required. Approaches to evidence-based practice consistent with social work and strategies for research capacity building are discussed.     

Retirement Village Resident Satisfaction in Australia: A Qualitative Enquiry

ABSTRACT

There has been limited research into the types of customer satisfaction experienced by residents in leisure-oriented retirement communities, particularly in Australia and the United Kingdom. Focus groups were conducted at a series of retirement communities. Results have lead to the development of a typology of retirement community resident satisfaction containing five different domains, including the Built Environment, the Financial Environment, the Service Delivery Environment, the Social Environment, and the Spiritual Environment. Furthermore, these five satisfaction domains encompass up to 24 distinct types or facets of customer satisfaction experienced by residents. This proposed typology of leisure-oriented retirement communities’ resident satisfaction is the most comprehensive investigation of retirement village customer satisfaction to date. Implications for both researchers and practitioners are discussed, including recommendations for the measuring, managing, and marketing of customer satisfaction with retirement community living.     

Ethical and Racial Conflicts in Urban-Based Action Research

Abstract

Through the use of a case study of a joint faculty-student research project, this paper discusses how community-based action research, policy analysis, and community organizing can be synthesized in work with low-income communities. It outlines potential implications of this synthesis for both community practice and social work education.     

Social work guanxi: a reflexive account of the social work relationship in the Chinese context

ABSTRACT

In a guanxi-driven acquaintanceship, the worker, the client, and the community are tied together more closely than they are in mutually agreed-upon service contracts. This paper re-examines the contemporary boundaries in the social work relationship, especially in Asian nations such as China, where ‘relationships’ are generally translated and perceived as ‘guanxi’. The indigenisation of social work must be managed with care when translating from West to East. Drawing from the experiences of community development projects in rural Hong Kong, this paper discusses how guanxi among social workers, clients and other stakeholders in Chinese communities might challenge the professionalism of social work and breach the boundaries of social work relationships.     

From local to global: Making social policy more effective for rural community capacity building

Abstract

In the context of a discussion of globalisation this paper examines developments in social policy aimed at building civil society and enhancing social capital. It notes that policy driven by a desire for minimal government intervention and market dominance has resulted in a clear disadvantage in rural Australia and growing inequities between urban and rural communities. Clearly poverty has a postcode and overwhelmingly the postcodes are rural. At the same time the demography of ‘rural’ Australia is changing as the inland empties and the coastal regions experience population overload with its accompanying environmental problems. This paper discusses the need for more effective targeted involvement of the state in rural policy development if we are to preserve quality of life, address inequities and overcome the divide between city and country. There is a strong role for social work in forging rural community development. However, the profession has to be much more politically astute in its dealings with governments and community groups if it is to carve out a central role. Strategies are discussed to develop such a role.

Margaret Alston is an Associate Professor in social work and is Director of the Centre for Rural Social Research at Charles Sturt University, New South Wales. She is a Director for the Foundation for Australian Agricultural Women, a member of the Advisory Board for the Social Sciences Unit, Bureau of Rural Sciences, a member of the Board of General Practice Education Australia and on the Editorial Committee for Australian Social Work     

Ties That Protect

SUMMARY

An ecological risk and resiliency framework was applied to explore how social contexts, especially the role of families and schools, are affecting Latino/a pre-adolescent substance use in the urban Southwest. A mixed research design, using both quantitative and qualitative methodologies, guided the study. Quantitative data were collected through surveys administered as part of a school-based prevention intervention experiment (N = 2,125). Individual interviews conducted with a randomly selected number of matched students (N = 60) provided the qualitative data. The main theme emerging throughout both data sets was a strong resilience against drug use of the participating 7th grade urban youth. The vast majority of students did not use hard drugs, and agreed that alcohol use was inappropriate at their age. A high degree of attachment and strong ties to their parents and their school environment emerged as a shared protective factor. Recommendations include social work interventions that support the resiliency characteristics of urban Latino/a youth in different social contexts such as communities, schools, and families. Limitations of the study are reviewed and suggestions for future research are offered.     

Development and application of a rubric to compare strategies for improving access to health care in rural communities in the United States

Rural areas are underserved in terms of the availability of and access to health care services. According to Healthy People 2020, access to health care continues to be the most frequently identified rural health priority in the United States.PurposeThe purpose was to develop an efficient approach for standardizing and prioritizing strategies to improve access to health care in rural areas across the United States. The rubric provides a quantitative metric of the effectiveness of each strategy in terms of impact and feasibility and allows community health departments and other access to care groups to compare strategies and facilitate discussion of various strategies’ ability to meet the needs of diverse communities.FrameworkThe Plan, Do, Check, Act (PDCA) cycle was used to create the rubric. The research team constructed a plan for creating a rubric to measure each strategy’s impact and feasibility. We checked the rubric by applying it to selected access to care improvement strategies evaluated by the Robert Wood Johnson Foundation (RWJF). Members of a rural community Access to Care Workgroup applied the rubric to several RWJF What Works for Health strategies. The final step was to compare the results of the application phase through facilitated conversations with the goal of determining which strategy or strategies would best meet the needs of the rural community.DiscussionA rubric is a valuable tool to facilitate assessment and discussion and for assisting community members in determining access to care priorities. After applying the rubric in a community setting, we identified two important tactics: 1) the rubric is best applied to strategies when they are summarized consistently and cohesively; and 2) it is important to involve community stakeholders early in the process of identifying strategies for evaluation. The next step is to apply the rubric to similar strategies in other rural communities to further validate the rubric’s effectiveness.     

Growth and Locational Impacts for Housing in Small Communities

Abstract Many Americans believe that small rural communities are ideal places to live. They assume that small rural communities offer a safe environment, a supportive community, and affordable housing. In contrast, research indicates that rural households are more likely to live in unsuitable or inadequate housing and have lower incomes, making affordable housing difficult to obtain. Although there are data highlighting regional or urban-rural differences, very little research has been conducted on the housing situation among small rural communities. The research presented here explores housing availability and affordability in 589 Midwestern communities. Findings indicate that, based on the community's growth and location, there are significant quantitative housing affordability and availability differences among small communities. However, these differences were contradicted by focus group discussions that indicated key similarities of housing concerns across small communities. The findings have potential impacts for public policy implementation in small communities.