Sense of coherence in women with a history of childhood sexual abuse

Women with a history of childhood sexual abuse experience a range of difficulties. The aim of the present study is to examine the personal resources of women with such a history measured using the SOC scale. The relationships of SOC to other factors were analysed. Eighty-one women who participated in self-help groups were questioned using the 29-item version of the SOC scale. The SOC mean score for the whole group was 104.1 (range 58–187). The women who had a more than ten-year duration of sexual abuse had a low SOC score (M = 96.8) but those who did not remember the number of years of duration had an even lower score (M = 94.4). In a first step of multiple regression analysis of childhood sexual abuse characteristics and SOC total score, only duration of sexual abuse was entered and accounted for 10.3 per cent of the variance. In a second step of multiple regression analysis, relationship to fellow workers was a significant predictor of SOC and contributed to 31.7 per cent of the variance.     

Transitions to employment from labour market enterprises in Norway

In this article we analyse a labour market programme for partially disabled workers that involves the transition from labour market enterprises to a job in the ordinary labour market. We found that the percentage of these people who found jobs after a maximum two-year programme period increased over time. In 1995, 28 per cent became employed in the ordinary job market after leaving the programme. Exit rates to employment increased to 36 per cent in 1998 and to 39 per cent in 1999. We also found heterogeneity in the job transitions. Employment ratios for men were relatively stable over time, varying between 30 and 40 per cent over the period 1995–1999. For women, however, we found a significant change in employment ratios, with 21 per cent finding a job in 1995 and 40 per cent in 1999. In 1995, employment ratios for female participants were below those of male participants, although there was no difference over the whole period studied (1995–1999). In 1999, the average transition rate to employment was higher for female than for male participants.     

The effectiveness of poverty reduction and the target efficiency of social security transfers in South Korea, 1999–2003

The purpose of this study was to investigate the impact of social security transfers between 1999 and 2003 in South Korea, the period during which the Asian economic crisis of 1997 occurred. The study used a secondary data set, which is part of the Korea Labour Panel Data. Of 5,000 original household samples, the results for the 2,728 households (54.6 per cent) that completed the surveys for all five years studied were analysed. One finding was that the average percentage of social security transfers appeared to be nominal, as was the 1.9 per cent in 1999, which grew to 2.4 per cent in 2003. Another finding was that the average poverty-reduction effectiveness for the five-year period was as low as 7.9 per cent, indicating a slightly increasing pattern. This percentage is only one-seventh to one-tenth that of Western countries. Target efficiency appeared to be 31.8 per cent. We give the following reasons to explain why the level of the poverty-reduction effectiveness of Korean social security transfers is comparatively low: the immaturity of the Korean Old Age Pension; the lack of diversity in social transfer programmes; and a cultural factor of stronger dependency on private transfers within the family structure.     

Different problems – same treatment. Swedish juvenile offenders in community‐based rehabilitative programmes

Ginner Hau H, Smedler A‐C. Different problems – same treatment. Swedish juvenile offenders in community‐based rehabilitative programmes Int J Soc Welfare 2011: 20: 87–96 © 2009 The Author, Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. Young delinquents may be regarded as children in need of rehabilitation or as offenders deserving of consequences proportional to the committed crime. The focus has increasingly been on the latter, while research shows that individual risk assessment is essential for effective rehabilitation. This study explored self‐reported history of antisocial behaviour among Swedish male offenders 15–17 years of age (n= 189) who were sentenced to participate in rehabilitative programmes conducted by local social services. Antisocial behaviour was extensive and, according to a principal component analysis, consisted of three dimensions: (i) adolescent delinquency; (ii) violence and theft; (iii) drug‐related crimes. Using cluster analysis, the participants were divided into four subgroups representing different levels and characteristics of delinquency, which explained 73 per cent of the variance in antisocial behaviour. The conclusion is that assignment to rehabilitative programmes appeared unrelated to subgroups, i.e. to risk level. Organisational obstacles to an evidence‐based practice are discussed.     

Hostel Care for Elderly People: The Association with Hospital and Nursing Home

In order to achieve its purpose a hostel should have a clearly defined association with both acute hospital and nursing home. This report is a study of the reasons for separation of residents from a hostel over a period of four years; it included temporary admissions to an acute hospital situation and permanent transfer to a nursing home. It is estimated that one nursing home place is needed for every three residents in this kind of hostel. Thirty-six of the 79 residents in a hostel with 32 places had a total of 58 temporary admissions to an acute hospital situation during the four year period. Thirty-three (42 per cent) of the 79 residents needed transfer to a nursing home during the study period. Analysis was made of the time spent (person years) in each institution. Although 42 per cent of the residents needed transfer from hostel to nursing home they spent approximately 75 per cent of their time in the hostel.     

Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.     

Integration and Targeting of Community Care for People with Severe and Enduring Mental Health Problems: Users' Experiences of the Care Programme Approach and Care Management

Correspondence to Professor John Carpenter, Director, Centre for Applied Social Studies, University of Durham, Elvet Riverside II, Durham DH1 3JT, UK. E-mail: J.S.W.Carpenter{at}dur.ac.ukJ.S.W.Carpenter@dur.ac.uk Summary We report the experiences of different models of community careof random samples of 262 people with severe and enduring mentalhealth problems living in four districts in the north of England.The districts were characterized in terms of the extent of (1)integration between the health service-led Care Programme Approach(CPA) and social services Care Management, and (2) targetingof services on people with severe mental health problems. Themajority of service users felt involved in planning their owncare and considered that they had choice in their care and treatmentwhen in the community, but not in hospital. Although all theseusers were formally subject to the CPA, the proportions of usersin the districts believing they had a written care programmeranged between 37 per cent and 60 per cent. Of these, the greatmajority were very positive about their care programmes andfelt that they were being helped to become independent. Theseresults were replicated when 87 per cent of the original samplewas re-interviewed six months later. There were significantdifferences between the four districts and evidence that userspreferred an integrated health and social care service. In addition,a higher proportion of users in inclusive districts were satisfiedcompared to those in targeted districts. Notwithstanding thesepositive findings, there is still considerable room for improvementin relation to the involvement of family carers and the provisionof adequate information about prescribed medication and makingformal complaints.     

A Consumer Study of Young People's Views on their Educational Social Worker: Engagement as a Measure of an Effective Relationship

Correspondence to Colin Pritchard, Mental Health Group, University of Southampton, Royal South Hants Hospital, Brintons Terrace, Southampton, SO14 0YG, UK. Summary This, the first ever consumer study of education social workers(ESWs), uses qualitative material and quantitative analysisby examining the views of 110 users of a county ESW service.Most pupils belonged to families with long-standing disadvantage;e.g. 53 per cent had unemployed fathers; over 70 per cent hadparents with disturbed personal and social relationships, 39per cent had a single parent; 30 per cent plus had mental healthproblems; and 10 per cent of parents had been in care as children,i.e. more than ten times the national average. The young people also had considerable disruption in their lives:for example 78 per cent frequently missed school; over 50 percent had school and peer difficulties; 30 per cent offended;over 30 per cent experienced bullying; 5 per cent were the subjectof child protection enquiries, 10 per cent had previously beenin care and 2 per cent had had an incident of ‘attemptedsuicide’ (50 times the national rate). They averaged sixmajor difficulties each. Despite these antecedents, 91 per cent of the young people demonstratedan ‘engaged’ relationship with their social worktrained ESW, with many examples of practical psychosocial helpbeing received. The concept of ‘engaged’ was statisticallyvalidated in the comparison of views between the ‘engaged’and ‘non-engaged’ research participants. The resultsindicate the value and effectiveness of a supportive rapport/relationshipas a vehicle to reach and to be of practical assistance to disturbedand disturbing young people.     

Prevalence of gambling problems among adolescents in the Nordic countries: an overview of national gambling surveys 1997–2009

Kristiansen S, Jensen SM. Prevalence of gambling problems among adolescents in the Nordic countries: an overview of national gambling surveys 1997–2009 Int J Soc Welfare 2011: 20: 75–86 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The study presents an overview of prevalence studies focusing on problem and pathological gambling among adolescent populations in the Nordic countries. Past‐year prevalence of problem gambling among adolescents in the Nordic countries ranges from 0.4 per cent (Denmark) to 4.2 per cent (Sweden). Past‐year prevalence of pathological gambling ranges from 0.1 per cent (Denmark) to 1.76 per cent (Norway). Results from the Nordic countries also show that boys gamble more than girls, older adolescents gamble more than younger adolescents and that, as shown in adult prevalence surveys, problem gambling is more widespread among adolescents than among adults. It is concluded that investigations of gambling problems among adolescents in the Nordic countries differ regarding age groups, sampling procedures, response rates, nomenclature and screening instruments, all of which complicates valid comparisons. More collaboration between researchers from different countries is urged in order to improve comparability between national studies.     

Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n = 387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing. When mean attitude scores were correlated with mean definition scores, Pearson's r returned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors of R² change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse. Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.     

Euthanasia and assisted suicide: a survey of registered social workers in British Columbia

This anonymous postal survey explores the attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) held by professionally registered members of the British Columbia Association of Social Workers. Social workers determine only a minor moral distinction between VE and AS and a large majority believe both acts should be legal, in certain circumstances (VE 75.9 per cent; AS 78.2 per cent). Approximately 80.0 per cent feel that social workers should be involved in social policy development concerning VE and AS, and, if such acts were to be legal, 70.0 per cent believe social workers should be involved in the decision making process with clients. Over 21.0 per cent of all social workers and nearly 40.0 per cent of social workers with medical employers have been consulted by a patient about VE or AS. Six respondents (1.1 per cent) reported assisting the death of a patient by VE. None had involvement in AS. Further research and education is required to better inform social work practice in this ethical area. Given the unique position of social workers in health care, they should, for the benefit of patients, families, and physicians, actively participate in the discussion concerning end of life decisions.     

Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps,and social equity considerations

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio-economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out-of-pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.     

Microfinance, the Labour Market and Social Inclusion: A Tale of Three Cities

Great hopes have been held out for microfinance and other community development finance institutions (CDFIs) in industrialized countries as an instrument of “financially sustainable welfare provision”, following on from their success in many developing countries. Using interview data drawn from an exploratory sample of 45 clients, this paper examines the social and economic impact of three microfinance institutions in Glasgow, Sheffield and Belfast. The tentative conclusion is that most loans we examined do hit the target of the “financially excluded but bankable”, and exert an impact on poverty and social exclusion through the labour market and through helping to build social networks which reduce interpersonal risk. Our initial estimate is that each loan studied here was responsible for about 0.67 exits from unemployment over the two years 2000–2. If this ratio holds good outside the sample (and we emphasize the limitations of small sample size), this could mean that in the absence of microfinance services, the national unemployment total would be higher by some 2.4 per cent (or 22,000 individuals). The loans we have examined also save about £0.4 million on what would otherwise have been social security payments; grossed up again to all microfinance organizations, this implies an annual saving of about £250 million (1.4 per cent) on the total social security budget. However, to achieve this optimal impact microfinance institutions need to diversify their product: for example by switching from business loans into consumption loans, micro‐insurance, and equity, particularly in the rehabilitation of run‐down council estates.     

Hidden Gems: Systematically Searching Electronic Databases for Research Publications for Social Work and Social Care

Correspondence to Brian Taylor, Queen's University Belfast, Department of Epidemiology and Public Health, Mulhouse Building, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland. E-mail: b.j.taylor{at}qub.ac.uk Summary Context: Electronic bibliographic databases are an importantsource for professional publications about social work and communitycare more generally. This article describes and evaluates amethod of identifying relevant articles as part of a systematicreview of research evidence. Decision making about institutionaland home care services for older people is used as an example.Method: Four databases (Social Science Citation Index, Medline,CINAHL and Caredata), which abstract publications relevant tohealth and social services, were searched systematically toidentify relevant research studies. The items retrieved wereappraised independently using a standard form developed forthe purpose. The searches were compared in terms of sensitivity,precision, overlap between databases and inter-rater reliability.Results: The search retrieved 525 articles, of which 276 wererelevant. The four databases retrieved 55 per cent, 41 per cent,19 per cent and 1 per cent of the relevant articles respectively,achieving these sensitivities with precision levels of 54 percent, 48 per cent, 84 per cent and 94 per cent. The databasesretrieved 116, 73, 24 and 15 unique relevant articles respectively,showing the need to use a range of databases. Discussion: Ageneral approach to creating a search to retrieve relevant researchhas been developed. The development of an international, indexeddatabase dedicated to literature relevant to social servicesis a priority to enable progress in evidence-based policy andpractice in social work. Editors and researchers should considerusing structured abstracts in order to improve the retrievaland dissemination of research.     

Is Sweden Being Torn Apart? Privatization and Old and New Patterns of Welfare State Support

This article examines the potential impact of institutional change on popular welfare support. The encompassing welfare state of Sweden provides an interesting case where the privatization of social service delivery has been widespread over the last decades. We use survey data from five rounds of the Swedish Welfare State Survey (1992, 1997, 2002, 2006 and 2010) in order to study how public preferences for the financing and organization of welfare services have changed over time. Based on a theory describing an ideal‐typical pattern of public support for an encompassing welfare model, we derive three types of public preferences: support for a pure state model, a pure market model and a mixed model (welfare services are funded by taxes but provided by private firms). We begin by tracking the development of these ideal‐typical attitude patterns between 1992 and 2010. We then investigate how preference patterns vary across municipalities displaying different degrees of privatization of social service delivery. Our results show that welfare support among Swedes over the last decades is better characterized as dynamic rather than stable. Swedes seem to take an overall more ideologically based position on the role of the welfare state over time. The share of respondents expressing such ideologically based preferences has increased from 54 per cent in 1992 to 78 per cent in 2010. This change is principally manifested in increased support for the state and mixed models. This trend seems to be parallel to the increasing share of private welfare service providers over the last decade. We also find a link between the municipal degree of privatization and support for our three ideal‐typical welfare models. Public support for a mixed welfare model and, to some extent, a market model, is comparatively stronger in municipalities where welfare services to a large extent are carried out by private actors. Conversely, data shows that public support for the traditional Swedish state model is more widespread in municipalities having a low degree of welfare services privatization. Lastly, we discuss some theoretical implications of our findings.     

Child Sexual Abuse and the Male Monopoly: An Empirical Exploration of Gender and a Sexual Interest in Children

Correspondence to Mike Freel, Child Protection and Review Unit, Kirklees Children and Families Services, Westfields, Westfields Road, Mirfield, WF14 9PW, UK. E-mail: mike.freel{at}kirkleesmc.gov.uk Summary Researchers argue there is a male monopoly in the perpetrationof child sexual abuse, and that a male sexual interest in childrenis relatively common in society. Government and organizationsworking with children have done little to address possible implicationsof such research. This study explores gender differences inan expressed sexual interest in children, a history of childhoodsexual abuse, and the relationship between these two factors.A self-administer questionnaire was given to a sample of 92female and 91 male public sector child care workers. Resultsshowed a significantly higher percentage of males (15 per cent)than females (4 per cent) expressed a sexual interest in children.Females (20 per cent) were more than twice as likely as males(8 per cent) to report childhood sexual abuse. More than twiceas many men who had been sexually abused as a child (29 percent) expressed a sexual interest in children compared withnon-abused men (14 per cent), but this did not reach statisticalsignificance. In summary, this study found that a sexual interestin children is relatively common among male public sector childcare workers. Prevalence findings for childhood sexual abuseare broadly in line with other research. Experiencing childhoodsexual abuse was not related to a sexual interest in children,but this finding is based on small numbers reporting such aninterest.     

Moral distress among social workers: The role of insufficient resources

The present study examined moral distress among Finnish social workers and the role of perceived resource insufficiencies in explaining it. The aim was to shed light on this understudied phenomenon in the field of social welfare. The study focused on work‐related moral distress, defined as impaired wellbeing that is connected to the continual inability to implement actions that one considers morally appropriate. The survey data were collected with an electronic questionnaire between the years 2011 and 2012. The respondents (n = 817) were social workers in the public social welfare services and the overall response rate was 46.5 per cent. Nearly 11 per cent of the respondents reported experiencing moral distress and perceived resource insufficiencies strongly explained this experience. Moreover, social workers with moral distress reported that they were less willing to continue in their post, were more frequently on sick leave and had positive work‐related experiences less often than their colleagues who did not experience moral distress. Key Practitioner Message: ● The concept of moral distress is useful in describing the experiences of social welfare workers when they are unable to practise their profession according to their moral code and the emotional burden related to this inability; ● Perceived resource insufficiencies are strongly associated with experiences of moral distress among frontline social workers; ● Social workers experiencing moral distress are less willing to continue in their work, take sick leave more often and less frequently have positive experiences related to their work.     

Pre-adolescents' Peer-relational Schemas and Social Goals across Relational Contexts

Current theorists stress the context-specificity of social behaviors and social cognitions. Although researchers have started to investigate the relationship as one context that might influence social cognitions, relatively little is known about the influence of relational context on the social goals endorsed by children and adolescents. The current study tested the hypothesis that pre-adolescents' goals would vary between individuals as well as across relational contexts, and examined factors that might explain such variation. Participants (N  =  102, 11–12 years) filled in questionnaires regarding their social goals and self- and peer-perceptions when around each same-sex classmate. Both goals and perceptions displayed significant variation between individuals, as well as between different relationship contexts. The goals pre-adolescents pursued in different relationships were partly explained by varying perceptions of self and of the relationship partner in each relational context, as well as by the affective nature of the relationship. After accounting for the relationship-specific variation, few associations were significant at the individual level. The results highlight the importance of studying contextual variance in social goals and social cognitions in general.