Enhancing Psychosocial Competence Among Black Women: A Psycho-Educational Group Model Approach

ABSTRACT

The lack of social work intervention models targeted toward the specific mental health needs of Black women has been recognized as a major gap in our knowledge concerning effective treatment. More recently, group work has been recognized as a useful and effective method of treatment for this population. This paper discusses the utility of a culturally specific, group intervention with Black women aimed at enhancing psychosocial competence as an effective mechanism to assist Black women in coping with the tasks of life and contributes to their ability to master life events. The model incorporates the use of literary works, authored by Black women as an innovative tool for enhancing the group process. Case vignettes are offered.     

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

ABSTRACT. Violence is a serious problem, and social and health care providers are in a key position for implementing successful interventions. This qualitative study of 6 focus groups with professionals (n = 30) examines the health care professionals’ ways of framing a domestic violence intervention. Of special interest here is how professionals see their own roles in the process of recognizing and helping victims of domestic violence. By using Erving Goffman's frame analysis, this study identifies several frames that either: a) emphasize the obstacles to intervention and justify nonintervention, or on the contrary, b) question these obstacles and find justifications for intervention. The possibilities for intervention are further explored by analyzing the ways in which the dynamics between the different frames allow redefinition of domestic violence interventions. Despite the challenges involved in a domestic violence intervention, there seems to be potential for change in personal attitudes and reform of professional practices. The research findings underline the role of social and health care professionals as members of a larger chain of service providers working collaboratively against domestic violence. Implications for practice and directions in policy and future research are suggested.     

Evidence-based interventions with older adults: concluding thoughts

Taken collectively, the articles in this volume provide a method to assess psychosocial outcome research in aging. Although the outcome literature on effective interventions with older adults is uneven across condition and treatment approaches, there are some particular intervention methods that have received consistent research support. This article condenses the rich analyses presented by the volume authors and summarizes the interventions for which some evidence base exists by life issue/condition (health, mental health/cognitive and social rules) and outcomes achieved.     

Can Psychosocial Intervention Improve Peer and Sibling Relations Among War‐affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial

Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war‐affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)‐year‐old girls (49.4 percent) and boys (50.6 percent)], who were cluster‐randomized into the TRT and wait‐list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well‐being at baseline (T1), postintervention (T2), and six month follow‐up (T3). Results showed gender‐specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.     

Treating the Effects of Interpersonal Violence: A Comparison of Two Group Models

Surveys have shown that one in four women in the United States experiences intimate partner violence in her lifetime. Interpersonal violence has demonstrated negative effects on a victim's health and well-being. Yet research on interventions aimed at treating the psychosocial effects of this experience is limited. The purpose of the research reported here is to deepen our understanding of the impact of group-based interventions for treating this population. Specifically, this study looks at two different group models to determine their effectiveness in treating two widely recognized effects of intimate partner violence: increased depression and lowered self-esteem.     

Providing Mental Health Services to Older People Living in Rural Communities

Summary

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional well-being and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

Ethical Dilemmas and Areas of Social Work Intervention in Spain

Abstract

The purpose of this study is to identify the types of ethical dilemmas that Spanish social workers face in their respective areas of intervention. The intervention areas that have been studied are health, children, immigrants, women, family, marginalized persons, ethnic minorities, young people, prisoners, elderly people, refugees and asylum seekers, schools and social and employment-related integration, mental health, disability and drug addictions. A quantitative methodology was chosen using a version of the questionnaire prepared by Eileen J. Ain in a sample of 700 Spanish social workers. The statistical analysis shows the correlation between the different areas of intervention in Social Work and the most significant ethical dilemmas that such professionals have to solve. The most pertinent ethical dilemmas are found in the healthcare sector (confidentiality, disclosure of personal information and patient autonomy). The article is an important contribution for Social Work at the national level that emphasizes the importance of the ethics of Social Work in social interventions. It is proposed to deepen the investigation of each of the areas of intervention for future research, as well as to carry out comparative studies between different countries.     

Integrative Body-Mind-Spirit (I-BMS) Interventions for Posttraumatic Stress Disorder (PTSD): A Review of the Outcome Literature

ABSTRACT

Background: A growing interest in integrative body-mind-spirit (I-BMS) approaches to treatment of PTSD has resulted in a significant increase in related research. Method: This study conducted a synthesized review of randomized controlled trials of I-BMS treatments for PTSD, yielding thirteen studies that included: mindfulness/meditation (7), yoga (3), acupuncture (1), spiritually-based intervention (1), and relaxation (1) from 2004–2015. The study used a modified Delphi List (mDL) and the California Evidence-Based Clearinghouse (CEBC) to evaluate study rigor and level of research support for each practice. Results: Overall, I-BMS interventions demonstrated positive outcomes. Based on an mDL range between 0 and 7, scores were: 6 for meditation/mindfulness, 5.67 for yoga, 7 for acupuncture, 3 for spiritually-based intervention, and 4.5 for relaxation training. All interventions were recommended as practices with Promising Research Evidence (Level 3). Effect sizes (d) ranged from .51 to 1.88 for relaxation, .38 to 1.02 for spiritual, .31 to 1.4 for acupuncture, .1 to 1.54 for yoga and .2 to 1.53 for mindfulness meditation. Discussion: This study identified acupuncture, meditation, and yoga as high-quality alternative therapeutic practices for PTSD with promising evidence as effective and safe approaches. Future studies should assess long-term effects to further elevate the level of research support.     

Moving Toward Medicare Home Health Coverage for Persons with Alzheimer's Disease

ABSTRACT

Medicare home health care policy does not incorporate research evidence of effective palliative home care interventions for Alzheimer's disease and dementia patients and caregivers. This article examines the dissonance between the needs and burdens of Alzheimer's disease patients and caregivers, research results on medical and palliative care interventions, and medicalized public policy in the Medicare home health benefit. The article asserts existing research establishes a prima facie case exists for the federal government to fund a Medicare Palliative Home Care for Alzheimer's disease demonstration project. The article cites the success of the Medicare Hospice Demonstration project and Hospice Medicare Benefit in reducing costs and improving client quality of life as precedent and a model for Alzheimer's disease. Other research implications are identified.     

Friendship Across the Life Cycle

Abstract

Using a group work model, this article discusses a short term group for older women developed to explore the importance of friendship in late life. In collaboration with group leaders, group members determined weekly topics that explored the significance of friendship through the life cycle. Social work group practice that focuses on the meaning and development of friendship for and with older women is presented as an effective therapeutic intervention for practitioners in settings such as community mental health clinics, senior centers, elderly housing, home care agencies and nursing homes.     

Toward an understanding of the etiology and treatment of psychological dysfunction among single teenage mothers: Part II

Abstract

This paper, the second of a two‐part series, examines the interplay of social, psychodynamic and developmental factors in the etiology of psychosocial dysfunction among a particular population of single teenage mothers. It also presents a model of expressively oriented, long term group intervention for mothers and children, which systematically addresses both environmental and developmental issues. The results of this project suggest that developmentally‐oriented groups may be a treatment of choice for young women who attempt to ameliorate the effects of significant environmental disadvantage and master the essential life stage tasks of adolescent development by assuming the social role of single mother, head of household.     

Effects of psychosocial interventions on behavioural problems in youth: A close look at Cochrane and Campbell reviews

Research indicates that a number of psychosocial interventions are effective for reducing behavioural problems in youth. These interventions are now often included on best practice lists aiming to facilitate informed treatment choices among practitioners. However, analyses in neighbouring research areas have highlighted serious shortcomings in how primary studies are analysed and how studies are synthesised in research reviews. This study took a closer look at the evidence of efficacy for psychosocial interventions that aim to reduce behavioural problems in youth, as shown in systematic research reviews by the Cochrane and the Campbell Collaborations (n = 8). The findings suggest a bias towards overemphasising the efficacy of the interventions in several reviews, an over‐confidence in the validity of the findings in some reviews and, overall, a somewhat uncertain evidence base for the efficacy of the interventions. Systematic reviews are crucial for summarising research but more attention to methodological issues may be needed in this area.     

Toward an understanding of the etiology and treatment of psychological dysfunction among single teenage mothers: Part 1, a review of the literature

Abstract

This paper, the first of a two‐part series to be published in sequential issues of the journal, reviews the recent intervention literature about single teenage mothers who are psychologically dysfunctional. It emphasizes the interplay of social, economic and developmental factors as stressors in the lives of these young women and explores some of the issues that need to be addressed in constructing effective therapeutic programs. The second paper describes an intervention program consisting of long‐term developmentally‐oriented groups for single teenage mothers and their children.     

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.     

A group-based,acceptance & commitment therapy intervention for chronic pain

ABSTRACT

As the effects of the opioid epidemic continue, the availability of interventions that address the emotional and psychological needs of people who suffer from chronic pain are increasingly necessary. Acceptance and commitment therapy (ACT) is one of the more actively researched psychological approaches amongst the third wave of developing psychotherapies. In fact, ACT has been shown to improve chronic pain in several different populations. In order to widen access to treatment, the use of group-based, ACT interventions with individuals who suffer from chronic, non-cancer pain should be made available in more traditional, mental health settings. The purpose of the current article is to describe a group-based, ACT intervention for people who suffer from chronic, non-cancer pain. A 10-session group intervention is outlined, and recommendations intended to increase the intervention’s efficacy are provided.     

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.     

Assessing the impact of an asset-based intervention on educational outcomes of orphaned children and adolescents: findings from a randomised experiment in Uganda

ABSTRACT

This paper examines the effect of an asset-based intervention on academic performance and school transition among orphaned and vulnerable children in Uganda. Participants were randomly assigned to either the control arm or two treatment arms receiving an asset-based intervention. Participants in the treatment arms scored better grades; and had higher odds of transitioning to post-primary education relative to the control arm. Programmes which target financial insecurity may have a positive impact on the educational achievement and progression of orphaned children. There is a need to consider incorporating asset-based interventions within the development of educational policy, especially in low-income countries.     

Recruitment and Retention in a Parenting Intervention: A Case Study with Parents Aging Out of the Child Welfare System

ABSTRACT

Parenting interventions are efficacious in reducing child maltreatment and negative child behaviors, yet the recruitment and retention of parents, especially vulnerable parents, in such interventions can be challenging. Prior research identifies several ways to improve recruitment and retention including laying the foundation for the intervention, fostering relationships with parents, ensuring fit of the intervention with the intended population, and identifying barriers to parents’ participation. This case study presents a process of recruiting and retaining a vulnerable group of parents, specifically parenting youth aging out of the child welfare system. In addition to outlining the strategies used, lessons learned are highlighted. Parents expressed interest in the parenting intervention, experienced significant needs, negotiated great instability in their lives, and valued the social connections facilitated by the group intervention. Despite the research team following best practices and investing significant time and resources, recruitment and retention remained challenging. Implications for future work in this area are presented.