The Play's the Thing: How Social Group Work and Theatre Transformed a Group into a Community

ABSTRACT

This paper explores the potential of the purposeful use of activity in cultivating community in a life review and performance group with bilingual elders in a community based organization. Activity used to promote community among group members enables a diverse group separated by language and cultural barriers to find commonality, accept differences, take risks as acts of self-determination, and find a strengthened identity in the pursuit of a shared goal. Examples are given that detail the ways in which expressive activity develops the group's ability to exercise self-determination.     

A perfect storm: Challenges encountered by family caregivers of persons with Alzheimer’s disease during natural disasters

ABSTRACT

Since Hurricane Katrina there has been a movement across the U.S. to examine best practice for disaster response within the aging population. However, little is known about the experience of natural disasters from the perspective of family caregivers of persons with Alzheimer’s disease and related dementia (ADRD). In this exploratory, qualitative study, family caregivers (n=27) were interviewed about their experience with the historic 2015 South Carolina flood. By using thematic analysis, themes were identified to better understand what unique challenges caregivers of person with ADRD experienced. While many caregivers stated they had experienced a natural disaster previously, none had ever done so in their current caregiving role. The caregiving role affected their ability to prepare for the storm and influenced their decision-making regarding evacuation and utilization of recovery resources. Thus, caregivers were confronted by a “perfect storm” of circumstances and uncertainty. Family caregivers need to have actionable emergency plans for disasters that are specific to their role as caregivers of persons with ADRD. Study implications also suggest the role social work professionals can have in educating, advocating, evaluating, and coordinating support to assist caregivers of persons with ADRD as a potentially vulnerable and at-risk population during all phases of disaster.     

A Qualitative Perspective of Family Resources Among Low Income,African American Grandmother–Caregivers

ABSTRACT

This ethnographic study describes a group of 7 low-income, African American, grandmother–caregivers' perceptions of family resources. An ethnographic design, enhanced by a genogram, captured those who were available and unavailable to provide support to the grandmother. The analysis used a constant comparative method to thematically capture grandmothers' perceptions of family support resources as absent, unavailable, dependent, and reliable support, and the circumstances that led to that status. The findings reveal that many African American grandmothers are rearing children with little family support, owing mainly to the devastation of negative social and economic conditions. The results suggest areas for improvement in social work assessment and intervention.     

Pathways to Service for Older Persons

Abstract

As services for older persons continue to shift from hospital and nursing home care to greater reliance on support for care at home, the need to understand the ways older persons obtain services becomes more important. This study examines the use of home-delivered meals as a case study to gain insight into the process of service use from the recipients' point of view. It explores the research question: What are the pathways by which older persons acquire home delivered meals? Narrative analyses of structured and unstructured questions asked of thirty frail older persons suggested that the process of acquiring home delivered meals was accompanied by patterns of adjustment in shifting between independence and dependence in managing loss of physical function, and themes of isolation, loss, and abandonment. The results provide insights for social workers in providing the support needed for the role transition that service acceptance symbolizes for older adults.     

Barriers to the Use of Mental Health Services by African-American and Hispanic Elderly Persons

Abstract

This study discusses barriers to the utilization of community-based mental health services by African-American and Hispanic elderly persons. The study sample consists of “key Informants,” chosen because they were knowledgeable about the mental health needs and use of mental health services by African-American or Hispanic elderly persons. Principal component analysis using orthogonal rotation was conducted on the 23 item barrier scale and identified three levels of service barriers for the entire sample and for each subsample of African-American and Hispanic informants. Based upon the study findings, a number of strategies are offered to improve Utilization and overcome service delivery barriers.     

Common Ground: The Development of a Support Group for Survivors of Homicide Loss in a Rural Community

ABSTRACT

Losing a loved one from human-perpetrated violence can lead to a debilitating process of stigma-generated isolation and trauma. Layers of social services are needed to support surviving family members, all secondary victims of homicide. Although urban populations have enriched access to victims-of-crime services, rural-bound populations often do not. This article describes homicide-specific trauma and the development of a community support group for rural-bound persons suffering homicide loss. The support group process offers potential for real help in areas where few trauma-informed options exist. The authors chronicle their journey of group-work practice with underserved persons coping with homicide loss.     

Reliability and Measurement Error in the Presence of Homogeneity

ABSTRACT

This paper describes a limitation of using Cronbach's Alpha to estimate reliability when using a sample with homogeneous responses in the measured construct. More specifically, it describes the risk of falsely concluding that a new instrument may have poor reliability and demonstrates the use of an alternate statistic that may serve as a cushion against such errors. Data from two validation studies are used to illustrate the utility of the new statistic, referred to as R-Alpha or Relative Alpha. Included is a discussion of the limitations and appropriate use of the statistic in validating multi-item tests, assessment scales, and inventories.     

Chapter 17. Rural Mental Health

SUMMARY

Mental health services available in many rural communities are too limited in scope and availability to meet the needs of rural citizens. The future of mental health services for the rural poor will be impacted by state government decisions about Medicaid funding priorities. It is important that rural practitioners, especially those that work in the fields of mental health, health, and aging services, engage in advocacy for better coverage of the rural poor and low-income elderly persons. This chapter discusses issues of advocacy related to improving the provision of mental health services to older rural citizens as an important goal in the larger effort to expand and improve rural mental health service delivery throughout the nation.     

Use of an Online Community to Provide Support to Caregivers of People With Dementia

One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.     

Minimizing Social Desirability Bias in Measuring Sensitive Topics: The Use of Forgiving Language in Item Development

Abstract

Social science research has long been concerned with attitudes, beliefs, and behaviors that are potentially objectionable, immoral, or illegal. These types of topics include, for example, racism, ableism, cheating, and stealing, among others. Referred to as “sensitive topics,” their investigation usually involves questions that require respondents to admit to attitudes, beliefs, and behaviors that violate social norms, making their assessment susceptible to error due to social desirability bias. This article describes an empirical investigation of an approach to minimize this bias, the use of “forgiving language” in survey item development and the effect on item variability. Using secondary data initially collected as part of a measurement development study of mental health providers’ stigmatization of service users, 15 pairs of similar, thematically targeted items, varying with respect to wording approach were tested using a purposive sample of mental health providers (N?=?220). Findings indicate that items crafted in a forgiving manner were not significantly influenced by social desirability bias, in contrast to items developed in more traditional language. Additionally, forgiving language-items produced higher levels of agreement, on average, when compared to those written in more traditional language. More research is indicated, including systematic variation of wording approaches, but these results seem promising.     

Did we do our assessment holistically,thoroughly, and continuously?

ABSTRACT

This paper presents assessment work and practice of the welfare workers in assessing their service users in various child welfare settings in Sarawak, Malaysia. It draws on a qualitative research based on in-depth interview with respondents selected through purposive sampling. Thematic analysis was one of the major methods of data analysis in the study besides narrative analysis. Findings revealed that assessment work and practice of welfare workers are not being done holistically, thoroughly, and continuously. Issues concerning their assessment work and practice show that the underlying challenges are due to lack of proper training/courses specifically in assessment work provided for them and no assessment framework available as a guideline for their assessment work.     

A Qualitative Exploratory Study on the Service Delivery System for the New Long-Term Care Insurance System in Korea

ABSTRACT

To cope with the rapid growth in its aging population, the Korean government introduced a new social long-term care insurance (LTCI) system for elderly people beginning in July 2008. This study aims to understand how National Health Insurance Corporation (NHIC) staff and home-visiting service providers experienced and evaluated the new service delivery system. A total of 26 semistructured in-depth interviews were conducted with NHIC staff primarily responsible for the functional assessment of the elderly and the home-visiting service providers responsible for providing direct services to elderly clients. In summary, interviewees had negative experiences with the new service delivery system such as difficulties in carrying out their roles. The findings suggest that Korea's new LTCI service delivery system faces challenges and that a more active role for the Korean government, especially regarding the introduction of a proper care management system, is needed to address the issues. Future research with larger sample sizes is needed to examine and understand the issues in detail.     

Former Spouse Ties and Postdivorce Relationship Quality: Relationship Effort as a Mediator

ABSTRACT

One potential problem area in remarriages is problems with or ties to an ex-spouse. This study focuses on identifying factors central to the relationship dynamics such as relationship satisfaction and stability. Additional emphasis is placed on specific and targeted work in a relationship with the goal of improving it, and its potential mediating effect on any negative relationship between ex-spouse ties and low relationship quality. Using secondary data from the RELATionship Evaluation Survey (RELATE), a sample of 1,546 individuals in postdivorce romantic relationships was examined. The results indicate that unresolved issues and negative interactions with an ex-spouse are negatively associated with relationship quality, but effort to mediate this negative association shows promise. Practice recommendations include exploring how family service agencies and clinicians can better serve couples in postdivorce relationships. Further, a focus on the repartnered family system and a recognition of its difference from other family system types (i.e., first marriage) are important for agencies, clinicians, and researchers interested in providing services to stepfamilies and family life after divorce.     

Spirituality Among Alzheimer's Caregivers: Psychometric Reevaluation of the Intrinsic Spirituality Scale

ABSTRACT

The purpose of this study was to reevaluate psychometric properties of the Intrinsic Spirituality Scale (ISS) and to compare its results to the original psychometric report. Attendees of Alzheimer's caregiver support groups constituted the sample, relevant to this measure given their traditional, frequent use of spirituality as a coping resource. Data were randomly split for factor and reliability analyses (N ₁= 152) and validity analysis (N ₂= 152). Factor analysis on the ISS loaded all items on a single dimension of spirituality. Reliability was strong. Convergent validity was suggested via significant correlations with prayer measures. Enhanced with the original findings, these results lend credibility to the ISS as a viable spiritual assessment tool. The ISS offers social service professionals a valuable tool for assessing spirituality that is inclusive of individuals whose spirituality is nontheistic or for whom spirituality exists independently from, or outside of, organized religious structures. Future analyses with additional populations may broaden the ISS applicability among persons with diverse demographic and spiritual backgrounds.     

Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis

ABSTRACT

Increasingly, social workers and behavioral health practitioners use assessment instruments to support service planning and to monitor progress. Following statewide implementation of the Adult Needs and Strengths Assessment (ANSA) to identify behavioral health symptoms, related functional challenges, risks, and strengths, this validation study explored the underlying structure of the instrument. An exploratory factor analysis used routinely collected information for Midwestern adults with diagnosed behavioral health disorders who participated in community-based services (N = 46,013). Five factors with adequate to good internal consistency (α = 0.733?0.880) emerged: personal recovery, trauma and stress related problems, substance use risks, self-sufficiency, and cultural-linguistic considerations. Validation of the ANSA supports use of the instrument to engage individuals and families, to plan services, to monitor progress, and to conduct research. Implications for social work education, supervision, and practice include the importance of understanding culture, holistic assessment, and services supporting personal recovery for individuals living with mental illness or substance use disorders. Confirmation of findings requires additional research.     

Working and caring for a disabled adopted child during a pandemic

Integrating work and family demands can be challenging for families caring for a child with one or more disabilities. The pandemic and its changes to work, schooling and service delivery potentially added to these challenges. This exploratory mixed methods study sought to understand how the pandemic affected adoptive parents' work–life fit and service use. A total of 200 participants responded to survey questions about parenting an adopted child with a disability prior to, and after, the onset of Covid-19. More than half of the parents (59.2%) reported that it was somewhat to very difficult to integrate both work and family demands. Parents with greater access to workplace flexibility and supportive supervisors had significantly less difficulties combining work and family. Families who reported more problems with accessing mental health services, special education and respite care reported significantly more challenges with work–family fit. Parents reported increased stress due to the pandemic changes, but many also shared positive changes such as more time for family. Online services were experienced as effective for some children and reduced time spent driving to appointments. Recommendations for workplace and social service practice and policy supporting adoptive parents of children with disabilities are discussed.     

Formal Alternative Transportation Options for Older Adults: An Assessment of Need

ABSTRACT

This study measured the need for formal alternative modes of transportation among older adults by applying traditional factors of the Behavioral Model. Survey participants who regularly drove were compared to those who could no longer drive. Race/ethnicity and self-reported health were significant predictors of perceived need for transportation services for both groups. However, income and service awareness were significant predictors only for drivers, while family proximity was a significant predictor only for non-drivers. Results suggest the importance of gaining a better understanding of the factors associated with need for senior-focused transportation services to more effectively plan such programs.     

Support in the Workplace: Buffering the Deleterious Effects of Work–Family Conflict on Child Welfare Workers’ Well-Being and Job Burnout

ABSTRACT

We examined the impact of work–family conflict (WFC) on worker well-being and job burnout, as well as the role of social support in the workplace as a potential buffer against the influence of WFC. Results of hierarchical multiple regression analyses in a cross-sectional sample of 361 public child welfare workers indicate that WFC was related to reduced well-being and increased job burnout, whereas supervisory support moderated the relationship between WFC and well-being. Findings from this study hold implications to workforce management practices aimed at improving worker well-being in human service and child welfare organizations. Human resource management policies designed to manage worker schedules should aim to facilitate workers’ ability to meet work and family demands through programs such as flexible work schedules and telecommuting. Recommendations for future research on WFC and worker well-being are discussed.     

Cross-Cultural Validation of the Child Abuse Potential Inventory in Finland: Preliminary Findings of the Study Among Parents Expecting a Baby

ABSTRACT

In order to decrease physical child abuse, measures to recognize parents' abuse potential are needed. In this article, cross-cultural validation of the Child Abuse Potential (CAP) Inventory, an American measure was used to screen child abuse potential in families. Data were collected in 2012 from Finnish families expecting a baby at maternity and child welfare clinics. The data come from 380 families, including 375 mothers and 303 spouses. The validation was conducted separately for mothers and spouses and was based on basic psychometric properties, such as reliability estimates, abuse scale construct validity, and the abuse scale factor structure. The internal consistency of the abuse scale was high among both the mothers and the spouses. There were some differences in abuse construct validity and the abuse scale factor structure compared to the original measure, which was written in English and tested in an American sample. Those differences were, however, similar to those found by other studies that used translated versions of the inventory. In summary, the CAP Inventory was found to be a valid screening tool for professionals to assess parents' child abuse potential in Finnish service settings, and therefore its implementation is recommended in maternity and child welfare clinics. The validation supports the cross-cultural use of the CAP Inventory and future research on the subject.     

Efficacy of an Educational Program for Relatives of Persons in the Early Stages of Alzheimer's Disease

Abstract

This article describes the results of an educational intervention for family caregivers of persons in the early stages of Alzheimer's disease. A total of 45 family caregivers participated in this intervention that consisted of five weekly educational sessions about the disease and aspects of caring for someone in the early stages. Measures of knowledge about Alzheimer's disease, self-efficacy, reactions to patients' memory impairment, and level of depression at pretest and posttest were analyzed. Participants' knowledge about the disease improved substantially, self-efficacy and reactions to patients' impairments improved moderately, and level of depression showed no significant improvement. Results suggest that this intervention has merit for family caregivers coping with the early stages of Alzheimer's disease. Implications for implementation and evaluation are discussed.