Mark My Words! Service User and Carer Involvement in Social Work Academic Assessment

This paper discusses the involvement of service users in academic assessment as part of a second year module for social work undergraduate students at Canterbury Christ Church University in the UK. The three main tasks undertaken in partnership are detailed: designing an assessment form, assessment of student group presentations and assessment of a written reflective essay. The paper starts by identifying key questions raised by the assessor team before providing a critical commentary on the process, and identifying challenges and learning points. The experience emphasises the need for a more critical and searching approach towards service user involvement in social work education in academic assessment. Moreover, the team's experience suggests that such work is best achieved in the context of collaborative working relationships based on trust, with opportunities for team reflection and supported by training in academic assessment.     

User satisfaction surveys and cognitive question testing in the public sector: the case of personal social services in England

Obtaining feedback from service users is a key element of the UK Labour Government's agenda for modernization of the public sector. This reflects a growing international trend in Europe and North America. Recognized difficulties in taking an approach to performance assessment based on the concept of user satisfaction are outlined. Ascertaining the views of people who use personal social services poses particular challenges which result from the levels of impairment and illness in the population, local variations in service provision and the 'care and control' functions of social care. It is argued that cognitive testing of questions, based on research knowledge about user views, provides a way of overcoming some of the pitfalls of traditional satisfaction surveys, while developing questions that are meaningful to respondents. The origins and principles of cognitive testing are described, followed by an example of their application in the development of a questionnaire for home care users. Strengths and limitations of the approach are identified.     

Are the voices of parents heard? A scoping review of satisfaction in parenting programs

Parenting programs are an effective approach to promote positive parenting. In evidence-based practice, client’s values and preferences contribute to promoting quality, and are a crucial component of service evaluation. The current scoping review summarizes quantitative research that examines parental satisfaction with parent training for families with child conduct problems. We aimed to know how much research had been undertaken; what measures have been used; and what were the findings related to parental satisfaction. A scoping review was conducted to retrieve peer-reviewed original articles.Out of 420 papers 5.5 % obtained data on parental satisfaction. Seven different measures were used, mainly Therapy Attitude Inventory and Client Satisfaction Questionnaire. Out of 23 papers, ten studies reported Cronbach's alpha coefficients on the assessment that was used to evaluate parental satisfaction. All of the 23 included studies found that parents are very satisfied with the parenting program they have received.The findings indicate that only a few studies included parents’ values and preferences in quantitative evaluation studies on parental programs. In addition, there is a limited arsenal of assessment tools to measure what matters to parents. There is a need to develop measures with high psychometric quality, which will promote more quality in service evaluation.     

Parenting capacity

We describe an approach to the assessment of parenting for families in which child abuse has been established to have occurred. Neither the category of abuse nor its physical severity adequately predicts the future wellbeing or safety of an abused child. The critical variable in determining the child's future is the level of disturbance in parenting. We argue against the most common approach to assessments of parenting, which is to generate a non‐hierarchical list of issues with the emphasis on relatively concrete and readily measurable dimensions such as social support, parental knowledge about parenting and the child's developmental status. We enhance the standard approach to assessment by organizing it around parenting capacity. We do not attempt to operationalize parenting capacity, de?ning it as the parents' ability to empathically understand and give priority to their child's needs. Adequate parenting requires that the parents be able to meet the challenges posed by their particular child's temperament and development (which may be shaped by the abusive experience) and also to accept and be prepared to address their own intrinsic characteristics which impede their parenting capacity. Parenting capacity is more dif?cult to assess than the more concrete and commonly measured aspects of parenting, but we argue that its assessment should be central to child protection management decisions. Copyright © 2004 John Wiley & Sons, Ltd.     

Children's services in the UK 1997–2003: problems,developments and challenges for the future

This article reviews developments in children's services since 1997 and considers their effect on children in need by examining government statistics, recent additions to the evidence‐base, and data from two studies conducted by the authors. It shows that there has been extensive service development, mainly beyond the Department of Health, and considerable effort to improve assessment and administrative data. The limits to what can be demonstrably achieved by children's services, particularly in a short period, are acknowledged, and it is argued that the approach of providing predominantly low level interventions to large groups may need re‐thinking if significant and lasting changes to children's development are to be secured. Copyright © 2003 John Wiley & Sons, Ltd.     

Effective relationship-based practice: A theoretical exploration

This paper looks at the importance of a relationship-based approach within social work. It explores past writings on the social worker-client relationship, why the relationship was seen to be central to effectiveness and good practice, and why this perspective fell out of favour. It revisits the importance of a relationship-based approach, within a psychosocial perspective, in relation to eight areas of practice. These include the assessment task and process; relationship difficulties; people who are vulnerable or reliant on others for their well-being; situations that require practitioners to be able to hold and contain anxiety; the relationship as a foundation for capacity building, empowerment and developing people's potential; and in relation to disadvantaged and marginalised sectors of the population, how social workers can use the 'front-line' knowledge they have gained through the relationships they have created in political ways--to bear witness and report on 'social ills' as they impact on the lives of service users. A final section looks briefly at how the service user-social worker relationship is perceived and described in the Benchmarking Statement, National Occupational Standards and the General Social Care Council's Rules and Requirements and their implications in terms of the new social work degree.     

The involvement of service users in the assessment of Diploma in Social Work students on practice placements

The government, local authorities and academic institutions in the United Kingdom all positively support the involvement of service users in social work practice and education. Based upon research undertaken for a Master's dissertation, this article argues for such an inclusive approach. The author works for the Training and Development Services of an English Social and Caring Services department, which delivers a Diploma in Social Work course in collaboration with the local university college. This course began to incorporate service users' views in the assessment of students on practice placements in the mid-1990s. This was a helpful development, although areas of ambiguity and difficulty became apparent, as did a lack of clarity and consistency in the implementation of the process. A qualitative survey of the views of practice teachers was conducted by means of semi-structured interviews, which focussed on the main principles, issues and practical implications of service user involvement in the assessment of DipSW students. The article offers a summary of the findings of the survey, and a critical discussion of the main issues and difficulties that emerged. Some recommendations are made for the course that the author is associated with, although they would probably apply to most DipSW courses in the United Kingdom. The author is male, white and British.     

Reducing youth's drug abuse through training social workers for cognitive–behavioral integrated treatment

Cognitive–behavioral integrated treatment (CBIT) is an intervention that social workers can learn to treat youth's drug abuse by cognitive restructuring, behavioral modification, and goal setting. A way to enhance the learning is training specifically for CBIT. Evaluation of the effectiveness of such training in raising social workers' CBIT practice and their young service users' illicit-drug-free days is the aim of this experimental study. This study first randomly assigned 14 outreach social workers to receive training for CBIT and 14 outreach social workers not to receive the training. The study also assessed 222 young service users (aged 11–22 years) engaged by 28 outreach social workers before the training and 169 of them after the training in a six-month follow-up. Furthermore, the study identified the reduction in the youth's dysfunctional cognition of playfulness as a means to deter the youth's drug abuse, based on personal interviews with outreach social workers and their young service users before the training. Derived from the statistical analysis of assessment data, results principally showed cascading effects from the social worker's reception of the CBIT training to the young service user's reception of CBIT, reduced playfulness, and lengthened drug-free days. A supplementary finding was that the young service user's time in the outreach social work service prolonged drug-free days and reduced playfulness. These results imply that the outreach social work service, CBIT training, and CBIT are useful for treating youth's illicit drug abuse.     

The Viability of Readiness Assessment in Contributing to Improved Career Services: Response to Jepsen (2000)

This article responds to D. A. Jepsen's (2000) commentary on Sampson et al.'s theory‐based approach to using readiness assessment to improve career services (J. P. Sampson, G. W. Peterson, R. C. Reardon, & J. G. Lenz, 2000). Three topics are included in this response: the reliability, validity, and utility of readiness assessment measures; verbal ability and the use of cognitive information‐processing theory in practice; and the potential contribution of reflective evaluation in career decision making. This article concludes with recommended research questions to examine the impact of readiness assessment on the effectiveness of career service delivery.     

The place of “think family” approaches in child and family social work: Messages from a process evaluation of an English pathfinder service

Findings are reported from a process study of an English multi-disciplinary team working with families with long standing and complex problems. The approaches and methods of the team are described and placed in the context of UK policy developments and of UK and USA research on professional practice with families facing multiple difficulties. Basic data are provided on all families referred in the first year and analysed with respect to the first 100 completed cases. A broadly ethnographic research approach is used for the observational study of the team interactions and decision-making on individual cases. For a one-third sub-sample of 33 cases, process and interim outcome data are analysed from information systematically extracted from case records. These are complemented by qualitative data from interviews with managers and caseworkers and by observation of ‘team around the family’ and professionals' meetings. The researchers conclude that the service succeeds in engaging a majority of the referred families who have been hard to reach or hard to change in the past and whose children are either ‘on the edge of care’ or likely to be significantly harmed without the provision of an intensive service. The researchers concluded that improvements were made in the life chances of children in 75% of the families. Aspects of the service identified as associated with more positive outcomes are: the allocation of two key workers (one for the child/ren and one for the parent/s); the centrality of relationship-based practice and flexibility of the approach rather than strict adherence to any particular practice model; the fact that the service is firmly embedded within the statutory children's services department, allowing for continuity of relationships with team around the family members when the intensive service ends; and flexibility about case duration and intensity.     

Internal and External Stress Factors Associated with the Identity Development of Transgendered Youth

Abstract

The goal of this paper is to present an alternative to a traditionally-held view that transgendered youth suffer from some sort of disorder, and instead shed light on the internal and external stress factors that may lead the young person to seek help. Social service professionals need to be aware of such factors in order to make a full assessment of what a potential transgendered adolescent client's issues are, and in order to work at changing some of these external pressures societally so that more transgendered youth can attain peaceful identity integration.     

The reform of the welfare services in Norway: one office – one way of thinking?

This paper discusses the professional role of social workers in the new Norwegian Nav system. The Nav reform merged the state social insurance office, the state employment office and components of municipal social services. The aim is to include clients in the work force by making the services more holistic and efficient. The paper presents a discussion of the introduction of the ‘Nav reform’, drawing on a qualitative multi-method study. The material sheds light on a social worker's role under pressure to work in a more standardised and ‘simplified’ way. Social workers at the Nav offices must adjust to expectations that require a general, basic and common competence for all employees, as one type of comprehensive, but simplified and non-specialised, approach. The study describes the dilemma of how to combine one-stop service and specialist principles. The paper attempts to criticise ‘the flexible system’ related to Whole of Government perspectives and one-stop service principles as a generalist ‘light’ approach, as opposed to the generalist approach in social work. The findings provide a basis for raising questions about the development of the social worker's role in light of the post-New Public Management (NPM) reforms and the potential threat to the professional basis of social work.     

Analysis of an addictions treatment system

A treatment system consisting of an assessment/referral service, a detox, a mission, a hospital recovery unit, and three recovery homes was examined using a retrospective client-tracking approach over 1 year. There were 4,187 admissions to the system accounted for by 1,522 individuals; system users tended to be males, unmarried, unemployed, and in their 30s and 40s. The best predictor of readmission to the system after treatment was prior system use. Use patterns and referral data indicated that perceived gatekeepers (i.e., detoxication and assessment services) were not consistently coordinating the system and that more socially stable clients appeared to be more likely to be involved with non-addiction specific services (i.e., medical, general counselling).     

Specialist assesstnent services for child abuse and neglect

This paper describes the Child Protection Service, Flinders Medical Centre, South Australia, a specialist assessment service for infants, children and adolescents following allegations of abuse and neglect. The psychosocial and medical services provided for infants, children, adolescents and their families are outlined briefly and the Child Protection Service's view that the assessment process can and needs to be therapeutic is discussed. Data was provided about the age and gender of infants, children and adolescents seen and the number of families referred on for longer-term therapeutic intervention. The unit's philosophical stance, affecting its clinical practice and interagency and consultation service, is described, as is its research focus. The paper also raises a number of issues that warrant further and detailed attention. These include the need for workers to monitor and attend to their emotional responses while working in the area of abuse and the destructive potential of denial that may consequently and subtly impact on professional practice. The tendency for professionals and the wider society to ignore the impact of physical abuse is also raised.     

A learning collaborative approach to training school-based health providers in evidence-based mental health treatment

Collaborative care models among pediatric primary care and child and adolescent mental health providers are increasingly emphasized to improve quality of and access to mental health services. The current case example of a multi-site clinical training opportunity in school-based collaborative care settings illustrates the success of a learning collaborative approach to improve children's mental health care in schools. Quality improvement data from participating sites indicated an increase in use of evidence-based practices (i.e., “core skills”) and an improvement in quality service delivery indicators for children's mental health (i.e., screening, risk assessment, diagnostic processes, associated diagnostic coding, use of core skills, associated procedural coding, and follow-up assessment and referral) over time. Clinician self-report and chart review data are supplemented by qualitative data from site leader interviews conducted following completion of the project. Implications for mental health workforce development to improve the quality of care to children and adolescents in schools and other community mental health settings are discussed.     

The Status of Nutrition Education in ACHA College and University Health Centers

Abstract

An assessment of the prevalence and scope of nutrition services offered through 208 randomly selected American College Health Association member student health centers revealed that 79% of the 160 respondents provided some type of nutrition education for students. One-to-one counseling, available at 96% of the institutions, was the most common approach. The larger the school's enrollment, the more likely it was to provide programs in nutrition. All of the institutions with student populations of more than 35,000 offered some type of nutrition service, as did 52% of the 19 schools with enrollments between 2,000 and 5,000. Health educators, nurses, doctors, dietitians, and trained peer educators provided the services, with registered dietitians the most common providers and often coordinators of the programs. Costs to students for nutrition interventions were nominal; weightmanagement programs were the most expensive and showed the greatest variation in content.     

The systems' approach and social work methods

Many social work courses are now using ‘system theory’, or as I prefer to call it, ‘a systems' approach’, in teaching social work method on a unitary basis. Most social work techers recognise that the systems' approach is not enough on its own and that traditional methods have a place in practice. What is not clear is how these methods relate to the systems' approach.

In this article the relationship between the systems' approach and various methods and theories of intervention is explored in a number of different ways. Firstly, there is an examination of the relationship of various client, target and action systems. Secondly. Lippitt's analysis of the ‘diagnostic orientations’ of change agents is discussed and related to strategies aimed at changing the goals and the power structures of target systems. Then certain counselling and casework methods are considered in relation to Lippitt's analysis, leading on to a brief comment on methods of intervention based on systems' theory. Finally, an educational strategy for presenting this approach is discussed.     

See no evil,hear no evil,speak no evil: assessing complex trauma in young children

Complex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings.     

Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.     

Aged Care Service Delivery in Japan

Summary

The implementation of Japan's Long-Term Care Insurance Scheme in early 2000 presaged many changes in service delivery and much debate among service providers, different levels of government, academic analysts, and major media interests. The first part of this paper gives an account of the major changes in the organization of service delivery that have increased opportunities for private sector providers, including large corporations, and restructured contractual relationships between municipalities and providers in all sectors. New arrangements for client assessment, classification, care management, and extended service types are then outlined. An assessment is then made of the likelihood that the expected outcomes of the scheme will be realized, with the concerns of welfare professionals that the public welfare system is under threat juxtaposed with bureaucratic goals of liberalizing the provision of long-term care.