Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Localising Social Work: Lessons Learnt from a Community Based Intervention amongst the Bedouin in Jordan

This paper presents an example of local social work practice in Jordan in the health field. It draws on a research study on Bedouin health in the North Eastern Badia. The project developed, implemented and evaluated a training intervention developed in partnership with a range of providers for improving local social work practice. Evaluation methods used included a pre and post test, focus group discussions and students' field notes. Findings revealed the significance of promoting culturally competent practice to respond to local health and social needs. Students and practice assessors agreed that the training interventions were an effective way to implement theory into local practice in relation to Bedouin society. This training intervention is an example of developing local social work practice as a way of responding critically to social inequalities.     

Moving On From Supportive Housing (MOSH): Development and evaluation of a transitional skill-building curriculum for providers helping residents exit homeless services

This article describes the development and evaluation of MOSH (Moving On From Supportive Housing), a transitional skill-building curriculum for providers helping residents exit homeless services to mainstream housing without embedded supports. In this evaluation, we assess the feasibility, acceptability, fit, and potential efficacy of the MOSH curriculum to improve proximal provider-level outcomes, including self-efficacy to provide MOSH-related independent living skills and supports. Homeless-services providers (N = 49) from a range of programs and settings participated in the training. Findings from focus groups and pre- and posttest surveys indicate high levels of overall satisfaction with the training. The majority of trainees perceived the training to be useful to their work and potentially useful for service recipients, felt the training would fit well within their existing day-to-day work, and said they were very likely to use MOSH skills in such work. Statistically significant improvements in self-efficacy regarding all skills but one were also found. MOSH holds promise as an intervention that can enhance provider practice and promotion of independent living skills in homeless services. Although these initial findings on MOSH are encouraging, further research will be needed to evaluate provider knowledge gains and effective use of these skills in practice.     

Issues in African-American family preservation

This article is concerned with African-American family preservation. The authors' assumptions are that (1) child welfare service takes place in a cultural context; (2) effective work with African-American families requires a culturally relative "nondeficit" perspective on African-American culture; (3) this begins with helping service providers to acquire an analytical approach to culture and factual knowledge about the cultural behavior of clients; and (4) staff members must be prepared through training to implement a cultural knowledge base in transactions with African-American families and must have the supervisory and policy supports to do this. The several practice issues central to African-American family preservation are highlighted.     

Making Continuing Professional Development Relevant and Accessible in Regional Social Work

ABSTRACT

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

IMPLICATIONS

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

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

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

     

Service providers to the homeless mentally Ill: Their thoughts,perceptions, and recommendations for the homeless

A qualitative research study was conducted to obtain an understanding of the people who provide services to persons who are homeless and mentally ill. Service providers were asked about the kinds of services they provide, what they consider beneficial to this population, the kinds of services they would like to provide, and what is needed to alleviate the homeless problem. Services found in the study included, those that meet basic needs, psychiatric/medical services, social services, and activities. Service providers indicated the major service priority is housing and the necessity of: (a) a safe environment, (b) additional psychiatric/social services, (c) day programs, and (d) health care. It is recommended that service providers advocate for the necessary improvements in services including, collaborative workshops and training sessions to the public and to each other.     

Therapists’ Assessments in Treating “Sex Addiction” and Their Relationship to Clients’ Gender,Relationship Status,and Exclusivity Status

A total of 208 therapists and therapists‐in‐training were surveyed to better understand if clinical assessments and recommendations regarding “sex addiction” changed based upon a client's gender, relationship status, or exclusivity status. Using clinical vignettes, this study examined the clinical assessment and recommendations of licensed mental health providers (n = 92) and mental health providers in‐training (n = 116). Results indicated that professional ratings differed based on relationship exclusivity and gender; specifically, female nonmonogamous behavior was rated more negatively than male nonmonogamous behavior, while male monogamous behavior was rated more negatively than female monogamous behavior. Recommendations for treatment varied, with higher addiction ratings leading to greater odds of recommending individual, group, and community support over relational therapy. Clinical and training implications are discussed. Video abstract accessible by clicking here .     

Variations in provider capacity to offer accessible health care for people with disabilities

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

The impact of state TANF policy decisions on kinship care providers

Based on a survey of public assistance and child welfare agency staff, this article examines how state Temporary Assistance for Needy Families (TANF) policy decisions have affected kinship care providers. Findings indicate that most states have continued using TANF to provide income support to kinship caregivers, and some have used TANF to find related support services. These payments, however, are much lower than rates for licensed providers, and many kinship caregivers are subject to work, training requirements, and time limits.     

Developing Family-Centered Models of Genetic Services

Abstract

This article reports the findings of an exploratory, multi-method study conducted for a state health authority to examine stakeholder perceptions of existing genetic services and service ideals using survey and focus group methodologies. A web-based survey of medical providers and allied health professionals (N = 567) examined the knowledge needed by service providers to deliver competent genetic care. A second web-based survey of programs (N = 15) viewed as potential partners in the delivery of genetic services was conducted to explore the potential for interagency coordination, the family-centered nature of these services, existing training, and general agency ideals and values. Focus groups were also conducted with 4 groups of families and 3 groups of service providers to explore their perceptions of current and ideal services. The strategies yielded important information around service needs, resource issues, barriers to service, psychological issues, and education and information needs related to the delivery of genetic services. Implications for professional education, especially social work education, are also covered.     

Service Providers to the Homeless Mentally Ill: Their Thoughts,Perceptions, and Recommendations for the Homeless

A qualitative research study was conducted to obtain an understanding of the people who provide senvices to persons who are homeless and mentally ill. Selvice providers were asked about the kinds of selvices they provide, what they consider beneficial to this population, the kinds of selvices they would like to provide, and what is needed to allevwte the homeless problem. Selvices found in the study included, those that meet basic needs, psychiatric/medical selvices, social setvices, and activities. Service providers indicated the major selvice priority is housing and the necessity of: (a) a safe environment, (b) additional psychiatric/social selvices, (c) day programs, and (d) health care. It is recommended that selvice providers advocate for the necessary improvements in services including, collaborative workshops and training sessions to the public and to each other.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

Social work students with personal experience of sexual abuse: Implications for diploma in social work programme providers

Social work training attracts a significant proportion of students with personal experience of psychosocial trauma and oppression, including various forms of abuse. This article considers some of the implications for social work educators. Sexual abuse is the oppression selected to illustrate this discussion because it is central to contemporary social work training and practice and it is the author's experience that student disclosures of sexual abuse are common. Emotive but unavoidable for both students and educators, sexual abuse issues demonstrate the need for programme providers to address their responsibilities to applicants, students, partner agencies and service users. Continued failure to do so ignores the risks of legal liability and raises questions of whether their practices are consistent with the DipSW's value base. DipSW programme providers are advised to take practical steps both to protect themselves and to provide appropriate support for students. They are asked to review application and selection procedures and urged to define the roles and expectations of course tutors and practice teachers.     

Getting to Know the Piece of Fluff in Our Ears: Expanding Practitioners' Cultural Self-Awareness

Israel being a multicultural society with a variety of ethnic groups, the delivery of culturally competent services is a crucial issue in social work practice. This paper describes the outcomes of a training model for cultural competence applied with social work graduate students in Israel. The model, based on work with immigrants' narratives, increased the cultural self-awareness of the trainees. Presented are conceptual and technical aspects of the training model as well as outcomes of an evaluation study. Fifty-one trainees submitted a short account of their personal experiences following the training. The reports indicated expansion in the trainees' cultural self-awareness: awareness of their own and their families' immigration experiences as well as of other transitions in their lives. Training elements that made this outcome possible are discussed.     

Educating for cross-disciplinary collaboration: Present trends and future possibilities

Abstract

Like other service providers, social workers periodically seek to harness different professional skills and insights in order to make a more comprehensive response to client needs. Unfortunately, cross-disciplinary relationships are hard to establish and maintain, due to structural and cultural barriers. Education and training programs can be used as tools to inculcate the knowledge, skills and attitudes on which successful collaboration depends. The targeting of undergraduate students is controversial. Since they have yet to develop a sense of professional identity, these students may resist pressures to trust and share. This paper contends that it is reasonable to begin instruction at the undergraduate level, and explores possibilities for curriculum development and research.

In summary

Like other human service providers, social workers must come to grips with industrial realities of the early 21st century. As part of this process, they must reappraise their role relationships with other service providers. On some matters at least, it may be possible to transcend traditional rivalries, and develop new forms of partnership and alliance. Education and training programs have a useful role to play in developing the knowledge, skills and attitudes on which successful cross-disciplinary work depends.     

Working with Homeless Populations to Increase Access to Services: A Social Service Providers’ Perspective Through the Lens of Stereotyping and Stigma

Through the lens of stereotyping and stigma, this article examines discrimination and prejudice toward homeless families from the perspective of social service providers. Semi-structured qualitative interviews were conducted with practitioners. A critical social work practice perspective is used to provide a framework for understanding how social worker knowledge about discrimination and prejudice informs the ways in which the workers engage with clients, build capacities, and advocate for clients in an anti-oppressive manner. The themes found in this study include: a) providers’ awareness of bias, stereotyping, prejudice, and discrimination; b) providers’ use of a range of strategies to work with people experiencing homelessness; c) providers’ ideas about strategies that organizations can implement for service provision; and) providers’ belief that additional advocacy and policy are needed in relationship to people experiencing homelessness.     

Service users’ involvement in social work education: focus on social change projects

ABSTRACT

This article presents and analyzes four projects focusing on diverse forms of service users’ involvement in social work training and research in different countries (Israel, Italy, Slovenia and UK). It highlights the value of service user involvement (SUI) to specific social change objectives and to social work education. The conceptual framework focused on the Standpoint Theory, while methodologically participatory action research was applied, and evaluation measures were developed. Key findings, facilitators and limitations to the involvement, students’ views of it and similarities and differences among the four projects are outlined. The challenges embedded in introducing and sustaining social change objectives in a co-production framework within social work education are identified, alongside the added value of meeting them. The differentiated impact the projects had on students is highlighted as well as their significance for health and social care providers were relevant. It is encouraging that in each project SUI was positively valued. The projects indicate the wide range of SUI in the content and format of social work education, as well as its applicability cross-culturally to a range of key issues pertaining to both training and research in social work.     

Training together: An exploration of a shared learning approach to dual diagnosis training for specialist drugs workers and Approved Social Workers (ASWs)

This paper is the first of two linked articles exploring a shared learning approach to developing 'professional collaboration' as one way of improving care for people with complex inter-related mental health and substance misuse needs. The target groups for the training in this study are Approved Social Workers (ASWs) and specialist drugs workers. The article describes the social and professional contexts that shape the different training agendas for the respective groups of workers in an attempt to identify common themes that can be used as a foundation for developing training solutions. The relevance of a shared learning method of training delivery is critically discussed and the way in which this was adapted to respond to training needs identified in Birmingham is outlined. The paper concludes by suggesting that training providers should be encouraged to identify the common agenda for drugs workers and ASWs working with people with mental health and substance use needs and utilise a shared learning methodology to respond in a proactive way to improving service delivery through effective training. The second paper provides an in-depth exploration of the training delivered. Using a formative evaluation framework the paper reflects upon the methods employed to: ” identify curriculum content; ” promote collaborative working through different approaches to interprofessional learning; and ” demonstrate how the training is impacting on practice outcomes.     

A Screening,Brief Intervention,and Referral to Treatment Collaborative: Impact for Social Work Students

Screening brief intervention, and referral to treatment (SBIRT) is a clinical intervention empirically linked to reductions in substance usage. However, less is known on how to effectively train social work students on SBIRT. This study examines the impact of a SBIRT training administered to BSW and MSW students (N=228) at the University of Oklahoma. Based on exposure to the training, our evaluation measured changes on students’ objective knowledge of how to perform SBIRT and in attitudes toward practicing with substance users. Results indicated exposure to the training was associated with robust gains across variables and across classes. Such results suggest that the proffered SBIRT training is an effective means to educate social work students on substance abuse practice.