Factors influencing service coordination in rural South Australia

This paper discusses those factors identified in both the review of literature and from the results of nine focus groups held in rural communities that influence service coordination. The paper shows that the practice wisdom of service coordination is congruent with the findings from research on this topic. It discusses the facilitators, inhibitors and triggers to service coordination within these communities. Informal networking and the support given by management are recognised as important facilitators and the competitive tendering funding process and ‘professional elitism’ are seen to be major inhibitors to service coordination. Important triggers of service coordination were perceived to be the efforts of key individuals in providing leadership of the coordination process and the keenness of human service workers to reduce duplication.     

Racial/Ethnic Differences in Court Referred Pathways to Mental Health Services for Children in Foster Care

Racial/Ethnic disparity in placement patterns and service utilization among children in foster care has been documented in a variety of studies. This study examined the role of the court process in referring children in foster care to mental health services and tested for racial/ethnic differences in the patterns of referral and service use. Court records for 142 children ages 2–16, representing Caucasian, African American, and Hispanic racial/ethnic groups were reviewed. Results indicate that the court process does play a significant role in referring children to services. Significant differences by race and ethnicity in mental health service utilization prior to the child's protective placement, as well as service orders, and post-placement service use were identified. Caucasian youth were more likely to receive orders for psychotherapy and to have documented use of psychotherapy than were African American and Hispanic youth, even when the possible confounding effects of age and type of maltreatment were controlled. Implications for the effective delivery of supportive services to those children most in need are discussed.     

Designing for social inclusion of immigrant women: the case of TeaTime

We present our design of a digital service supporting social inclusion among immigrant women in an ethnically and socially diverse neighbourhood of a small Finnish town. The aim is to explore experiences and perceptions as well as potential barriers and challenges for using the web-based service. The case study is framed as design research having a strong user-centred design approach. We describe the design process and present the results of a mixed-method evaluation. The results are scrutinized from the perspectives of experience design. The analysis reveals a potential to facilitate social inclusion through the fulfilment of needs related to relatedness, autonomy, competence, pleasure and stimulations as well as popularity. However, some challenges in the interface design and communication of the security and purpose of the site were identified in the study. Significant differences were also found between immigrant women and local people regarding the need for this digital service.     

The dysfunctional side effects of quantitative indicator production: illustration from mental health care (a message from Chicken Little)

In the current context of economic conservation, accountability and retrenchment from social programs, justification is required in order to maintain human service capacity. In this effort, evaluation is a key component. Yet desire to base action upon information resulting from evaluation must be tempered by increased attention to the effects of the evaluation process. All too often premature application of quantitative indicators formerly used for individual assessment and research to bureaucratic decision making produces side effects that are dysfunctional in nature. Frequently these side effects influence service delivery directly. More insidious, because they are less easily discerned, are distortions introduced into the data by evaluation pressure. These not only delay effects on service but also impair understanding of the very process they are meant to illuminate. In order to illustrate this phenomenon, the author reviews a general literature and utilized examples from mental health care. Common themes are identified and a tentative theory of side effect generation proposed.     

The Impact of Clinical Information Systems on Human Service Organizations

Summary

Human service organizations are beginning to utilize computerized information systems for a variety of purposes. This new information technology is expected to have a major impact on human service organizations. However, work to date has explored the impact of information systems designed for administrative and managerial tasks while clinical information systems focusing on direct practice have yet to be studied systematically. In this paper, is described the impact of a clinical information system on the work of line workers and the HSO as a whole. Five stages in the problem solving process are identified: Information collection, information processing, professional judgment, decision making, and action. They are viewed as stages in a feedback loop such that die action sequence of one cycle leads to an information collection stage in the subsequent cycle and so on. The possible impact of a CIS on practitioners at all levels from line worker to HSO clinical leadership is analyzed at each of these five stages. A case example of the CIS developed for the foster care service in Israel is utilized as an illustrative example.     

Matching needs and services: an assessment tool for community-based service systems

This article presents results from an outcomes-based needs assessment in an urban service district, using case record data to profile service needs in different communities. The methodology emphasizes consistent collection of data from actual case records and explicitly includes line staff and clients in the planning process. Such reviews could benefit a variety of community-based child welfare, health, and education systems, although implementing identified service strategies can be challenging.     

Service Learning in a Small Groups Course

This paper describes a service learning program used in a Sociology of Small Groups course. Service learning programs attempt to apply knowledge learned in the classroom in a setting of community service. This paper advocates the use of service learning as a tool for applying social knowledge even in courses that are not traditionally linked with service learning. The usefulness of a service learning program in a group processes course is identified. Details on the content of the program, the methods of evaluation and the relevance to the course material are provided. Numerous examples of how service learning can lead to classroom enhancement activities are described.     

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.     

The Fount of All Knowledge: Training Required to Involve Service Users and Carers in Health and Social Care Education and Training

A modified Delphi study was carried out in order to obtain consensus regarding the content of a university training course to involve service users and carers at all stages of the health and social care educational process within a higher education environment. Telephone interviews were carried out with service users and carers, educationalists and leaders in the field of service user and carer involvement to generate curriculum ideas. A questionnaire was developed from their responses and sent to a purposive sample of 65 people (24 service users and carers, 28 health and social care educationalists and 13 leaders in the field of service user and carer involvement). Fifty‐five statements were generated with consensus being reached on 46 (84%) statements. Mismatches between service users and carers, educationalists and leaders in the field were explored. Key themes to be included in the curriculum were identified. This paper demonstrates that the best training is not imposed upon service users and carers by academics or others who think they know best; rather, that service users and carers themselves can play a leading role in identifying their training needs and devising strategies to ensure these needs are effectively met.     

Children's protective services and law enforcement: fostering partnerships in investigations of child abuse

Although collaboration in child abuse investigations has been emphasized since 1974, barriers, including role conflicts and organizational differences, have often been reported. This study describes the process of collaboration based on the perceptions of investigators working with a Child Advocacy Center. Telephone interviews were conducted with 290 child protective service workers and law enforcement officers from 28 child advocacy centers in 20 different states. Respondents identified barriers to the process of collaboration such as conflicts over case control and facilitators including co-housing and cross-training. Conditions that should contribute to successful collaboration are discussed.     

Agency policy and the participation of children and young people in the child protection process

This article explores agency policy in relation to children's participation in the child protection process. This was done by examining policy documents and conference minutes and by interviewing social workers and conference chairs working in child protection in Wales. Issues and dilemmas surrounding the participation of children and young people in the child protection process are identified and examined. The lack of children's more direct participation was noted, but many agencies were taking action to inform themselves of children's views indirectly. Advocacy was being more frequently used, and highly valued where it was available, but did raise some role dilemmas. The essentially child‐unfriendly nature of child protection processes (particularly the conferences) was identified as a significant barrier to promoting children's voices. The contradiction of trying to promote children's direct participation in a process that is inherently not geared towards their direct involvement was noted. The total lack of children's input into service planning for child protection services was seen as significant. Copyright © 2006 John Wiley & Sons, Ltd.     

Rural gentrification and the processes of class colonisation

The term rural gentrification is examined and contrasted with contemporary debates over urban gentrification. A common root, in the displacement of a working-class populace by middle-class incomers, is identified and also criticised. Attention is drawn to debates current within urban studies concerning the definition of gentrification as a process of capital investment or as a means to purchase particular lifestyles, the role of reproductive work and service provision, and the possibility of diverse types of gentrifiers and processes of gentrification. The paper investigates, through a substantive study of households in four villages in Gower, whether some of these arguments can illuminate understandings of rural gentrification. Claims that gentrification is necessarily associated with home owners acting as capitalist developers or with an emergent service class are questioned and the possibility of ‘marginal gentrifiers’ is raised. It is also suggested that asymmetries in class positions of householders may be constitutive of rural gentrification. Finally it is argued that comparative work should be undertaken to draw out both the commonalities and differences between rural and urban gentrification and also within gentrification in various rural localities.     

Overcoming Barriers to Homeless Delivery Services: A Community Response

Homelessness is one of the most pressing social problems today. The.lnstitute of Medicine defines the problem as a failure in the support systems created to prevent the problem and a tighter housing market. The assumption is that the support system should help to prevent the occurrence of homelessness. The Eastern Fairfield County area peiformed a study to look at the relationship between those services serving people who are homeless and near homeless to determine the availability, accessibility, and adequacy of services for homeless people. The study identified several barriers in the service delivery system. A strategy was then developed to address these barriers. This paper shows how a research process can facilitate a community response to a social problem. The paper presents the steps that were taken so other communities may replicate the process.     

Using primary and secondary stakeholders to define facility-to-community transition needs for adjudicated youth with disabilities

Stakeholder participation, specifically the primary beneficiary, enhances evaluation results by increasing the overall validity of the evaluative measure. This article provides an example of how the addition of adjudicated youth, the primary beneficiary, as a stakeholder group in a needs assessment provided additional information important for program development of a multi-agency transition program. The needs assessment consisted of five regional community forums comprised of youth correctional facility and community-based service providers (n=127), as secondary stakeholders. A nominal group process was completed defining both supports and barriers to the development of the service delivery model. Additionally, qualitative in-depth interviews were conducted on adjudicated youth (n=33) to describe their perception of the barriers and supports necessary for a successful transition from either a youth correctional facility or off of probation. Both groups identified and ranked the top 12 supports and barriers. Common themes emerged from both groups with substantive differences providing information that helped shape the program service delivery model to accommodate needs of both the adjudicated youth and secondary stakeholder participants. Implications for the development of the service delivery model are described.     

Overcoming Barriers to Homeless Delivery Services: A Community Response

Homelessness is one of the most pressing social problems today. The Institute of Medicine defines the problem as a failure in the support systems created to prevent the problem and a tighter housing market. The assumption is that the support system should help to prevent the occurrence of homelessness. The Eastern Fairfield County area performed a study to look at the relationship between those services serving people who are homeless and near homeless to determine the availability, accessibility, and adequacy of services for homeless people. The study identified several barriers in the service delivery system. A strategy was then developed to address these barriers. This paper shows how a research process can facilitate a community response to a social problem. The paper presents the steps that were taken so other communities may replicate the process.     

Perceived Needs of Therapeutic Service Providers in Their Work with Families in the Child Welfare System

Each year approximately half a million children are identified as victims of abuse or neglect in the United States. Referrals to therapeutic service providers are a primary means to help alleviate risks leading to child maltreatment and promote child and family well-being, yet it is not clear how well therapeutic service providers are prepared to meet the specialized needs of a child welfare client population and/or navigate the contextual characteristics of child welfare practice. The purpose of this study was to assess the gaps in knowledge and skill among therapeutic service providers working in this specific service setting. Five focus groups were conducted with 40 current therapeutic service providers working with clients involved with state child protective services. Data were analyzed using conventional content analysis methods. Fifteen themes emerged and were organized into three primary categories of needed knowledge and skill development: (1) cross-system, (2) therapeutic, and (3) functional. Implications for training and practice are discussed, as well as directions for future research.     

Rural Area Agencies on aging: An overview of activities and policy issues

This article presents an overview of the nature and service activities of rural Area Agencies (AAAs) with data from a recently completed national survey. Compared to their urban counterparts rural AAAs serve much larger, more sparsely populated areas with poorer and older elderly populations; have much smaller budgets and staffs; and support fewer services. This leads to a clear rural disadvantage in resources and services for the elderly. Policy makers need to examine and address factors identified as associated with this rural-urban inequity including SUA intrastate funding formulas, “rural” service models and training needs, and regulations regarding direct service provision. Important research and policy questions in need of further study are also identified.     

Oppression and Barriers to Service for Black,Lesbian Survivors of Intimate Partner Violence

This narrative study identified service barriers from the perspectives of 16 Black lesbian survivors of intimate partner violence (IPV). Qualitative analysis revealed diverse interrelated barriers similar to those identified by service providers in a previous study by the authors, including societal barriers such as heterosexism, and institutional barriers such as ambiguous policy. Results indicate that the theory of intersectionality is best poised to frame an investigation of the complex barriers encountered by these survivors. Results also demonstrate that although these women desire to receive services, current inequities prevent them from accessing support and further endanger, victimize, and isolate them. Strategies for improving services and reaching culturally diverse survivors are also discussed.     

Design Imperatives to Enhance Evidence-Based Interventions with Persuasive Technology: A Case Scenario in Preventing Child Maltreatment

ABSTRACT

This article examines how current thinking in persuasive technologies may be applied to evidence-based therapeutic interventions through a planned and multidisciplinary design process. Design steps identified in the human services and the design sciences are merged to generate six design imperatives. The need for human service knowledge to inform design is discussed in each design imperative. A case scenario using Healthy Families America (HFA), a broadly implemented child abuse and neglect prevention program, is presented as illustrative. The final design imperative argues for continuous attention to ethics across all disciplines. The design imperatives provide an initial framework for optimizing the development of persuasive technology applications in the human services.     

Family characteristics as predictors of intensity in family services

This article investigates factors influencing the number of hours families are involved with family services and uses these factors to develop a predictive model. This research began with focus groups involving family service workers who identified three key domains influencing service intensity: worker/family relationship, family motivation, and family characteristics. The family characteristics domain is the focus of this article. Influencing factors within this domain are examined through analysis of database information from 258 families who had previously accessed family services through a community services organization. Key predictors identified include the gender of main consumer, family size, and presence of issues such as family violence and physical illness. These findings are used to develop a model to predict intervention intensity for families accessing family services. The ability to estimate service intensity provides data to effectively develop innovative programs and enable better balancing of staff workloads and resources. Additionally, the capability to predict intensity helps allocate families to appropriate workers and programs.