Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Gynecological services utilization by contraceptive clients: a cost analysis

A cost analysis of gynecological service use by students enrolled in a prepaid health plan at the University of Massachusetts revealed that pregnancy and abortion-related services account for almost half of total costs. The medical records of 495 randomly selected students who presented for diaphragm care during 1980-81 were reviewed and 78% of these women were interviewed. 27% had had at least 1 pregnancy; in 15% of these cases, the pregnancy was diaphragm-related, yielding a Pearl Index of 9.75 pregnancies/100 woman-years of use. Overall, 25% of students (33% of seniors) had an abortion while at college. Study subjects made a total of 1483 visits to the gynecological service and saw an average of 3.3 practitioners. 67% of contraception-related visits were for diaphragm fits, checks, or replacements; 24% involved a change to pills. The average cost per visit for diaphragm fit or method change was $31.20 if the provider was a physician ($22.60 for a nurse practitioner); the cost for diaphragm follow up by a physician was $23.60 ($16.60 for a nurse practitioner). For seniors, the average cost to the health plan over 3.4 years of visits was $83.10 for contraception, $47.43 for pregnancy-related care and abortion counseling, and $100.51 for other gynecological problems (e.g., vaginitis, menstrual disorders) and the annual examination. The $231.04 total cost/senior represents half of the $460 paid in direct premiums. Further analysis is recommended to determine whether increased resource allocation to contraceptive counseling would reduce pregnancy-related costs.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

Severe self-neglect: an epidemiological and historical perspective

Older adults with severe self-neglect have multiple deficits in various social, functional and physical domains, and often live insqualor. These individuals often present with poor personal hygiene, domestic squalor and hoarding which results in a threat to their own health as well as personal and public safety. Severe self-neglect occurs along a continuum with older adults often having cognitive and affective disorders compared with younger individuals presenting with psychiatric illnesses. In cases of severe self-neglect with hoarding, evidence has shown this behavior occurs in diverse social strata and not among the wealthy and professionals alone as believed earlier. Due to the multiple conditions associated with severe self-neglect, this population will require an interdisciplinary, multidimensional approach to reduce morbidity and mortality rates including nursing home placement. Research on this group has been limited and is rarely described in the medical and nursing literature. Future research is needed to provide practitioners with effective screening instruments and interventions on cases of severe self-neglect.     

Utilizing social media for social work: insights from clients in online youth services

ABSTRACT

This study explored and conceptualised service users’ experiences in online outreach projects supported by the Hong Kong SAR government. Fifteen active users were interviewed. The study used thematic analysis to explore service users’ experiences that might not have been possible without technology. Participant utterances were non-mutually-exclusively tagged with a specific theme. Each utterance reflected an aspect of user experience which combined a technical component with a service-need component. Six themes were identified, including: (i) Personalised newsfeeds help identify service information and news, (ii) Online status indicators improve service accessibility, (iii) Online communications enable a disinhibition effect, (iv) Asynchronous communications facilitate continual feedback loops, (v) Incomplete communicative modalities may cause misunderstanding and (vi) Asynchronous communication may disrupt conversations. The findings reveal that there are middle-level concepts between broad social work concepts and ever-changing technology. Implications for research and practice are discussed.     

Computerizing protective services intake expertise: Preliminary research

Decision making at child welfare intake has been the subject of considerable investigation for the last thirty years. Previous reserach on the dynamics of abuse and neglect resulted in complexity and inconsistency to the extent that research moved away from determining the relevant information for creating a more structured decision making process. Recent developments in knowledge engineering and computerized expert systems provide new tools for examining protective services intake decision making. These tools are appropriate for organizing the vast amount of information workers use during decision making, extracting decisions from that information, and presenting the decisions and their supporting logic. This research examines existing expertise with a small sample of child welfare experts to determine the feasibility of developing an expert system for supporting intake decisions.     

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.     

Income characteristics and the use of microfinance services: evidence from economically active persons with disabilities

The purpose of this empirical research from Uganda is to provide initial insight into the ‘black box’ of understanding the economic behaviour of persons with disabilities and about their use of microfinance services. First, we analyse the income levels of persons with disabilities in relation to their sources of income. Second, we study the income sources and income levels for different types of disabilities. Finally, we analyse how income level and income source relate to the use of microfinance services for persons with disabilities. We present evidence that farmers with disabilities and persons with visual impairments have lower income levels than other persons with disabilities. We then document that those with the lowest income levels have the least access to microfinance services, in particular services from formal institutions. Moreover, respondents involved in farming and manufacturing have less access to formal microfinance services than those involved in retail/wholesale or service activities.     

Privatization of government services: Pressure-group resistance and service transparency

Even when efficiency gains can be expected from contracting out municipal services, it surprisingly rarely occurs. Political pressure by interest groups, especially unions, is usually assumed responsible. We argue that the effectiveness of such pressure is actually a function of a service’s “transparency,” which determines voter’s knowledge of the quality and cost of the service as well as the tax burden. A model is presented of the interplay between union opposition to contracting and service transparency. Policies are offered to increase transparency and make contracting optimal for governments.     

Investigation laws and practices in child protective services

This study was triggered by the experience of one state agency when a state audit found that its investigation response and completion rates of child abuse and neglect reports did not reach 100%. At compliance rates of 99.6% and 97.58%, respectively, the auditors and news media reported a lack of compliance by the state child welfare agency. This article reviews the approaches legislatures and agencies have used to address and resolve problems of ensuring agency responsiveness without setting standards and expectations that are impossible to meet.     

Evaluation of adult protective services: perspectives of community professionals

Due to challenges associated with client characteristics, funding, and the expectation of poor outcomes, few studies have evaluated the services provided by Adult Protective Services (APS). The article reports community-based professionals' satisfaction with APS when investigating cases of suspected elder abuse. Results from a 12-item quantitative survey indicate respondents were most satisfied with the intake process, followed by assessment, and case management. Satisfaction was higher than expected, though areas for improvement are identified. This survey and its results should serve as a starting point for more extensive evaluation methodologies needed to enhance the delivery of services provided by APS.     

Animal-human relationships in child protective services: getting a baseline

Inclusion of certain aspects of animal-human relationships (AHR), such as animal abuse and animal-assisted interventions, can enhance child welfare practice and there are resources available to promote such inclusion. However, there is little knowledge of whether this is being accomplished. This study sought to fill this gap by conducting a national survey of state public child welfare agencies to examine AHR in child protective services practice, their assessment tools, and cross-reporting policies.     

A positive youth development measure of service use satisfaction for youth: The 13-item youth services satisfaction (YSS-13)

Using data from 593 at-risk adolescents (12–17 years) this article reports on an examination of the psychometric properties of a reduced version of the Youth Services Survey (YSS), a youth self-report measure of service quality. The paper reports on the content validity, internal validity, reproducibility, floor and ceiling effects and responsiveness of the measure. The analysis supports the use of a 13-item version of the YSS as a valid and reliable measure of service quality. The YSS-13 is broadly consistent with “The Big Three” principles of PYD. Therefore the measure can be used to assist service providers in assessing the extent to which their service delivery aligns with these principles and to identify areas where service delivery can be strengthened.     

A longitudinal analysis of some risk and protective factors in marijuana use by adolescents receiving child welfare services

The present study sought to identify risk and protective factors in marijuana use by adolescents involved in child welfare services. Longitudinal records of 1797 adolescents were extracted from the National Survey of Child and Adolescent Well-Being data set. The obtained multivariate results from generalized estimating equations showed that an adolescent's likelihood of being a current marijuana user rose with prior lifetime use of the drug and was also associated with out-of-home child welfare services, perceived parental monitoring, perceived closeness to parent, engagement with school environment, and age. Implications for child welfare services are discussed.     

Innovations in child protective services inservice training: commitment to excellence

The overwhelming obstacles to effective CPS intervention created by increasing reports of abuse and neglect, funding shortfalls, and the lack of qualified workers have prompted national efforts to reform the public child welfare system in the United States. Organizations such as the American Public Welfare Association, the Children's Defense Fund, the Child Welfare League of America, and the National Association of Social Workers are currently working closely with other national organizations to develop legislative proposals that will enable child welfare agencies to be more responsive to the needs of children and families. A critical component of this reform is the need to recruit, train, and retain qualified and competent CPS workers. The four training programs described in this article are examples of innovative programs seeking to enhance service delivery by enhancing the knowledge and skills of their staff members. Although the four programs were developed in very different political and social climates and within diverse organizational structures, they all provide useful lessons in how to develop efficient and effective training for workers delivering protective services for children. Any national, state, or local efforts to design and develop new CPS training programs should take into account the significant strides made by these agencies.     

Comparing differential responses within child protective services: a longitudinal examination

This study examines the efficacy of a family differential response program to lower rates of (1) reentry into child protective services (CPS) and (2) child removal. Data were collected over 20 months from one region of British Columbia, Canada. Comparisons between family development response (FDR) and cases assigned to regular investigation (INV) suggest that FDR does not decrease recidivism to CPS. However, fewer children in the FDR group were removed than children in the INV group.