Choice and control in social care: Experiences of older self-funders in England

This paper considers the experiences of older self-funders in England in the context of policies promoting choice and control. Self-funders are people who are not state-funded; they pay for social care from their own resources. Choice and control have been operationalized through personal budgets, based on the assumption that managing resources enhances ability to access appropriate care and support. This paper uses data from 40 qualitative interviews with self-funders and their relatives, and 19 with professionals. It explores the impact of the financial and social capital that self-funders are assumed to have and asks how older self-funders experience choice and control. The study found that older self-funders drew on personal experiences, family, and friends for information; were reluctant to spend their wealth on care due to competing priorities; and felt they had more control over the timing of decisions than people who were state-funded. Personal wealth appears to be perceived differently to funds “gifted” to people through cash for care schemes.     

Living in poverty: a qualitative inquiry of emaciated adolescents and young women coming from low-income families in a Chinese context

Anorexia nervosa (AN) is no longer a disease of the rich in the West. Hitherto, no study has been carried out in the West or in the Chinese context that documents the experiences of poor people suffering from AN. This qualitative study aims to identify the subjective experiences of seven Chinese emaciated adolescents and young women coming from low‐income families, their family difficulties and needs, and resilience in coping. The results of the study have shown that family poverty has significantly triggered the onset of AN for two emaciated adolescents, while factors such as parents’ marital discord and relentless pursuit of thinness have also been reported. Family difficulties experienced included problems in parenting, inadequate financial resources, and insufficient information and access to health and social services. Strong family motivation and filial piety are found to be important cultural assets conducive to recovery. Implications of this study for social work practice are discussed.     

Toward Empowerment: ReVisioning Family Support Groups

ABSTRACT

Family support groups (FSG) have been recognized as an important and viable means for responding to the needs of family caregivers. How these groups work, however, is not well understood. The purpose of this qualitative exploratory study was to explore the impact of attending a family support group on the caregiving experience from the perspective of the family member. Personal, semi-structured interviews took place with eleven family members who had participated in at least one FSG. Data was analyzed for themes, using a constant comparative categorizing strategy. This analysis suggests that attending a FSG impacts the caregiving experience in four important ways: helping the family member to construct a self-identity as a ‘caregiver’; promoting a sense of personal competence; fostering the use of formal support groups; and creating a community context within which to experience the caregiving role. Cumulatively, these have the potential to contribute to a sense of empowerment for the family member by helping him or her to reposition the caregiving experience as more than a personal issue and promoting the emergence of a more collective voice.     

Working with the whole family: What case files tell us about social work practices

Practice theories to support child protection social work in the United Kingdom, as in the United States and Australia, are being squeezed out by a focus on performance targets and procedural timescales. This study examines an innovative programme designed to reverse this trend initiated by an English local government authority. The programme aimed to embed systemic family practice in situations where children are deemed to be at risk of harm. The findings, derived from an analysis of a case file sample, indicate that the social worker interaction with family members is predicated on who is living with the child in conjunction with the risk status of the case file. Conversely, practitioner interactions with family members are divorced from family structure and the lived experiences of kin relationships. This study concludes by examining why, despite training in systemic family practice, it was problematic for social workers to integrate it into their encounters with families.     

The challenges presented by parental mental illness and the potential of a whole‐family intervention to improve outcomes for families

Parental mental illness (PMI) can negatively affect the lives of all family members, and there is acknowledged need to work with family and social contexts to promote recovery. However, programmes undertaking such work remain rare and knowledge concerning mechanisms through which PMI impacts families and through which recovery might be achieved is underdeveloped. This paper outlines a new family intervention programme and presents evidence from focus groups with 16 professionals into their experiences of work with families with PMI. Evidence suggests that interactional effects of PMI, family communication and family relationships are key to understanding its impacts, but professionals are liable to struggle to engage with these due to concerns over stigma, lack of skills and low confidence. Positive impacts on practice were achieved through raising awareness of the whole‐family context in relation to PMI, building confidence to raise and engage with PMI and the provision of structured tools for use with families. Positive impacts on the lives of family members were then achieved by professionals in relation to symptoms for the ill parent, the burden on children and overall family well‐being, strongly mediated through improved family communication, understanding and relationships. Implications for policy and practice are considered.     

弱关系的弱势及其转化——“关系”的一种文化阐释路径

本文试图对“关系”的文化特质加以探讨。作者首先梳理了学界有关“关系”的文化论题、结构论题和工具论题，并阐明了重拾文化论题的必要性。在此基础上，作者指出，有必要突破以往过于倚重中国社会本土概念的文化阐释方法，寻求更具有普遍意含的社会学概念和理论工具来界说和分析中国社会的“关系”现象。作为一种初步尝试，作者提出，社会网络理论中的弱关系概念对于认识中国社会的“关系”具有特殊的意义。在作者看来，在中国社会，“关系” 是与家族（或家族）内部关系相对应的一种社会关系形式，前者以弱关系为特征，后者以强关系为特征，两者在满足的功能、成员的可供选择性、规范性和社会分层效应等诸多方面都具有明显的差异。作者认为，“关系”实际上是指导社会成员处理某些家庭外部社会关系的行动模板。作者还提出，中国的“关系”不仅是一种弱关系文化，而且由于它善于促成弱关系向强关系的方向转化，善于从弱关系的动员中释放出巨大的社会能量，因而深刻地塑造了中国的社会结构形态。     

Social workers' personal death attitudes, experiences, and advance directive communication behavior

This research surveyed 29 social workers to examine their personal death attitudes and experiences in relation to their advance directives communication practice behavior. The study measured death attitudes on 5 dimensions: fear, avoidance, neutral, approach, or escape acceptance of death. Participants' personal experiences with terminal illness and death were also assessed. Advance directive communication practices were operationalized as 7 phases: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, discussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Findings suggest that social workers' advance directive communication behavior differs by practitioners' death attitudes and experiences. Implications for social work education and professional development are discussed.     

Children's and young people's experiences in various residential arrangements: a longitudinal study to evaluate criteria for custody and residence decision making

Summary The child's welfare or the child's best interest is, in manycountries, the court's paramount consideration for determiningcustody and residence of a child after parental separation ordivorce. This longitudinal study evaluates the custody criterionchild's relationships and residence preferences. Based on aqualitative study design including interviews with childrenand parents, the experiences of 62 children of separated ordivorced parents in various residential arrangements are analysed.The main findings are: (i) a residential arrangement in accordancewith the child's relationships and residence preferences accordswith the child's welfare and represents a positive living situationwith loved people in the family and social environment; (ii)the personal relationships of the child are in no way static,but demonstrate a noticeable dynamic as they change under theinfluence of internal and external factors. Therefore a timelychange of residence, which occurs in accordance with the changedemotion preferences of the child, is beneficial; (iii) a residentialarrangement contrary to the child's relationships and residencepreferences represents for the child involved a difficult situation,which can lead to one of three different processes: adjustment,a trajectory of suffering or initiatives to change the livingsituation. This means that some children adjust, others experiencetrajectory processes of suffering, and those in the remainingcases act as competent social agents, who can autonomously representtheir own interests and pursue them in order to initiate orcontribute to a change of their residence. Findings of the studyare discussed, and suggestions are offered for substantive andprocedural laws to guarantee the child's welfare in custodyand residence settlements and for further research.     

Social Workers' Personal Death Attitudes,Experiences, and Advance Directive Communication Behavior

Abstract

This research surveyed 29 social workers to examine their personal death attitudes and experiences in relation to their advance directives communication practice behavior. The study measured death attitudes on 5 dimensions: fear, avoidance, neutral, approach, or escape acceptance of death. Participants' personal experiences with terminal illness and death were also assessed. Advance directive communication practices were operationalized as 7 phases: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, discussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Findings suggest that social workers' advance directive communication behavior differs by practitioners' death attitudes and experiences. Implications for social work education and professional development are discussed.     

Poverty‐aware social work practice: service users' perspectives

In recent years, there has been an increase in scholarly writing on the theory and practice of critical social work with people living in poverty. Yet there is a lack of research on the experiences and perspectives of service users regarding this kind of practice. This paper presents a qualitative study that explored the practice of a special poverty‐aware social work programme in Israel, through the experiences of women who took part in it. Using an interpretative interactionist approach, in‐depth interviews with nine women were held three times over a 2‐year period. Findings reveal a high degree of satisfaction with the programme on the part of the women. The satisfaction was derived from four main experiences: the experience of visibility, the experience of the active partnership in the fight against poverty, the experience of close, hierarchy‐challenging relationships, and the experience of responsiveness to material and emotional needs. The findings are discussed in terms of three principles of practice: intervention in a real‐life context, relationship‐based intervention and the focus on both the material and emotional needs and their fulfilment.     

Fitting in: the roles of social acceptance and discrimination in shaping the daily psychological well-being of Latino youth

Objectives: We examine how acculturation experiences such as discrimination and social acceptance influence the daily psychological well-being of Latino youth living in newly emerging and historical receiving immigrant communities. Methods: We use data on 557 Latino youth enrolled in high school in Los Angeles or in rural or urban North Carolina. Results: Compared to Latino youth in Los Angeles, Latino youth in urban and rural North Carolina experienced higher levels of daily happiness, but also experienced higher levels of daily depressive and anxiety symptoms. Differences in nativity status partially explained location differences in youths’ daily psychological well-being. Discrimination and daily negative ethnic treatment worsened, whereas social acceptance combined with daily positive ethnic treatment and ethnic and family identification improved, daily psychological well-being. Conclusions: Our analysis contributes to understanding the acculturation experiences of immigrant youth and the roles of social context in shaping adolescent mental health.     

Driving outcomes: learning to drive,resilience and young people living in residential care

There are continuing concerns about the experiences offered to older adolescents being looked after (‘in care’) in the UK and, especially, to care leavers. Questions are asked about the limitations of State care compared with normal family life. This paper reports on an initiative to provide driving lessons to a group of six young men living in residential homes in one city. It links with resilience theory – how individuals can have relatively good outcomes despite early adversity. A qualitative study was undertaken to explore the effects of the initiative, including individual interviews with young men, heads of homes in which they lived and children's services managers. The overall results indicated that the initiative was very worthwhile. The lessons were a significant part of young people's lives. Possible effects on young people were divided into personal, instrumental and social. Benefits were reported from all parties concerning young people's self‐esteem and self‐confidence, as well as in forging close relationships with supportive adults. Driving would not be seen as a panacea for complex personal histories and structural problems, yet this small experiment suggests that driving lessons could be of disproportionate benefit and there is a moral obligation to provide them in any case.     

Interconnections among Homelessness,Family Separation,and Mental Health: Implications for Multi-Sectoral Social Services

This qualitative study explored the interconnections among the phenomena of homelessness, family separation, and mental health and substance abuse issues within the social services, geographic, and infrastructure context of northern Ontario. In-depth semi-structured interviews were conducted with thirteen participants. Findings revealed the effects of colonization in the form of poor and overcrowded housing conditions in the northern First Nations, difficulties in obtaining affordable and suitable housing in northern towns and cities, reliance on the scarce social services for survival, and valiant attempts to cope with the cold climate of northern Ontario. All participants reported multiple and intergenerational experiences of separation from family due to involvement of child welfare system, placement in residential schools, death of family member(s), flooding, and epidemics. Participants described their lifelong struggles with mental health and substance abuse issues. All three phenomena were tied together in various configurations of causes and consequences. The implications include the need for critical examination of the historical policies and practices, early intervention for mental health and substance abuse issues, greater support for youth transitioning out of care, creation of a continuum of housing options, collaboration across multiple social services sectors, and incorporation of Indigenous worldview and practices in the mainstream services.     

Learning Experiences of Older Volunteers in a Community-based Social Program for People with Dementia

Abstract

This qualitative study aimed to explore older adults’ perspectives on volunteering in an activity-based social program for community-dwelling people with dementia called Stepping Stones. Semi-structured interviews were individually conducted with eight older adults who had volunteered in Stepping Stones. Interpretative phenomenological analysis was used to analyze interview data. Four themes related to learning experiences of older volunteers in Stepping Stones emerged. These themes include (a) self-growth and confidence in working with people with dementia; (b) understanding dementia, people with dementia, and needed support for people with dementia and their families; (c) desire not to develop dementia, while recognizing that anything can happen in old age; and (d) exercising person-centered approaches and taking on advocacy roles. Findings suggest that older volunteers gain feelings of personal growth and confidence in working with people with dementia, better understanding, and enhanced attitudes toward people with dementia through volunteering in an activity-based social program for people with dementia. Older adults will be able to fill the needs of community programs for people with dementia, while experiencing benefits from volunteering and learning in later life. Further research is needed to examine to what extent having previous dementia experiences make their experiences and learning different.     

A Qualitative Case Study on Recovery and Personal Growth in Korean Drug Addicts

ABSTRACT

In recent years, crimes related to drug smuggling and production have gradually increased in Korea. This qualitative case study explores the experiences of Koreans recovering from drug addiction and identifies specific details and mechanisms of recovery. For this purpose, participants were selected based on criteria such as engaging in social activities after recovery from addiction for 3 years or more. Next, one-on-one in-depth interviews were conducted with five voluntarily consenting participants. Data were analyzed using the within-/cross-case analysis suggested by Creswell. Substantial personal growth took place in the recovery process for drug addicts. Nineteen themes were identified as manifestations of personal growth through within-case analysis. Four common themes were then derived through cross-case analysis. These four common themes were “reconnection with reality,” “embracing the essence of one's own existence,” “reconstructing oneself in social relations,” and “self-love.” The study's results suggest that a recovery program needs to be developed wherein the program not only enables drug addicts to reflect on their current existence but also allows them to develop their specific coping skills. Future research should be broadened to consider the social support mechanism and viewpoints of people including family and local community members in close contact with drug addicts.     

Less than human: a qualitative study into the experience of parents involved in the child protection system

This paper reports on the findings from a qualitative study into the experiences of parents who were involved in the English child protection system in 2013. Seventeen in‐depth interviews were conducted involving 19 parents and/or partners, and a framework approach was used to analyse the data. There were positive experiences of individual social workers and some positive experiences of the child protection system. However, the overwhelming theme of the parents' experiences was that the system was uncaring, inflexible and for some harmful to both themselves and their children. Despite being included in the child protection process, parents felt they were not afforded the same rights as a participant, as a decision‐maker or as a partner in seeking to improve the situation. The threat of consequences silenced parents who felt unable to speak out or challenge the things they disagreed with or coerced others into signing agreements they did not agree to. Such experiences related to a sense that they were being treated as ‘less than human’. These findings are considered within the context of recent reforms within the English child protection system.     

Community Service and Political Identity Development in Adolescence

This article addresses the interconnection of political socialization and identity development. We begin with Erikson's work, which identified the development of political commitment in adolescence as a key aspect of identity formation. We then seek to shed light on the social processes through which youth become engaged in political activities and issues. We discuss the influences of family and peers as well as participation in community service and other civic activities. The development of social responsibility and agency, and an understanding of the complexity of social issues are considered as important facets of political commitment. Data from a case study of Black urban adolescents who participated in a year-long service learning program are used to illustrate our perspective. We conclude that social-historical context, instantiated in social relationships and actions, plays a pivotal role in the process and shape of political socialization and identity formation.     

The Role of Peers and Siblings in Toddlers’ Developing Understanding of Incompatible Desires

According to previous research, social experiences with other children might explain why three‐year‐olds are already quite proficient in understanding desires but not beliefs as subjective mental states. This study investigated toddlers’ (N = 50) developing subjective understanding of incompatible desires around the age of 3 years (M = 35.5 months) and the associated social factors (i.e., family demographics, peer, and sibling variables). Results indicated a developmental sequence from understanding desires to understanding desire‐dependent emotions with an unexpected positivity bias in toddlers’ prediction of own emotions. A hierarchical regression model revealed that specific social factors (i.e., reported quality of peer interactions and day care attendance) individually contributed to explaining the variance in children's desire‐reasoning skills. Findings are interpreted as supporting a belief–desire asymmetry, and specific social experiences, such as positive peer interactions and desire conflicts, may promote toddlers’ understanding of incompatible desires as subjective mental states.     

Adult children of parents with mental illness: navigating stigma

The experiences of children who live with parental mental illness are becoming increasingly recognized. However, there remains a limited body of knowledge in relation to an individual's longer term experiences. This study sought adult children's experiences of childhood parental mental illness. It generated reflections of 13 adult children who had lived with parents with mental illness during their childhood. The narrative design of the study facilitated a voice for participants. The paper presents one main theme of the findings. The findings offer a unique insight into childhood awareness of social stigmas and children's behavioural changes to avoid disclosure of parental mental illness. Participants noted that they were aware of social stigmas associated with mental illness during their childhood. This contributed to their fear of disclosure to others that fuelled a culture of familial secrecy, reinforcing the children's own sense of difference. Further work is required to enhance community understanding about the familial journeys of parental mental illness and the impact of negative‐natured stigmas.