Barriers to Treatment for Female Problem Gamblers: A UK Perspective

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme ‘Barriers to Treatment’ is examined here. Internal and external barriers to treatment organically emerged in all female participants’ accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning.     

Service Learning in Baccalaureate Social Work Education: Results of a National Survey of Accredited Programs

Service learning is neither field education nor volunteerism. Rather, it is a pedagogical approach designed to reinforce classroom instruction with concurrent service activities occurring in the local community. This service is driven by community-identified needs. Service learning supports social work values, yet the profession has been slow to embrace it in social work education. This article reports results of a national survey examining the use of service learning among baccalaureate programs accredited by the Council on Social Work Education. The majority of respondents report service learning is a required component of at least one course (generally an introductory or practice-based course) and has been incorporated into their programs for more than a decade. Results also suggest some programs may not implement service learning appropriately as it remains undifferentiated from volunteerism or field education.     

The Service Provider and Medication Usage Grids: A New Method to Measure “Treatment as Usual” (TAU)

This article reviews the creation and evaluation of two instruments that measure “treatment as usual” (TAU) in a clinical research setting. The Service Provider and Medication Usage Grids were developed to assess children’s past and current utilization of mental health services and medications. A pilot study revealed that compared to information gathered from other sources, these instruments provide an accurate method to assess, record, and track TAU in clinical studies. In addition, these instruments provide a clear and concise way to organize this information and do not require much time to administer. Limitations and directions for future research are discussed.     

Service quality framework for the South African Revenue Service from the perspective of the tax practitioner

The objective of the present research was to propose a service quality framework regarding the service quality of the South African Revenue Service (SARS) from the perspective of the tax practitioner. In order to develop the specific “lens of the tax practitioner” regarding the service quality of SARS, an in-depth, qualitative approach was required to identify a comprehensive range of determinants that potentially drive service quality in the revenue service industry and setting. One such qualitative method is the critical incident technique, which relies on a set of procedures to collect comments on service experiences, to perform a content analysis and to classify the observations of service experiences. A process of natural language argument was used to convert the data analysis results and the relevant elements of the theory from the literature survey into the service determinants. This “lens of the tax practitioner” can be used as a basis for developing a service quality measuring instrument that could measure the service quality of SARS from the perspective of the tax practitioner.     

The Emergency Dental Service at Southern Illinois University/Carbondale

Abstract

The Student Emergency Dental Service (SEDS), a program of Allied Health and Public Services, Southern Illinois University at Carbondale (SIUC), began treating patients in January 1978. The purpose of the program is twofold. The main emphasis of SEDS is to treat patients with dental-related disorders of an emergency nature. The other purpose of SEDS is to help raise the level of dental knowledge among the student population so as to prevent the emergency situations from occurring.

The Student Emergency Dental Service is essentially an “emergency only” service, even though prevention is highlighted. Such an emergency service cannot compete with a comprehensive service in terms of providing total patient dental care. Hence, the SEDS program has some innate limitations a comprehensive service does not. It must work from certain guidelines. It cannot treat everyone, and the mode of treatment must be altered to aid the emergency patient. This creates dilemmas that will be addressed in this paper. The organization, accomplishments, and advantages and disadvantages of the SEDS program at Southern Illinois University are also discussed.     

Managing Care and Joined Up Thinking in the Curriculum

This paper discusses the curriculum development of a level three undergraduate course in managing care. It was produced and is presented by The Open University. The course is aimed at frontline managers in health and social care. The course team made consultation with service users, carers and managers a priority in developing the curriculum. The paper discusses this consultation process and the learning gained from it. A major contribution was to clarify debates about how far the course should have one core curriculum and how far it should offer specialist options for managers in different settings. Service users and carers had strong views on the need for better co‐ordination of services and recognition of individual needs rather than divisions into service‐led categories. Managers stressed the importance of reflecting the reality of frontline management. This helped the course team to develop a framework that stresses the commonality in the work and the importance of ‘practice‐led’ management. Service users and managers were involved as critical readers of course texts to ensure that the consultation process continued through the course development. A second strand is the need for the course to be accessible to those not yet in management positions, and extracts from an interactive CD‐ROM which presents case study material demonstrate the innovative joined up and accessible approach taken to student learning needs.     

Planning for the delivery of special services in public schools : A multidimensional needs assessment framework

Public Law 94–142 requires that public school districts provide special service programs to handicapped and potentially handicapped children with diverse psychological, educational, and physical needs. In order for such programs to be developed and implemented in an appropriate and timely manner, procedures for assessment of pupil needs as well as assessment of school district resources that might address those needs, have been considered as important service delivery prerequisites. Toward that end, a Multidimensional Needs Assessment Framework, which has been developed by the authors and used in numerous public schools, is described in this paper. The Framework, which allows needs assessment to be seen as an integral part of the program planning process, requires that needs assessment and program planning activities occur in relation to three distinct, yet interrelated dimensions: Special Service Recipients, Special Service Resources, and Organizational Unit. Considerations necessary for design and implementation of needs assessment using the Framework are discussed, and suggestions for further development of the approach are noted.     

Desistance-Focused Treatment and Asset-Based Programming for Juvenile Offender Reintegration: A Review of Research Evidence

Research indicates that juvenile delinquency, if not intervened earlier, could potentially lead to the youth’s future involvement with the criminal justice system as an adult. This study identifies research evidence to support the building of a desistance-focused pathway for juvenile offenders positively reentering society. It examines the “desistance” components of treatment programs and assets that help ex-offending adolescents achieve success in reintegrating back to the community. A review of research evidence summarized the empirical data from twelve studies published between 2007 and 2017. Diverse service components were found in addressing the treatment needs of young offenders, indicating that multiple services are needed to lower their recidivism rate. These diverse components were benchmarked with the 40-asset model developed by the Search Institute, providing additional support that these service components are resilience-based and desistance-focused. Both internal and external assets were emphasized in these reviewed studies. Highlighted are the holistic nature of asset-based programs and service components for helping juveniles gain internal awareness and access external resources. A balanced treatment model is recommended with an emphasis on building assets for designing a holistic plan of reintegration to help juveniles reenter society and stay crime-free.     

MUNICIPAL GOVERNMENT APPROACHES TO SERVICE DELIVERY: AN ANALYSIS FROM A TRANSACTIONS COST PERSPECTIVE

Municipal governments are less likely to contract out for service delivery if citizen preferences for the service are heterogeneous. This conclusion is based on an analysis that extends to the public sector the empirical industrial organization literature on transaction costs and the "make or buy" decision faced by private firms. Service delivery practices for sixty-three municipal services are examined. The findings are consistent with the proposition that the cost for writing and monitoring contracts may be an important consideration in municipal service delivery approach and that bureaucratic supply may not be as inefficient as some previous studies indicate.     

Determinants of Bureaucratic Turnover Intention: Evidence from the Department of the Treasury

This study employs a novel statistical strategy to examine thedeterminants of turnover intention in government service. Toappropriately measure a main determinant of turnover intention—functionalpreferences—I estimate an ordinal item response modelusing data from the Federal Human Capital Survey. The sampleis selected to facilitate an important comparison: the InternalRevenue Service (IRS) has undergone significant performance-basedpay reforms for supervisors, but not for nonsupervisors, whereasthe Office of the Comptroller of the Currency (OCC), also asubunit of the U.S. Treasury, has not. Inferential models ofturnover intention reveal among other things that functionaland friendship solidary preferences are important determinantsof turnover intention, but increased accountability is associatedwith greater turnover among subordinates. IRS supervisors, whoface paybanding, are significantly less likely to consider leavingthan their counterparts in the OCC, who do not face such incentives.     

Service learning and the practice of social justice and care

The values of a social justice pedagogy in teacher education are assumed to be firmly established in South African higher education. This article discusses how serviced learning (SL) can provide practical experience of caring and serve the promotion of the ideals of social justice in two initial teacher education programmes. However, an analysis of data in this case study shows that, although SL practice has served as a platform for social justice and for care as two basic educational values, participants were not yet able to verbalize and theorize these values. They were also not able to embed these values in their reflection about service as an inherent component of education. With data from different role players in a number of SL projects, we show that the students’ discourse of what it means to be a caring teacher in a just society has not yet been developed despite the successful practical experience. It was found that, although the students had been building a practice ‘platform’ for service, they had not yet been able to articulate the conceptual intersect of care and social justice clearly. With this epistemological notion in mind, two main themes from the data analysis are discussed: 1) How SL shifted student learning from ideas ‘about’ service to implemented service, and 2) how the practical experience promoted reciprocity in inter-institutional and inter-generational communities of practice.     

Organizational constructs as predictors of effectiveness in child welfare interventions

Organizational context, including line worker characteristics and service settings, may help explain the equivocal findings of intervention studies in the field of child welfare. Yet organizational context has been largely ignored in studies of child welfare interventions. The purpose of this article is to expound upon the likely role of the organizational context in explaining service effectiveness in child welfare. Several bodies of literature within child welfare and human service organization and administration are reviewed and synthesized. A conceptual framework that can be used to guide future child welfare research is then proposed.     

Ethnic and class factors affecting mental health clinic service

Service delivery by a mental health clinic to clients from an older suburban catchment area containing both lower and middle class blacks and whites was studied. The epidemiologic method was employed, relating service delivery to the characteristics of the various population groups within the catchment. The findings indicate that low service rates for blacks were not related to ethnicity alone, but to the combination of black ethnicity and low social status; however, middle class blacks and middle class whites who entered treatment received similar service. Poor blacks had higher admission rates than poor whites with similar need indicators. In continued treatment, poor blacks received lowest service rates while minority status poor whites living in a predominantly black area received highest service rates. Social class mediated black service utilization. Severity of illness, interacting with social class and minority status mediated white service utilization. Outreach is suggested not only for poor blacks but also for poor whites, especially those living in areas in which they represent an ethnic minority.     

Why Are Some People's Needs Unmet?

Australia has legislation that states that 'people with disabilities have the same rights as other members of society to services', yet nearly one-third of all people with spinal injuries have their need for community services unmet. If all people have the same rights, why are some people's needs unmet? How equitable is the distribution of services? This study challenges service providers' beliefs that decisions about the provision and distribution of services are made objectively and equitably. To obtain needed services, people had to demonstrate their worthiness by conforming to providers' stereotype-based expectations of the disabled, based in entrenched philosophies. Service structures reinforce these disabling ideologies Service provision must thus undergo fundamental philosophical and structural change in order to meet community service needs.     

Perceived Stigma and Depression among Black Adolescents in Outpatient Treatment

Despite the high prevalence of depression among children and adolescents, most that need mental health treatment do not seek care. This is especially true for ethnic minority adolescents. Prior research has shown that perceived stigma may act as a barrier to the initiation of and adherence to depression treatment, yet few studies have examined the relationship between stigma and depression among Black adolescents. This exploratory study examined the relationship between Black adolescents' depression severity and their current level of perceived stigma in an outpatient sample. Face-to-face interviews were conducted with a clinical sample of adolescents referred for mental health services at a community-based outpatient clinic (n =108), participating in a prospective pilot study on adolescents' patterns of mental health service use. The analyses revealed that greater depression severity was significantly associated with higher perceived stigma (p < .05), particularly among females. The results also suggest that Black adolescents appear to exhibit an appropriate level of self-assessment regarding their need for mental health services. These results are interpreted in relation to previous literature, and limitations and directions for future research are discussed.     

Regulating truancy: the role of the education welfare service

This paper considers the responses made by the Education Welfare Service to school non-attendance, or truancy’ The historical development of the service is examined, along with Victorian discourse on schooling. This discourse provided the rationale for the introduction of compulsory schooling, and contributed to the pathologisation of truancy. The development of a ‘pathology of truancy’ over the past century has involved, firstly, the categorisation of truants, and secondly, the regulation of truants and their families. The dichotomy between ‘care’ and ‘control’ measures is central to an understanding of these two processes of categorisation and regulation. These processes are discussed with reference to the Education Welfare Service in a city in the North Midlands. The article concludes with an exploration of possible future developments within the national service, in the light of the Children Act 1989.     

Using Generational Intelligence to Examine Community Care Work between Younger and Older Adults

Exploring the factors that contribute to sustainable forms of an intergenerational relationship is becoming an important conceptual and practical challenge, not least because of the growing need for an aged care workforce that is both motivated and suitably trained. Generational intelligence is a means of examining interaction between younger and older people which has been applied to community care settings. Dimensions of generational intelligence include recognising and valuing generational differences, finding common ground, plus negotiating social and practical outcomes from the situation. A case study plus a series of qualitative interviews are used to examine the value of this approach both as a means of exploring the processes involved in generational exchange and in providing recommendations for work preparation and training. It is suggested that intergenerational relations have been a missing factor in the understanding of sustainable care and that in future, service delivery should not simply be analysed as comprising professional and lay perspectives but also as containing generationally distinctive perspectives that require negotiation.     

Trust and Health Care

Trust is believed to be particularly salient to the provision of health care, and since the establishment of the National Health Service (NHS) in the UK, trust has played an important role in the relationships between its three key actors: the state, healthcare practitioners, and patients and the public. Service users trusted the judgement, knowledge and expertise of health professionals to provide a competent service that met their needs, and they trusted the state to ensure equity in the allocation of public goods and services. These implicit or taken-for-granted trust relationships have, it is claimed, been challenged as a result of the introduction of changes in the organisation and funding for the health service, in the regulation and performance assessment of health professionals, and in public attitudes to health care and scientific medicine. This paper considers the influences of social changes and recent policy and professional initiatives in health care on the structure of trust relations in health care in the UK. It presents a theoretical framework for examining trust relations using the NHS as a case study and concludes with an agenda for future research.     

A study of 185 foster children 5 years after placement

This study's findings are similar to those of other studies. The majority of children who enter foster care return to their families within a relatively short time. A small group, because of the severity of their problems or those of their parents, need extended care. This group of children, over time, form the hard core of foster care placements. Our findings also bear out those of others that the foster care experience is a relatively stable one for children, with the majority having one or two placements while in care. Clearly, the need for and use of foster care is frequently misunderstood. The methodology used in research studies has gradually improved, adding to objective knowledge about this aspect of the child welfare system. Longitudinal studies, such as Jenkins [1967], Fanshel and Shinn [1978], and the one reported here, point to the need for deeper, more refined studies that examine not only the going and coming of children in foster care but the professional service component that can make foster care a constructive experience for children placed in it. Meyer issued an intelligent and timely challenge to the field of child welfare to give up "debates about permanency" and, if it is not too late, to "retrieve child welfare from the control of lawyers and MBAs" [1984: 499]. If the profession of social work can more clearly define the components of foster care service and can differentiate among the children needing care those who can best be served by this type of placement, then the field will be well on its way to offering an appropriate service for certain children. Attempts to denigrate a potentially helpful service for needy children simply destroy one aspect of a complex system. A wide range of services is necessary to serve all children appropriately. Without this kind of continuum, children are more likely to receive inappropriate services and to be placed at risk.     

Social and emotional learning in middle school curricula: A service learning model based on positive youth development

Service learning is an instructional methodology that may benefit students' social and emotional learning (Zins, Bloodworth, Weissberg, & Walberg, 2007). Though service learning is not a new pedagogy, there are few examples of how to successfully deliver service learning in school curriculum for middle school students (Gestsdottir, Bowers, von Eye, Napolitano, & Lerner, 2010; Mueller et al., 2011). This article discusses the theoretical basis for and practical implementation of a school-based positive youth development model that utilizes service learning to build the social and emotional skills of middle school students. First, this article presents the importance of social and emotional learning during adolescence. Next, utilizing a positive youth development framework, the possible social and emotional outcomes of service learning are outlined. Lastly, a case study of the Wyman Center's Teen Outreach Program® is presented as an example that integrates service learning, built on a positive youth development framework, into middle school curricula. Challenges of this model, future research questions and implications on practice and policy are suggested.