Practitioners’ experiences of using blended models within family support: A proof of concept study involving Cognitive-Behavioural Therapy (CBT), Multisystemic Therapy (MST) and Incredible Years (IY) interventions

ABSTRACT

Evidence-based models have demonstrated significant potential for improving outcome. However, it has been proposed that single-issue interventions cannot adequately address the multiple needs that some families experiences. This paper outlines a novel approach in which three evidence-based practices (Multisystemic Therapy, Incredible Years, and Cognitive-Behavioural Therapy) were concurrently implemented within the same programme. The objectives are to explore the experience and perceptions of practitioners who implemented the blended model, to explore the novelty of blended approaches, to examine the extent to which families were engaged in and were retained in this programme, and compare the outcomes for families who received blended and nonblended approaches. Method: Data was collected for 158 families between March 2014 and March 2016. Thirty-one families engaged in the blended approach. to explore the feasibility, semistructured interviews were undertaken with 14 staff. Results: Not all families are in need of a blended approach, but families who experience multiple complexities may benefit more from this type of approach. From the perspective of practitioners, blended models provide an opportunity to address multiple needs within the family. However, there are implementation challenges that could be explored further.     

The utility of the DSM-5 Z-codes for clinical social work diagnosis

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard reference text used by social workers for diagnosing mental disorders. The social work profession has always had an uneasy relationship with the DSM, but for 33 years there was an opportunity to note a client’s psychosocial stressors on Axis IV. With the publication of the DSM-5, however, the multiaxial diagnostic system was abandoned, and many social workers are concerned that this change limits their ability to provide comprehensive diagnoses. The purpose of this article is to consider an expanded use of Z-codes as one way to continue including social work’s psychosocial perspective on human functioning in the diagnostic process.     

The Association Between Sexual Behavior and Affect: Moderating Factors in Young Women

Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Female first-year college students (N = 477) completed monthly assessments of their sexual behaviors and positive and negative affect. Participants reported more negative affect in months in which they engaged in sexual behavior compared to months in which they did not. This association was moderated by partner type, such that only sexual behavior with casual partners was associated with increased negative affect. Participants reported more positive affect during months with kissing/touching only compared to months without sexual behavior; however, this association did not differ significantly from the association between oral/vaginal sex and positive affect. Condom use did not moderate the association between vaginal sex and positive or negative affect. In this sample of young women transitioning to college, engaging in sexual behavior was generally associated with negative affect; however, changes in affect depended on partner type and sexual behaviors. Findings have implications for sexual health education.     

What Is “Elder Abuse”? Voices From the Margin: The Views of Underrepresented Canadian Older Adults

We know relatively little about the definitions and perceptions of elder abuse held by marginalized groups of older adults in Canada. The current study used focus group methodology to explore perceptions of elder abuse among marginalized groups such as Aboriginal persons, immigrants, refugees, and lesbians. We found both similarities and differences in perceptions of elder abuse across groups. Groups identified traditional forms of elder abuse (i.e., physical, sexual, psychological/emotional, financial abuse, and neglect) as well as less frequently identified types of abuse such as disrespect and government or systemic abuse. Groups also discussed issues related to immigrant sponsorship arrangements and abuse in nursing homes.     

Elderly in America: A Descriptive Study of Elder Abuse Examining National Incident-Based Reporting System (NIBRS) Data, 2000–2005

Elder abuse is the newest form of intrafamilial violence to garner the attention of the public, policy makers, health officials, researchers, and the criminal justice system. Despite evidence that elder abuse is a growing problem, there is little known about the phenomenon because of persistent limitations in the extant empirical work. The present study examined a large cross-national sample of reported incidents (n = 87,422) collected as part of the National Incident-Based Reporting System (NIBRS), 2000–2005. Addressing limitations in prior works, this research employed a criminal justice oriented definition of elder abuse examining victim, offender, and incident characteristics using chi-square tests and logistic regression to establish baseline findings from a more comprehensive sample of data than previously existed. Results render a baseline profile of victims and abusers and suggest that gender differences prevail throughout elder abuse. This work both corroborates and contrasts past findings of elder abuse research, providing new insights and much needed baseline data.     

Gender,the Work‐Life Interface and Wellbeing: A Study of Hospital Doctors

Long and unsociable hours and intensive work pressure have been dominant features of the medical profession, especially in hospital work. The increased presence of women in medical occupations, however, has stimulated debate about the nature and consequences of such work practices on doctors' wellbeing. Against the backdrop of this debate the article explores how factors relating to the work–lfe interface affect the wellbeing of a sample of hospital doctors. A key aim is to assess whether gender differences are discernible in the pattern of factors associated with perceptions of job burnout and intentions to quit. The research suggests that female doctors were more likely to experience job burnout than male doctors. It also shows that aspects of the work–life interface affect the wellbeing of all doctors but women tend to rely on different forms of social support from men to alleviate burnout and reduce the likelihood of leaving their job.     

Hidden Markov model for discrete circular–linear wind data time series

ABSTRACT

In this work, we deal with a bivariate time series of wind speed and direction. Our observed data have peculiar features, such as informative missing values, non-reliable measures under a specific condition and interval-censored data, that we take into account in the model specification. We analyse the time series with a non-parametric Bayesian hidden Markov model, introducing a new emission distribution, suitable to model our data, based on the invariant wrapped Poisson, the Poisson and the hurdle density. The model is estimated on simulated datasets and on the real data example that motivated this work.     

Second‐order Accurate Confidence Regions Based on Members of the Generalized Power Divergence Family

Recently, a technique based on pseudo‐observations has been proposed to tackle the so‐called convex hull problem for the empirical likelihood statistic. The resulting adjusted empirical likelihood also achieves the high‐order precision of the Bartlett correction. Nevertheless, the technique induces an upper bound on the resulting statistic that may lead, in certain circumstances, to worthless confidence regions equal to the whole parameter space. In this paper, we show that suitable pseudo‐observations can be deployed to make each element of the generalized power divergence family Bartlett‐correctable and released from the convex hull problem. Our approach is conceived to achieve this goal by means of two distinct sets of pseudo‐observations with different tasks. An important effect of our formulation is to provide a solution that permits to overcome the problem of the upper bound. The proposal, which effectiveness is confirmed by simulation results, gives back attractiveness to a broad class of statistics that potentially contains good alternatives to the empirical likelihood.