Impact of Race on the Implementation of Empirically Supported Treatments in Substance Abuse Treatment

The effort to address the gap between research and practice in substance abuse treatment has largely neglected the role of local resources and political trends. This study seeks to clarify the role of the local environment in implementing empirically supported treatments (ESTs). The study consisted of secondary data analysis of substance abuse treatment centers (N = 13,079) and U.S. Census data to determine the likelihood of using EST by substance abuse treatment centers in counties with 50% or more Black residents. Bivariate and multivariate models were employed. After controlling for various factors, results indicate that substance use disorder treatment agencies that accept federal funding are less likely to use ESTs if they are located in counties with predominantly (> 50%) Black residents. Implementation of ESTs could be influenced by community racial distribution (% Black), but environmental constraints and events might shift implementation patterns.     

Being disabled,being a manager: ‘glass partitions’ and conditional identities in the contemporary workplace

This article critically explores the working lives and views of disabled senior staff working in UK organisations. The qualitative research at the core of the article establishes that some disabled people are confounding established notions of disabled people only working in peripheral employment roles by exploring the working lives and perceptions of disabled managers. The findings do, however, point to continued barriers to what disabled staff in senior positions can be seen to do and be organisationally. Here both practical and ontological risk inheres in organisationally induced change, openness about impairment and risky identities. Such ideas, it is argued, present limits to further promotion and workplace inclusion for some disabled managers.     

Communication in assisted living

This study of communication in an Assisted Living Facility (ALF) focuses on staff's interpretive frameworks and situational tactics for managing elderly residents. It is based on interviews with staff and residents in an ALF together with ethnographic fieldwork. As in other quasi-total institutions, staff members engage in control as well as care, monitoring residents for compliance with rules and directives. Residents, aware of the threat of being moved to a nursing home, also monitor their own behavior and cognition in comparison to other residents. Other communication issues include the infantilization of the elderly by staff, and the race, class, and ethnic prejudices of residents.     

Children’s Psychosocial Rehabilitation: Clinical Outcomes for Youth with Serious Emotional Disturbance Living in Foster Care

Children living in foster care are an especially vulnerable population who often come to the attention of Medicaid mental health providers. These children experience a high incidence of emotional and behavioral disorders and may have specialized treatment needs related to their living arrangement status. This study assessed whether Children’s Psychosocial Rehabilitation could effectively treat youth with severe emotional and behavioral disorders who live in foster care. Analysis of data from an open trial of 218 clinically-impaired youth, aged 3–18 years, revealed no reliable differences in treatment outcome between foster versus non-foster children, with a trend toward more favorable outcomes for foster youth. Findings justify further study of the effectiveness of this Medicaid-funded service for the treatment of youth in care.     

Barriers to Help-seeking for a Gambling Problem: The Experiences of Gamblers Who Have Sought Specialist Assistance and the Perceptions of Those Who Have Not

This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers to seeking help, responses indicative of pride (78% of HS participants, 84% of NHS participants), shame (73% of HS participants, 84% of NHS participants) or denial (87% of NHS participants) were most frequently reported. These three factors were also most often identified as the real or perceived primary barrier to help-seeking (collectively accounting for 55% of HS, and 60% of NHS, responses to this question) and were the only barriers to be identified by more than 10% of either HS and NHS participants without prompting. It was of note, however, that participants in both groups identified multiple barriers to help-seeking (mean of 6.7 and 12.2, respectively) and that, when presented with a list of 21 possible barrier items, NHS participants endorsed 19 of the listed items significantly more often than their HS counterparts. The implications of these findings, with respect to promoting greater or earlier help-seeking activity amongst problem gamblers, are discussed.

The Impact of Elder Abuse Education on Young Adults

The present study examined the effectiveness of educational interventions in altering tolerance for and behavioral intentions of elder abuse among college student young adults. Participants were 225 undergraduates who were assigned to one of four educational groups: Elder Abuse Education, Aging Education, Family Education, and a Pre- and Posttest only condition. While the Elder Abuse Education group reported less tolerance and intentions for elder abuse compared to the other groups at the immediate posttest, a decrement in such positive changes at 1-month follow-up was observed in such persons. These mixed findings suggest that while specific interventions may reduce elder abuse tolerance, supplemental educational efforts over time may be necessary to maintain intervention-specific gains in intentions and behaviors particular to elder abuse.     

Do single mothers in the United States use the Earned Income Tax Credit to reduce unsecured debt?

The Earned Income Tax Credit (EITC) is a refundable credit for low-income workers mainly targeted at families with children. This study uses the Survey of Income and Program Participation’s topical modules on Assets and Liabilities to examine associations between the EITC expansions during the early 1990s and the unsecured debt of the households of single mothers. We use two difference-in-differences comparisons over the study period 1988–1999, first comparing single mothers to single childless women, and then comparing single mothers with two or more children to single mothers with exactly one child. In both cases we find that the EITC expansions are associated with a relative decline in the unsecured debt of affected households of single mothers. While not direct evidence of a causal relationship, this is suggestive evidence that single mothers may have used part of their EITC to limit the growth of their unsecured debt during this period.     

Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.