How do you solve a problem like Maria? Family complexity and institutional complications in UK social work

ABSTRACT

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers’ conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family’s situation in terms of the range of issues identified and candidate ‘causes’. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies’ involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning.     

The governance of primary mental health planning by Primary Health Networks

The establishment of Primary Health Networks (PHNs) was accompanied by assignment of responsibility for funding for primary mental healthcare. To ensure this funding is spent in line with government priorities, the Federal government developed a planning document with established priorities and guidance documents for how the planning document should be completed. This paper examines how these documents shape service delivery through enabling some activities and excluding others and identifies the assumptions that underpin these documents. Data were drawn from discourse and content analysis of completed planning documents from the PHNs and of the guidance documents and from reflection upon mental health planning from 55 interviews with key personnel from six PHNs. Service delivery is shaped by outcome measures that promote service access, cost‐effectiveness and clinical effectiveness, contributing to service options that favour self‐management for mild mental illness and clinical (but not social) services for people with severe mental illness. There is also limited scope for mental health promotion with prevention activities focused upon populations identified by the government as being at‐risk. This occurs to the detriment of other at‐risk populations.     

Parents’ Beliefs about Emotions and Children’s Recognition of Parents’ Emotions

This study investigated parents’ emotion-related beliefs, experience, and expression, and children’s recognition of their parents’ emotions with 40 parent-child dyads. Parents reported beliefs about danger and guidance of children’s emotions. While viewing emotion-eliciting film clips, parents self-reported their emotional experience and masking of emotion. Children and observers rated videos of parents watching emotion-eliciting film clips. Fathers reported more masking than mothers and their emotional expressions were more difficult for both observers and children to recognize compared with mothers’ emotional expressions. For fathers, but not mothers, showing clearer expressions was related to children’s general skill at recognizing emotional expressions. Parents who believe emotions are dangerous reported greater masking of emotional expression. Contrary to hypothesis, when parents strongly believe in guiding their child’s emotion socialization, children showed less accurate recognition of their parents’ emotions.

Centering the voices of international students in family studies and family therapy graduate programs

In this article, we report the results of a survey that accessed the perceptions of family studies and family therapy international master's and doctoral students across the United States. Our goals included giving collective voice to the experience of international students and gathering their suggestions for improving programs. Themes that emerged from responses to open- and closed-ended questions included feeling (mis)understood and (de)valued; forming personal connections and experiencing marginalization; the importance of including international perspectives in curricula; considering the relevance/transferability of knowledge; and attending to barriers to learning. Based on the results, we share suggestions for improving family studies and family therapy graduate programs relative to program planning, curricula revision, teaching strategies, and faculty development.     

Elder abuse and oral health care providers: an intervention to increase knowledge and self-perceived likelihood to report

The objective of this study was to ascertain whether a symposium on elder abuse raises the level of knowledge and the self-reported likelihood to report elder abuse among licensed oral health care providers. 130 dentists, hygienists, and assistants voluntarily attended a 4-hour training symposium and completed both pre- and postsurveys testing their level of knowledge. Results by statistical analyses, using repeated measurements, Wilcoxon signed-rank test for nonparametric data, showed increases in awareness of reporting process, knowledge/awareness of elder abuse, knowledge of mandated reporter requirements, and comfort levels with recognizing signs and symptoms of elder abuse and neglect. In conclusion, a symposium can increase the self-reported likelihood of reporting elder abuse.     

Which factors explain the decline in infant and child mortality in Matlab,Bangladesh?

Infant and child mortality rates have decreased substantially in Matlab, Bangladesh, as they have in many developing areas. We use data from the Matlab Demographic Surveillance System on nearly 94,000 singleton live births that occurred between 1987 and 2002 to investigate the extent to which the change in mortality over this period can be explained by changes in reproductive patterns and socio-economic characteristics. We estimate Cox proportional hazards models for four subperiods of infancy and childhood. Changes over time in reproductive patterns (maternal age, parity, and pregnancy spacing) and in the socio-economic characteristics we consider (e.g. maternal education, SES) explain between 10 and 40% of the decline in mortality rates. Changes in maternal education explain the largest portion of the reduction in infant and child mortality over time that we are able to explain, followed by reductions in the incidence of short interpregnancy intervals. In the other direction, decreases in fertility over time led to increases in the proportion of births that were first births, putting upward pressure on mortality.

Associations of eldercare and competing demands with health and work outcomes among manufacturing workers

Employees juggling eldercare and work report work–family conflicts and poor health-related outcomes, but little is known about eldercare demands (ECDs) in the context of competing demands in the manufacturing workforce. This study determines how ECDs vary by age, gender, income, and job category, and how ECDs and competing demands are associated with health-related and work-related outcomes, among manufacturing workers. Employees from six manufacturing companies completed questionnaires. ECDs were defined as providing assistance to an adult aged 65 and older due to disability or chronic illness; those with ECDs were asked how many care-hours per week and whether assistance included personal care. Workers over age 45 were more likely than younger workers to report ECDs. After adjusting for competing demands and socio-demographic characteristics, ECDs were associated with greater depressive symptoms and family-to-work conflict (FWC), providing 5 or more hours of eldercare weekly was associated with greater depressive symptoms, and providing personal care was associated with greater FWC.     

Intergenerational Mobility of the Mexican‐Origin Population in California and Texas Relative to a Changing Regional Mainstream

We combine two approaches to gauge the achievements of the Mexican‐origin second generation: one the intergenerational progress between immigrant parents and children, the other the gap between the second generation and non‐Latino whites. We measure advancement of the Mexican‐origin second generation using a suite of census‐derived outcomes applied to immigrant parents in 1980 and grown children in 2005, as observed in California and Texas. Patterns of second‐generation upward mobility are similar in the two states, with important differences across outcome indicators. Assessments are less favorable for men than women, especially in Texas. We compare Mexican‐Americans to a non‐Latino white reference group, as do most assimilation studies. However, we separate the reference group into those born in the same state as the second generation and those who have migrated in. We find that selective in‐migration of more highly‐educated whites has raised the bar on some, not all, measures of attainment. This poses a challenge to studies of assimilation that do not compare grown‐children to their fellow natives of a state. Our model of greater temporal and regional specificity has broad applicability to studies guided by all theories of immigrant assimilation, integration and advancement.     

“First Train Out”: Marriage and Cohabitation in the Context of Poverty,Deprivation, and Trauma

There has been a steep rise in the proportion of children born to and living with unmarried parents. Unmarried parents are increasingly likely to cohabitate, especially low-income couples, placing their children at elevated psychosocial risk. This life history study of poor, White single mothers suggests that the current focus on differences between married and cohabiting poor women may overstate underlying similarities in factors associated with their partner formation and dissolution and that poor women's decisions about marriage and cohabitation must be understood in a developmental context that reflects the stacking, over time, of multiple forms of vulnerability to unstable partnerships, single motherhood, and continuing poverty into adulthood.