Iowa Case Management for Rural Drug Abuse

OBJECTIVE: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. METHOD: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.     

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.     

Personal empowerment program: addressing health concerns in people with schizophrenia

Three staff nurses in the Outpatient Schizophrenia Service of the Foothills Medical Centre in Calgary, Alberta, Canada, became concerned about the weight gain of their patients. Patients and their family members were also concerned and asking for help. Before integrating a program to address these concerns, staff first had to demonstrate that a program of this nature would be beneficial for clinic patients. Of the 75 clients screened, many presented with problems in the areas of weight, blood pressure, and fasting blood sugar and lipid levels. Although not a research study, an 8-month pilot project was implemented to address these concerns. It was hypothesized that integrating all dimensions of wellness in patient programming would have a positive effect on various defined indicators (e.g., weight, body mass index, blood pressure, and fasting blood sugar and lipid levels). Screening tests before, during, and after the 8-month project provided the physical outcome measurements. Social and psychological outcomes were described through observation and group member feedback. The positive results are significant in terms of empowering patients in the long-term management of their health.     

Integrating a family-centered approach into social work practice with families of children and adolescents with disabilities

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

The meaning of workplace discrimination for women with disabilities

Studies have found that persons with disabilities who are also members of other minority groups or women encounter dual discrimination. This paper describes how women with disabilities who are in the workplace experience discrimination. In order to determine whether discrimination was a viable issue, theoretical contexts of feminist theory, disability theory, and attribution theory were examined as well as literature examining employment of women with disabilities. For this study, three women with various disabilities were interviewed regarding the effect of their disability on their typical workday, their employment and job seeking history, and employment opportunities. Qualitative data were also provided through mapping by the participants and pictorial data of worksites. Data were grouped into themes of pre-conceived notions of others, attitudes of others, accommodation issues, inclusion issues and exploitation issues. From these themes definitions of discrimination, nondiscrimination in the workplace were developed. Conclusions include the need for more research on workplace experiences of other or more specific populations that experience discrimination as well as the need for ethical reflection on the part of the researcher regarding vulnerable populations.     

Item validity of the physical demands from the Dictionary of Occupational Titles for functional capacity evaluation of clients with chronic back pain

This study assessed the item validity of 15 of the physical demands from the Dictionary of Occupational Titles (DOT), as evaluated in a new approach to functional capacity evaluation (FCE) for clients with chronic back pain, the Gibson Approach to FCE (GAPP FCE). Fifty-two occupational therapists were sent the specifications of the items in the GAPP FCE procedures and were asked to rate the items in terms of item-objective congruence, relevance and difficulty. A response rate of 59.2% was obtained. The majority of the therapists agreed that most of the items were congruent with the objectives based on the definition of the physical demands from the DOT. The items evaluating Balancing and Pushing and Pulling had the lowest item-objective congruence. The evaluation of Balancing and the Lifting, Carrying and Pushing and Pulling of loads greater than light-medium weight (10-16 kg) were not considered significantly relevant. Concerns were raised about the difficulty and safety of the evaluation of Lifting, Carrying and Pushing and Pulling with clients with chronic back pain, particularly if the therapist evaluates the manual handling of medium to heavy loads. These results may have implications for other FCEs, particularly those which are based on the DOT, or when assessing clients with chronic back pain.     

Vocal types and stereotypes: Joint effects of vocal attractiveness and vocal maturity on person perception

Subjects rated the power, competence, warmth, and honesty of stimulus persons whose voices systematically and independently varied along the dimensions of vocal attractiveness and vocal maturity. The results revealed that the effects of vocal attractiveness on person perception can be attenuated or augmented by variations in vocal maturity; and that the effects of vocal maturity on impressions can be similarly modified by level of attractiveness. Implications of the data for the understanding of vocal stereotypes are discussed.