Culturally Competent Practice with Bisexual Individuals

Working with lesbian, gay, and bisexual individuals requires clinical social workers to demonstrate cultural competency with these populations. Although there are many common issues across these identities, bisexual individuals experience unique challenges that differ from lesbian and gay individuals. Bisexuality is sometimes misunderstood by heterosexual as well as lesbian and gay individuals, leading to experiences of marginalization from multiple sources. Moreover, clinical social workers may incorrectly assume that the treatment needs of bisexual individuals are the same as lesbian and gay individuals. This paper utilizes qualitative interviews with 45 bisexual-identified people to illuminate five prominent issues in clinical practice with bisexual people. They are: (a) biphobia, (b) practitioner attitudes about bisexuality, (c) identity development, (d) social relationships, and (e) sexual health. Findings illuminate clinical practice strategies that will facilitate culturally competent social work practice with this population.     

Gender differences in perceptions of aftercare supports and services

Youth depart residential care with many continued risk factors, unique needs, and challenges as they reintegrate into the home, school, and community settings. Currently, there is limited research on needs and best practices in aftercare services and supports for youth departing from residential settings and even less is known about how these differ by gender. While preliminary studies have explored perceptions of need during reintegration and aftercare by youth and caregivers, little is known about how these may differ by gender or if perceptions change over time after experiencing the initial transition period. One way to address this knowledge gap is to identify how prepared males and females feel for reintegration in critical life domains, their beliefs about aftercare, and preferences regarding potential services or supports to aide in the reintegration at discharge. Therefore, the purpose of this study was to explore if males and females differ on preparedness for reintegration across critical life domains, beliefs about aftercare, and preferences regarding potential services or supports to aide in the reintegration at departure from a residential treatment facility (N = 132). Overall, very few differences were found between males and females at departure. Implications, limitations, and future research are discussed.     

Dimensions of Structural Disadvantage: A Latent Class Analysis of a Neighborhood Measure in Child Welfare Data

ABSTRACT

Contextual constructs, such as neighborhood structure, may contribute to child welfare involvement. Secondary data analysis is used with the nationally representative, longitudinal National Survey of Child and Adolescent Well-Being-II (N = 5,872). This study employs latent class analysis (LCA) to identify the number of classes needed to explain the distribution of caregiver responses on the Community Environment Scale. LCA is ideal for this study to identify meaningful groups of caregivers involved with child welfare using neighborhood risk factors. Three latent classes are identified: high social order/medium social capital; high social order/low social capital; low social order/low social capital. Multinomial logistic regression tests whether there are significant differences across the classes, partially validating the LCA that poor, minority caregivers live in neighborhoods with lower social order and capital. Understanding neighborhoods as “high” versus “low” risk may not fully illuminate contextual risk factors in order to develop neighborhood-based interventions. This study reveals that there is a third group of caregivers who reside in places with higher social order but lower social capital. Social capital might be an important factor in preventing child maltreatment. Future work is needed to understand additional individual and neighborhood characteristics that predict membership in each class.     

Managing in the Trenches of Consumer Care: The Challenges of Understanding and Initiating the Advance Care Planning Process

To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized.     

EPA's 2006 Human-Subjects Rule for Pesticide Experiments

Arguing that the 2006 Environmental Protection Agency (EPA) human-subjects rule allows use of unethical third-party research (on pregnant women and children) in setting pesticide regulations, this article first (a) provides a brief history of U.S. pesticide regulation, particularly regarding childhood safety. Next it (b) outlines ethical and scientific loopholes in the 2006 EPA rule; (c) shows how the Human Subjects Review Board, mandated by the 2006 rule, has been implemented in flawed ways; and (d) illustrates that one source of problems with the rule may be influence by those with conflicts of interest.     

Electronic support groups, patient-consumers, and medicalization: the case of contested illness

This article illustrates the role electronic support groups play in consumer-driven medicalization. The analysis is based on an observational study of a year in the life of an electronic support group for sufferers of the contested illness fibromyalgia syndrome. The analysis builds on and extends scholarship concerning the growing influence of lay expertise in the context of medical uncertainty by showing how the dominant beliefs and routine practices of this electronic community simultaneously (and paradoxically) challenge the expertise of physicians and encourage the expansion of medicine's jurisdiction. Drawing on their shared embodied expertise, participants confirm the medical character of their problem and its remedy, and they empower each other to search for physicians who will recognize and treat their condition accordingly. Physician compliance is introduced as a useful concept for understanding the relationship between lay expertise, patient-consumer demand, and contemporary (and future) instances of medicalization.     

Prevalence, type, disclosure, and severity of adverse life events in college students

OBJECTIVE: Some information on the prevalence of adverse life experiences is available for the general population and college students, but the extent, nature, and severity of these events is unclear. PARTICIPANTS: The authors recruited undergraduate college students (N = 6,053) from diverse academic settings (public and private schools) and geographic locations. METHODS: They examined the prevalence, nature, severity, and disclosure of adverse events, in addition to reports of posttraumatic stress disorder (PTSD) symptomatology within the sample. RESULTS: Across multiple studies, prevalence rates of adverse events ranged from 55.8% to 84.5%, replicating previous findings in larger samples. In a subset of undergraduate students (n = 97) who the authors interviewed in greater depth, 9% reported symptoms of clinical PTSD and an additional 11% reported subclinical symptoms. CONCLUSIONS: Research using college samples for the study of stressful life events is a useful and reasonable strategy. The authors discuss implications for research, as well as screening and referral services at universities.     

A National Survey on Depression,Internalized Homophobia,College Religiosity,and Climate of Acceptance on College Campuses for Sexual Minority Adults

ABSTRACT

Sexual minority persons have an increased risk for negative mental health outcomes in adulthood. This seems to largely be due to experiences of stigma in social settings. This study sought to understand the relationship between attending a religiously conservative college, internalized homophobia (a measure of sexual stigma), and depressive symptoms for sexual minority adults. Sexual minority adult participants (n = 384) from across the U.S. were recruited and completed a Web-based, anonymous survey. A mediation model predicting depression through college religious conservatism, college acceptance of sexual minority identities, and internalized homophobia was tested using path analysis. Results revealed an indirect effect of increased religious conservatism of a college predicted higher depression through lower college acceptance and higher internalized homophobia. Implications for the mental health of sexual minority adults and future research are examined.     

Money value of consumption and income of rural families: Two measures of economic status

In this study a measure of economic status, money value of consumption, is defined and its relationship to income is examined using data collected from 628 U.S. rural families and 1170 North Carolina rural families. Findings suggest that for rural families money value of consumption is linearly related to income, that the variance of money value of consumption is proportional to income and that money value of consumption is more equally distributed than income. Money value of consumption is more closely related to income for one-and four-or-more-person families than for two-or-three-person families. A comparison of how the two measures (money value of comsumption and income) rank rural families by consumption status indicates that income is most likely to rank families inaccurately at very low and very high levels of income. Findings should assist in the appropriate interpretation of income when it is used as a proxy for consumption.     

Self-care: Why do parents leave their children unsupervised?

We used a preferences-and-constraints model to develop four hypotheses to explain why parents may choose self-care (an unsupervised arrangement) as the primary child care arrangement for their children over supervised alternatives and tested them in a multivariate framework using 1995 data from the Survey of Income and Program Participation. We found that the choice of self-care over supervised care alternatives is linked to the availability of parents' time to care for children, the child's level of responsibility and maturity, and the neighborhood context. However, we found no evidence that parents' ability to pay for child care is related to the choice of self-care. The results also suggest that parents use different decision-making processes, depending on their children's ages.