Preparing Social Work Students for Integrated Health Care: Results From a National Study

ABSTRACT

Integrated health care serves a vital role in addressing interrelated physical and behavioral health conditions, but social work graduates often lack sufficient training to work on integrated teams. We surveyed 94 deans of master’s of social work programs to assess the current and planned integrated health care curricula and the aptitude of schools to teach this material. We applied chi-square analyses to evaluate differences among programs that reported already teaching integrated health content and programs not yet delivering this curriculum. Findings suggest that deans of schools not yet teaching this material not only felt less prepared but also reported a lower capacity to do so. Implications and next steps to increasing integrated health curricula are presented and discussed.     

CONDITIONAL EXPECTATION FORMULAE FOR COPULAS

Not only are copula functions joint distribution functions in their own right, they also provide a link between multivariate distributions and their lower‐dimensional marginal distributions. Copulas have a structure that allows us to characterize all possible multivariate distributions, and therefore they have the potential to be a very useful statistical tool. Although copulas can be traced back to 1959, there is still much scope for new results, as most of the early work was theoretical rather than practical. We focus on simple practical tools based on conditional expectation, because such tools are not widely available. When dealing with data sets in which the dependence throughout the sample is variable, we suggest that copula‐based regression curves may be more accurate predictors of specific outcomes than linear models. We derive simple conditional expectation formulae in terms of copulas and apply them to a combination of simulated and real data.     

Psychotherapy dropouts: differences by modality, license, and DSM-IV diagnosis

Dropouts are frequent in mental health care. Several client factors have been identified as dropout predictors, including ethnic minority status, race, low SES, and more severe symptoms. Research on therapist and process variables is less common, and findings are inconsistent. This study used administrative data for 434,317 patients from CIGNA Behavioral Health (CIGNA) to examine dropout rates by profession of provider, therapy modality, and DSM-IV diagnosis. Results indicate that among the providers, MFTs have the lowest dropout rates in the CIGNA network. Of the therapy modalities, individual therapy is associated with lower dropout rates than family therapy. Mood and anxiety disorders have lower dropout rates than other diagnosis categories, while schizophrenia, psychotic, and substance use disorders have the highest dropout rates.     

Effort-Shape Characteristics of Emotion-Related Body Movement

The purpose of this study was to characterize the movement qualities of 5 target emotions during walking. We used an autobiographical memories paradigm for elicitation and observer judgments for emotion recognition. For each of the felt and recognized emotion portrayals, 6 Effort-Shape qualities were judged on a continuum between opposite qualities at the anchor points. Three general categories of movement style emerged, so that anger and joy shared anchor qualities at one end of the continuum, sadness had qualities at the opposite anchor, and content and neutral had qualities between the anchor extremes. The Effort-Shape profiles were unique for each target emotion, however, and mean scores were different between emotions even when emotions shared similar qualities. Emotions were classified using the Effort-Shape scores with accuracies ranging from 74–32 % for sad, anger, content and joy, respectively. For most of the target emotions, decoding accuracy was related to at least 4 Effort-Shape qualities, suggesting that decoding accuracy may be associated with a profile of movement qualities. This study highlights the importance of movement quality in bodily expression of emotion and demonstrates the effectiveness of Effort-Shape analysis in distinguishing among emotion-related movement styles.     

Costs of Treating Depression With Individual Versus Family Therapy

Depression is one of the most common concerns that bring clients to treatment. Although marriage and family therapy has been shown to be an effective treatment, little research exists regarding the cost‐effectiveness of related services. In this study, we examined claims data for 164,667 individuals diagnosed with depression to determine (a) differences in the cost of treating depression according to type of therapy and license type, (b) differences in recidivism rates by age, gender, type of therapy, and type of mental health professional, and (c) differences in cost‐effectiveness by therapy modality and type of professional. The results showed that services provided by marriage and family therapists resulted in the lowest recidivism rate, and family therapy services were the least expensive.     

“Breaking Even” under Intensification? Gendered Trade‐Offs for Women Milk Marketers in Kenya*

Despite the commonly vaunted “win‐win” prospect of combining intensified livestock production with greater gender equality, the benefits of formal marketization of livestock products are generally skewed toward men. In response to this global trend, there is a growing impetus to better understand the gender dynamics underlying women's market participation to curtail the risk of worsening gender inequalities in agricultural systems transitioning to intensified production. This study analyzes the spectrum of women's informal milk market practices in two Kenyan Counties undergoing dairy system intensification. Qualitative data were gathered from dairy stakeholders and market traders to explore the localized system of gender relations mediating women's engagement with milk markets and current practices. Results indicate that increased dairy intensification and informal market use is challenging existing gender norms and disrupting the boundaries between hegemonic (socially acceptable) and pariah (socially disruptive) gender relations. While women are generally better able to control the proceeds from their dairy labor in informal markets, they also face high social culpability and danger from engaging in illicit activities that transgress local norms. These contradictory “win‐lose” dynamics and trade‐offs highlight the contested nature of gender market relations under agricultural intensification and commercialization currently being pursued under low emissions dairy development (LEDD) in Kenya. The risk of exacerbating existing gender inequalities has profound implications for LEDD and agricultural intensification more broadly.     

Sex Differences in Sociology Specializations, 1975–1985: Women's Liberation to Ghetto Specialization

Abstract

This report explores the division of labor by sex in sociology. Using the Guide to Graduate Departments for the years 1975, 1980 and 1985, first-cited specialty areas for all women and a one-fifth sample for men were obtained. Comparison of these specialty areas for women and men suggests that a division of labor by sex exists in sociology. Further, the correlations between specialty areas for men and women are decreasing over time, indicating an increasing division of labor by sex. Of particular interest are: 1) the nearly exclusive participation of women in Gender Studies and the increase of women over time who choose this as a first-cited specialty; 2) the decline in the core area of Methods by both men and women; 3) the decline in the core area of Theory by women.     

Utilizing the Fundamentals of Science in Educating for Social Work Practice

This paper explicates a competency-based direct practice curriculum for graduate social work education. Specifically, admission and graduation requirements related to five knowledge-skill areas are outlined: (1) interpersonal behavioral control, (2) judgment and decision making, (3) contracting and goal setting, (4) selection and application of change method, and (5) assessment of outcomes. The implications of this empirically based educational model are discussed in terms of accountability and congruence between educational objectives and practice behaviors.