One-year outcomes from the CASAWORKS for Families intervention for substance-abusing women on welfare

AIM: To evaluate the effectiveness of a multiservice intervention designed to move substance-abusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. DESIGN: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women conducted in 11 selected sites across the country. There were significant improvements shown in substance use and family and social functioning by the 6-month point, and additional improvements in employment by the 12-month point. By 12 months, more than 46% were abstinent from alcohol and other drugs, and 30% were employed at least part-time. There were only modest improvements shown in the medical and psychiatric status of these women. These preliminary findings suggest that site-level interagency coordination and program-level case management were associated with improvements in the targeted areas as predicted by the model. Future work will require a more closely specified, manual-guided form of the intervention plus the inclusion of control groups and cost measures to fully evaluate the cost benefits from the final form of the intervention.     

Smoking reduction & cessation: a hospital based survey of outpatients' attitudes

1. Most people with mental illnesses have made at least one attempt to quit smoking on their own. 2. Psychiatric diagnosis and degree of nicotine dependence do not appear to be predictive of ability to quit. 3. People with mental illnesses are aware of nicotine replacement therapy (NRT), but do not combine it with a behavioral program, possibly contributing to the higher rates of recidivism in this population. 4. The lack of participation of mental health care providers in promoting smoking cessation is a complex issue.     

Appreciating Impact: Evaluating Small Voluntary Organizations in the United Kingdom

Within the mixed economy of care in the United Kingdom there are debates about the ways in which impact can be evaluated, in order to shape funding and policy decisions. One of the tensions evident in this debate is whether the evaluation approach should reflect the perspectives and goals of the voluntary organizations and their members, or whether evaluation should reflect the wider goals of the whole system of provision. The former runs the risk of being insular and self-congratulatory, while the latter may be inappropriate and dismissive of achievements. This paper explores this tension by reporting on a study that used Appreciative Inquiry to evaluate 10 small-scale not-for-profit schemes for older people. The data indicated some unexpected and long-term impacts that demonstrated the distinctiveness of the sector. Subsequently the findings were mapped on to the “impact grid” developed by Wilding and Lacey (2003). While this was straightforward at the levels of individuals and interorganizationally, it was more difficult at the sector/community level, suggesting that more work needs to be done to bring these two perspectives together.     

Project Employ: engineering hope and breaking down barriers to homelessness

The homeless population in the US has dramatically increased in the past two decades. People who are homeless often lack skills sets such as stress management and social skills, independent living skills, and skills for vocational and leisure engagement. Best practice vocational education and training programs for individuals who are homeless recognize that success in the worker role often hinges on a person's capacity to manage day-to-day living. Life skills and pre-employment training are essential components of vocational programs but no more important than interpersonal skill development including anger management, developing self esteem and motivation, building goal setting capacity, and skills for money management, personal budgeting and self-advocacy. These areas of performance have all been traditionally included in occupational therapy's domain of practice. This article describes Project Employ, a grant funded supportive employment program that has grown out of collaboration between Duquesne University's Department of Occupational Therapy and Bethlehem Haven, an emergency shelter and residential recovery program and primary service provider for homeless people in Pittsburgh, Pennsylvania. The purpose of this article is to describe the history, structure and outcomes of Project Employ.     

An examination of relationships between children's protective services social worker assessment of risk and independent LONGSCAN measures of risk constructs

Risk assessment as a Child Protective Services (CPS) decision-making model has been implemented in the field since the late 1980s. Research activities on risk assessment have included comparative analyses, prioritization, classification studies, implementation, and cultural sensitivity analyses. In the last decade, the major research focus has been on studies related to predictive validity. Little research on risk assessment has focused on other types of construct validity, including convergent validity. Using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) and CPS investigation records, this study examined the correlations between CPS workers' ratings of risk on nine risk factors and independent measures of the same risk constructs collected by research interviewers. The data indicate significant correlations with caregiver risk factors such as physical/mental/emotional impairment, however there is little correlation with child risk factors associated with developmental or behavioral issues, or socio-economic factors such as stress and social support. Implications of the findings for policy and practice are discussed.     

Coerced Sexual Experiences Among Adolescent Substance Abusers: A Potential Pathway to Increased Vulnerability to HIV Exposure

This study describes the forced sexual experiences, serious internalizing problems, risky sexual behavior, and alcohol-related correlates of risky sexual behavior of 120 substance abusing adolescents and young adults (87 men, 33 women; mean age = 17.2 years) undergoing treatment. Prior coerced sexual experiences were associated with suicidal thoughts and attempts, higher levels of risky sexual behaviors, avoidance motives for drinking, and sexual decision-making conducive to risky sexual behavior. Sexual coercion was associated with patterns of sexual behavior and alcohol use that potentially increase vulnerability to HIV exposure. Social workers can play a number of significant roles in addressing ongoing psychological distress associated with sexual coercion among these predominantly female adolescents. Therefore, effective social work practice should enhance treatment effectiveness and reduce risk for a range of maladaptive outcomes including exposure to sexually transmitted diseases (STDs) and revictimization.     

Self‐Destructive Symptomatic Frames in Clinical Adolescents: Is the Same Different?

This study examines individual and family predictors of different self‐destructive patterns—only suicidal ideation, only nonsuicidal self‐injury (NSSI), or suicide attempts (that may also include both suicide ideation (SI) and NSSI)—in a sample of outpatient adolescents (N = 42; 86% females) with mean age of 16 years (SD = 1.86). Results indicated that there are differences in youngsters with self‐destructive behaviors in their perception of paternal rejection and maternal control, when compared with youngsters reporting only SI. Adolescents from the groups with self‐destructive behaviors differ only in age. Together, these data highlight the relevance of adopting an ecosystemic perspective, which includes both the patients and their families, regarding treatment and prevention of self‐destructive symptomatic frames.     

Aftershocks of Chile's earthquake for an ongoing, large-scale experimental evaluation

Evaluation designs for social programs are developed assuming minimal or no disruption from external shocks, such as natural disasters. This is because extremely rare shocks may not make it worthwhile to account for them in the design. Among extreme shocks is the 2010 Chile earthquake. Un Buen Comienzo (UBC), an ongoing early childhood program in Chile, was directly affected by the earthquake. This article discusses (a) the factors the UBC team considered for deciding whether to put on hold or continue implementation and data collection for this experimental study; and (b) how the team reached consensus on those decisions. A lesson learned is that the use of an experimental design for UBC insured that the evaluation's internal validity was not compromised by the earthquake's consequences, although cohort comparisons were compromised. Other lessons can be transferred to other contexts where external shocks affect an ongoing experimental or quasi-experimental impact evaluation.     

Optimality conditions for a bilevel matroid problem

In bilevel programming there are two decision makers, the leader and the follower, who act in a hierarchy. In this paper we deal with a weighted matroid problem where each of the decision makers has a different set of weights. The independent set of the matroid that is chosen by the follower determines the payoff to both the leader and the follower according to their different weights. The leader can increase his payoff by changing the weights of the follower, thus influencing the follower’s decision, but he has to pay a penalty for this. We want to find an optimum strategy for the leader. This is a bilevel programming problem with continuous variables in the upper level and a parametric weighted matroid problem in the lower level. We analyze the structure of the lower level problem. We use this structure to develop local optimality criteria for the bilevel problem that can be verified in polynomial time.