Gearing Up for Personalisation: Training Activities Commissioned in the English Pilot Individual Budgets Sites 2006–2008

The transformation of social care in England is taking place though changes affording greater choice and control for people using services. Individual budgets were one key element of these changes and were piloted in 13 local authorities in 2006–2008. This article reports on interviews with training leads in these local authorities that took place in 2008 as part of an independent evaluation of the individual budget pilots. The aims of the interviews were to explore the role of training as part of the processes of transformation, the use of resources and establishment of training strategies within the local authority. Participants revealed that the subject of training was acquiring higher profile within their authorities, although uncertainties remain about the extent of local authority responsibilities for training. Within local authorities, training resources were yet to be determined and models of training were not fully developed. The article concludes that training will remain a central issue when implementing personalised social care services and that models of training for such changes should be shared and evaluated over the long term.     

Growing Parental Economic Power in Parent–Adult Child Households: Coresidence and Financial Dependency in the United States, 1960–2010

Research on coresidence between parents and their adult children in the United States has challenged the myth that elders are the primary beneficiaries, instead showing that intergenerationally extended households generally benefit the younger generation more than their parents. Nevertheless, the economic fortunes of those at the older and younger ends of the adult life course have shifted in the second half of the twentieth century, with increasing financial well-being among older adults and greater financial strain among younger adults. This article uses U.S. census and American Community Survey (ACS) data to examine the extent to which changes in generational financial well-being over the late twentieth and early twenty-first centuries have been reflected in the likelihood of coresidence and financial dependency in parent–adult child U.S. households between 1960 and 2010. We find that younger adults have become more financially dependent on their parents and that while older adults have become more financially independent of their adult children, they nevertheless coreside with their needy adult children. We also find that the effect of economic considerations in decisions about coresidence became increasingly salient for younger adults, but decreasingly so for older adults.     

Book review

Enhancing Psychodynamic Theory with Cognitive Behavioral Techniques, Terry Brumley Northcut and Nina Rovinelli Heller

Complex Adoption and Assisted Reproductive Technology: A Developmental Approach to Clinical Practice, Vivian Shapiro, PhD, Janet Shapiro, PhD, and Isabel Paret, PhD     

Group Therapy With Homeless Women

Women's groups are a treatment of choice for homeless women who have been abused, used substances, have mental health concerns, and have suffered traumatic events that have ruptured their attachments. Women in dialogue can learn to see themselves reflected, find each other's strengths, and make advances in empathy, which can alter relational abilities. Their experiences of sharing similar traumatic events in a safe and containing environment can increase a sense of belonging. Psychoeducation and advocacy can further foster knowledge and self-empowerment. Leadership issues are important as the leader must create safety and serve as a model, but may also be used as a object of displacement for disavowed negative feelings among group members.     

Racial/Ethnic Disparities in Access to Medicare Home Health Care: The Disparate Impact of Policy

The Balanced Budget Act of 1997 dramatically decreased reimbursements for traditional Medicare home health patients. A multivariate analysis of Medicare Current Beneficiary Survey data showed that African American and “other” users experienced greater decreases in home care between 1996 and 1998 than did White users. These results suggest (a) race/ethnicity is an independent factor in determining service use post-BBA and (b) health policy has a disparate impact on minority older adults. Capitated payment systems must be pursued cautiously to avoid negative effects on vulnerable populations. The potential for current and future Medicare policy changes to negatively affect vulnerable populations is also discussed.     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Contraceptive sterilization in Puerto Rico

For twenty years Puerto Rico has had the world’s highest prevalence of sterilization. From the 1982 Puerto Rico Fertility and Family Planning Assessment we examine whether the probability of obtaining sterilization is changing and what impact sterilization has on fertility, finding that the use of contraceptive sterilization has not declined and will probably continue to increase in Puerto Rico. Nonuse rather than temporary methods of contraception is the second most likely circumstance after sterilization. We also find that sterilization has reduced the total marital fertility rate by over 33 percent, thus having a significant effect on reducing the rate of natural increase; by all indications, it will have a greater effect in the future.     

The labor supply of Latinas in the USA: Comparing labor force participation, wages, and hours worked with Anglo and Black women

This study explores the determinants of labor supply patterns among Latinas in the USA. We use recent microeconomic data from the Panel Study on Income Dynamics/Latino National Political Survey (PSID-LNPS) to estimate models of labor force participation, wages, and hours worked for a sample of Cuban, Mexican, and Puerto Rican women. We estimate the same models for Anglo and Black women in order to explore ethnic differences in the impact of characteristics affecting both the reservation and the market wage. We find that differences exist in the return to characteristics, such as education, but that there are also substantial differences in the levels of those characteristics across ethnic groups. The low wage rates and labor market activity of Latinas relative to Anglo and Black women are thus likely to be the combined result of lower investments in human capital and larger family size, the greater negative impact of macroeconomic conditions, and a stronger responsiveness to wages. Among Latinas, we find that there are differences in labor market outcomes between national origin and nativity groups. We also find that age at arrival and years in the USA play a role in labor supply, and that this is particularly true for Puerto Rican women.