Decision-Making and Evidence in Direct Practice

This article presents the results of research designed to explore decision-making by direct practitioners in selected non-profit human service settings. Forty interviews were conducted with workers at front-line, supervisory and higher-management levels. The research questions included; what sources of information are used in decision-making, what variables enhance or impede utilization of evidence-based knowledge in decision-making and what would be important resources for improving availability, access and utilization of evidence-based knowledge in decision-making? Our results indicate that respondents relied most heavily on experience; on their professional values and beliefs, and on an empathic understanding of their clients’ uniqueness. Compared to these sources of information use of research and the professional literature were less enthusiastically endorsed.     

Positive and negative impacts of job loss on family life: the perceptions of Australian car workers

This article contributes to research on the impact of job loss on families. It is based on survey responses from 371 workers and in‐depth interviews with 39 of them about the family impacts of their job loss from the Mitsubishi car factory in Adelaide in 2004–2005. A majority of workers said family life had been affected by their job loss. Quantitative analysis identified four variables significantly associated with family impacts: marital status, children living at home, employment status and financial management. Qualitative responses showed the predominantly negative impacts were financial strain, loss of relationship stability and general stress and worry, although few faced catastrophic impacts from their job loss. However, in contrast to most previous research, the in‐depth interviews also revealed positive impacts from job loss, such as having more time at home and to spend with their family. We conclude that the existence of ongoing income support and public health insurance in Australia were important in avoiding catastrophic financial impacts on these workers and their families.     

The Effect of Chair Yoga on Biopsychosocial Changes in English- and Spanish-Speaking Community-Dwelling Older Adults with Lower-Extremity Osteoarthritis

Chair yoga (CY), a mind-body therapy, is a safe nonpharmacological approach for managing osteoarthritis (OA) in older adults who cannot participate in standing exercise. However, there is no linguistically tailored CY program for those with limited English proficiency (LEP). This 2-arm randomized controlled trial compared the effects of a linguistically tailored yoga program (English and Spanish versions) on the outcomes of pain, physical function, and psychosocial factors compared to the effects of a linguistically tailored Health Education Program (HEP; English and Spanish versions). Participants with lower-extremity OA, recruited from 2 community sites, completed the Spanish (n = 40) or English (n = 60) version of twice-weekly 45-min CY or HEP sessions for 8 weeks. Data were collected at baseline, 4 weeks, 8 weeks, and 1- and 3-month follow-ups. English and Spanish CY groups (but neither HEP language group) showed significant decreases in pain interference. Measures of OA symptoms, balance, depression, and social activities were not significantly different between English and Spanish versions of CY and English and Spanish versions of HEP. It was concluded that the Spanish and English versions of CY and HEP were equivalent. Linguistically tailored CY could be implemented in aging-serving communities for persons with LEP.     

Family Caregiving and the Site of Care: Four Narratives About End-of-Life Care for Individuals with Dementia

Little is known about end-of-life care for individuals with Alzheimer’s disease and other dementias. Four case studies are presented, using data collected by qualitative interviews conducted with family caregivers who were closely involved with end-of-life care for relatives with dementia. The case studies are formatted in two pairs, with one reflecting two deaths occurring at home and the other pair representing two deaths in the nursing home. The cases reveal a range of end-of-life experiences, suggesting that there is not just one “good” path. The extent of care needed, the responsiveness of the individual, the health of the caregiver(s), and the residence and support situations, can all intersect in a variety of ways that make no one scenario the answer for all. Although most people say they would prefer to die at home, in some situations the nursing home can be a satisfactory choice, particularly if hospice is involved. These narrative case studies give the reader insight into the variety of the end-of-life experiences and suggest the environment should be considered as part of the care provision.     

Self-reported Barriers to Professional Help Seeking Among College Students at Elevated Risk for Suicide

Abstract

Objectives: This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants: Participants were 165 non–treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Methods: Data were collected using Web-based questionnaires. Two coders coded students’ responses to an open-ended question about reasons for not seeking professional help. Results: The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Conclusions: Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.     

Exploring the Experiences of Lesbian,Gay, Bisexual,and Questioning Adolescents in Foster Care

This article is based on the findings from a subset of gender identity and sexual orientation questions from The Casey Field Office Mental Health Study (CFOMH). It aims to contribute the experiences of youth in the care of Casey Family Programs to the increasing body of research on lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth in foster care, as well as inform future studies in this area. The CFOMH study interviewed 188 adolescents ages 14 to 17 who were receiving foster care services from Casey Family Programs in 2006. The experiences in care of youth who identified as LGBQ (n = 10) are presented in narrative form, along with data from all youth in care (N = 188) regarding their perceptions of the foster care environment for LGBTQ youth. These findings are intended to underscore the need to conduct a larger, more in-depth study of the experiences of LGBTQ youth in foster care and the environment that foster care provides for them.     

Do We Need More “Doing” Activities or “Thinking” Activities in the Field Practicum?

How do MSW students learn new professional skills in the field practicum? Does students' reflection affect the use of other learning activities during the field practicum? Students in field practica participate in activities that involve observation, doing (participatory), and conceptual linkage. In this study of MSW students, conceptual linkage activities represent students' overall reflective capacity to integrate classroom theory and field practice. The results indicate that conceptual linkage activities are more strongly related to learning outcomes than observation or participatory activities. There is also a significant interaction effect between participatory activities and conceptual linkage activities when students' satisfaction is considered. Discussion includes suggestions for increasing students' reflection to integrate classroom and field.