Carol A. Stalker

The Case for Integrating Grounded Theory and Participatory Action Research: Empowering Clients to Inform Professional Practice

Grounded theory and participatory action research methods are distinct approaches to qualitative inquiry. Although grounded theory has been conceptualized in constructivist terms, it has elements of positivist thinking with an image of neutral search for objective truth through rigorous data collection and analysis. Participatory action research is based on a critique of this image and calls for more inclusive research processes. It questions the possibility of objective social sciences and aspires to engage people actively in all stages of generating knowledge. The authors applied both approaches in a project designed to explore the experiences of female survivors of childhood sexual abuse with physical therapy and subsequently develop a handbook on sensitive practice for clinicians that takes into consideration the needs and perspectives of these clients. Building on this experience, they argue that the integration of grounded theory and participatory action research can empower clients to inform professional practice.

A comparison of short-term group and individual therapy for sexually abused women

Objective: To compare the effectiveness of 10 sessions of group therapy with that of 10 sessions of individual therapy in a sample of 86 adult women seeking treatment for the effects of childhood sexual abuse. Method: Participants were randomly assigned to the 2 treatment modalities and tested at assessment, pretherapy following a 10-week wait condition, posttherapy, and 6-month and 12-month follow-up. Results: Participants had fewer symptoms and better psychosocial functioning posttherapy and were further improved at the 6- and 12-month follow-up. Neither treatment modality was superior to the other. Approximately one-half of the sample sought further treatment during the follow-up periods. Conclusions: Improvement in symptoms and functioning was associated with short-term treatment in both modalities, but many patients remained distressed and required further treatment. Future research should investigate whether sexually abused women who meet criteria for specific diagnoses require more focused and/or longer-term therapy.

Making the Grade: The Quest for Validity in Admissions Decisions

This article reports a preliminary study examining the relationship between pre-admission data and later problems in the practicum and classroom for students in a two-year graduate social work program. Pre-admission data for those students identified as having problems by two or more faculty members were compared with data from randomly selected files of students who were not identified. Students in the problem group were on average older than other students, were more likely to be male, had lower undergraduate grade point averages, had more experience in social service related work, and were rated lower in emotional maturity based on personal statements. The authors encourage schools to provide additional supports to students at risk for problems, rather than arbitrarily reject applicants meeting these criteria.

The Experiences of Minority Immigrant Families Receiving Child Welfare Services: Seeking to Understand How to Reduce Risk and Increase Protective Factors

Wide recognition that families in the child welfare system experience multiple stressors has resulted in the development of a range of prevention and intervention strategies at individual, family, and policy levels.1 This article reports on a research study with minority immigrant families. The aim was to understand stressors they perceived as contributing to child welfare interventions, and services they found helpful or unhelpful. Using the conservation of resource (COR) theory, the findings highlight the erosion of resources that increases their vulnerability. Themes that emerged were: loneliness, betrayal, hopelessness, and financial and language struggles. Application of the COR theory combined with contextual insights from participant perspectives can guide policy and practice to focus on resource gain and prevent resource attrition.

Dysthymia: A Randomized Study of Cognitive Marital Therapy and Antidepressants*

Preliminary data from a randomized study of the effectiveness of combined marital therapy and antidepressant medication in the treatment of dysthymic married women is presented. The study compares doxepin with placebo, and a marital therapy designed to enhance intimacy through facilitating self-disclosure between spouses with a more supportive and educational therapeutic approach. After ten weeks of combined treatment, the dysthymic women show statistically significant improvement on all the depression measures as well as on the intimacy scale. A trend is developing for greater reduction of depressive symptomatology in the group treated with self-disclosure. The evidence appears to suggest the possibility that the presence of a patients husband as a supportive figure may of itself be a potent therapeutic manoeuvre in the treatment of dysthymic women.

The Gatekeeper and the Wounded Healer

Abstract Schools of social work and field practice educators are jointly charged with the responsibility of being gatekeepers of the profession. While screening of individuals who present with attitudes and behaviors that are incompatible with social work practice at the time of admission may be preferable, often it is in the field practicum where problems surface. This study attempts to identify students at potential risk through a content analysis of personal statements prepared by candidates for admission to an MSW program. Issues identified include: a focus on personal histories of abuse, injustice, or neglect and plans to work with other persons with similar experiences. Implications for field practice education are discussed.

Solution-Focused Brief Therapy - One Model Fits All?

This article expresses concern about the indiscriminate acceptance of the solution-focused brief therapy (SFBT) model by some social workers and social agencies in spite of the dearth of empirical support for its claims to provide clients with more rapid and more enduring change than other treatment models. The article reviews the core assumptions and techniques of SFBT and outlines the strengths and limitations of the model in the context of the findings of psychotherapy process and outcome research and from the perspective of mainstream social work. The authors argue that social workers should avoid rigid adherence to narrow models of therapy and that social work students need to be exposed to multiple theories and techniques to be adequately prepared for practice. Agencies are encouraged to offer services based on a variety of treatment models in order to more adequately serve their clients and also to better position themselves to contribute to research that would further inform the profession about the combinations of model, client, and worker characteristics that lead to the most efficient and effective outcomes.

What Works for Survivors of Childhood Abuse: Learning From Participants in an Inpatient Treatment Program

Thirty adults were interviewed about their experiences in a 6-week program for recovery from posttraumatic stress. The most valued aspects were their relationships with staff and the staffs expertise in treating the long-term effects of abuse. They valued the structured group treatment that allowed them to process emotions with the goal of healing. A few were upset by process groups, whereas others had difficulty with the sudden loss of support at discharge from the program.

Facilitating Effective Relationships Between Survivors of Childhood Sexual Abuse and Health Care Professionals

Clients in psychotherapy related to childhood sexual abuse often consult a variety of health care professionals, including physical therapists, massage therapists, and chiropractors. On the basis of interviews with 27 women survivors of childhood sexual abuse, this article offers suggestions for facilitating the relationships between survivors and physical therapists. Awareness of the difficulties that many survivors face when receiving therapy involving touch will increase the ability of psychotherapists to help clients receive the maximum benefits from these therapies.

A randomized clinical trial of cognitive marital therapy.

Thirty-three couples with severe marital discord referred to a psychiatric outpatient department were randomly assigned to Cognitive Marital Therapy or a control group. Cognitive Marital Therapy is a brief, structured couple therapy, which involves spouses in reciprocal self-disclosure of personal constructs. The control group received the same number of sessions of self-disclosure from a programmed marital enhancement text. Personal distress, marital adjustment, marital quality, and aspects of self-disclosure were measured before and after treatment. Symptoms of depression as well as somatic and compulsive complaints showed significant improvement in both groups. The wives exhibited a trend suggesting that they were making more self-disclosures to their spouses after counseling. No discernable differences in outcome were found between the marital therapy group and the control group. Marital intimacy and marital satisfaction did not improve significantly over the course of 10 therapy sessions. This study suggests that the role of self-disclosure in marital therapy needs further clarification.