Gilbert J. Greene

A Social Constructivist Framework for Integrating Cross-Cultural Issues in Teaching Clinical Social Work

This article describes a teaching framework that combines culturally sensitive and culturally competent perspectives in preparing students for cross-cultural clinical social work. Both content and proven instructional methods are presented for the framework’s three components: (a) an overview of social constructivism; (b) an exploration of culture and self, which encourages students to develop openness to cultural diversity; and (c) a social constructivist approach to the help-seeking process of clients, which provides students with guidelines for exploring the culture-specific content of clients’ problem-solving efforts. This framework helps students to understand clients’ social realities nonpresumptuously and to engage in respectful clinical social work intervention.

The Language of Empowerment and Strengths in Clinical Social Work: A Constructivist Perspective

Enhancing client empowerment is a major concern of clinical social workers. Empowerment is a process and an outcome. There are numerous interventions that enhance client empowerment, and among them is focusing on client strengths. Both the strengths-based and empowerment-based approaches emphasize the importance of skillfully using language in dialoguing with clients; however, there is little specificity in either of these 2 approaches on how to operationalize this process. This article discusses specific ways to use language in working with client strengths and empowering clients. The discussion and examples are presented from the metatheoretical perspective of constructivism.

Integrative Families and Systems Treatment: A Middle Path Toward Integrating Common and Specific Factors in Evidence-Based Family Therapy

A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility in manual development. A preliminary integrative model termed Integrative Family and Systems Treatment is offered as one option in developing and testing a moderate common factors approach. Such a model might then be studied in eventual clinical trials with other well-developed evidence-based protocols to further address the common versus specific factor debate. Implications for further research and practice are offered.

A Solution-Focused Approach to Case Management and Recovery With Consumers Who Have a Severe Mental Disability

Community mental health systems have been increasingly emphasizing providing services and using interventions that support mental health consumers recovering from severe mental disability. It has been noted in the literature that the strengths approach to case management is supportive of mental health consumers experiencing recovery. Although strengths-based case management has been operationalzed by six principles and five functions, it has not been very well operationalized at the micro level of direct interactions between case managers and mental health service recipients. This article describes how the perspective of and techniques from solution-focused therapy can be used to further operationalize the strengths perspective for these direct, one-on-one interactions to facilitate mental health consumer recovery.

Key processes, Ingredients and Components of Successful Systems Collaboration: Working with Severely Emotionally or Behaviorally Disturbed Children and Their Families

Systems collaboration has repeatedly been cited as a component of successful social service delivery. Through qualitative data, this study explored the process involved in inter-agency collaboration when providing Integrative Family and Systems Treatment (I-FAST) for families with severely emotionally or behaviorally disturbed children. Data were collected through a series of eight focus groups with 26 agency collaborators across 11 counties in Ohio. Data analysis revealed two emergent phenomena: the process of developing collaboration, consisting of making initial contact, a trial period and developing trust; and the key ingredients of collaboration, focusing on interpersonal and professional qualities. Implications of each theme are discussed.

Using Live Supervision in Field Education: Preparing Social Work Students for Clinical Practice

This article presents a qualitative study exploring respondents’ perceptions of live supervision as the primary field instruction method for MSW students participating in an internship that emphasized family therapy. Participants were specifically asked in what ways live supervision supported and facilitated learning clinical practice. Identifying live supervision as important for bridging the pedagogical gap between teaching theory and practice learning stood out as an important metatheme of the study, not previously discussed in the literature. Important emergent categories included learning-in-action pedagogy, feedback loop for integrative learning, the safety net in parallel observation, transparency in the supervision process, and building capacity for entering the workforce. Incorporating the principles of adult learning theory, live supervision offers an important contribution to social work field education.

Making It Work: Administrator Views on Sustaining Evidence-Based Mental Health Interventions

This qualitative study explored the perspectives of 16 administrators from 11 mental health agencies serving children, youth, and families on what affects the successful implementation and sustained use of evidence-based interventions. Both positive and negative factors impacting sustainability are identified and implications for practice are presented.

Using benchmarking research to locate agency best practices for African American clients.

Using a collective case study design with benchmarking features, research reported here sought to locate differences in agency practices between public mental health agencies in which African American clients were doing comparatively better on specific proxy outcomes related to community tenure, and agencies with less success on those same variables. A panel of experts from the Ohio Department of Mental Health matched four agencies on per capita spending, percentage of African American clients, and urban-intensive setting. The panel also differentiated agencies on the basis of racial group comparisons for a number of proxy variables related to successful community tenure. Two agencies had a record of success with this client group (benchmark agencies); and two were less successful based on the selected criteria (comparison agencies). Findings indicated that when service elements explicitly related to culture were similar across study sites, the characteristics that did appear to make a difference were aspects of organizational culture. Implications for administration practice and further research are discussed.

Common and Specific Factors Approaches to Home-Based Treatment: I-FAST and MST

Objectives: This study examined the treatment outcomes of integrated families and systems treatment (I-FAST), a moderated common factors approach, in reference to multisystemic therapy (MST), an established specific factor approach, for treating at-risk children and adolescents and their families in an intensive community-based setting. Method: This study used a nonrandomized noninferiority trial design to compare the outcomes of 79 families who received I-FAST, the test intervention, to 47 families who have received MST, the reference intervention. Results: I-FAST was noninferior to MST in reducing problem severity and improving functioning based on youth, parents, and workers’ assessments. Conclusions: While the nonrandomized design of this study precludes any definitive conclusions, implications of the study were discussed with respect to the debate regarding common factors and specific factor approaches to family treatment and implementation of evidence-based treatments.

Treatment Efficacy of Integrative Family and Systems Treatment (I-FAST) With and Without Consultation: The Role of Model Training in the Sustainability of Evidence-Based Family Treatments

Abstract This study examined the efficacy of the Integrative Family and Systems Treatment (I-FAST) training model that seeks to support development of model expertise within the agency in the context of facilitating the sustainability of evidence-based family treatment within community mental health settings. A quasi-experimental design was used to examine treatment outcomes of I-FAST among agencies that received ongoing Consultation and agencies that received No Consultation upon completion of I-FAST training. χ2 analyses and independent samples t test analyses showed that there were no significant differences between the two groups on clients who had achieved reliable change on Problem Severity and Functioning based on parents’ assessments. Significance of this study is discussed in the context of the role of evidence-based family therapy (EBFT) training in facilitating its sustainability in community mental health settings.