Joanne Riebschleger

Social workers' suggestions for effective rural practice

Two focus groups of participants at a national rural social work conference answered the research question, “What are your suggestions for engaging in effective social worker practice in rural areas?” The participants offered specific recommendations for social work practice with rural people and communities. They supported these recommendations with illustrations from their experiences as social work practitioners in rural settings. Text data drawn from transcribed audiotapes of the focus groups were coded into open, axial, and selective data themes. While generalizability is limited, this small sample of social workers offered a glimpse of their views of rural practice. They offered practical, down-to-earth advice for rural social work practitioners within main data themes of community, connections, generalist practice, and diversity.

How are the experiences and needs of families of individuals with mental illness reflected in medical education guidelines

ObjectiveThis descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness.MethodsKey family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a review of over 6,000 sources in the mental health practice literature that were identified within a systematic search and thematic development process. The study identified the extent and nature of family-focused key literature themes as reflected in medical education curriculum guidelines for psychiatry and primary care practice specialties of family practice, internal medicine and pediatrics. An iterative process was used to retrieve and analyze text data drawn from the curriculum guidelines of national accrediting organizations for undergraduate, graduate, and continuing medical education.ResultsThe key family-focused themes, as drawn from the mental health practice research literature, were: mental illness stigma; family caregiver burden; information exchange and referral; family stress, coping, and adaptation; family support; crisis response; and family psychoeducation. Two of these seven themes appeared in medical education curriculum guidelines: information exchange and caregiver burden. The most frequently appearing family-focused key literature theme was information exchange. Psychiatry and undergraduate medical education reflected the most family content.ConclusionIt appears that medical education curriculum guidelines have insufficient content about families of people with mental illness. The educational experiences of psychiatrists and primary care physicians may not adequately prepare them for working with family members of their patients. It is recommended that medical education curriculum guidelines incorporate information about family stigma; family/caregiver burden; information exchange; family stress, coping, and adaptation; family support; crisis response; and multiple family group psychoeducation.

Foster Care Youth Share Stories of Trauma Before, During, and After Placement: Youth Voices for Building Trauma-Informed Systems of Care

Many research studies address child trauma experiences that take place before foster care placement. However, few studies focus on the types and patterns of trauma experiences that reportedly take place during and after foster care placement; that is, after entry into adult living. This study examined the testimony of 43 foster care youth who spoke to a listening panel comprised of state legislators, child welfare professionals, and university educators. Qualitative analyses of transcribed text data revealed 3 main themes. First, the youth reported experiencing trauma before, during, and after placement. Second, the youth described trauma events and situations that were chronic (i.e., intense, composite, or cumulative). Third, youth offered suggestions for reducing traumatic experiences for foster care youth. They recommended earlier family interventions, access to people who listen and care, improved parenting skills for foster parents, continuity of relationships, and opportunities for leadership for foster youth. Foster youth voices offer important suggestions for building, strengthening, and evaluating trauma-informed systems of care.

Early outcomes of a pilot psychoeducation group intervention for children of a parent with a psychiatric illness

OBJECTIVE This study reports early findings of a still-developing Youth Education and Support (YES) pilot intervention of multifamily group psychoeducation for youth with a parent with a psychiatric illness. METHODS Hypotheses predicted YES participants would increase pre-to-post: 1) Knowledge of psychiatric illness and recovery, and 2) Coping. A purposive sample of 17 youth, ages 10-16, participated in six lively, activity-focused, two-hour sessions within four groups facilitated by the PI and professionals employed within two public mental health agencies. Data revealed a significant increase in pre-to-post youth-reported knowledge (p= less than .001) and no significant change in overall coping. At post-intervention, youth reported significantly increased use of the coping skills of avoiding problems and relaxing, as indicated within these coping subscales. CONCLUSIONS Study limitations merit interpretation caution. They are useful for future research, including development and testing of youth psychoeducation programs with longer interventions, more emphases on coping, parent-inclusion, and larger samples using randomized, experimental designs. Suggestions for research, practice, and policy are provided.

What do mental health professionals really think of family members of mental health patients

Mental health professionals working at three rural public community mental health agencies were asked for their views on the families of mental health patients. Findings revealed themes that included families as supportive caregivers, as unsupportive agitators, as in pain, as uninformed, and as unequal partners. Implications for clinical intervention, education, and research are discussed.

Mental Health Professionals' Contact With Family Members of People With Psychiatric Disabilities

Seventy-three community mental health professionals described their contact with family members of people with psychiatric disabilities. Survey questions asked about contact frequency, patterns of contact, and barriers to contact with families. A multiple regression model analyzed facilitators of increased family contact. Professionals reported a median of 2 family contact hours per week. Professionals who served children reported more family contact. Family members most often initiated telephone contact, especially parents, spouses, and siblings. Most frequent activities included listening, accessing information, and helping with resources and coping. Formal family-inclusive interventions were infrequent. Time was the most frequently reported barrier. Serving children and increased consumer contact predicted increased family contact time. Recommendations are offered for family-inclusive mental health practice.

Writing a Dissertation: Lessons Learned

An author with a new doctorate shares lessons learned about writing a dissertation. Lessons include (1) there are few sources to guide one on how to write a dissertation; (2) it is easier to critique research than to create research; (3) dissertation writing is an evolutionary communication process; (4) criticism is good; (5) dissertation writing produces a product; (6) hypotheses rule and methods matter most; and (7) less is more. Additionally, the author asserts that (8) writing for dissertation is an apprenticeship experience that prepares one for writing for publication.

Community mental health professionals' theoretical assumptions about families: Responses to a practice simulation vignette

Seventy-three community mental health professionals read a practice simulation vignette about a man with increased schizophrenia symptoms who appears at a community mental health agency accompanied by his parents. Professionals reported their levels of agreement that the parent/s may play a role in the mans schizophrenia symptoms and/or mental health treatment, i.e., serving as treatment resources; expecting consultation from professionals; serving as partners and allies; expressing negative emotions; expressing double bind communication; engaging in hostile behavior per the schizophrenogenic mother; having marriage conflicts; and also having a psychiatric disability. Professionals reported their level of agreement that the parents may be experiencing responses to their sons schizophrenia such as coping; grieving; adjusting to a biological illness; dealing with caregiving responsibilities/burdens; and remaining strong, resilient people. Findings revealed that this sample of mental health professionals most strongly agreed that families are coping, grieving, and positive treatment resources.

Parents Describe Finding Income and Resources for Their Medicaid-Eligible Children With Disabilities

In the U.S. social system, the roles of work and parenthood are often in conflict, and this conflict is especially problematic for parents of children with special needs. This study was designed to give parents an opportunity to describe their experiences in finding income and resources while caring for a Medicaid-eligible child with a chronic illness or disability. Three themes emerged: work and parenting responsibilities constantly intersected; resources for families were often insufficient or unavailable; and when parents received help, the helpers took extraordinary measures. Findings were compared to those of emerging literature; in addition, parents offered many practice and policy suggestions. Ecological and social construction theory frames were supported, including a need for family-focused perspectives.

Successful recruitment strategies for prevention programs targeting children of parents with mental health challenges: An international study

AbSTRACT Research substantiates children of parents with mental disorders including substance abuse face increased risk for emotional and behavioral problems. Although evidence suggests that support programs for children enhance resiliency, recruiting children to these groups remains problematic. This study identifies successful recruitment strategies for prevention programs for children of parental mental illness. The participants were recruited from an international network of researchers. E-mail invitations requested that researchers forward a web-based questionnaire to five colleagues with recruitment experience. Forty-five individuals from nine countries practicing in mental health responded. Descriptive statistics and qualitative content analysis techniques were used. Results: Schools, adult, and youth mental health services were recruitment sources. Nine themes were identified: Relationships, diversified information output, logistics, program consistency, family involvement, recruitment through adults, stigma, recruiting locations, social media. Recruitment barriers were: stigma, inadequate knowledge about parental mental illness and limited time. Transportation to programming was an essential component of successful recruitment.