Jodi Jacobson Frey

Advancing Training to Identify, Intervene, and Follow Up with Individuals at Risk for Suicide Through Research

Research and training on suicide is critical given the fact that the majority of suicide deaths are preventable with accurate identification of risk and intervention by trained individuals. However, implementing and evaluating training is difficult because of the multiple factors involved, including, but not limited to, the heterogeneity of trainees, their diverse roles in suicide prevention, absence of clear guidelines for training content across settings, and limited methods for assessing outcomes. Here, three groups of trainees are discussed: community and professional gatekeepers and behavioral health providers. The roles each group plays in managing suicide risk and the training content it needs to be effective are addressed. A staged training approach is proposed, building on the core components of currently used suicide training: knowledge, attitudes, and skills/behaviors. Limitations of current assessment methods are identified and recommendations for alternative methods are provided. The article concludes with a discussion of next steps in moving the field forward, including overcoming challenges and identifying and engaging opportunities.

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories

Objective: Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. Methods: The Health and Work Performance Questionnaire–Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). Results: The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. Conclusions: Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

SBIRT Training in Social Work Education: Evaluating Change Using Standardized Patient Simulation

A grand challenge for social work is addressing widespread public health problems of alcohol misuse. MSW students (n = 83) received Screening, Brief Intervention, and Referral to Treatment (SBIRT) training through didactic sessions, role plays, and pre–post videotaped standardized patient (SP) interactions. SBIRT knowledge, self-reported practice behaviors, and confidence were assessed at pretest, 30 days, and 6 months posttest. Videos were coded to assess intervention-adherent behaviors. General linear mixed models analyzed changes. Participants demonstrated increased adherence to SBIRT behaviors, and knowledge, skills, and confidence increased posttraining. Findings suggest SBIRT training increases students’ capacity to implement evidence-based interventions designed to reduce alcohol misuse.

Evaluation of a Continuing Education Training on Client Financial Capability

The researchers conducted an evaluation study assessing outcomes among 37 social workers who completed a continuing education course on financial capability and working with clients. Key constructs assessed included participants’ attitudes about financial capability, self-efficacy to provide services, organizational barriers, and basic financial knowledge. Social work participants reported that financial problems among their clients were almost unanimous as a reason for seeking services. Organizational barriers, such as lack of time and access to staff with financial knowledge, prevented social workers from providing client financial services. At follow-up, social workers reported improved personal financial knowledge and behaviors. Suggestions for future research and improving social work continuing education and integrating financial capability into the social work curriculum in academic settings are suggested.

Psychosocial Assessment by Hospice Social Workers: A Content Review of Instruments From a National Sample

CONTEXT Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patients comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS Using a cluster random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake. We then systematically reviewed the content of these assessments to determine which domains were included and which were omitted. A total of 105 hospice agencies participated (response rate 42%). Among the assessments provided, 76 (72%) were unique assessments. RESULTS Participating hospices were largely freestanding (65%), nonprofit (60%), and either medium (39%) or small (37%) in terms of average daily census. Over 60% of the sample, assessments included content on the following: financial resources; family structure; coping resources; bereavement risk; past losses; caregiver depression; religiosity/spirituality; patient anxiety, patient depression; and advance directives. However, most assessments did not include items evaluating the following: patient physical/functional status; preferences for treatment/care; awareness of diagnosis, prognosis, or disease progression; communication and literacy issues; changes in relationship intimacy/sexuality; and cultural values, beliefs, and customs. CONCLUSION Hospice social workers should consider modifying their assessment practices to include a comprehensive array of assessment topics pertinent to patients and families. An accurate, comprehensive assessment that contributes to a holistic, interdisciplinary approach will likely lead to better clinical outcomes.

Financial Social Work

Beginning in the Progressive Era, social workers collaborated with home economists to improve financial wellbeing in US cities swelling with poor rural migrants and immigrants. Today, in the wake of the Recession, there is a resurgence of interest in financial social work (FSW) in an era where finances increasingly shape human wellbeing. With a focus on low-income and financially vulnerable communities, social workers provide financial guidance and education, and access to sound financial supports, services, and wealth building opportunities. Social science theory and key social work principles—including person-in-environment and the strengths perspective—guide FSW practice. Social workers use direct practice, organizational development, community organizing, policy advocacy, and research to help households achieve income sufficiency, financial capability, and asset building. Looking to the future, schools of social work are launching FSW curricula aimed at tackling growing economic challenges affecting financially vulnerable households and communities.

Predicting Changes in Behavioral Health Professionals’ Clinical Practice Skills for Recognizing and Responding to Suicide Risk

Objective: Behavioral health professionals who have primary contact with people at risk for suicide play a critical role in suicide prevention. Previous studies suggest that training helps professionals build clinical practice skills to identify and assess suicide risk, but only limited research is available regarding which factors influence changes in clinical practice skills. This study aims to identify those factors, as measured by written responses to 3 vignettes, over time. Social cognitive theory is used as the conceptual framework to develop models of changes in clinical practice skills. Method: Secondary data (n = 314) from the Recognizing and Responding to Suicide Risk (RRSR) training are analyzed using multilevel modeling analyses. Results: Model 1 shows higher levels of self-efficacy and more positive attitudes toward suicide prevention significantly predict improvement in clinical practice skills over time. Model 2 shows other significant predictors of changes in behavioral health professionals’ clinical practice skills include self-efficacy, gender, age, and educational degree. Conclusions: Findings from the analyses suggest those designing trainings or interventions intended to increase professionals’ skills in suicide prevention should account for individual characteristics, differing levels of self-efficacy, and variability in attitudes toward suicide prevention among behavioral health professionals.

Training Social Workers and Human Service Professionals to Address the Complex Financial Needs of Clients

ABSRACT In social work and other community-based human services settings, clients often present with complex financial problems. As a need for more formal training is beginning to be addressed, evaluation of existing training is important, and this study evaluates outcomes from the Financial Stability Pathway (FSP) project. Designed to prepare professionals with the knowledge, attitudes, and skills to effectively assess and respond to clients’ financial problems, we evaluated the FSP using a one-group pre-, post-, and follow-up design. Results suggest that with training and ongoing booster sessions including peer support, professionals’ preparedness and confidence increased, which strongly predicted the use of practice behaviors learned during training. Implications for professional education and training are discussed.

Experiences of internal and hybrid employee assistance program managers: Factors associated with successful, at-risk, and eliminated programs

ABSTRACT Employee Assistance Programs (EAPs) originated as workplace-focused programs delivered largely by peer employees. Over the past 25 years, the once standard internal EAP has largely been replaced by internal/external hybrid programs or outsourced EAP vendors. Many long-standing internal programs have been downsized or eliminated, along with their internal program manager positions. This qualitative study examined the organizational, leadership, and programmatic characteristics associated with the internal and internal/hybrid EAPs from the perspectives of EAP managers working in programs that have thrived and those that have depreciated. Twenty-four current and former internal or internal/hybrid EAP managers were interviewed using a semistructured interview schedule. Qualitative methods were used to identify patterns and themes within the data to describe the experience of internal and internal/hybrid EAP managers and the critical success and risk factors associated with their positions and programs. Five final themes, with 15 subthemes emerged from the data, suggesting that both individual and organizational characteristics of EAP internal and hybrid programs are important to the program’s sustainability. These findings offer insights regarding best practices and critical success factors to EAP professionals, EAP purchasers, and the EAP industry.

Financial Capability and Asset Building: Building Evidence for Community Practice

Community practitioners have long been involved in helping clients manage their household finances and gain financial capability and build assets (Cruce, 2001; Stuart, 2013). Toward these ends, practitioners work in diverse community-based organizations to assist clients to acquire, maintain, and manage income; obtain education and training to enter the workforce; acquire and maintain employment; manage their finances; and many other direct services. Informed by their first-hand experience with clients, they also develop and direct workforce development, financial management, and asset development programs; evaluate their work; and disseminate their findings to other practitioners. Many household financial problems are rooted in systemic forces, such as poverty, discrimination, and poorly designed and unsafe financial products (Karger, 2015). Practitioners, therefore, also advocate in local communities for affordable and appropriate financial products, as well as empower and mobilize financially vulnerable people and communities to engage in policy practice to advance favorable social conditions, such as a higher minimum wage and affordable, accessible healthcare so that families can become more financially stable and secure. The diverse work just described occurs within the context of communities comprised of working families challenged by today’s financial realities. America’s working households are struggling with low financial security (Wiedrich, Sims, Weisman, Rice, & Brooks, 2016). Despite an economy in the United States and globally that has largely recovered from the Great Recession, the majority of US households are facing their own increasingly difficult economic and financial realities. At the national level, the United States is experiencing extraordinary income and wealth inequality (Pew Research Center, 2015; Piketty, 2014; Saez & Zucman, 2014). This means that most of the income and wealth produced is going to the most affluent households (Pew Research Center, 2015), and the majority of US households hold a decreasing share of all income and wealth produced in the economy. Almost half of all income produced in 2014 went to upper-income households (i.e., those earning over