Kevin Corcoran

CONFRONTING ETHICAL DILEMMAS IN MANAGED CARE: GUIDELINES FOR STUDENTS AND FACULTY

As managed care continues to alter the landscape of health and mental health services, so too does it affect social work education. In addition to changes in curricular emphases and the availability and selection of field education sites, managed care presents students with legal and ethical issues involving conflicts of interest, client confidentiality, informed consent, negligent care and client abandonment, and pressures to breach fiduciary responsibilities. This article examines each of these dilemmas and illustrates ways they are manifested under managed care. The authors describe resources for anticipating, avoiding, or addressing such difficulties. They conclude with recommendations for assisting students with this difficult content.

Practice Evaluation in the Context of Managed Care: Case-Recording Methods for Quality Assurance Reviews:

This article discusses the practice evaluation model in the context of quality assurance reviews in managed care. Managed care demands the three essential elements of practice evaluation; namely, specified client problems and treatment goals, suitable measurements, and analysis of change. The article delineates and demonstrates two case-recording procedures that facilitate quality assurance reviews of clinical social work practice.

“All my friends are doing it:” The Impact of the Perception of Peer Sexuality on Adolescents' Intent to have Sex

The purpose of the authors in this study was to determine if the proportionality of peers who believe other youth are having oral sex or vaginal/anal intercourse influence the youths intention to also have oral sex or vaginal/anal intercourse in the next three months. The results supported the hypothesis that the proportionality of perceiving ones peers as sexually active was correlated with ones intent to have oral sex in the next three months (r = .34 and .39, p < .01) and ones intent to have vaginal or anal sex within the next three months (r = .51 and r = .65, p < .01). Approximately 50% of youth who intent to have oral sex are also likely to have vaginal/anal sex. The results were not moderated by age, gender, or Hispanic/White status, but were moderated by being in a special/committed relationship.

From the Scientific Revolution to Evidence-Based Practice: Teaching the Short History with a Long Past

This article concerns the introduction of evidence-based practice (EBP) in foundation research. Five suggestions are discussed: (a) EBP relative to other epistemologies, (b) EBP in the context of the history of science, (c) research designs and levels of EBP, (d) EBP and measurement, and (e) systematic reviews as a review topic of the content of the research course.

MENTAL HEALTH SCREENING RESULTS FOR NATIVE AMERICAN AND EURO-AMERICAN YOUTH IN OREGON JUVENILE JUSTICE SETTINGS

Mental health needs of Native American youth in the Oregon juvenile justice system are compared to those of Euro-American youth. The comparison is between 109 Euro-American youth and 22 Native American youth drawn from two samples of youth adjudicated to community service and incarcerated. The youth completed a mental health history and indices of mental health and health status. Native American youth are disproportionately represented in the Oregon juvenile justice system. Mental health profiles of Native American youth reflect problems at least as severe as those of Euro-American youth, and both Native American and Euro-American youth in the juvenile justice system had profiles different from those of youth not referred for clinical services. More Native American youth .(42.5%) compared to Euro-American youth (27.5%) reported considering suicide in the past 12 months. Mental health screenings for both Native American and Euro-American youth are indicated.

Clients Without a Cause: Is There a Legal Right to Effective Treatment?

This article considers the legal right to effective treatment. Such a cause of action is distinguish able from the estabhshed right to treatment because the standard of care ensured by the latter is so minimal Tort law of negligence, law of the fiduciary, and contract law were explored. The outcome suggests there is little legal basis for social work to assume a right to effective treatment.

The Children's Action Tendency Scale: Is It Reliable and Valid with Latino Youngsters?

The Childrens Action Tendency Scale (CATS) is designed to ascertain how a youth will tend to behave in conflict situations. Although the CATS has favorable psychometric properties, it was developed with an Anglo sample. We evaluated the CATS with a sample of Latino youth and obtained similarly positive findings with respect to the instruments reliability and validity, suggesting that it may be usefully employed in social work practice with Latino sixth and seventh graders.

Emotional and Behavior Problems in Urban and Rural Adjudicated Males: Differences in Risk and Protective Factors

Abstract Emotional and behavior problems in rural adjudicated youth have received scant research attention. The association of risk and protective factors with emotional and behavioral problems were examined in samples of urban and rural adjudicated youth. Urban youth had higher levels of personal and peer risk. For both samples, family and community risk were strong risk factors. The effects of family and school variables on emotional and behavioral problems were stronger for rural youth. The closer social ties of rural communities provide protective effects. Programs that facilitate more supportive family and community networks are consistent with the results of this study.

Book Review: USING WORKBOOKS IN MENTAL HEALTH: RESOURCES IN PREVENTION, PSYCHOTHERAPY, AND REHABILITATION FOR CLINICIANS AND RESEARCHERS, by Luciano L’Abate. Binghamton, NY: Haworth Press, 2004. 398 pp.

A quite revolution has occurred in clinical practice, one which Luciano L’Abate has witnessed, contributed to, and now summarizes over 20 years of the development of self-help workbooks. Workbooks are distinguished from self-help books, which have been recently reviewed (Norcros et al., 2000), in that self help books are often simply read passively. Workbooks, in contrast, require active participation with treatment assignments, tasks, exercises and other procedures with the purpose of facilitating personal change. A workbook, in many respects, is an intervention. As such, workbooks may be used as treatment in face-to-face interventions, as self-change interventions, and as self-changed interventions supervised by a provider. While acknowledging that workbooks are not yet routinely used by the typical provider, L’Abate asserts this will change because of three reasons, mass applicability, versatility, and cost-effectiveness. Trying to grasp an understanding of the diverse literature and commercially available workbooks would have been a formidable challenge. Until now, anyway. In this marvelous and inexpensive book, L’Abate reviews over 200 commercially available workbooks, and refers the reader of a large number of other workbooks reviewed in other works, most noticeably L’Abate’s (2004). Each workbook is perused on five criteria: (1) the subject content, such as a clinical condition, (2) the degree of structure in the workbook, (3) the specificity of the intervention, (4) whether the goal of the workbook is prescriptive, cathartic, instructional, or exhortatory, and (5) the level of abstraction. Most, but not all reviews, conclude with comments by L’Abate which range from cursory to quite detailed. The range of foci of the numerous workbooks is impressive, literally ranging from abilities and abuse to work and worry issues. Reviews of some of the more salient clinical conditions include various addictions, eating disorders, most of the anxiety disorders, ADHD, control problems in children and adolescents, many of the affective disorders, couple and various family conflicts and issues (e.g., time management), impulsivity, obsessive compulsivity, pain, and some personality disorders, such as borderline. A goodly number of other treatment workbooks are also reviewed, including skill development (e.g., conflict resolution, empathy, parenting skills), problem solving, clinical treatment planners, and stress management, to name only a few content areas. Community Mental Health Journal, Vol. 41, No. 2, April 2005 ( 2005) DOI: 10.1007/s10597-005-2662-9

49.95 (softcover).

A quite revolution has occurred in clinical practice, one which Luciano L’Abate has witnessed, contributed to, and now summarizes over 20 years of the development of self-help workbooks. Workbooks are distinguished from self-help books, which have been recently reviewed (Norcros et al., 2000), in that self help books are often simply read passively. Workbooks, in contrast, require active participation with treatment assignments, tasks, exercises and other procedures with the purpose of facilitating personal change. A workbook, in many respects, is an intervention. As such, workbooks may be used as treatment in face-to-face interventions, as self-change interventions, and as self-changed interventions supervised by a provider. While acknowledging that workbooks are not yet routinely used by the typical provider, L’Abate asserts this will change because of three reasons, mass applicability, versatility, and cost-effectiveness. Trying to grasp an understanding of the diverse literature and commercially available workbooks would have been a formidable challenge. Until now, anyway. In this marvelous and inexpensive book, L’Abate reviews over 200 commercially available workbooks, and refers the reader of a large number of other workbooks reviewed in other works, most noticeably L’Abate’s (2004). Each workbook is perused on five criteria: (1) the subject content, such as a clinical condition, (2) the degree of structure in the workbook, (3) the specificity of the intervention, (4) whether the goal of the workbook is prescriptive, cathartic, instructional, or exhortatory, and (5) the level of abstraction. Most, but not all reviews, conclude with comments by L’Abate which range from cursory to quite detailed. The range of foci of the numerous workbooks is impressive, literally ranging from abilities and abuse to work and worry issues. Reviews of some of the more salient clinical conditions include various addictions, eating disorders, most of the anxiety disorders, ADHD, control problems in children and adolescents, many of the affective disorders, couple and various family conflicts and issues (e.g., time management), impulsivity, obsessive compulsivity, pain, and some personality disorders, such as borderline. A goodly number of other treatment workbooks are also reviewed, including skill development (e.g., conflict resolution, empathy, parenting skills), problem solving, clinical treatment planners, and stress management, to name only a few content areas. Community Mental Health Journal, Vol. 41, No. 2, April 2005 ( 2005) DOI: 10.1007/s10597-005-2661-x