Marlys Staudt

The operationalization, implementation, and effectiveness of the strengths perspective : A review of empirical studies

ABSTRACT Although the strengths perspective is pop u lar in so cial work, it is un clear how it var ies from traditional social work practice approaches. Studies of the effeetiveness of strengths-based inter ventions are reviewed to as certain: (1) how the strengths perspective is operationalized and im pie mented, and (2) the empirical support for its effeetive ness. Few evaluations of strengths-based treatment have been published. In those studies reporting positive outcomes, it is not possible to determine whether out comes are due to the strengths perspective or to the delivery of additional services. Moreover, results indicate that the directives of the strengths perspective are not adequately operationalized or measured. The strengths per spec tive is a value stance, but there is littie support for it as a distinct and uniquely effective prac tice model.

Mental health services utilization by maltreated children: research findings and recommendations.

Many maltreated children have, or are at risk for, emotional and behavioral disorders. Some of these children need mental health services but do not receive them because of service delivery and use barriers. Knowledge about the factors related to service utilization is needed to increase access to and use of services. Studies on mental health services utilization by maltreated children in foster care or otherwise monitored by child protective services are reviewed to ascertain service use correlates. Children in foster care had higher use rates than comparison groups of Aid to Families With Dependent Children not in foster care. Need and nonneed variables predicted service use. Race was the most consistent nonneed predictor. Future research needs include the development of conceptual models to guide research on service access and use. More work is needed on the conceptualization and operationalization of mental health services, need for services, and service use.

Helping Children Access and Use Services: A Review

High rates of dropping out from mental health services are documented for children and their families. These high rates exist at different treatment stages, in different service settings, and for different populations of children and families. Some researchers have developed and tested engagement interventions to address barriers to service access and use and increase participation in services by children and their families. Studies of engagement interventions for children and their families are critically reviewed in this paper. Overall, the engagement interventions were effective in increasing attendance at first appointments. Only those with an ecological and total service delivery approach reduced the drop-out rate. However, even then, the drop-out rate was 26% to 29%. Suggestions for future research are made, including ascertaining from children and families their reasons for quitting or staying in treatment, comparing the outcomes of drop-outs with the outcomes of those who remain in treatment, developing and testing conceptual models of engagement for subgroups of at-risk children and their families, and examining the cost-effectiveness of engagement interventions.

Using Telephone Reminders to Increase Attendance at Psychiatric Appointments: Findings of a Pilot Study in Rural Appalachia

OBJECTIVE This study examined whether phone reminders increased attendance at intake and therapy appointments in an Appalachian community mental health center and whether it mattered who (therapist or staff) made the call. METHODS One of three conditions (no reminder calls, therapist made calls, or staff made calls) was assigned to each week of the nine-week study. During the study period, 451 appointments were scheduled (310 for therapy and 141 for intake). Mixed-effects logistic regression was used to analyze the data. RESULTS Phone reminders were effective for intake appointments when therapists made direct contact with patients (43% for no contact and 94% for direct therapist contact). The other conditions did not significantly increase appointment keeping. As a result of these findings, therapists were asked to place reminder calls to patients scheduled for intake appointments for a ten-week period. Findings from the second pilot study replicated findings from the first, with direct contact resulting in significantly more kept appointments. CONCLUSIONS Direct contact with therapists before initial appointments may increase appointment keeping by patients.

Barriers and facilitators to use of services following intensive family preservation services.

The primary caregivers of 101 families that used short-term, intensive home-based services were interviewed 2 months after the services to ascertain use of the recommended aftercare services, perceived barriers to service use, and perceived facilitators of service use. While 88% of the families accessed at least some of the recommended services, more than 50% failed to access all of the recommended aftercare services. The most often noted barriers to service use were enabling factors at the agency or community level. Yet, many of the services were used, and the respondents indicated that professionals played a role in helping them link to services. Researchers should continue to study the use of recommended aftercare services and the relationship between aftercare service use and clinical outcomes.

Two Years Later: Former Students' Perceptions of a Clinical Evaluation Course and Current Evaluation Practices.

Abstract The Council on Social Work Education accreditation standards requires that the social work curricula include content on practice evaluation. To meet this requirement, many schools have a course devoted to clinical evaluation. The desired outcome of these courses is that students not only learn the content but also retain it and implement evaluation in their practices after they graduate. This article reports on the results of a survey that was mailed to three cohorts of clinical evaluation students two years after graduation. The survey contained questions about current practice evaluation activities, attitudes toward practice evaluation, and their perceptions of how helpful the required clinical evaluation course had been to them in their practices. The findings show that respondents are implementing evaluation components and that they value the importance of evaluation. Respondents suggested that content on clinical evaluation should be integrated in practice courses. They also want more inform...

Use of Services Prior to and Following Intensive Family Preservation Services

A goal of short-term intensive family preservation services (IFPS) is to facilitate access to other services. However, service use following IFPS has rarely been studied. I describe the types of aftercare services that IFPS therapists recommended and use of these services in the two months following IFPS termination. Since families were using services that were not on the recommended aftercare plans, use of these services is also described. Primary caregivers of families who received family preservation through either child welfare or mental health were interviewed at two months after family preservation for the purpose of ascertaining service use. Different types of services were recommended and used based on whether families received IFPS through child welfare or mental health. However, there were also differences in the presenting problems and demographics between families in child welfare and mental health. Future research should include an independent assessment of need in order to determine the relationship between need and the types of services recommended and used. Even though families used services prior to IFPS, the findings indicated that IFPS facilitated use of new services. More research is needed on the process of how therapists decide what services to recommend and what they do to help families access services. It is also important to examine whether use of less restrictive services helps prevent out-of-home placements and the relationship between informal support and use of formal services.

Parents Involved With Child Welfare: Their Perceptions of Mental Health Services

Parents involved with child welfare were interviewed to ascertain their experiences with the outpatient mental health treatment they and their children had received. Semi-structured interviews consisting of open ended questions were conducted with 20 parents recruited from three agencies providing home-based services to children and families referred by child welfare. Interviews were audio-recorded and transcribed. Transcripts were analyzed using the traditional qualitative iterative approach of reading and re-reading transcripts to identify patterns in the data. Four primary themes emerged from the analysis: relationships with therapists, perceived treatment benefits, availability and accessibility of services and therapists, and treatment expectations. Recommendations for practice and for future research are made.

Child Welfare Caseworker Education and Caregiver Behavioral Service Use and Satisfaction With the Caseworker

Social work has long been identified with child welfare, and research has generally found that child welfare caseworkers with a social work degree are better prepared than caseworkers with other degrees. Little knowledge exists though about the relationship between caseworker professional background and caregiver behavioral health service use or their satisfaction with the caseworker. Using data from the National Survey of Child and Adolescent Well-Being, we found no significant relationships between having a social work degree and caregiver use of services or satisfaction with the caseworker. More research is needed to clarify how caseworker characteristics, including professional preparation, influence child welfare outcomes.

Practitioner Biases and Child Service Use Disparities: Implications for Social Work Education.

Disparities by race/ethnicity exist in the use of childrens mental health and related services. It is no doubt that many factors contribute to these disparities, but practitioner biases may be partly responsible for disparities. The purpose of this article is to show a potential link between practitioner biases and service use disparities and to discuss the implications for social work education. The implications for social work education focus on 2 strategies for educators to consider: (a) helping students to become aware of and overcome their biases and (b) teaching practice strategies that have been shown to help low-income and ethnic minority children and families engage in the helping process.