Melissa D. Grady

Do Children with Developmental Disabilities and Mental Health Conditions have Greater Difficulty Using Health Services than Children with Physical Disorders

The objective of this study is to determine whether achievement of the Maternal and Child Health Bureau core outcome ease of use of health services differs between children with developmental disabilities, mental health conditions and physical disorders. We analyzed data from the 2005 National Survey of Children with Special Health Care Needs. Children with special health care needs were classified into 4 health condition groups: developmental disabilities (DD), mental health conditions (MH), physical disorders (PD) and multiple conditions. The outcome measure was ‘difficulty using services’. We conducted bivariate and multivariate analyses to determine the associations between the health condition groups and the outcome. Of the CSHCN included in the study, 2.6% had DD, 12.9% had MH, 49.9% had PD and 34.6% belonged to multiple conditions group. Four percent of CSHCN with PD, 17% of those with DD, 13% of those with MH and 20% of those in the multiple conditions group had difficulty using services. In multivariate analyses, CSHCN with DD had 2.3 times and MH conditions had 2.6 times the odds of having difficulty using services compared to those with PD. Existing programs for CSHCN should be evaluated for the adequacy of services provided to children with DD and MH. Future studies should evaluate how developmental disabilities and mental health policies affect navigating the health care system for this population.

The missing link: the role of social work schools and evidence-based practice.

The translation and adoption of evidence-based practice principles has proved to be more difficult than researchers anticipated. Schools of social work are in a unique position to support this process within their home communities. Using the evidence-based practice process steps outlined by previous researchers, this article identifies specific strategies that schools of social work can adopt to support their broader communities as they attempt to adopt and sustain empirically supported interventions.

Making Room for Dynamics in Evidence-Based Practice: The Role of Psychodynamic Theory in Client-Centered Approaches.

The move toward evidence-based practice has fortified, and continues to strengthen, the social work profession through accountability, greater support for social interventions, and linking research and practice. This article considers potential limitations in exclusively promoting evidence-based practice in social work programs and advocates for an integrative approach when teaching clinical practice to master of social work students. Such an approach includes using psychodynamic principles in an effort to teach social work students the importance of self-awareness, dialoguing about diversity issues, and the use of theory in case formulations. Implications for social work education are discussed.

Does Volunteering for Sex Offender Treatment Matter? Using Propensity Score Analysis to Understand the Effects of Volunteerism and Treatment on Recidivism

A common critique of program evaluations of prison-based sex offender treatment holds that the samples inherently show selection bias because the participants typically volunteer for treatment. To address this critique, we used propensity score analysis to assess the influence of volunteerism on treatment effects. We examined recidivism outcomes for a sample of participants who volunteered for treatment, of whom some participated in treatment (n = 161) and some did not (n = 282) and compared these outcomes to the recidivism rate of a matched sample of nonvolunteers for treatment (n = 443). The primary finding is that offenders who volunteered for treatment did not demonstrate any differences in recidivism rates when matched with and compared to inmates who did not volunteer to participate in treatment. Furthermore, our results revealed that there were a number of significant differences between unmatched volunteers and unmatched nonvolunteers, perhaps most importantly in their risk for future recidivism as measured by the STATIC-99 risk assessment. We discuss study strengths and limitations and present the implications of the findings for policy, practice, and research.

Thorough Clinical Assessment: The Hidden Foundation of Evidence-Based Practice

Evidence-based practice (EBP) has refocused social work practice and education. The current social work literature, and that of allied professions, includes very little discussion of assessment in EBP in direct practice. The authors argue that assessment is the hidden foundation on which EBP efforts are based, and that assessment in social work practice includes many important decisions that shape and orient it. Pivotal issues in assessment and in social work assessment practices are explored, addressing variation across agencies, clients, and practitioners. Without a thorough and wide-ranging assessment, including the active participation of the client(s), EBP efforts may be misdirected or less than optimally effective. Assessment is the actual foundation of EBP and warrants much greater attention in scholarship, education, and professional advocacy.

Linking Adverse Childhood Effects and Attachment A Theory of Etiology for Sexual Offending

Sexual violence continues to be a significant public health problem affecting significant portions of the population. Unfortunately, an agreed upon theory of etiology remains elusive leading to challenges in developing effective prevention and treatment interventions. Recently, there is a growing body of literature examining the role of adverse childhood experiences (ACEs) in the development of sexually violent behavior. This research has begun to explore the rates of various types of child maltreatments and family dysfunction in individuals who have been convicted of a sexual crime. These empirical inquiries have been primarily descriptive in nature and have not yet provided a cohesive theoretical model as to why the presence of ACEs might contribute to sexually abusive behavior. This article suggests that attachment theory offers an explanatory link between early adversity and sexually abusive behavior in adulthood. We first summarize important attachment theory concepts, then integrate them with research in the area of developmental psychopathology and ACEs, and finally propose a model by which attachment can be used as an explanatory theory for subsequent sexualized coping and sexually abusive behaviors. Finally, this article explores the implications for practice, policy, and research using this explanatory theory as a framework for understanding sexual violence.

Examining Inclusion of Evidence-Based Practice on Social Work Training Program Websites

Websites represent a visible medium for social work programs to communicate information about social work research, academics, and professional training priorities, including evidence-based practice (EBP). However, few studies have examined the content of social work program websites. This exploratory study aimed to answer the question: Are EBP efforts in social work reflected on school websites? A guided content analysis of 40 randomly selected websites for schools of social work was used to identify how training, implementation, dissemination, and research related to EBP were represented through this medium. Implications for social work education, practice, and research are discussed.

Measuring the Implicit Curriculum: Initial Development and Results of an MSW Survey.

This study presents pilot data using an instrument called the Implicit FactorsSurvey (IFS) that is designed to measure factors within the implicit curriculum,or the educational environment in which the explicit curriculum is delivered.The implicit factors explored included community, diversity, faculty advising,and support services. Also included in the IFS were field and academic experiences.Sixty-four graduating MSW students completed the survey, and descriptivedata and qualitative data were collected for each of the measured areas.Several important findings emerged from the data, including the variability inthe quality of classroom instruction that students received and the comfort levelthat students felt in expressing their political or religious views. Implicationsfor social work education and research are discussed.

Suppression of racial disparities for children with special health care needs among families receiving Medicaid

This study examines whether the US public health insurance program Medicaid suppresses racial disparities in parental identification of service needs of their children with special health care needs (CSHCN). We analyze data from the 2001 US National Survey of CSHCN (n = 14,167 children). We examine three outcomes which were parental identification of (a) the childs need for professional care coordination, (b) the childs need for mental health services, and (c) the familys need for mental health services. A suppression analysis, which is a form of mediation analysis, was conducted. Our results show a disparity, reflected in a negative direct effect of race for all three outcomes: Black parents of CSHCN are less likely to report a need for services than White parents of CSHCN and Medicaid coverage was associated with reduced racial disparities in reporting the need for services. These analyses suggest receipt of Medicaid is associated with a suppression of racial disparities in reported need for services.

The impact of a sex offender treatment programme on the attachment styles of incarcerated male sexual offenders

Abstract The purpose of this study was to test whether attachment styles change over the course of a sex offender-specific treatment programme for incarcerated adult male sex offenders. To measure attachment styles, 44 male sex offenders (treatment n = 26, waitlist n = 18) completed the Relationship Scales Questionnaire (RSQ) and the Adult Attachment Scale (AAS). The results indicated that treatment participants showed significant decreases in levels of anxious attachment measures from pre- to post-test. Furthermore, the results from the RSQ 2-factor showed that participants in the treatment group demonstrated a significant decrease in avoidant attachment levels at post-test compared to the waitlist group. The results from the AAS showed that participants in the treatment group demonstrated a significant decrease in dependent attachment levels at post-test compared to the waitlist group. Implications of results are discussed.