Stuart A. Kirk

Using pencil and paper, Internet and touch-tone phones for self-administered surveys: does methodology matter?

To compare responses to personally sensitive questions, 352 undergraduates were randomly assigned to respond anonymously to a survey using one of three survey methods: pencil and paper mail-in, Internet survey, or an automated touch-tone telephone response system. The survey contained 68 brief Yes/No questions ranging from low to high sensitivity in 13 domains, such as general honesty, academic honesty, prejudice, illegal behavior, alcohol use, substance use, violence, and sexual behavior. We found no significant differences (p>0.05) in participants’ responses among these three media for any of the questions. This suggests that for some populations, under some circumstances, Internet and touch-tone telephone systems achieve the same results as traditional pencil and paper surveys.

Science and social work : a critical appraisal

1. Knowledge, Science, and the Profession of Social Work2. Science and Social Work: A Historical Perspective3. Client Problems as Organizing Foci for Knowledge4. The Scientific Model in Practice: The 1960s and Beyond5. Engineering Social Work Intervention6. Computer-Assisted Social Work Practice: The Promise of Technology, by Stuart Kirk, William Reid, and Carrie Petrucci7. Research-Based Practice8. Research Dissemination and Utilization: Spreading the Word9. Knowledge for Practice: Issues and Challenges

The Role of Social Work Journals in the Development of a Knowledge Base for the Profession

Journals play a fundamental role in the development of professions by selecting and preserving elements of their body of knowledge. What editors choose to publish has consequences. One way of assessing how editors and journals are performing is by examining whether what is published is used by other scholars. Using impact scores derived from citations, we examine the impact articles published in core social work journals have on other scholars. The data indicate that the profession is served by several core journals that have consistently improved their contribution over the years. The data also suggest that some journals publish work that is rarely used and apparently has little effect on the profession.

The effect of social context on psychiatrists' judgments of adolescent antisocial behavior

BACKGROUND The DSM assumes that mental disorders can be identified by the presence of specific co-occurring symptoms associated with certain duration and impaired functioning, independent of the social context in which symptoms occur. The validity of this assumption was tested using the judgments of experienced psychiatrists. We hypothesized that psychiatrists would judge an identical set of adolescent antisocial behaviors, meeting the DSM-IV diagnostic criteria for conduct disorder, as indicative of mental disorder or non-disordered problem-in-living, depending on the social context. METHOD A representative sample of 483 psychiatrists in the United States read one of three experimentally manipulated vignettes depicting adolescent antisocial behavior and responded to questions concerning its nature, prognosis, cause, and response to various treatments. RESULTS Results supported our hypothesis. Under some circumstances, a youth may exhibit behaviors that meet the DSM-IV diagnostic criteria for conduct disorder, but be judged by psychiatrists as not having a mental disorder. In addition, as predicted, psychiatrists reached different judgments about course, etiology, and treatment responsiveness when the identical behaviors occurred in different social contexts. CONCLUSIONS The findings illuminate weaknesses in the validity of classification systems based on behavioral criteria independent of their social context. Implications of findings are discussed.

Diagnostic consistency in assessing conduct disorder: an experiment on the effect of social context.

The major objective of the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (see, e.g., the 4th ed., American Psychiatric Association, 1994) has been to achieve better diagnostic consistency. This has proved to be an elusive goal, because the diagnostic criteria and their rules for application can be ambiguous. This study mailed systematically varied case vignettes of conduct disorder to a nationally representative sample of 1,500 mental health clinicians in order to examine the effect of social context on diagnostic consistency. It found that consistency of diagnosis was modest and that it was affected by context and varied by profession.

Good Intentions Are Not Enough: Practice Guidelines for Social Work

Practice guidelines are the latest attempt to bring science to bear on social work practice. They are a worthy effort, but like earlier efforts, may achieve limited success. It is unlikely these documents will be read by social workers, and the guidelines themselves may not be readily usable. Moreover, the social work knowledge base is thin and practice decisions are governed by many nonscientific considerations.

The lay concept of conduct disorder: do nonprofessionals use syndromal symptoms or internal dysfunction to distinguish disorder from delinquency?

Background: Conduct disorder (CD) must be distinguished from nondisordered delinquent behaviour to avoid false positives, especially when diagnosing youth from difficult environments. However, the nature of this distinction remains controversial. The DSM-IV observes that its own syndromal CD diagnostic criteria conflict with its definition of mental disorder, which requires that symptoms be considered a manifestation of internal dysfunction to warrant disorder diagnosis. Previous research indicates that professional judgments tend to be guided by the dysfunction requirement, not syndromal symptoms alone. However, there are almost no data on lay conceptualizations. Thus it remains unknown whether judgments about CD are anchored in a broadly shared understanding of mental disorder that provides a basis for professional–lay consensus. Objective: The present study tests which conception of CD, syndromal-symptoms or dysfunction-requirement, corresponds most closely to lay judgments of disorder or nondisorder and compares lay and professional judgments. We hypothesized that lay disorder judgments, like professional judgments, tend to presuppose the dysfunction requirement. Method: Three lay samples (nonclinical social workers, nonpsychiatric nurses, and undergraduates) rated their agreement that youths described in clinical vignettes have a mental disorder. All vignettes satisfied DSM-IV CD diagnostic criteria. Vignettes were varied to present syndromal symptoms only, symptoms suggesting internal dysfunction, and symptoms resulting from reactions to negative circumstances, without dysfunction. Results: All lay samples attributed disorder more often to youths whose symptoms suggested internal dysfunction than to youths with similar symptoms but without a likely dysfunction. Conclusions: The dysfunction requirement appears to reflect a widely shared lay and professional concept of disorder.

Should DSM be the Basis for Teaching Social Work Practice in Mental Health? No!

It is ironic that we are having a debate about using DSM as the basis for teach ing social work practice in the field of mental health, because the approach taken in DSM contradicts many basic tenets of social work. Important social work per spectives—systems theory emphasizing the crucial role of families, small groups, and communities; a growth and develop ment model of human behavior; the indi vidualization of the client; a sensitivity and commitment to multicultural diver

Influence of Social Workers’ Characteristics on the Perception of Mental Disorder in Youths

Modern versions of the Diagnostic and Statistical Manual are meant to reduce biases in judgment. This vignette‐based study of 250 student respondents in master of social work programs assesses the influence of their social characteristics on judgments of mental disorder among youths. Most respondents appropriately use contextual information to judge mental disorder. Minorities and women are less likely than nonminorities and men to judge that disorder is present, suggesting that they may be more sensitive than others to the consequences of labeling youths as having mental disorders. Diagnostic and Statistical Manual training removes differences between racial and ethnic groups.

Unjust Freedom: The Ethics of Client Self-Determination in Runaway Youth Shelters

Client self-determination has been called “the most confounding and professionally debilitating concept of all the intellectual principles under-girding social work” (Rothman, 1989). Identifying the appropriate parameters of client self-determination is a particularly acute problem for social workers employed by runaway and homeless youth shelters where minors are making adult decisions free from parental guidance. We examine the ethical dimensions of practice with minor clients in runaway shelters by arguing that a conflict exists between the liberty-based principle of self-determination and the justice-based notion of client competency. We analyze the conflict by using minimal distributive justice as the organizing principle of social work practice. We conclude that client self-determination in runaway shelters should be restricted and that presuming client competence violates the basic value tenets of the profession.