Susan Tebb

Strengths-Based Practice With Family Caregivers of the Chronically Ill: Qualitative Insights

Using a strengths-based perspective, this paper looks at the experiences of family caregiving to the chronically ill. Qualitative research allows researchers and practitioners to gain a deeper understanding of the family caregiver experience, adding breadth to the assessment and intervention process. Themes generated from a qualitative inquiry on the impact of the care-giving experience for the caregiver are explored and discussed in terms of implications for strengths-based practice, thus providing a positive experience for the caregiver and care recipient.

Using Structural Equation Modeling to Test for Multidimensionality

Unidimensionality is an assumption of many statistical techniques that examine the psychometric properties of measures. In fact, unidimensionality is necessary for construct validity. This article illustrates how structural equation modeling can be used to test the multidimensionality of a measure. By using data collected on a multidimensional measure, we compare an oblique factor model with a higher order factor model. Results indicate that the oblique factor model fit the data significantly better, because the measure is multidimensional. If the measure was unidimensional, then the higher order factor should explain the correlation between the latent variables. Implications for researchers and measurement development are discussed.

Caregiver Isolation: An Ecological Model

Abstract Caregiving to a partner with Alzheimers disease results in isolation, which impacts on the help/service seeking behaviors of care givers. In-depth interviews done with caregiving wives found that they experienced multiple dimensions of isolation. A tentative ecological model of the dimensions of caregiver isolation is proposed. Research participants did not engage early in supportive help because they were not aware of their isolation, did not know about available supports, and were not identified by medical or social services personnel as needing support and assistance. Social workers need to be aware of the isolating effects of caregiving and reach out to caregivers to avoid or lessen isolation in their caring role.

Depression as a Mediator: Viewing Caregiver Well-Being and Strain in a Different Light

This study examines the relationship between caregiver characteristics and caregiver well-being as comprised of two components, activities of living and basic needs. The role of depression in predicting caregiver well-being is explored using a sample of caregivers of family members with a chronic illness. Using a path-analysis model, multivariate findings suggest that depression explains 56% of the variance in activities of living and 64% in basic needs. Path analysis further identifies depression as a mediator between stress and well-being. Implications for research and practice are highlighted.

Cognitive Stimulation Therapy: A Tool for Your Practice With Persons With Dementia?

To the Editor: As a community of geriatric professionals, we are well aware that most residents in long-term care and a growing percentage of community-dwelling older adults have dementia and are dependent oncare fromothers.Dementia can lead to increasedbehavioral issues, the use of medication, and lack of stimulation.1 Cognitive stimulation therapy (CST) is a brief, evidence-based, psychosocial group intervention program for persons with mild to moderate dementia focusing on implicit information processing,2 which was developed following a review of both reality orientation and evaluation of research.3,4 The UK government guidelines for developing and evaluating dementia interventions5 recommend this program be used with those with mild to moderate dementia. Evidence shows CST enhances cognition and improves the well-being of those with a dementia.6 This group intervention is cost-effective and is currently, in the United Kingdom, the only nonpharmacological intervention recommended to improvecognition.5Another formofCST, SAIDO,has been shown to improve Mini Mental Status Examination scores in nursinghomes.7 Theeffects ofCSTappear tobeof a comparable size to those reported with the currently available antidementia drugs2 and thus we are working to expand this program’s availability in the United States. De Oliviera and colleagues8 conducted a trial of CST in nursing homes and the community. Both groups showed improved performance, but the performance in the nursing home group was greater. Apóstolo et al9 carried out a randomized controlled trial of CST in 56 residents and found an increase in cognition but no improvement in depression. Loraine and colleagues10 combined CST with exercise in the nursing home and found an improvement of cognition. Twenty-four weeks of CST maintenance sessions and individually focused CST also have been developed for use with those with dementia. Weekly maintenance CST (MCST) sessions following the CST program are shown to lead to continuous benefits in cognition, quality of life, and cost-effectiveness.11,12

Recruitment and Retention of Minority Students in Bachelor of Social Work Programs

This paper examines two issues relevant to baccalaureate social work programs: 1) successful recruitment of diverse racial and ethnic groups of students and 2) the problem of attrition as a major obstacle in graduating racially and ethnically diverse students. While minority recruitment may be actively pursued, many efforts are not effective, regardless of the sophistication or level of funding. Those that are successful provide substantial counseling, financial assistance, curriculum flexibility, and alternate scheduling opportunities. What can BSW programs do to increase the likelihood that students will enter and remain in school and graduate? Many minority students leave school after the first semester for a variety of reasons including lack of financial resources, poor school-support services, or feelings of isolation. For those who remain, attrition is still much higher than in the traditional student population. The authors conclude that to be successful in recruiting and retaining a diverse studen...

The Use of Complementary and Alternative Interventions as a Holistic Approach with Older Adults

The use of complementary and alternative interventions by health care clinicians, in particular social workers, as a method to relieve chronic conditions, such as depressive symptoms in older adults, is addressed in this paper. Psychotherapy, pharmaceuticals, and other medical interventions are often enhanced when accompanied by alternative practices like yoga. Practitioners can learn to use these methods and/or work with a clinician who has a particular alternative skill set. Bringing complementary interventions into ones practice assures that older adults are receiving “best practices.”

Assessing the health of adult daughter former caregivers for elders with Alzheimer's disease.

Past research is varied in assessing the effect of caregiving on health, particularly caregivers in the postcaregiving phase. The variation may be due, in part, to methodological issues, including the use of health measures not psychometrically tested. The study examines the Medical Outcomes Study Short Form 36 (SF-36)1 health survey with 102 former caregivers whose family member was deceased for at least one year at the time of the study and had been identified as having Alzheimers disease or a related disorder. The SF-36 measures eight dimensions of physical and mental health and has been tested on a variety of populations, though not with former daughter caregivers. Confirmatory Factor Analysis supported the factorial validity of the SF-36 for this population, indicating it is a promising tool for understanding postcaregiver health.

Validating a measure across groups: The use of MIMIC models in scale development

ABSTRACT This study tests the effects of causal indicators on the factorial invariance of a measure across groups. If a measure lacks invariance, MIMIC models (Multiple Indicators/Multiple Causes) can be used to identify the source of invariance. Using the Caregiver Well-Being Scale, two phases of multi-group modeling with post-care-givers and non-caregivers were analyzed. The first phase tested the scales validity and reliability using multi-group modeling without controlling for the demographics differences between the groups. The second phase analyzed a MIMIC model with multi-group modeling. Results indicate that when a MIMIC model is not used, the measure is unequally reliable across groups (unequivalent structure). By controlling for the demographic differences using MIMIC modeling, analysis indicates that the scale is factorially invariant. Implications on the use of MIMIC models in scale development are discussed.

Client-Focused Recording: Linking Theory and Practice

The current use and teaching of recording is explored. The development of the use of records for worker accountability and the loss of recording as part of the social work process is traced historically. An alternative to the medical model (problem-oriented record) is proposed based on a client-focused model that espouses social work values.