Theresa J. Early

Measures for Practice with Families from a Strengths Perspective

Social work practice from a strengths perspective is increasingly a preferred mode of practice. In the current environment of managed care in many fields, practitioners are required to measure and document various aspects of client problems and service effectiveness. The problem focus is inconsistent with the strengths perspective, but strengths-based practitioners are not immune from the accountability demands. This paper identifies and evaluates measurement instruments that can be used in practice with families—from a strengths perspective—and will also enable social workers to document service effectiveness.

Building a Model of Family Caregiving for Children with Emotional Disorders

In this article we describe the results of an ongoing effort to better understand the caregiving process in families of children with severe emotional problems. We make two assumptions. First, we assume that these families are essentially like other families but are faced with a special challenge in raising and caring for their special children while at the same time performing the multiple tasks and demands faced by all families. Second, we assume that public policy and programs must be supportive of the care of these children in their own homes and communities whenever possible. The purpose of this article is to present a model of family caregiving that draws broadly from available theory and empirical literature in multiple fields and to subject this model to empirical testing. We use structural equation modeling with latent variables to estimate an empirical model based on the theoretical model. Results of the model testing point to the importance of the childs external problem behaviors and the familys socioeconomic status and coping strategies as determinants of caregiver stress. Other findings highlight difficulties in measuring and modeling the complex mediating process, which includes formal and informal supports, perceptions, and coping behaviors. The use of structural equation modeling can benefit our efforts to support families by making explicit our theories about the important dimensions of this process and the relationship between these dimensions, which can then be subjected to measurement and validation.

Battling in the Trenches: Case Managers’ Ability to Combat the Effects of Mental Illness Stigma on Consumers’ Perceived Quality of Life

Intervention effectiveness research requires that investigators include “real world” variables in the design of studies to develop an understanding of how interventions perform in the “real world.” Two areas that have been neglected in effectiveness research on mental health case management are mental illness self-stigma and the effects of different case managers. Self-stigma is a reality for many consumers that negatively impacts their lives. Case managers, themselves, are a potential source of autocorrelation and likely provide services differently. This study explores the relationship between self-stigma and quality of life for consumers receiving services from different case managers. Cross-sectional data were collected from 160 consumers of an urban case management agency. Self-stigma was negatively associated with quality of life. Case managers did not account for a significant amount of variance in quality of life scores. However, the interaction between case manager and self-stigma was significant. Some case managers were able to mitigate the negative effects of self-stigma on quality of life. Future effectiveness research in community mental health case management needs to account for the effects of self-stigma, case managers, and the interaction between the two in the research design.

Mental Health and Substance Abuse Service Engagement by Men and Women During Community Reentry Following Incarceration

Individuals reentering the community following incarceration are at high risk for experiencing mental health and substance use problems. This longitudinal study explores patterns and barriers for engaging treatment services during early reentry. Seventy-five men and 62 women in jail, prison, or community based correctional facilities (CBCFs) participated in pre- and post-release interviews. Findings indicate that services were engaged at a lower-than-needed rate and barriers were greater for individuals leaving jails compared to prison or CBCF. Exploratory factor analysis of the barriers instrument is presented. Implications for extending service access to this population are discussed, as are future directions for research.

A Qualitative Exploratory Study of Substance Abuse Prevention Outcomes in a Heterogeneous Prevention System

The prevention of abuse of alcohol and other drugs is a concern for parents, policy-makers, educators, and social service professionals. Prevention programs are sponsored by many different types of social and educational agencies using a variety of intervention strategies. This article reports a study of a sample of such programs in the state of Nevada. The overall prevention system in the state espouses a “risk and resiliency” approach to prevention. Focus group methodology was used to study perception of outcomes of these programs from the viewpoints of various program stakeholders (youth participating in the programs, parents of participants and program staff). Analysis of the qualitative data yielded findings about potential outcomes as well as implicit program theories. Implications for future planning efforts as well as further evaluation efforts are discussed.

A Family Systems Perspective in Prisoner Reentry

This chapter examines theories about family systems applicable to the prisoner reentry process. Specifically, the focus is on adults released from incarceration and the nature of family reintegration under these circumstances. Literature and data from criminal justice and social work are explored, along with lessons learned through analogous family reintegration circumstances. The chapter begins with an overview of family systems, role, and adaptation constructs, exploring the nature of families as dynamic systems and how they might experience a member’s incarceration and community reentry. The discussion next analyzes prisoner visitation evidence related to preserving family connectedness. Ideas for meeting the special needs of these families are then explored. Finally, conclusions are drawn concerning practice, policy, and future directions for research.