Dissertations Ph.D. Program
Engaging our Workforce: How Job Demands and Resources Contribute to Social Worker Burnout, Engagement and Intent to Leave
Schwartz, Sara Laura
Social worker stress and burnout are pervasive problems that harm workers, organizations, and clients. Past research has identified burnout, a psychological response to work stress, as an important predictor of intent to leave and ultimate turnover. An emerging body of research has examined work engagement, considered to be the opposite of burnout, as a predictor of retention. The problem of burnout and turnover within organizations employing social workers has been addressed in the literature for many years. This dissertation responded to a call in the literature for a greater emphasis on burnout prevention and enhancement of workforce engagement and retention. The three goals of the study were: 1) to measure levels of work engagement in a sample of social service workers employed in public child welfare; 2) to examine the psychometric properties of two new instruments that measure burnout and engagement; and 3) to use the Job Demands-Resources model to test a hypothesized model of the unique relationships between job demands, job resources, burnout, engagement and intent to leave. Survey data were collected from 243 public child welfare workers employed with Oregon?s Department of Human Services, Children, Adult and Families Division, Service Delivery Area 2 serving Multnomah County. Findings revealed that half of the workers were highly engaged and that 18% of intent to leave was explained by work engagement. An alternative measure of burnout, the Oldenburg Burnout Inventory, demonstrated good internal consistency, convergent validity with the MBI and explained 26% of the variance of intent to leave. A series of path analyses indicated support for a partially-mediated model. The findings indicated that burnout and/or engagement mediate the effects that demands and resources have on intent to leave. Supervisor support appeared to exert both direct and indirect effects on intent to leave. This study demonstrated the applicability of the Job Demands-Resources Model to a sample of social service workers employed in public child welfare. Results indicated that job demands and resources, particularly supervisor support, play an important role in intent to remain employed. Research, education, policy and practice implications involving the development and support of child welfare supervisors are addressed.
Family Participation: What Is It? How Does It Relate to Outcomes for Youth with Serious Emotional Disorders?
The participation of families of children with emotional or behavioral disorders is increasingly seen as an essential component of children?s mental health services. Although it is frequently discussed in the literature, family participation has not been a major focus of most research surrounding youth with serious emotional disorders (SED). This study explored the concept of family participation in the context of services for youth with SED and examined the relationship between family participation in treatment planning and child outcomes. Using both qualitative and quantitative methods, family participation was examined based on family narratives, potential indicators of participation and the relationship between family participation in treatment planning and child outcomes. This study utilized both primary and secondary data from several sources. Data for this study came from Clark County Washington?s Children?s System of Care. Qualitative data were collected using both a focus group format and through individual interviews involving families who are either employed by or enrolled in Clark County?s Juvenile Justice system. Secondary data analysis was performed on quantitative data collected for the recent evaluation of the System of Care (SOC) initiative in Clark County, Washington and from Clark County Department of Juvenile Justice records. Results from this study add to the knowledge base linking (a) child and family characteristics to child outcomes, (b) child and family characteristics to family participation, and (c) family participation to child outcomes. The results also expand our understanding of the nature and meaning of family participation through the perspective of families involved in a wraparound program in juvenile justice. Implications for social work practice, policy and research are discussed.
Training Social Workers in Palliative Care: Evaluation of a Self-Efficacy Model
McCormick, Andrew John
The intensive care unit has become a focal point for decision making in end-of-life care. High technology medicine can often extend life beyond the point of providing benefit to the patient. In these circumstances we have a modern social problem of prolonged death. Palliative care programs have been expanding in U. S. hospitals with the goal of promoting patient comfort and patient and family involvement in treatment planning. Social workers are frequently part of palliative care consult teams and are involved with families to assist them with decision making, end-of-life care, bereavement counseling, and discharge planning. However, many of these social workers report lacking specialized training for their work. This study evaluated a palliative care training program for social workers who work in intensive care units. The social workers received training in the principles of palliative care in the ICU, communication with patients and families, pain and symptom management, withdrawal of life-support, bereavement support, and cross-cultural awareness. The program was based on Bandura?s theory of self-efficacy. Data were collected from social workers and other clinicians and family members of patients who died while in the ICU. The study used a pre-post intervention design and the analysis included t-tests, multiple regression and hierarchical linear modeling. An overall positive effect for the intervention was found. Social workers increased their satisfaction with meeting family needs and provided more total social worker activities after being trained in the principles of palliative care. Four individual social workers who saw more than 20 families had more consistently high scores on the outcome variables. A multilevel model showed that when the number of families seen by a social worker was controlled for as a predictor, social workers provided an increased number of services. The findings are encouraging that palliative care training can be delivered in an ICU environment with good effects. Social workers are encouraged to expand their work in palliative care and recommendations for practice and research are made.
Creative interpretation and fluidity in a rights framework?: The intersection of domestic violence and human rights in the United States
This study explores the manner in which leaders working in the domestic violence field in the U. S. have or have not adopted a human rights framework and what impact this has had on domestic violence policy and intervention. Additional research objectives include assessing whether there is active resistance to adopting a human rights framework and benefits and challenges to using the framework. This research uses the critique and experiences of women of color as a focal point. Data were gathered through interviews with key individuals working within national and regional U.S. organizations on issues of domestic violence and key individuals from human rights organizations within the U.S. Through the use of critical ethnography and autoethnography, this study examines the manner in which the power to frame and define social problems unfolds. Findings suggest a limited dialogue to date between national domestic violence and human rights organizations with a range of thoughts regarding potential benefits and barriers to reframing domestic violence as a human rights violation. Barriers include lack of resonance/U.S. exceptionalism, power of the State to direct funding and focus, and reluctance to shift status quo based in part in white privilege. Benefits of cross-organizational dialogue include expanding focus, building coalitions, and engaging diverse communities in addressing domestic violence issues. Intersectional issues related to gender, race/ethnicity, immigration, and sovereignty are also explored.
Family-friendly Workplace Culture, Flexibility, & Workplace Support for Dependent Care: The Perspectives of Human Resource Professionals
Huffstutter, Katherine June
Integration of family responsibilities and employment demands is challenging for all families, but particularly for those families with extraordinary care requirements of children with mental health disabilities. Utilization of workplace supports, such as flexible work arrangements, has been identified in the work-family literature as an important indicator of organizational responsiveness to employee?s family needs (Allen, 2001; Eaton, 2003; Hammer, Neal, Newsom, Brockwood, & Colton, 2005; Secret, 2000). A better understanding of which organizational conditions may improve utilization of available family-friendly supports by employees caring for children with mental health disorders can improve work-life integration for these families. This study examines some factors that affect accessibility of supports in the workplace for workers with dependent care responsibilities. The exploratory study uses a series of six regression models to identify organizational conditions indicative of a family-friendly workplace culture. Human resource professionals, organizations? primary gatekeepers of workplace policies and practices, were surveyed. The Work-Life Flexibility & Dependent Care Survey was completed by 550 members of WorldatWork or its subsidiary, the Alliance for Work-Life Progress. Key results of the study suggest that organizations with a formal policy on flexible work arrangements create an important pathway for availability and utilization of workplace supports. Family-friendly workplace culture was identified as an important predictor that human resource professionals would likely grant an employee?s request for flexible work arrangements for dependent care needs, including those for mental health care reasons. Implications for social work educators and practitioners, human resource professionals and work-family researchers are discussed. Suggestions for research directions are presented.
Food Security and Hunger Among Low Income US Households: Relations to Federal Food Assistance Program Participation
This dissertation describes the conceptual and empirical framework that guides the definition of food insecurity and hunger, the present status of federal programmatic responses, and the status of current research on the topic. It also examines relations between hunger and federal food assistance program participation. Logistic regression is utilized to 1) predict federal food assistance program participation from household structure, income, community characteristics, and demographics and 2) predict food insecurity/hunger from household structure, income, community characteristics, demographics, and federal food assistance program participation. Results based on 2004 Current Population Survey data from low income households reveal that household size and earnings are strong predictors of federal food assistance program participation. The odds of food insecurity for households that participated in federal food assistance program were higher than for households that did not participate. Implications for Social Work and policy are discussed.
Is It Just Me? Felt HIV-Related Stigma among Adults with HIV.
Block, Rebecca Gila
HIV carries a significant social stigma in the United States based on the virus being contagious, incurable, visually apparent, and still somewhat mysterious to the public. People who are HIV positive, people who love them and people who work with them may all experience HIV-related stigma. The effects of HIV-related stigma vary from individual to individual; from community to community. The magnitude of feeling stigmatized and experiencing stigmatizing behaviors such as discrimination and exclusion also vary among individuals. Individuals experience stigma differently and respond to the experience in diverse ways. The objective of this stud was to explore felt HIV-related stigma among adults who are HIV positive to inform potential future research, policy and social work practice with adults with HIV. In this study, qualitative data describing the individual experiences of adults who have HIV with feeling stigmatized provided insight into both emotions and coping skills in the face of stigma, and illustrated a concept of resilience applied to the management of stigma. The definition of stigma was reviewed and data collected from this study provided support to the accuracy of the definition in the literature as reflective of the experiences of individuals. In exploring the experiences of adults with felt HIV-related stigma, a deeper understanding of stigma was gained in addition to a theoretical conceptualization of stigma viewed through a lens of resilience. Data provided rich insights and definitions of both stigma and the experience of feeling stigmatized. A grounded theory approach led to the development of a theoretical model in this study, which is an iterative conceptualization of felt stigma with a resilience framework. Risk and protective factors, as well as coping skills were identified in the management of felt stigma, which together inform the mechanism of resilience against felt stigma, how stigma is experienced and level of vulnerability towards felt stigma. Information gleaned from this study is paramount in social work practice, providing invaluable information for service provision to adults with HIV. Future research will focus on instrument development and model testing to further the examination of resilience and quantify both felt stigma and vulnerability to feeling stigmatized.
Sons Providing Care at End-of-Life: Common Threads and Nuances
While family care is common in the majority of families in the United States, the primary care providers have predominantly been women. For older adult family members this most often means wives, daughters or daughters-in-law. As the proportion of the oldest old, age 85 and older continues to expand, so too will the need for family care providers. Recent demographic changes have served to deplete the pool of available caregivers. Caregiving research has naturally evolved into investigations into the experiences of women with little attention paid to the care contributions men make. This investigation undertook the task of examining the perceptions of sons who engaged in the role of primary caregiver for their dying elderly parent. It is believed that by looking at the contributions they provided and the challenges they faced, we can come to a greater understanding of their world view of caregiving separate from the contributions of their female counterparts. A secondary analysis of data from a study entitled, "Family Perceptions of Community-Based Dying" was used to further investigate the experiences of adult sons providing care to elderly parents. The Family Perceptions study was conducted at the Oregon Health & Science University's (OHSU) Center for Ethics in Health Care and School of Nursing in Portland, Oregon from 2000 to 2002. A qualitative approach was utilized to analyze the responses to three open ended questions from thirty adult sons who served as the primary caregiver for their dying parents. The implications from this analysis suggests these thirty caregiving sons did not remain on the periphery as concerned family members but became actively engaged in the care provided and the decisions made in relation to their parents at end-of-life. They recounted their experiences in considerable detail, providing a small glimpse into the weeks and months leading up to and sometimes beyond the death of their parents. They were distressed by the ravages of the illnesses and symptoms their parents endured, were engaged in the care provided to their parents by healthcare professionals, and were moved to share their thoughts and opinions about a variety of end-of-life issues all families face. Unlike other caregiver groups studied to date these men identified dementia, nutrition-related issues and respiratory problems as the symptoms their parents endured at end-of-life which they found most distressing. Research on supportive services for male caregivers has been limited. Additional efforts are needed to gain a greater understanding into the needs of these son caregivers so that gender relevant programs can be created in order to support the caregiving roles they are engaging in. This preliminary investigation was the first of its kind to look at the perceptions of a group of adults sons who have taken on this type of family caregiving role. Based on the need to engender all family care providers at end of life, given the dwindling number of available family members and the increasing need for family care for this older adult population at the end of their lives, additional study is needed.
Social Workers Addressing Student-perpetrated Interpersonal Violence in the School Context: Knowledge and Use of Evidence-supported Program
Cawood, Natalie Diane
Researchers have argued that there is a research-practice gap in the delivery of prevention and mental health services in the school setting. An extension of the work of Astor and his colleagues (Astor et al., 1997, 1998, 2000), this study addresses that gap by examining the extent to which evidence-supported school violence intervention programs (ESP) are known and used by school social workers, and the barriers that are related to the use of ESPs. A cross-sectional, web-based survey was completed by 250 members of the School Social Work Association of America, the majority having an MSW as their highest degree. Participants worked in a variety of geographical regions and diverse communities. Using blocks of variables, two hypotheses were tested through multiple regression analysis: (1) reported level of violence and practitioner capabilities will predict practitioner knowledge of ESPs; and (2) reported level of violence, practitioner capabilities, and knowledge of evidence-supported programs will predict the use of ESPs. As expected, the greater the practitioner's time addressing violence, years of experience, confidence about successfully implementing violence intervention programs, and familiarity with the term ?evidence-supported program the greater the awareness of ESPs the social worker reported. Additionally, the higher the practitioner's level of preparedness to effectively respond to school violence and the more awareness of ESPs, the greater the reported use of ESPs. Despite 98.8% of the respondents being aware of at least one ESP, only 72.4% of participants reported using an ESP during the last three years. In addition, more than 90% of the school social workers reported implementing numerous interventions that were not evidence-supported. Practitioners had difficulty acquiring ESPs due to unknown effectiveness of programs, programs being cost prohibitive, and not knowing where to locate ESPs. Barriers social workers identified were a nearly exclusive focus on academic subject areas and lack of time to implement interventions. The findings have implications for university and school district training programs, can inform national and state policy regarding the dissemination and use of evidence-supported programs, and be used by organizations of school social workers to address the implementation of evidence-supported programs to prevent student-perpetrated school violence.
Adolescent Mothers: Youth in Need of Developmentally Appropriate Services
Zimmerman, Patricia Arlyne
This research examines the childhood abuse and maltreatment experiences of adolescent mothers (age 14 to 17; N = 80) to investigate if these experiences have hindered their socioemotional development and consequently, their parenting behaviors and attitudes. Data were gathered using four standardized self-report instruments: the Child Trauma Questionnaire (CTQ), the Trauma Symptom Checklist for Children (TSCC), the Bar On Emotional Quotient Inventory Youth Version (EQi-YV), and the Adult Adolescent Parenting Inventory (AAPI-2). Two additional questionnaires were developed to gather demographic and social service information to add to the knowledge base of the field, and to examine what (if any) developmentally focused services young mothers may need. Interitem and interscale correlations, simple regressions, and hierarchical regressions were produced and examined to determine the strength and types of relationships between the variables. The explanatory capabilities of sets of predictor variables were tested as well. Overall 76.3% of participants reported experiencing childhood abuse and/or maltreatment above minimal levels. Predictor variables high levels of emotional neglect and depression significantly predicted lower socioemotional development (p < .001 and p < .05); socioemotional development significantly predicted corporal punishment values (p < .05); and age and SES predicted empathy (p < .05). Demographic and services data are provided, descriptively analyzed, and discussed. Study limitations and practice considerations, and a new assessment and service delivery model are offered, as are suggestions for future research.
Transplants in the West: A Study of Settlement and Adjustment Issues among Nigerian Immigrant in Portland, Oregon
Ette, Ezekiel Umo
Though the number of Nigerian Immigrants in the United States has increased since 1965, the literature on transnational communities has been selective in its examination of this population. The present study examines the adjustment and settlement issues of Nigerian immigrants in Portland, Oregon. The focus is on barriers, challenges and struggles that this group encountered as they settled in the area. The study examined the meaning of the experience of immigration for a group of twelve immigrants. Since the study sought to describe the immigration experience from the individuals' perspective, the method of study was phenomenology. The focus of the study, therefore, became the description of the phenomenon (immigration), the individual experiences of arrival, settlement and adjustment and the relationships and differences in these experiences. These individual experiences were then taken together and conclusions and lessons were drawn. The goal was exploratory with a view to stimulating interest among researchers in this particular population. Semi-structured interviews were conducted with 12 Nigerian immigrants, with an equal number of males and females, who lived in the Portland metropolitan area stretching from Multnomah County, in Oregon to Clark County, Washington. The stories collected were analyzed using themes that emerged and organized into an interpretive framework that included: reasons for coming to the United States, reasons for staying in the Northwest, barriers/challenges/struggles encountered, practical coping strategies, cognitive coping strategies, interpretation, and meaning imposition on the experience. Participants had different reasons for coming to and settling in the Northwest. Education played a large role both in the impetus to emigrate as well as in the coping process in the settlement phase. The participants reported lack of familiarity with formal networks and heavy reliance on informal networks. Social workers must pay attention to these concerns and issues of racism and culture raised in this study and employ appropriate practice skills in working with this population.
Exploring the Relationship of Anger, Sadness and Men's Violence
Patrick, William R.
This study explored the relationship of men's gendered emotional response patterns to difficult life events and men's violence in relationships. Using a framework informed by social information-processing theory and current theory on masculinity, two hypotheses were generated. The first hypothesis was that higher levels of anger would be associated with higher levels of violence. The second hypothesis was that higher levels of sadness would be associated with lower levels of violence. Survey data were gathered from men in a batterer intervention program and from men in a community-based sample. The independent variables included measures of anger and sadness. Response variables were measures of psychological aggression, physical assault, sexual coercion, physical injury, and other forms of abusive behavior. Participants were also asked open-ended questions about sadness. The findings suggested that although there was some support for the hypotheses, the relationship between emotions and behavior is complex, and that different forms of abusive behavior have different etiologies. The findings also suggest that crying is a pro-social response to negative life events that should be encouraged in men, and that social workers need to be engaged in social change efforts aimed at reducing the level of male violence in society.
"That Relationship is Such an Important Piece": The Experience and Meaning of Graduate Social Work Education for Lesbian and Gay Students
Diehm, Thomas Michael
This study reports the findings of interviews with 122 lesbian and gay graduate social work students in an effort to gain an understanding of their educational experiences within the context of a commitment to social justice. Volunteer students for this phenomenological study came from graduate social work education programs in the Pacific Northwest. Individual, semi-structured interviews were conducted, transcribed, and analyzed to isolate common themes, experiences, and interactions. The data resulted in a model that identifies the primacy of relationships and the interactions that inform those relationships as the core category under which the data falls. Relationships with faculty and other students were described along a continuum from Marginalizing to Inclusive, including those relationships and interactions that were Dismissive, Ambiguous, Supportive, and Validating. How lesbian/gay content was integrated into the classroom (or not) and being able to identify and connect with gay and lesbian social work faculty members were critical issues for participants. In addition to the findings from interviews, this study offers an interpretation of the meaning of social work education to the gay and lesbian student who participated. Implications for social work education and suggestions for further research are offered.
The Environment of the Correctional Institution: An Exploratory Study of Staff Attitude and Institutional Characteristics
Based on a survey of all staff in the Oregon Department of Corrections, this study investigated the relationship between institutional means of social control and correctional staff characteristics as well as attitude regarding inmates and staff role. Based on a Principle Factor Analysis, three subscales emerged from the staff attitude measure; using the subscale scores as the dependent variable and staff demographics as the independent variable, an ANOVA was calculated for each subscale to investigate the relationship between staff attitude and demographics. Findings suggest that years of service, gender, education and job position are significantly related to the belief in the inmate's ability to change and gender and job position are significantly related to the supportive role of the correctional officer. Additionally, a Pearson's Correlation Coefficient found no significant relationship between means of prison social control and staff attitude. The institutional response rate was too low to produce the statistical power appropriate for institutional level data. This study discusses the impact of staff demographics on relationships with inmates as well as the need for staff training. Suggestions for further research for increasing the response rate for the prison population are also discussed.
Applying the Transtheoretical Model to Cigarette Smoking by Pregnant and Parenting Adolescent Females
Sussex, Barbara Mary
This dissertation examined measured from the TMC and variables associated with smoking behavior in a population of pregnant and parenting females 18 years-of-age and under. Data were from the baseline survey of 245 young women enrolled in a three-year randomized controlled trial through a teen parent program in Portland, Oregon. Objectives were to: 1) investigate whether factors identified in literature as associated with initiating and quitting smoking were associated with never smokers and teens in the stage of change, 2) determine whether stage effects were exhibited from the TMC constructs of decisional balance, temptations to smoke, processes of change, and self-efficacy for the total sample and by pregnancy status. Significant associations by categories of never smokers and TMC stages of change were found for several psychosocial variables including pregnancy status, perceived wrong and harm of smoking, partner and friends smoking, current alcohol and marijuana use, smoking self-efficacy, and smoking intention. Smoking as a mean to deal with stress and frustration and to avoid unpleasant emotions were significant factors. Also, lack of use of stage-appropriate internal processes of change and coping methods may indicate that teens who have quit smoking are at a high risk for relapse. Implications of these and other findings as well as recommendations for social work research, policy, and practice are discussed.
The Effects of Psychiatric Problem Severity on Substance Abuse Treatment Participation and Outcomes
Polen, Michael Robert
This study examined the effects of psychiatric problem severity on participation in, and outcomes of, treatment for alcohol or other drug (AOD) problems. A conceptual model of AOD treatment participation and outcomes was developed, based on the AOD treatment research literature and the Anderson model of health services utilization. Hypotheses about the effects of psychiatric severity on AOD treatment participation and outcomes addressed whether psychiatric severity moderated the effects of other factors, or, if not, whether direct effects were evident. The study re-analyzed data from 293 individuals recommended for intensive outpatient AOD treatment in a specialty addiction medicine program. Participants were interviews at intake and at 6-month follow-up. The Addiction Severity Index was used to measure psychiatric and substance use problem severity, the Stages of Change Readiness and Treatment Eagerness Scale was used to measure readiness to change, and the number of hours in treatment was obtained from program records. Hierarchical multiple logistic and linear regression analyses found no evidence that psychiatric problem severity moderated either a) the relationships between substance use severity and readiness to change with treatment participation and outcomes, or b) the effect of treatment participation on treatment outcomes. Small negative direct effects of psychiatric problem severity on treatment participation and outcomes were evident, however. Path analyses using significant predictors from the regression analyses confirmed these negative effects. Psychiatric problem severity among individuals seeking treatment for substance abuse problems had pervasive negative effects on the AOD treatment experience, by diminishing both time in treatment and likelihood of being abstinent following treatment. The findings underscore the importance of assessing psychiatric symptoms among AOD treatment clients, as well as the need to provide services that address their psychiatric symptomatology. Such treatment has potential to increase treatment retention and improve treatment outcomes.
Mental Health and HIV Risk Behaviors in Homeless Youth
This NIMH-funded dissertation project attempts to discover the relationships between depressive symptoms, substance use, and HIV and Hepatitis C (HCV) risk behaviors among homeless youth in the greater Portland area. Specifically, it is of interest to determine if depressive symptoms and substance use are predictive of risk behaviors among this population of marginalized young people. Practice and policy implications that may stem from this research will be related funding of, and culturally-appropriate treatment options for dually diagnosed homeless youth. Practical implications include the potetntial ability to identify high-risk youth and target culturally appropriate harm reduction HIV and HCV interventions.
The Personal is Political: Psychoanalysis and Emancipatory Social Work Practice
(Dissertation in progress)
Describing the Experience of Pregnant or Parenting Adolescents and Intimate Partner Violence
Knight, Karen Lea
This qualitative research expands upon studies documenting high prevalence rates of abuse among adolescent parents by describing the experiences of pregnant or parenting adolescents in physically abusive relationships. 16 female participants who had been in abusive relationships, ages 19 21 years, reported entering into their relationships for diverse reasons: the men were attentive, attractive, and represented hope for help in solving a personal problem. Participants gradually arrived at their decisions to leave their abusive relationships through an accumulation of incidents but their actual leaving was spontaneous. Social services and educational services helped participants in various ways and should they have had accesses to support services such as emergency housing, job training, financial assistance, and childcare, virtually all of them would have left their abusive relationship sooner. Recommendations include research into the effects of adolescent and gender development on domestic violence, revised abuse reporting policies, and such emergency and transitional assistance as housing, childcare, and independence-enhancing support services.
Getting There from Here: Variables Associated with the Adoption of Innovation in Public Child Welfare
Cahn, Katharine Campbell
The intent of this study is to expand and elaborate on existing theories of the adoption of innovation as they might apply to child welfare. The research used qualitative methods to examine variables present in two urban child welfare offices in which an innovation called Strengths/Needs Based Practice has been adopted. Community contact, both political and cultural, is much more important in public child welfare than previous innovations research would suggest. This leads to the need to articulate two new roles, community mobilizer and external advocate. The dance of adoption of innovation is a balanced choreography of support and accountability; steps are identified that a social worker can take at many points in the system to improve the likelihood a desired innovation will be taken up to scale.
Control and Support Variables during Pregnancy and the Development of Depressive Symptoms during the Postpartum Period
The study tested the predictive value of measures of reported sense of control and perceived social support in work and family domains measured during the third trimester of pregnancy on the development of depressive symptoms measured at 3 months postpartum. Reported sense of control and social support from work and family were measured as moderating variables of depressive symptoms evident in the postpartum period. Personal control at work included measures of skill discretion and decision authority. Control in the family was measured in two ways: reported control in the relationship with partner and parenting control questions. Social support measures included support at work from supervisor and coworkers, and family support from partner and parents. The predictive value of the model was explored after controlling for history of depression, age, and social economic status. The results from this study demonstrate that mothers reported sense of control both within the family and at work measured during pregnancy have predictive value for depressive symptoms measured at 3 and 6 months postpartum; mothers reporting more sense of control during pregnancy also tended to report fewer depressive symptoms. The reported sense of control at home and supervisor support both measured during pregnancy were the strongest predictors of depressive symptoms in the postpartum period, with each negatively related to depressive symptoms. Different sources of support and types of support varied in their importance. The implications of findings for clinical interventions and policy developments are discussed.
Testimonios from the Intersection of Mexican America Culture and an American Death
Eggman, Susan T.
This dissertation explores the experiences of Mexican American families as they cope with the terminal illness and eventual death of a loved one while interacting with the American health Care system. This qualitative research project, through a collection of seven testimonios, presents an understanding of the multidimensional context of intersection of the American health care system at the end of life and Mexican American culture. Full text testimonios serve as rich material for social workers in health care in health care settings to deepen their understanding of the outcome of their practice from a patient's experience. Reflections about testimonios include a discussion about the following dimensions: family, spirituality, personalismo, the layering of oppression, complications of diabetes and end stage renal disease, acculturation, end of life decision making, ways of knowing and end of life care in general. Implications for policy, practice, research and social work education are also presented.
Leaving Welfare: Stories of Struggle
Vegdahl, Sonja B.
This study explored the experience of leaving welfare from the perspective of those who have recently stopped receiving cash assistance. In particular, this study examined the individual strengths and family and community resources which single mothers drew on as they managed their family both on and off welfare. Qualitative interviews were conducted with 15 single women who had been off welfare at least six months and no more than two years. Narrative analysis was used to examine these participants' stories. This analysis revealed valuable individual strengths such as a commitment to parenting, creative use of resources, a strong work ethic, and contributions to their communities. Women described the critical role that family and friends played in the lives of their families as well as the reciprocal responsibilities this assistance created. However, these stories made it quite clear that individual strengths and family resources alone were inadequate to move welfare recipients out of poverty. Women performing the dual roles of worker and parent, particularly those being paid low wages, needed additional kinds of assistance. The participants in this study demonstrated strong support for the values underlying welfare reform such as a preference for work to welfare, a desire to be independent of government services and support for the nuclear family. Through their stories, these women call for social policy which would make it possible for low-income, single mothers to be good parents and good workers. Such policy would include living wages, flexible work schedules, high-quality childcare, health insurance and affordable housing.
Identifying and Building on Strengths of Children with Serious Emotional Disturbances
Taylor, Michael Orval
The aim of this study is to explore strengths assessments and the participation of parents in assessment of strengths and functioning of their children challenged by serious emotional disorders. The research questions investigated are the concordance of families and professionals in assessment of strengths, differences in assessment of strengths, problems in specific domains of functioning, and relationships of characteristics of the child with recognition of strengths by the parent and professional. This study uses data collected from families of children with serious emotional disorders receiving services through community-based wraparound services supported by the mental health services program for children #5 HSS SM52297 awarded by the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. The children in this study have a high level of exposure to mental illness, domestic violence and substance abuse in their biological families and are living with family members or foster families in the community. These children are at high risk of placement outside of their homes and communities due to serious emotional and behavioral problems. Eighty-five children served from January 1999 through December 2001, were assessed by the parent and professional using the Behavioral and Emotional Rating Scale (BERS), the Achenbach Child Behavior Checklist (CBCL), and the Child and Adolescent Functioning Scale (CAFAS). A repeated measures analysis of the strengths scores from the BERS revealed significant differences in the assessment of strengths by the parent and professional raters in domains of intrapersonal strengths, affective strengths and family involvement. The study results support the utility of strengths and deficit measures from multiple informants, including the family, to provide unique information regarding the child's strengths and functioning. The data provide an opportunity for both professionals and parents to explore differences in perceptions and increase discourse about areas of agreement and difference. These findings support implementation of strengths measurement and demonstrate the importance of communication about the results into the day to day practice of agencies and professionals providing services to children and adolescents.
A Grounded Theory Study of the Processes of Resilience in Young Adults with Disabilities during Their Transition into Adulthood
Oschwald, Mary Martha
The purpose of this qualitative study was to identify the underlying processes of resilience that support young adults with disabilities during transition into adulthood. Study questions related to their external supports, the internal strategies, the interactions between these, and the ways the support and strategies were used to overcome obstacles during transition. One area of concern unique to youth with disabilities is the management of their heath and wellness, so an additional question addressed the opportunities young adults with disabilities had to access medical and mental health services. The theoretical perspectives that guided this study were: adult development, resilience, and within and cross disability theory. In-depth individual interviews were conducted with 13 diverse young people with a variety of disabilities. Themes obtained using grounded theory analysis were organized into the theoretical Young Adult Transition model. Regarding the health domain, participants said it was important to be self-directed in managing their health, to gain access to adult healthcare, and to voice their concerns with professionals. Youth who depend on others for care also have to create supportive relationships to be as independent as possible. Social workers need to pay attention to these concerns and encourage youth to make decisions, and assist them in developing their leadership, autonomy, and capacities for the successful transition into adulthood.
Measuring client engagement in non-voluntary child protective services
Yatchmenoff, Diane K.
This study reports on the development and test of a multi-dimensional measure of client engagement in child welfare services. Five dimensions of engagement were identified, based on literature review and data from interviews with child welfare workers and clients. A pool of items was generated to reflect these five dimensions, with input from three expert panels of researchers, scholars, practitioners, and consumers. Pilot data from the resulting measure were collected from 287 primary caregivers who were non-voluntary clients of the child protective service system. Internal consistency reliability, construct validity, and criterion validity were examined, and tests of the fit of the data to the hypothesized measurement model were conducted and reported. Results supported the presence of four underlying factors and also the presence of a single latent variable. Implications for practice and research are discussed.
Association Between Risk and Protective Factors and the Mental Health Status of Youth in the Juvenile Justice System
Hooper, Richard Ivan
The Social Development Model specifies how risk and protective factors predict delinquency. This research sought to extend the Social Development Model by using risk and protective factors to also predict mental health status. The purposive sample included 145 adjudicated youth (ages 12-18 years) from Multnomah, Polk, and Umatilla counties in Oregon. Data was collected by self-report and a survey completed by court counselors. Mental health status was measured by the MHI-5, a subset of the SF-36 (Ware, Kosinski, & Keller, 1994), and the Internalizing subscale of the Youth Self-Report (Achenbach, 1991). Delinquency was measured by the Externalizing subscale of the Youth Self-Report. Risk and protective factors were measured using items selected from the Student Survey of Risk and Protective Factors and Prevalence of Alcohol, Tobacco, and other Drug Survey (Catalano, Hawkins, & Pollard, 1997). Five hypotheses were tested using hierarchical regression analysis, t-tests, ANOVA, and the z-statistic. The five major findings of this study include, first, risk and protective factors were significantly predictive of delinquency. Second, only risk factors were significantly correlated to the YSR Internalizing t-scores of these youth. While the combined effects of risk and protective factors were predictive of YSR Internalizing t-scores. Third, delinquency was found to be an intervening variable between risk and protective factors and YSR Internalizing t-scores. Fourth, there were no significant differences in mental health status between whites and youth of color. And fifth, while there was a significant difference in mental health status between males and females, the linear regression model failed to be significant for the female only sample.
Service Integration in HIV and Mental Health Care: Does It Predict Improved Outcomes?
Douglas, Jane Patricia
This research was designed to test a method for identifying people who are living with moderate and severe mental illness in addition to HIV, to measure the degree to which mental health and medical services are integrated for these individuals, and to evaluate the relationship between service integration and mental health-related outcomes. 175 patients from two HIV clinics were recruited for this study. Data on the presence and severity of mental illness, treatment providers, levels of service integration, and physical and mental health outcomes were collected. The analysis focused on assessing the rates of moderate and severe mental illness, provider identification of mental illness, the effect of mental health treatment on HIV and mental health outcomes and effect of service integration on HIV and mental health outcomes. The findings indicate not only high rates of severe mental illness in these two HIV patient populations, but also high rates of moderate mental illness. Service integration was found to be an important mediating influence for all participants with moderate or severe mental illness, but in some analyses it appeared that service integration was an outcome of adverse events, rather than a mediating influence on decreasing them.
A Dissertation on African American Male Youth Violence: "Trying to Kill the Part of You that Isn't Loved"
Leary, Joy DeGruy
This dissertation is based on Sociocultural Theory, Social Learning Theory and Trauma Theory, as well as a new theoretical framework (Post Traumatic Slave Syndrome) which takes into account multigenerational trauma. Five research questions involving independent variables believed to predict violent behavior in African American male youth were investigated. The first three questions addressed stressors experienced by African Americans: violence witnessing, violence victimization, and daily urban hassles. The fourth and fifth questions concerned the sociocultural characteristics of racial socialization and prosocial attitudes toward respect. Participants were 200 African American male youth residing in inner Northeast Portland, Oregon who were recruited from four organizations. The study included two groups of African American male youth ages 14 to 18, 100 of whom were incarcerated and 100 of whom were non-incarcerated. All five independent variables significantly predicted use of violence in separate regression equations. Multiple regression analyses revealed that the strongest predictor of the use of violence was victimization extent which alone accounted for 43.3% of the total variance in use of violence. Variables excluded from the final regression equation were racial socialization and urban hassles which failed to significantly increase the prediction of the criterion variable of extent of use of violence. The data provide evidence that trauma characteristics of absent mothers, witnessing violence, experiencing violence, and feeling disrespected by others are key factors that can provide practitioners a better lens to use in assessment and treatment planning than the current response of punishment and incarceration for displays of violent behavior.
The Child Witness to Domestic Violence: The Relationship Among Battered Mothers' Characteristics, Child Abuse, and Child Behavior Problems
Morley, Evelyn Godbold
This qualitative study aimed at advancing our understanding of the repercussions to children of witnessing domestic violence and/or being a victim of child abuse. The characteristics of battered mothers that may make it difficult for them to meet the needs of their children are analyzed; these characteristics include the severity of the battering, the mothers' perceived level of empowerment, and mothers' service utilization. One hundred and six battered mothers, with at least one child between 4 and 16 years of age, were interviewed. Information on mothers' characteristics and characteristics of the children was obtained. Findings show that children who both witnessed battering and were the victim of child abuse had the highest child behavior problem scores, children who witnessed domestic violence but were not victims of abuse had intermediate scores, and children who were neither witnesses nor were victims of abuse had the lowest problem behavior scores. Neither mothers' sense of empowerment nor the severity of abuse they endured were correlated with child behavior scores. Mothers who utilized more services had children with higher behavior problem scores.
The Assessment of Children with Attachment Disorder: The Randolph Attachment Disorder Questionnaire, the Behavioral and Emotional Rating Scale, and the Biopsychosocial Attachment Types framework.
Ogilvie, A. Myrth
This dissertation explores three research questions. First, can scores on the BERS predict attachment disorder as measured by the RADQ? Second, can the six subcategories of the BAT be measured using selected BERS items plus additional author-developed items? Finally, if selected items measure the BAT categories, are the resulting measures reliable and valid? Assessment of AD in children ages 6 to 18 utilizing two instruments and a new framework developed by the author, Biopsychosocial Attachment Types(BAT), were explored. The Foster Family Survey completed between January and March of 1999 by 285 foster parents of children in British Columbia, Canada, provided the data. Results included an 18-item BAT measure and a 7-item subscale predicting RADQ scores. The regression equation BAT best-fit model yielded a cumulative adjusted r square of .515. The BAT measure achieved an alpha of .91. Factor analysis distinguished BAT subcategories with BERS and pool items.
Voices of Our Past: The Rank and File Movement in Social Work, 1931-1950
Hunter, Richard William
During the period of the late 1920s through the late 1940s, a most remarkable event in the history of American social work emerged: the development of a vital radical trade union organizing effort known as the rank and file movement. Born within the growing economic crisis of the 1920s and maturing in the national economic collapse and social upheaval heralded by the Great Depression, the rank and file movement would attract the support and membership of thousands of professional social workers and uncredentialed relief workers in efforts to organize social service workers along the lines of industrial unionism. Within its relatively short life span, the rank and file movement would grow in sufficient number and influence to challenge both the prevailing definitions of social work as a profession - its form and identity - and the essence of its function - its practice. It is the thesis of this study that an understanding of the rank and file movement is central to a modern understanding of our profession. The origin, development and demise of the rank and file movement reflects more than the historical curiosity of a momentary tendency in the evolution of a profession; rather, it reveals the enduring legacy of individuals, organizations and collective intellectual discourse in common struggle for the possibilities of a more just and democratic social order. And, perhaps unlike any other profession, the domain of social work is historically one uniquely born of this struggle, encompassing the self-imposed imperatives and paradoxes of morality, socially purposive service and scientific rationality. Consequently, this study seeks to inform the terms of this enduring legacy within the dynamic world of social work. It does so by: 1) locating the history of the rank and file movement within the context of an evolving profession; 2) analyzing this specific history of a profession within the context of broader social and political forces that defined both the limits and potentials of that evolution; and 3) assessing the implications of this history for social work in terms of its past, present and future.
An Innovative Family Preservation and Support Program in an African American Community: Analysis of Six- and Twelve-Month Follow-up Data
Cilberti, Patricia E.
Neglect affects many African American children who live in poverty, causing developmental delays, health problems, low academic achievement, and placement. The researcher hypothesized that families served by a culturally responsive family preservation program, when compared with similar families served directly by state child protective services, would improve significantly more on relevant outcome measures. The study utilized a matched groups longitudinal comparison design, with both groups composed of African American families. At six and twelve month follow-ups, number of placements, number of days in placement, and number of reported incidents of maltreatment were assessed. Findings showed that although treatment families had significantly greater improvements than comparison families at the six-month follow-up, the treatment effect lowered at twelve months. Additional analyses revealed that most of the FEP families who continued to have children in placement at the twelve- month follow-up were using kinship care, an important element within African American communities.
Critical and Fatal Child Maltreatment in Oregon: Escalating Violence or Distinct Behavior?
deHaan, Benjamin Daniel
This study examined 924 cases involving children under the age of 6 from Oregon's public child welfare system to determine if 24 family/parental factors and 22 child characteristics used by front-line child protection workers were valuable in identifying the most severe maltreatment cases. Using data from two previous studies, sample cases were assigned to four severity groups and then compared to one another on the basis of family factors, parental factors, and child characteristics. Results suggested that 1) Specific factors were associated with mild, moderate, and severe cases. However, these factors had little value in predicting maltreatment severity. 2) Although the data did not demonstrate an association between children's disabilities and increased severity, 40 of the 42 fatal cases in the sample involved children with a documented physical, mental, or behavioral problem. 3) Abuse and neglect cases were two distinct populations. 4) Cases did not form an unbroken severity continuum. Cases in the mild group were the most distinguishable because they shared the fewest factors with the other severity groups. 5) Fatal cases of child maltreatment had fewer of the factors commonly associated with maltreatment severity than any of the other groups in this study.
Grandmothers Laughing: Intergenerational Transmission of Cultural Beliefs Among Native American Women about Pregnancy and Childbirth
Long, Claudia Robin
This dissertation reports findings from a qualitative study. Proposed is a theory of intergenerational transmission that explains four pathways used by Indian women to gain information about pregnancy and childbirth. Antecedent, consequent, and core elements are associated with the transmission process. Discriminant sampling was used to identify the middle generation of Indian mothers and grandmothers, between 36 and 65 years of age, residing on or near the reservation, with experience of assimilation policies that had moved off-reservation temporarily. The researcher used the grounded theory method to analyze responses to the profile instrument, the Ethnic, Culture, Religion/Spirituality (ECR) instrument (Cross, 1995), May's (1982) social integration schema, and open-ended focus group interviews. Two focus groups were conducted, Group I with 4 women, and Group II with 3 women. Interview data were analyzed using the method of constant comparative analysis. In the process of cultural transmission, the middle generation of women identified with balancing both world views. Yet, in comparison with the Rural Oregon Minority Prenatal Project study (1995a), elders identified more with the traditional world, and the young Indian women did not identify with either world and were described as caught between two worlds.