Showing papers in "Journal of Family Social Work in 2010"

Characteristics and Trends in Family-Centered Conceptualizations

Abstract: Early-intervention and early childhood professionals have long considered family-centered service delivery best practice. Exactly what family-centered practice means, however, remains unclear. The lack of consensus in defining family centeredness results in incongruence in the manner and degree to which professionals implement family centeredness. This review of the literature examines current conceptualizations of family-centered practice in an effort to determine whether there is a common definition; and, if so, how that definition has changed over the past decade. The authors found that, though the key elements of family centeredness (i.e., family as the unit of attention, family choice, family strengths, family–professional relationship, and individualized family services) have remained consistent, the emphasis has shifted from the family as the unit of attention to family–professional relationship and family choice. Implications for early intervention practice and research are discussed.

Family-Centered Early Intervention for Infants and Toddlers With Disabilities

Abstract: Almost 300,000 children in the United States from birth to 3 years of age are affected by a developmental disability. Disabilities have a lasting effect on a child's development and, in turn, may have a psychosocial impact on the child's family. In addition, the limitations of a child with a disability are often related to family members' stress, depression, and feelings of helplessness. Accordingly, not only do children with disabilities have special needs, but also families have unique needs as well. This review article describes the value of a family-centered approach to early intervention services for infants and toddlers and their families. Authors also describe barriers to the implementation of family-centered care and the role that social workers may play in addressing these barriers.

Family-Centered Care for Children with Special Health Care Needs: Are We Moving Forward?.

Abstract: Family-centered care (FCC) is widely acknowledged as supporting positive outcomes in children with special health care needs (CSHCN) and their parents. The intent of this mixed-method research was to enhance understanding of family-centered behaviors in professionals who had received specialty training in the principles of FCC and to explore provider perceptions of challenges to FCC implementation. Eighty-nine professionals who had completed the Leadership Education in Neurodevelopmental Disabilities (LEND) training program at a large, urban university were mailed an anonymous survey containing a self-report measure of FCC, the Measure of Process of Care for Service Providers, and an open-ended question on barriers to FCC. Thirty-three participants returned the survey (37% response rate). Descriptive analyses of MPOC-SP subscales indicated that the interdisciplinary professionals were providing care consistent with the principles of FCC in the areas of treating people respectfully, communicating specific ...

Predictors of Depressive Symptomatology in Family Caregivers of Women With Substance Use Disorders or Co-Occurring Substance Use and Mental Disorders

Abstract: This study utilized a stress-process model to examine the impact of having a female family member with substance use or co-occurring substance use and mental disorders on family caregivers' depressive symptomatology. Participants were 82 women receiving substance abuse treatment and the family member providing the most social support for each woman. Greater caregiver depressive symptomatology was predicted by greater care recipient emotional problems, less care recipient social support, and poor caregiver health. Implications of findings for treatment and future research are discussed.

Professionals' Perspectives on Organizational Factors That Support or Hinder the Successful Implementation of Family-Centered Practice

Abstract: This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff were invited to participate in qualitative interviews and focus groups, resulting in 36 people responding (front-line service coordinators, supervisors, and key informants). The analysis identified factors related to the organization's culture and climate (such as caseload size and activity, supervision, and training), policy limitations, and collateral services, as negatively affecting the ability to successfully implement FCP. The findings suggest that organizations should develop and maintain organizational cultures and climates necessary to support, implement and sustain FCP to positively impact service quality and outcomes.

A Qualitative Evaluation of the Effects of Mandatory Reporting of Domestic Violence on Victims and Their Children

Abstract: This purpose of this research was to evaluate the mandatory reporting law for domestic violence victims in the state of Kentucky through the qualitative interview of 24 female victims of domestic violence. Victims were generally supportive of the law and felt that professionals should be required to report domestic abuse. They did not feel that the report placed them at higher risk of revictimization or loss of their children to child protective services. The women were offered and utilized a range of supportive services. Criticisms of the process included the “secrecy” of contact, a simplistic conceptualization of family violence, and failure by police to act on the report. This research offers preliminary support for mandatory reporting as an effective intervention for domestic violence from the perspective of victims.

The Rape Prevention and Education (RPE) Theory Model of Community Change: Connecting Individual and Social Change

Abstract: Social work practice has long focused on the connections between an individual and the social environment that affect the individual's social functioning. The Rape Prevention and Education (RPE) Program's theory model, Creating Safer Communities: The Rape Prevention and Education Model of Community Change, provides family social workers with a framework for examining and changing the individual and social factors that lead to sexual violence. This model connects two societal change theories, community readiness and diffusion of innovations, with three individual level theories, theory of reasoned action, theory of planned behavior and the health belief model, for the purpose of ending sexual violence. The Centers for Disease Control and Prevention (CDC) created this theory model to promote the use of theory-based prevention strategies among RPE Program grantees. In this article the authors (1) describe the theoretical underpinnings of the RPE theory model; (2) explore how one RPE grantee, supported with f...

Testing Self-Efficacy as a Pathway that Supports Self-Care among Family Caregivers in a Psychoeducational Intervention.

Abstract: This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer’s disease (N ¼325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care behaviors. Data were analyzed using repeated measures and multivariate analysis of variance and multiple regression. Qualitative written accounts of the impact of the intervention augmented the quantitative findings. The study’s findings revealed that family caregivers experienced reductions in health risk behaviors and improvements in exercise, stress management, and relaxation activities as a result of participating in the psychoeducational intervention. Improvement in selfefficacy was linked with reductions in health risk behaviors and increased involvement in stress management and relaxation activities. Implications are discussed in terms of the need to understand the mechanisms by which interventions influence family caregivers and the role these mechanisms play in supporting family-centered care.

Partnering With Professionals: Family-Centered Care From the Parent Perspective

Abstract: It has different names; in health care it is referred to as family centered, in mental health, family driven, and in social work, relationship based. Regardless of the name, all of these concepts share the same core principle that professionals intentionally partner with families: seeking family input, viewing the family as the primary expert on the child, and responding to family concerns in a strengths-based manner that incorporates the philosophical, cultural, and unique needs of the family and individual.

“It Should Have Been Happening To Me”: The Psychosocial Issues Older Caregiving Mothers Experience

Abstract: The occurrence of cancer is an event of significant importance to family functioning. The present analysis reports on an understudied group profoundly affected by this health event: older mothers caring for an adult child with cancer. As part of a study of breast cancer survivors and their family caregivers, a subsample (N = 13) of older caregiving mothers (mean age 68) participated in focused interviews. The interviews, conducted in English or Spanish, were audio-taped, transcribed, and subjected to content analysis. Analyses of the mothers' accounts elucidate complex psychosocial reactions to their adult daughters' cancer diagnosis that are informed by life-cycle considerations. These reactions, which include a reawakening of maternal behavior, a need to come to terms with the asynchronous nature of their daughters' health event, and an intense feeling of personal responsibility, illustrate the need for family-centered care in oncology.

Parental Caregivers' Desires for Lifetime Assistance Planning for Future Supports for Their Children with Intellectual and Developmental Disabilities

Abstract: Future life planning is a growing concern among families with children with disabilities. This article presents a needs assessment evaluating feasibility of a new model for future life planning for family caregivers, Lifetime Assistance, which will provide ongoing planning and monitoring for individuals with intellectual and developmental disabilities. Using surveys informed by a series of focus groups, data were gathered from older and younger parents in one midwestern state regarding the potential program. Study results indicate that respondents did not feel the current system of support was adequate for planning for their child's future, nor sufficient for monitoring the quality of life for their children in the future. Although almost all families had identified a person to support their family members when they were no longer able to do so, parental caregivers overwhelmingly identified the need for the Lifetime Assistance program and many were willing to pay for this service themselves.

Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults With Dementia

Abstract: Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to relatives with dementia, access to home- and community-based services, and the potential benefits of a consumer-directed service model. The authors conducted three focus groups with family caregivers (N = 25) in eastern Missouri who were recruited through support groups and service providers. Family caregivers reported difficulty in acquiring services, high levels of psychological and physical stress, greater need for caregiving supports, and a desire for public policy change to support caregiving families. Caregivers cited differences in knowledge, family relationships, and health and employment circumstances as reasons why they would prefer a traditional case ma...

Strengthening Systems for the Primary Prevention of Intimate Partner Violence and Sexual Violence: CDC's DELTA and EMPOWER Programs

Abstract: Over the past three decades, the effect of intimate partner violence (IPV) and sexual violence (SV) on individuals and families has become better understood by practitioners, researchers, and socie...

Kinship Care and “Child-Only” Welfare Grants: Low Participation Despite Potential Benefits

Abstract: Several U.S. social policies identify kinship care as the preferred out-of-home placement. However, financial assistance to defray the cost of kinship caregiving is limited. One option is the child-only welfare grant. This study investigates kinship households' eligibility for, utilization of, and educational benefits associated with these grants. Most kinship households are eligible for these grants, which in 2003 provided a median monthly benefit of $227. However, analysis of National Longitudinal Study of Adolescent Health data indicates that few eligible kinship households receive the grants. Regression analysis indicates that an increase in this amount of monthly household income during adolescence is associated with a 7% greater likelihood of kinship youth graduating from high school.

Youth Action Strategies in the Primary Prevention of Teen Dating Violence

Abstract: This article describes a school-based youth-driven teen dating violence prevention project. The project objectives are to provide opportunities for students to plan presentations and activities; develop knowledge and awareness about unhealthy gender norms, seen as an important root cause of relationship violence, particularly for teenagers; and identify ways to cope with and influence their environment with respect to this issue. This project was conducted in a rural Wisconsin community over the course of 5 years. It started as a multischool “drop-in” program with students from various high schools but eventually evolved into a youth action team at an alternative high school as a for-credit service learning class. Evaluation findings show the project to have promise in changing individual attitudes and beliefs while promoting bystander intervention. This youth-led health approach provides excellent opportunities for youth to become involved and empowered, and collaborating with schools can also be a succe...

Trends Impacting Public Policy Support for Caregiving Families

Abstract: Public policy aimed at supporting the caregiving capacity of families has risen to prominence on the public agenda in the United States. Initiatives at the state and federal levels have created some initial services. Three trends that are pushing the issue of family caregiving to the surface are discussed, including large-scale social, demographic, and economic changes. The pressures on women from increased caregiving demands are discussed, along with the taken-for-granted cultural value placed on the home as a locus of care for family members who need assistance with common daily activities. Experiments at the state level with consumer-directed care and capitated wrap-around services are described. The authors argue that support for caregiving families is likely to remain a prominent concern of the public and policy makers for the foreseeable future.

Pediatric Disability and Caregiver Separation.

Abstract: The evidence that the birth of a child with a disability leads to divorce or separation is equivocal, with the majority of recent research suggesting that such a birth and childrearing may be stressful, but not necessarily toxic, to the caregiver relationship Such research has been limited by small sample sizes and nonrepresentative samples and has not been able to examine the caregivers' relationship stability over time Using the National Survey of Supplemental Security Income (SSI) Children and Families (NSCF), data related to severity of the child's condition, caregiver burden, respite, and support group use were examined in relation to caregiver separation Most variables showed no statistical significance Our results did not support the hypothesis that the birth of a child with a disability leads to relationship dissolution The instability of the child's condition and only extremely high levels of caregiver burden (the need for respite care and the need for the family to provide more than 48 hour

Child Care Preferences of Foreign-Born Immigrant Groups in California

Abstract: This study using California Health Interview Survey 2005 Child Survey data presents disparities among three major immigrant groups' child care preferences. Asian immigrant families used a grandparent or a relative care and a preschool more than Latino and European immigrant families. Latino immigrant families used child care from a nonfamily member in the provider's home and Head Start more than Asian and European immigrant families. To understand the predictors of time spent in child care by California's immigrant children, a multiple regression analysis was run. Being a child from an Asian immigrant family, child's age, being a girl, and being a child from a single mother-headed immigrant family emerged as predictors explaining 17.2% of the variance in the amount of time spent in child care. Variations in child care usage among immigrant groups warrant concern and suggest a need for culturally sensitive child care programs for immigrants.

Latina Mothers Caring for a Son or Daughter with Autism or Schizophrenia: Similarities, Differences, and the Relationship between Co-Residency and Maternal Well-Being.

Abstract: In this cross-sectional study, we examined similarities and differences in depressive symptoms and psychological well-being between Latina maternal caregivers of persons with autism (N=29) and schizophrenia (N=33). We also explored predictors of maternal outcomes and the relationship of co-residence to them. Regression analysis found that mothers of adults with schizophrenia had lower levels of psychological well-being than mothers of youth or adults with autism. For the overall sample of mothers, co-residing with their son or daughter was significantly related to lower levels of depressive symptoms. Qualitative analysis of the nine mothers who lived apart from their son or daughter revealed that extreme behavior problems of the son or daughter and poor maternal health contributed to living apart. Despite overcoming these challenges, mothers expressed a profound sense of sadness about their son or daughters’ living arrangements.

Using Social Network Theory to Influence the Development of State and Local Primary Prevention Capacity-Building Teams

Abstract: This article examines the role that social network theory and social network analysis has played in assessing and developing effective primary prevention networks across a southeastern state. In 2004 the state began an effort to develop a strategic plan for the primary prevention of violence working with local communities across the state. The process included an analysis of how family service organizations and community collaborators networked to solve community problems. In 2005, the state joined the Center for Disease Control and Prevention's Enhancing and Making Programs Work to End Rape project to specifically focus on building capacity for primary prevention of perpetration of sexual violence.

The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

Abstract: A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden, objective burden, stress burden, and uplifts). Regression analyses indicated that the five dimensions of family functioning were significantly related (p < 0.01) to relationship burden (R 2 = .27) and uplifts (R 2 = .29). More specifically, increased relationship burden was associated with problems in family roles, and increased uplifts was related to higher levels of affective responsiveness.

The Intergenerational Transmission of Parenting Styles of Irish Immigrant Mothers

Abstract: The research on child developmental outcomes underscores the importance of exploring parenting styles and identifying their multifactorial and intergenerational influences. This descriptive study examined the individual parenting styles of a sample of 82 Irish immigrant mothers and investigated the factors that influenced their individual parenting style. The findings suggest that the permissive and authoritative parenting style scores of this sample of Irish immigrant mothers are related to their perception of their mothers' parenting style scores. The relationship between the Irish immigrants mothers' authoritarian parenting style scores and their mothers' authoritarian parenting style scores approached significance at .063. These findings suggest that, when asked to compare their parenting styles to their mothers, the Irish immigrant participants reported a stronger authoritative parenting style, a stronger permissive parenting style, and a weaker authoritarian parenting style. In a standard multiple r...

Using Empowerment Evaluation to Facilitate the Development of Intimate Partner and Sexual Violence Prevention Programs

Abstract: This article addresses the question, “What factors contributed to successful completion of a needs and resource assessment in local communities, using the empowerment evaluation approach?” Case studies of three successful projects allow the exploration of organizational, community, state, and national factors that contributed to a strong needs and resource assessment, including original data collection, to guide the development of a plan to prevent intimate partner and sexual violence. The overall project was guided by empowerment evaluation principles. Each local community used additional conceptual frameworks, including grounded theory, Kolberg's theory of moral development, gender-role attitudes as operationalized by the rape myth acceptance and Olweis' systemic approach to bullying. Local programs focused on specific populations and collected original data through a variety of methods. For instance, one local agency utilized already existing surveys to assess bullying within their public school settin...

Building the Capacity of States to Ensure Inclusion of Rural Communities in State and Local Primary Violence Prevention Planning

Abstract: Rural, frontier, and geographically isolated communities face unique challenges associated with ensuring that they are equal partners in capacity-building and prevention planning processes at the state and local level despite barriers that can inhibit participation. By their nature, rural, frontier, and geographically isolated communities and states experience geographical isolation from planning partners and differential funding and staffing for prevention programming, as compared to urban or metropolitan states and local communities. At the same time, rural populations can face heightened risk associated with intimate partner violence (IPV) and sexual violence (SV) that intensifies the need to promote an inclusive primary prevention planning process that allows equal access of remote stakeholders to decision making related to prevention programming. This article presents a case study of two states to examine challenges and innovative solutions associated with ensuring inclusivity of rural and frontier c...

Changes in Capacity Among Local Coordinated Community Response Coalitions (CCRs) Supported by the DELTA Program

Abstract: Coalitions are often the means through which communities plan and coordinate services for individuals and address larger environmental issues associated with social problems. Since 2003, the Centers for Disease Control and Prevention (CDC) has supported local coordinated community response coalitions (CCRs) in 14 states to prevent intimate partner violence (IPV) through its Domestic Violence Prevention Enhancements and Leadership Through Alliances (DELTA) Program. Utilizing quantitative and qualitative evaluation data from 2003 and 2006 from DELTA-funded CCRs (N = 59), this article reports on improvements in internal CCR capacity and external supports that can affect the ability of CCRs to prevent IPV. Data are examined through the Interactive Systems Framework for Dissemination and Implementation (ISF) to convey how CCR internal capacity and external supports contribute to the substantial infrastructure needed to effectively address IPV. Family social workers will gain an understanding of the capacities ...

Caregivers' Perceptions of a Consumer-Directed Care Program for Adults With Developmental Disabilities

Abstract: This article examines results from a consumer and caregiver-directed care pilot program for families with adults with developmental disabilities. Surveys were administered to 50 caregivers and three project coordinators, and focus groups were conducted with 44 individuals, including caregivers, consumers, and support coordinators. Significant pre- to posttest changes were seen in terms of caregivers' perceptions of choice, goodness-of-fit of services to needs, and satisfaction with the program. Analysis of focus group discussions yielded three major themes: trust, flexibility, and relief. Although support and program coordinators had some concerns that the program was more caregiver than consumer oriented at times, overall, the program was viewed positively.

Support Services for Victims of Political Violence and Their Families: A Comparison Between Israelis and Palestinians

Abstract: This report summarizes interviews with five social workers who helped families that experienced political violence, and with 16 families that lost a family member due to terrorist activity in Israel and Palestine from 2000 to 2005. Results revealed a great disparity between the Israelis and the Palestinians on the types of and extent of benefits and support services given to the victims and their families of a terrorist incident. Israeli has a well-established system of victim compensation and has immediate and long-term benefits. Palestinian victims and their families have few services, little money for reparation, and no well-organized system for the support and compensation for acts of political violence.

Family Support in Nursing Homes Serving Residents with a Mental Health History

Abstract: Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were found to be in regular contact with their relatives and supportive of their care. In nursing homes, daily contact, an ongoing relationship, involvement in assessment, and being responsible for the resident constitute the model family support. This study advances the understanding of family support in nursing homes and conveys information to guide practice through proposing ways to enhance family support and involvement in nursing homes.

Psychometric Testing of the FACES III with Rural Adolescents

Abstract: This study tests the validity and reliability of the Family Adaptability and Cohesion Scale III (FACES III) in two samples of rural adolescents. The underlying theory is the linear 3-D circumplex model. The FACES III was administered to 1,632 adolescents in Grades 7 through 12 in two counties in a rural western state. The FACES III Scale and the Cohesion Scale demonstrated high internal consistency, although the Cohesion Scale was more consistently predictive of self-esteem and higher in internal consistency than was the Adaptability Scale. Findings confirmed previous methodological critiques regarding linearity, the correlation of factors, and internal consistency. The presence of two orthogonal factors was consistent with the original 3-D circumplex model, but items from the Adaptability Scale relating to changing of rules for children's roles and egalitarianism tended to be problematic.

Preface: Introduction to the Special Issue on Family-Centered Care

Abstract: This special issue of the Journal of Family Social Work focuses on family-centered health services, covering a range of perspectives, populations, and methodologies. The concept of family-centered ...