Showing papers in "Social Work in 1998"

Social Work and Social Reform: An Arena of Struggle

Abstract: The twin pressures of containment and change have plagued social work since its origins in the late 19th century. The profession can boast of a long history of progressive activism directed to individual and social change. At the same time, observers within and outside social work have often accused the profession of serving as a handmaiden of the status quo. This contradiction has made the social work profession a site of ongoing struggle. Although often difficult, the battles the profession has endured have ensured that social work practice with individuals, families, groups, and communities is neither handed down from above nor written in stone. Rather, the design of social work as we know it reflects internal and external political struggles. The presence of this tension becomes critically important, because with it comes opportunity for change. The centennial gives occasion to celebrations, critical reviews, and future visions for the profession. In this spirit, this article reviews the history of activism in social work in a framework of the relationship between social work and social reform as an arena of struggle. Most histories of social work present the story chronologically. I use the history to bring the activist struggles in social work into bold relief. More specifically, I have developed three parallel narratives centered on social work as an arena of struggle: (1) the largely untold history of activism in the profession during the 20th century, (2) the effect of the process of professionalization on social work activism, and (3) the ways the changing political climate shaped the relationship between the profession of social work and its impulse for social reform. The Prochange Mandate in Social Work Social work's commitment to both individual and social change stems from at least three sources: (1) the mandates of our professional organizations, (2) the professional literature, and (3) the long history of activism among social workers themselves. Professional Mandates Since the mid-1960s both the Council on Social Work Education (CSWE) and the National Association of Social Workers (NASW) have recognized social work's role in social reform. The 1994 CSWE Curriculum Policy Statement (CSWE, 1994) and the 1996 NASW Code of Ethics continue to call for action to improve social conditions as one way for social work to honor its primary obligation to individual and community welfare. Review of the Literature Many social worker scholars have articulated social work's commitment to social reform (Galper, 1975; Haynes & Mickelson, 1997; Mahaffey & Hanks, 1982; Withorn, 1984). "Systems," "transactional," "person-in-situation," "empowerment," and other practice theories emphasize the relationship between social conditions and the quality of life for individuals, families, groups, organizations, and communities. The theories assume that individuals grow, change, and develop a sense of mastery best when they can gain self-insight, have real choices, and secure access to the resources and power needed to realize these goals. The theories recognize that communities thrive when governments promote individual and collective responsibility, equal opportunities, and social solidarity. In brief, social work scholarship suggests that, although a focus on individuals is critically important, it may not be enough (Payne, 1991; Simon, 1994). History of Activism The third foundation of social work's commitment to social reform stems from the long history of activism among social workers themselves. Social work activism has had many strands. As is the case in any large group of people, the politics of social workers range across the political spectrum. During the past 100 years, the most visible and documented activism of the organized profession has tended toward liberal reform. The goals of the activist members, however, have ranged from liberal to radical, leading to both collaboration and conflict. …

Social Support for Adolescents at Risk of School Failure

Abstract: The positive relationship between social support and an individual's physical and mental well-being (Ganster & Victor, 1988; Hardy, Richman, & Rosenfeld, 1991) has provided the impetus for a great deal of research on the clinical utility of social support for individuals and groups. For example, support has been used for purposes such as decreasing morbidity (House & Kahn, 1985), reducing stress (Cutrona & Suhr, 1994; Richman & Rosenfeld, 1987) and feelings of loss (Hobfoll & Stephens, 1990), combating burnout (Etzion, 1984; Pines, Aronson, & Kafry, 1981), increasing feelings of well-being (Ganster & Victor, 1988), increasing job performance and work innovation (Albrecht & Hall, 1991), improving performance on academic examinations (Goldsmith & Albrecht, 1993; Sarason & Sarason, 1986), reducing loneliness (Jones & Moore, 1987), and providing information and support for rural residents with AIDS (Rounds, Galinsky, & Stevens, 1991). Social support also has been widely studied as a variable specifically designed to promote the development and adaptation of children and adolescents; for example, support has been indicated in research as useful for working with adolescent depression (Barrera & Garrison-Jones, 1992), improving academic and behavioral adjustment (Dubow, Tisak, Causey, & Hryshko, 1991; Ford & Sutphen, 1996), supporting high-risk youths and their families (Tracy, Whittaker, Boylan, Neitman, & Overstreet, 1995), and reducing delinquent behaviors that correlate highly with poor school performance (Zigler, Taussig, & Black, 1992). Furthermore, the literature on risk and protective factors and educational resilience clearly endorses the primacy of the supportive role provided by the family, the peer group, the school, and the community in predicting positive outcomes for students (Benard, 1991; Bogenschneider, 1996; Richman & Bowen, 1997; Wang, Haertel, & Walberg, 1994). Social support is often less present in the lives of children and youths who are at risk of school failure (Coie et al., 1993; Richman & Bowen, 1997). The purpose of the present study was to explore how the self-perceived social support of adolescents at risk of school failure varied by the type and provider of support and to examine the effects of particular types of social support on school performance outcomes, such as attendance, grades, time studying, and school self-efficacy. By understanding provider networks, students' support patterns, and the effect of support on school performance outcomes, implications may be drawn for the use of social support as an intervention strategy for children and youths at risk of school failure. Social support is a multidimensional concept that needs to be defined and measured accordingly (Milardo, 1992; Norbeck, Lindsey, & Carrieri, 1981; Sarason, Levine, Basham, & Sarason, 1983; Streeter & Franklin, 1992). Each of three broad types of social support - tangible, informational, and emotional (Cobb, 1976; House, 1981) - are communicated by support providers when they behave in ways that are perceived by recipients as enhancing the recipients' well-being (see Shumaker & Brownell, 1984). These perceptions of others' communication behaviors may take eight distinguishable forms: 1. listening support - the perception that an other is listening without giving advice or being judgmental 2. emotional support - the perception that an other is providing comfort and caring and indicating that she or he is on the support recipient's side 3. emotional challenge - the perception that an other is challenging the support recipient to evaluate his or her attitudes, values, and feelings 4. reality confirmation support - the perception that an other, who is similar to and who see things the same way the support recipient does, is helping to confirm the support recipient's perspective of the world 5. …

Young People as Competent Community Builders: A Challenge to Social Work

Abstract: What would happen if society viewed young people as competent community builders? This question is not trivial, for the dominant view of youths in any society will affect the beliefs and behaviors of adults and of youths themselves. Because adults often view young people as victims or problems, rather than as competent citizens capable of meaningful participation in society, it is not surprising that social work thought and practice also emphasize troubled youths and the services they require (Armstrong, 1996). Not at issue is the competence of youths and the role of adults as allies in the community-building process. In contrast, we started with the view of young people as competent community builders and searched for community-based initiatives in which youths took this approach. We built on the recognition of "youth as resources" (Kurth-Schai, 1988) and as thoughtful, active citizens in a living democracy (Lappe & DuBois, 1994). We sought initiatives in which youths were active participants in the process of personal, organizational, and community change (Checkoway, Finn, & Pothukuchi, 1995). This article reports on a pilot study of exemplary community-based youth initiatives in which young people actively participated in solving problems, planning programs, and providing services at the community level. We identified the initiatives, studied the accomplishments, and analyzed the lessons learned from practice. This article summarizes the research method, highlights case studies, and offers lessons for social work practice. As we learned to listen to the voices and appreciate the capacities of young people as community builders, many of our beliefs about youths were called into question. Perspectives on Youths as Resources Crime, drugs, dropouts, pregnancy: These are the types of images that permeate professional and popular thinking about youths today. This view assumes that young people are vulnerable victims of adult-neglect, poverty, racism, or other forces beyond their control, or that they are "bundles of pathology" threatening the social order (Annie E. Casey Foundation, 1994; Hancock, 1994; Males, 1996; Moseley,1995). Proponents of this view have responded with problem-focused interventions aimed at treatment, rehabilitation, and what Armstrong (1996) called the "medicalization of defiance," an infatuation with mental health solutions to the social problems affecting young people. Social workers, in particular, have adopted this view and seek to "save the children," "defend their rights," or protect them from worsening conditions by expanding needed services for youths. Social workers speak broadly of "youths at risk" as the target for a range of adult-directed helping interventions. The emphasis on youths as victims or problems prevents social workers from looking at young people as competent citizens and providing for their meaningful participation in civic life (Strom, Oguinick, & Singer, 1995). When young people are viewed in this way and relegated to the periphery, they see their social role as marginal and question the relevance of their relationship to the larger social, political, and economic context in which they live. Many interventions, such as those focusing on character education, sex education, and moral training, are value laden and personal in their orientation (Hancock, 1994). They attempt to inculcate particular values rather than to engage young people in critical questioning of the politics and ideologies embedded in the values. Furthermore, such interventions fail to locate the personal struggles confronting young people in a larger political and cultural context that speaks to the interrelatedness of challenges young people face. Questions of racism, sexism, and classism seldom figure into the construction of the problem or the solutions. And, for the most part, young people remain the passive recipients of services rather than active participants in a process of community change. …

The Evolution of Social Work Ethics

Abstract: Ethical issues have always been a central feature in social work. Throughout the profession's history social workers have been concerned with matters of right and wrong and matters of duty and obligation. The National Association of Social Workers' (NASW) recent ratification of a new code of ethics (NASW, 1996) signals social workers' remarkable progress in the identification and understanding of ethical issues in the profession. The 1996 code - the first major revision in nearly two decades and only the third code of ethics ratified in NASW's history - reflects the impressive growth in social workers' grasp of complex ethical issues in practice. The celebration of social work's 100th anniversary provides a particularly auspicious moment to reflect on the evolution of social work ethics. Social workers' core values and ethical beliefs are the profession's linchpin. Social workers' concern with ethics has matured considerably during the past century, moving from frequently moralistic preoccupation with clients' values to concern about complex ethical dilemmas faced by practitioners and strategies for dealing with these dilemmas. Social work's concern with ethics spans four major, sometimes overlapping, periods: (1) the morality period, (2) the values period, (3) the ethical theory and decision-making period, and (4) the ethical standards and risk management period. The Morality Period In the late 20th century, when social work was formally inaugurated as a profession, there was much more concern about the morality of the client than about the morality or ethics of the profession or its practitioners (Leiby, 1978; Lubove, 1965; Reamer, 1995a). Social workers' earliest practitioners focused on organized relief and responding to the "curse of pauperism" (Paine, 1880). Often this preoccupation took the form of paternalistic efforts to bolster poor people's morality and the rectitude of those who had succumbed to "shiftless" or "wayward" habits. Social workers' focus on the morality of poor people waned significantly during the settlement house movement in the early 20th century, when many social workers turned their attention to structural and environmental causes of individual and social problems, particularly social workers' ethical obligation to promote social justice and social reform. As has been well documented in the profession's literature, many social workers were concerned with "cause" rather than, or in addition to, "case." This was evident in social workers' social reform efforts designed to address the toxic environmental determinants of problems related to poverty, inadequate housing and health care, mental illness, alcoholism, and violence (Brieland, 1995; Lee, 1930). Emphasis on clients' morality continued to weaken during the next several decades as social workers created and refined various intervention theories and strategies, training programs, and educational models. During this phase, many social workers were more concerned about cultivating perspectives and methods that would be indigenous to social work, partly in an effort to distinguish social work's approach to helping from those of allied professions, such as psychology and psychiatry. Exploration of Values Although a critical mass of serious scholarship on social work ethics did not appear until the 1950s, there were several efforts earlier in the 20th century to explore social work values and ethics (Frankel, 1959). As early as 1919 there were attempts to draft professional codes of ethics (Elliott, 1931). In 1922 the Family Welfare Association of America appointed an ethics committee in response to questions about ethical problems in social work (Elliott, 1931; Joseph, 1989). In addition, there is evidence that at least some schools of social work were teaching discrete courses on values and ethics in the 1920s (Elliott, 1931; Johnson, 1955). These efforts were consistent with Flexner's (1915) widely respected assertion that a full-fledged profession should have a clearly articulated, values-based ethical foundation. …

New Directions in Systems Theory: Chaos and Complexity

Abstract: At least since the 1940s, attempts have been made to construct a theory that would address the way in which ordered systems arise and behave. Social work practitioners have adopted such popular theoretical models as "general systems theory," developed by Ludwig von Bertalanffy and others, which has sought general principles that would apply to biology, psychology, sociology, or any other discipline that sought to explore self-sustaining, "open systems" (von Bertalanffy, 1968). Similarly, theorists such as Germaine and Gitterman (1981) developed models of social work practice based on an ecological metaphor, which seek broad principles of practice that will apply across different levels of human social systems. Recently, Wakefield (1996a, 1996b, 1996c) critiqued systems theories as an important basis for social work practice. Wakefield questioned the utility of systems theory and the empirical basis of the theories. This article responds in part to these critiques by introducing advances in systems theory that provide a more promising empirical and mathematical basis for studying human systems. During the past two decades, a mixed group of physical, social, biological, and computer scientists have devoted increasing attention to two systems-related disciplines: chaos theory and complexity theory. Often termed nonlinear dynamics because they seek to understand systems that change in ways that are not amenable to the linear cause and effect models familiar to social scientists, these theoretical perspectives are thought to have application across a wide range of scientific and social scientific disciplines (Kauffman, 1995; Kiel & Elliott, 1996). This article discusses the disciplines of nonlinear dynamics - chaos and complexity - in a way that is understandable and relevant to social work practitioners and researchers. This introduction to nonlinear dynamics will be mostly conceptual in nature, but will involve some mathematics as well. As yet, no general introductory text on nonlinear dynamics aimed specifically at social scientists exists, although the volume edited by Kiel and Elliott (1996) included solid articles on most of the central issues, including data analysis and theory. For those with a modest background in calculus and a love of math textbooks, either of two books by Devaney (1989, 1992) would constitute an excellent introduction to the mathematics involved. Kaplan and Glass (1995) also gave an excellent introduction, with an emphasis on biological applications. The mathematics is actually a bit more advanced than in the two Devaney texts, but the verbal discussion is easier to follow. Peak and Frame (1994) provided a thorough introduction without using mathematics any more complicated than high school algebra. A number of enjoyable and thoroughly nonmathematical introductions to chaos theory exist, including Gleick (1987) and Briggs and Peat (1989). Kellert (1993) introduced chaos theory in a nonmathematical manner that still manages to catch many of the technical nuances, in addition to discussing its implications for the future of science. Waldrop (1992), Lewin (1992), and Johnson (1995) introduced complexity theory in a similar fashion. After this introduction, the article explores the relevance of nonlinear dynamics to social work. Some of this exploration will, unavoidably, be metaphorical; nonlinear theory in the social sciences is only now being developed, and empirical work is still in the stage of basic research. Nevertheless, we hope that this material will provide social workers with new information that will inspire new and more empirical work on the applications of systems theory to social work practice. Understanding the Meaning of Nonlinear Dynamics and Deterministic Chaos The phrase "nonlinear dynamics," like most nomenclature, sounds more intimidating than it really is when you become familiar with the vocabulary and ideas. A dynamical system is a system that changes over time (Devaney, 1992). …

Human Rights and Social Work

Abstract: [The] recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world. - United Nations, 1948 So begins the preamble of the Universal Declaration of Human Rights, the first multinational agreement specifying basic rights to which all people are entitled. This year marks the 50th anniversary of the adoption of the Universal Declaration by the United Nations General Assembly. For social workers, this anniversary provides an opportunity to reflect on the meaning and significance of human rights for their work. In the aftermath of the horrors of World War II, the international community was motivated to make a statement and adopt a platform that would express their collective repugnance at these atrocities and to forge an agreement that might prevent such tragedies in the future. Under the leadership of Eleanor Roosevelt and with considerable urging and support from nongovernment organizations, the United Nations convened representatives of various member states to draft a document that would enumerate the rights and freedoms of all people. After three years of work, revisions, and debates - the final one lasting until the call for a predawn vote - the Declaration was adopted without dissent on December 10, 1948 (National Coordinating Committee for UDHR50, 1998). In the 50 years since its adoption, and despite several other agreements and covenants, the world has seen, and continues to see, numerous new offenses inflicted on humanity. Yet despite its inability to eliminate abuses to life and basic dignities, the Declaration remains a significant document. Its articulation of the idea of universal rights, its recognition that such rights cannot be divorced from social and economic arrangements (Gil, 1994), and its inclusion of human rights in international discourse have had a beneficial impact on the lives of countless people. The precepts and values embedded in the Declaration are familiar and central to our professional identity. They include "existential" statements about humanity, such as "All human beings are born free and equal in dignity and rights." They include "positive rights" such as the right to life, liberty, and security of person; to recognition as a person before the law with equal protection; to a nationality; to freedom of thought, conscience, and religion and "negative rights" such as protection from slavery or servitude, arbitrary arrest, detention, or exile. They also include the economic, social, and cultural rights indispensable for dignity and development; the right to work, including equal pay for equal work; and the right to a standard of living adequate for health and well-being, including food, clothing, housing, medical care, and necessary social services (United Nations Center for Human Rights, 1992). These statements express social work's most basic values and vision for humanity, a point well understood by our international colleagues: "Human rights are inseparable from social work theory, values and ethics, and practice. Rights corresponding to human needs have to be upheld and fostered, and they embody the justification and motivation for social work action. Advocacy of such rights must therefore be an integral part of social work" (United Nations Center for Human Rights, 1992, p. 10). In the United States these commitments to human rights appear less visible and integrated with social work practice and research. In my view, this is the result of our emphases on individual change, psychological explanation, and conventional science. Our human rights stance also is influenced by our (that is, Western) view of ourselves as the center of the universe and the representation of good (Galtung, 1994). This perspective is reinforced by a capitalist, political economy whose myths tend to obscure rights issues while claiming to champion them. But the problems that social workers confront cannot be divorced from the human rights struggles within and beyond our borders. …

The One Hundred-Year Debate: Social Reform versus Individual Treatment

Abstract: After 100 years, one would think that professional social workers would agree about the basic goal of the profession; yet any social work conference, journal, or even professional dialogue is still filled with disagreements about that goal We still hear "social work's basic treatment modality is clinical practice and its primary goal is individual treatment" versus "Social work's historic roots and major goal is social reform" The NASW Code of Ethics states that the goal of the profession of social work is "to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty A historic and defining feature of social work is the profession's focus on individual well-being in a social context and the well-being of society" (NASW, 1996, p 1) Thus, NASW provides an inclusive goal with a statement of focus on the disadvantaged That goal seems clear, comprehensive, and noncontroversial, right? Wrong Even given that professionally sanctioned goal, the debate within the profession about what skills, what target client group - indeed, what the goal of "treatment" is - continues to wage The debate continues even though the Council on Social Work Education (CSWE) has strengthened the concepts and methods of advocacy and empowerment in its curriculum policy statement (CSWE, 1994) CSWE was as clear as NASW that this statement provided legitimization for social work educational programs to include or strengthen these elements - not to replace or diminish the focus on individual treatment through clinical methods This debate is still current and extremely critical in our profession as we approach the 21st century The elements of the debate often appear to highlight the mutually exclusive premises rather than focus on the inherent commonalties of purpose; the debate often views social work's breadth of methods and client systems as a weakness rather than as a strength Indeed, debaters can agree that the profession's mission is to train students to become experts in individual and social change and agree that the systems perspective is a unique and useful one to maintain, yet disagree because the debaters feel that the professional pursuit of both will diminish both (Abramovitz & Bardill, 1993) The controversial position explicated by Specht and Courtney (1995) in Unfaithful Angels raised the level of the debate within the profession several decibels as it continued this dialogue Although Jim Mickelson and I did not concur with all of their points, we agreed with their basic premise that social work may have lost sight of the public social services and the public arena as a legitimate place for social work intervention We noted in the preface to our third edition of Affecting Change: Social Workers in the Political Arena (Haynes & Mickelson, 1997) that, in 1997, it had been "20 years since we became angry at the profession for its 'dispassionate, objective, and apolitical stance'" (p xiii) We, like Specht and Courtney (1994), did not like the profession's silence in the political arena or its distance from its historic roots and commitment to public service And we did not like being labeled as "anti-clinical" or "anti-professional" for these views We only wanted to ensure that advocacy, empowerment, and public social services were included and valued However, we believed that the Specht and Courtney attack on our profession was, in some places, inaccurate or uncalled for This article is derived from the text of a speech I gave It was to have been the keynote speech given by Dr Harry Specht at the Texas NASW conference in November 1994 Unfortunately, Dr Specht became ill, and I was asked to step in I agreed to present Dr Specht's remarks if I could debate them His words are those written by him for this speech Permission to publish this speech was obtained from Dr …

Clinical Social Work's Contribution to a Social Justice Perspective

Abstract: Social justice is increasingly being seen as the organizing value of social work. For clinical social workers, this conceptualization clarifies and focuses a unique contribution that clinical social work can make to the mental health professions. In this article "clinical social work" is used in this sense to include case management, advocacy, teamwork, mediation, and prevention roles, as well as therapeutic and counseling roles. Clinical social workers engage in supervision, organizational change, directing programs, and community education. They also join with other social workers and their clients in social action (Swenson, 1995). Clinical social work should not be equated with practice based on a medical model, a focus on pathology, "blaming the victim," or social conservatism. Clinical social workers can consider what a social justice perspective means and how it can be enacted in clinical contexts. They can think about work with individuals, families, and groups from a social justice perspective. They can provide leadership in assessing theories, practices, and service delivery arrangements from the point of view of increasing social justice. Defining Social Justice First, the profession must consider what "social justice" is and why it is being considered the organizing value for social work. Furthermore, what is an organizing value? The term comes from Wakefield (1988a, 1988b), who has written one of the most definitive statements about social justice in social work, particularly in regard to clinical social work. He described the "defining function" or primary purpose of a profession as its "organizing value," in the sense in which the organizing value of medicine is curing disease; of education, learning; and of law, legal justice. Traditionally, when social work has tried to define its function, it has emphasized the "person-in-situation" construct. That construct became more conceptually rigorous as systems and ecological theories and theories of attachment, coping, adaptation, and resilience, as well as "two-person psychologies" in psychodynamic thinking developed. So, for instance, we had Gordon's (1969) definition of social work purpose as matching people's coping capacities and the qualities of impinging environments. The person-in-situation conceptualization has always had some difficulties. Social work is not the only profession adopting systems thinking or any of the other theories mentioned, and many professions could be said to improve the goodness of fit between people and environments. In fact, in one way or another, all professions do. Education gives people skills and knowledge to navigate their world more competently and effectively, and law helps people make claims against some unjust environments. Medicine cures people of diseases they have caught from noxious environments, makes environments more healthy, and helps people overcome health challenges that compromise their functioning in various environments. Social justice would seem to be a more convincing organizing value for social work than the person-in-situation construct. But then what does "social justice" mean? Social justice defines a goal to which the person-in-situation construct can be directed, a goal both broader and more specific than "producing growth-inducing and environment-meliorating transactions" (Gordon, 1969, p. 10). Dorothy van Soest (1995), in the Encyclopedia of Social Work, said that there are three components of social justice: legal justice, which is concerned with what a person owes to society; commutative justice, which is concerned with what people owe each other; and distributive justice, which is "what society owes a person" (p. 1811). She said that distributive justice involves decisions about allocating resources and that it is the most important, in the sense that it underlies the other two. Others divide social justice into different components, but distributive justice - social workers' concern - is always one component. …

“Gathering the Spirit” at First Baptist Church: Spirituality as a Protective Factor in the Lives of African American Children

Abstract: Spiritual socialization can be central to children's healthy development. In the following narrative fragment, Mrs. H, a 73-year-old African American woman, spontaneously recounted to me her experiences as a seven-year-old child walking to a segregated school: "The whites would be walking one way, and we'd be walking the other. They'd yell at us, 'You dirty, black niggers! We hate you! We hate you!' I'd go to Mama and ask her, 'Why do they hate us?' She'd always take me to the Bible. She taught me that God loves us all. God is the judge. She taught me not to take hate inside of myself." Mrs. H went on to explain that when we hate, we destroy that part of God that he left inside each of us when he created us. Thus, from the perspective taught to her by her mother, Mrs. H was not the victim of this story, rather, her taunters were. My research on the spiritual socialization of African American children is informed by the concept of resilience. Investigators of resilience attempt to understand individuals like Mrs. H, who have developed well despite profound, ongoing stressors (for example, Fraser, 1997). Unfortunately, very little systematic research has explored the strengths of African American children, their families and communities, including the ways in which African American adults like Mrs. H socialize resilience. Rather, research focuses on social problems such as educational underachievement, poverty, teenage pregnancy, drug use, and crime. Thus, the first goal of this article is to describe effective socialization contexts and practices that support children's healthy development in an African American community. Identifying sources of resilience has become a basic component of assessment and intervention in social work practice with children (Maluccio, 1995). Ethnographic methods represent one important strategy for developing such knowledge in ethnically diverse communities (Devore & Schlesinger, 1996). Although ethnographic methods are receiving growing acceptance and appreciation within social work (for example, McRoy, 1995), there remain relatively few examples of their application to the generation of knowledge in social work practice. Thus, the second goal of this article is to provide a model of the use of ethnographic strategies to generate knowledge of an African American community. Although understanding ethnographic methods is important, it is not sufficient to effective social work practice. Social workers must go one step further than the ethnographer to apply their knowledge of diverse cultures to their own practices (Thornton & Garrett, 1995). Thus, the third goal of this article is to demonstrate how knowledge generated from ethnographic strategies was used to generate ethnic-sensitive social work interventions in an African American community. Children's Spiritual Socialization in African American Sunday Schools The church has been discussed as a potential community-level source of protective factors (Masten, Best, & Garmezy, 1990). Throughout its history the African American church has played a significant role in the provision of social support and services (see, for example, Franklin, 1980). Unfortunately, almost no research has investigated the role of the church in the socialization of competence (Ogbu, 1985) or resilience in African American children. Available empirical evidence suggests a relationship between socialization experiences emanating from the African American church and a number of positive developmental outcomes. For example, Brown and Gary (1991) found that self-reports of church involvement were positively related to educational attainment among African American adults. In an interview study of African American urban male adolescents, Zimmerman and Maton (1992) found that youths who left high school before graduation and were not employed, but who attended church, had relatively low levels of alcohol and drug abuse. In a questionnaire administered to African American adults (Seaborn-Thompson & Ensminger, 1989), 74 percent responded "very often" or "often" to the statement, "The religious beliefs I learned when I was young still help me. …

Indigenous People in a Multicultural Society: Unique Issues for Human Services

Abstract: Indigenous peoples have a unique place within a multicultural society. The history of indigenous people in the United States differs from those who came here as immigrants. For many Native Americans a primary goal has been self-preservation through separation and isolation rather than seeking a place within a multicultural society. Many people are not aware that the federal government and some state governments have specific moral and legal rights and responsibilities toward Native Americans, unlike other groups in the United States. Human services providers who work with Native Americans must understand the issues specific to indigenous people in a multicultural society. This article examines the unique status of Native Americans in the United States and explores the practice implications of that status. The article begins with an overview of the components of culturally competent social work with Native Americans, then examines specific issues such as historical trauma and sovereignty with which social workers and other human services workers should be familiar to serve Native American clients effectively.

Psychological and Spiritual Growth in Women Living with HIV

Abstract: Women living with HIV and AIDS face tremendous obstacles to wellness, yet many find ways to use their experience of HIV as a vehicle for psychological and spiritual growth A qualitative study was conducted to better understand this process Thirty-four women living with various stages of HIV were interviewed Five components were found to be important in their psychological and spiritual growth: reckoning with death, life affirmation, creation of meaning, self-affirmation, and redefining relationships Implications for social work practice and future research are discussed

Does the Glove Really Fit? Qualitative Research and Clinical Social Work Practice

Abstract: The rapid growth of qualitative methods as a preferred mode of inquiry among many in social work has been marked by the recent appearance of a number of works (Riessman, 1994; Sherman & Reid, 1994; Tutty, Rothery, & Grinnell, 1996). Although advocacy of this "new" approach has emerged from academia (rather than agency-based practice), qualitative methods have been heralded by many as the best way to carry out research in the complex world of social work practice. By offering an epistemological and methodological alternative to quantitative methods, qualitative methods afford an opportunity for practitioners to embrace research without submitting to the "context-stripping" and "reductionistic" approaches of quantitative methods. Indeed, the fit between qualitative methods and social work practice has been characterized rather elegantly as "like sliding a hand into a well-made glove" (Gilgun, 1994, p. 115). This article explores whether the glove actually fits as well as it appears. At first glance, the parallels between qualitative research and clinical practice are compelling. But on closer scrutiny, a cautionary tale emerges. It is this tale that I wish to tell. In the reflexive spirit of qualitative inquiry, I note at the outset that I am an advocate and practitioner of qualitative (as well as quantitative) research. Trained as an anthropologist, I have been a faculty member at a school of social work for eight years. In teaching and talking with students and colleagues over these years, I have come to appreciate the relevance of qualitative research for practitioners. The attraction is real and understandable. However, it is also those same conversations that have stimulated me to examine more closely whether the match is as complementary as it appears. It is only by examining ways in which the clinical and qualitative research perspectives differ that a true appreciation of each can be attained. Attraction of Qualitative Methods for Social Work It is perhaps no surprise to see qualitative methods eagerly embraced by many in social work. The attraction is particularly powerful to clinically-oriented professors and students seeking alternatives to quantitative methods as a mode of inquiry. After all, the prospect of intensively interviewing a small number of people and generating research findings in narrative form appears more congruent with practice. It is interesting that the field of psychotherapy research, a field congruent with clinical social work, is overwhelmingly quantitative and positivist (Greenberg & Pinsof, 1986; Talley, Strupp, & Butler, 1994; Toukmanian & Rennie, 1992). Some psychotherapy researchers have sought to introduce qualitative methods to the field (Bruner, 1987; Stiles, 1994), citing the natural fit between narrative analyses and psychotherapy. But the emphasis on quantitative methods among the majority of psychologists and psychiatrists who are psychotherapy researchers continues to hold sway. Gilgun (1994) discussed several ways that direct practice parallels the techniques of qualitative research. (In fairness to Gilgun, her primary concern is with one particular qualitative method - grounded theory [Glaser & Strauss, 1967]). However, her description of grounded theory as it compares with direct practice captures the salient features of qualitative methods in a general way. According to Gilgun (1994), the parallels are numerous. Similar to the context-rich and inductive approaches of qualitative research, social workers start "where the client is," view clients as part of a wider social context, and favor individualized assessment and maximum detail in chronicling the lives of clients. Furthermore, practitioners think both inductively and deductively, examining information from a variety of sources before drawing conclusions about a client's problems and appropriate treatment, and responding to new information by modifying treatment approaches. …

Youth Crime, Public Policy, and Practice in the Juvenile Justice System: Recent Trends and Needed Reforms

Abstract: Historically, juvenile justice policy has oscillated between rehabilitative and punitive approaches to managing young offenders. Policy and practice in the 1970s and 1980s emphasized individual treatment for young offenders in nonsecure, community-based programs. An increase in violent youth crime during the past decade has renewed interest in punishing delinquent youths. Cyclic fluctuations in juvenile justice policy and their relationship to policy, practice, and youth crime are examined. Our analysis suggests that overall crime rates have remained relatively stable over the past three decades and are independent of prevailing juvenile justice policies. The findings support the need for targeted prevention efforts addressing the root causes of juvenile crime. Needed policy reforms, public education efforts, and practice approaches are outlined.

Promoting Same-Race Adoption for Children of Color

Abstract: Opponents of policies to protect same-race adoption for children of color assert that it is necessary to lift all restrictions on transracial adoption (alternately referred to as "interracial," "interethnic," or "transethnic" adoption) of the many children of color believed to be "languishing" in foster homes, residential programs, and institutional settings. This article briefly presents the history of the transracial adoption controversy and discusses its current status; counters assertions typically used to oppose same-race adoption policies for children of color; summarizes the positions of several social work organizations regarding adoption and race; and makes recommendations for education, policy, research, and practice. History of Transracial Adoption The adoption of orphaned children from other countries by U.S. families began in the 1940s with the end of World War II (Simon & Alstein, 1977). A rise in the number of such adoptions accompanied later wars, including the Korean and Vietnam Wars (Silverman, 1993). In the 1960s, widespread use of artificial birth control, the legalization of abortion, and decreased social stigma associated with bearing a child outside of marriage were accompanied by a substantial decrease in healthy white infants available for adoption. There was, however, no corresponding decrease among African American and other children of color (although foreign countries began to establish rules that limited some adoptions in those countries). It has been suggested that adoption agencies, feeling the pressure of reduced fee income, found in the availability of children of color an opportunity to increase adoption fees (McRoy, 1989). One writer (Bartholet, 1991) suggested that as the United States became accustomed to children of color from other countries in its communities, it became easier to accept the transracial adoption of African American children. By 1971 transracial adoptions had reached an annual high of 2,574 (Simon & Alstein, 1987). Responding to this increase, a 1972 meeting of the National Association of Black Social Workers (NABSW) ended with a resolution opposing transracial adoption: Black children belong physically and psychologically and culturally in black families where they can receive the total sense of themselves and develop a sound projection of their future. Only a black family can transmit the emotional and sensitive subtleties of perceptions and reactions essential for a black child's survival in a racist society. Human beings are products of their environment and develop their sense of values, attitudes, and self-concept within their own family structures. Black children in white homes are cut off from the healthy development of themselves as black people. (quoted in McRoy, 1989, p. 150) In response to that resolution, and to the Indian Child Welfare Act of 1978 giving tribal courts exclusive jurisdiction over American Indian child custody proceedings, some states established policies and procedures limiting transracial adoption and requiring that serious efforts be made to place children of color with adoptive parents of their own racial or ethnic group. Agencies specializing in same-race placements were established, and many traditional agencies modified their programs in the same direction. Some parents who had adopted transracially were offended, however, by the NABSW resolution, perceiving it as not based in truth and disagreeing with the assertion that they were not capable of parenting their adoptive children of color adequately (Hermann, 1993). White foster parents began to file legal suits to prevent children of color who were in their care from being placed with same-race adoptive parents and to be allowed to adopt the children themselves (Elias, 1991). Advocates of transracial adoption, some of them transracial adoptive parents themselves (Bartholet, 1991; Mahoney, 1991), began to speak and write publicly in its support and in opposition to same-race protective policies. …

Women at Midlife

Abstract: The cultural narrative provided for women at midlife is either medical and menopause oriented--hot flashes, osteoporosis, heart disease, the estrogen replacement therapy decision--or socially devaluing--"empty nest," a fertility has-been, abandoned for a younger woman, depressed. Without alternative images these demoralizing cultural stereotypes can become a self-fulfilling prophecy. The study discussed in this article investigated midlife experiences of a group of white women in the New York City area and identified factors associated with successful negotiation of midlife transformation. Although midlife was a challenging stage of life, 72.5 percent of the women studied described themselves as happy or very happy. Factors predicting well-being at midlife included an annual family income above $30,000, a confidante or a group of women friends, good health, high self-esteem, lack of self-denigration, high self-effectance, a benign superego, goals for the future, a positive life narrative, the belief that one has a right to a life, positive midlife role models, and positive feelings about one's appearance.

School Social Workers and School Violence: Personal Safety, Training, and Violence Programs

Abstract: Concern over school violence has permeated multiple layers of U.S. society. For example, one recent study found that the public considered school violence the most important problem facing schools (Elam, Rose, & Gallup, 1994). The federal government has designated the reduction of school violence as a national education priority (National Education Goals Panel, 1994a, 1994b, 1995, 1996). Many states have drafted laws and commissioned investigations to address the growing public concern about school violence (see Furlong, Babinski, Poland, & Munoz, 1996; James, 1994). In addition, school districts across the country have voluntarily initiated a variety of school-based violence prevention programs and districtwide antiviolence policies (National Education Goals Panel, 1994a, 1994b, 1995). In response to this widespread concern, various professional organizations have recommended that professionals be trained to deal with or prevent school violence (American Psychological Association, 1993; Furlong et al., 1996; National Education Goals Panel, 1996; Nicklin, 1996). Elam et al. (1994) found that 92 percent of the public supports violence training for school personnel. Given this social climate, social workers could occupy a visible and central role in implementing school-based violence programs. However, little is known about the current involvement of school social workers with school violence programs or the training needed for social workers to contend with school violence. Furthermore, it is quite possible that social workers are already coordinating programs that address school violence, yet are not receiving recognition for their efforts. To date, the vast majority of the research on issues surrounding school violence has focused on students, and to a lesser extent, parents and teachers (see Metropolitan Life Insurance & Harris Poll, 1993/1994, and National Center for Educational Statistics, 1991, 1992, for examples of large-scale surveys). In light of the absence of data regarding school social workers and violence, researchers at the University of Michigan in collaboration with NASW undertook the first national study of school social workers that focused explicitly on the topic of school violence. The survey collected data from school social workers on the following four areas related to school violence: (1) direct questions about violence in schools including their perceptions of school violence as a problem and reports of specific violent events (see Astor, Behre, Fravil, & Wallace, 1997 for a detailed multivariate analysis on these questions); (2) questions about their personal victimization, safety, and precautions taken to protect themselves; (3) questions about current violence prevention or intervention programs in their schools, including their involvement with these programs; and (4) questions about their current school violence training and future education needs. This article reports the major descriptive findings about personal victimization, safety, and precautions; existing training; and future training needs. An earlier article reported the results related to violent events in the schools (Astor et al., 1997). Many survey questions were adapted from a previous national survey of school violence with a sample of school psychologists that was used by the California Commission on Teacher Credentialing School Violence Advisory Panel (Dear, 1995). The current questionnaire was revised and expanded to include questions on program involvement specific to the social work role in schools. Data about school violence from the perspective of school social workers could be used to inform state, university, agency, or school district training programs; to promote the inclusion of social workers in national school violence legislation; to expand the collaborative role of school social workers; and to facilitate the development of a national strategy to better address the problem of school violence from a social work perspective. …

Prototypes of Social Work Political Participation: An Empirical Model

Abstract: Since the founding of the profession, social workers have been urged to assume a key role in social welfare policy. Despite this, the profession remains "at war with itself about the extent to which it should engage in matters of social justice and reform" (Thompson, 1994, p. 457). This conflict occurs at a time when opportunities for political participation abound, the welfare state is under attack, and public- and private-sector social welfare program funding patterns have become increasingly complex (Gummer, 1990; Jansson, 1994). When social workers neglect to engage in the politics of social welfare policy, that is, in acts aimed at influencing policymakers' resource distribution decisions, the needs of social work clients and the profession itself are left out of the policy development process. Social workers are in a unique position to increase the political salience of social problems. Expertise and "interests" place social workers as mainstream policy actors who can make a difference in policy design, implementation, and outcomes (Burch, 1991; Laumann & Knoke, 1987; Peterson, 1990-91). Understanding how social workers can and do participate in the politics of social welfare policy is integral to advancing the profession's philosophy and goals (Haynes & Mickelson, 1991; Weismiller & Rome, 1995). With emerging policy reform action among other disciplines and organized interests, social workers must exhibit greater dedication to policy practice or risk being undermined by others who take the lead (Figuiera-McDonough, 1993; Hoefer, 1993). "If you do not make [policy choices], you have selected someone else's policy as your default choice, which is probably different than what you would have preferred" (Burch, 1991, p. 197). Many opportunities exist in the American political arena to realize the resource distribution and political interests of social workers who apply analytic, assessment, problem-solving, and political skills to build policy agendas; define problems; construct proposals; and enact, assess, and evaluate policy (Jansson, 1994; Schorr, 1985). The importance of practitioners' paying attention to resource (that is, political) decisions lies at the interface of policy and practice: "Professionals who ignore social choices and social values in favor of developing practice skills are like musicians playing background music to a melody that seems to come from nowhere" (Gilbert, Specht, & Terrell, 1993, p. 21). Because of these dichotomies, discrepancies remain in the levels and types of political participation engaged in by social workers (Ezell, 1993; Reeser, 1986; Reeser & Epstein, 1990). To expand the profession's contributions to social welfare policy decision making, social workers must become more cognizant of and act on the "political" actions that already are an integral part of their practice. Literature Review Social work literature cites numerous reasons for the variations in social action and political participation activity. One reason pertains to the need to develop a model of political participation that is easily integrated into professional practice and identity. When greater emphasis is placed on learning clinical skills at the cost of developing attitudes, knowledge, and skills in advocacy and social action, practitioners are ill prepared to succeed in the political arena (Figuiera-McDonough, 1993; Gilbert et al., 1993; Haynes & Mickelson, 1991; Wolk, Pray, Weismiller, & Dempsey, 1996). The reluctance to get involved in politics also stems from practitioner concerns that political activity will compromise professional values or threaten the individual's position within an agency (Ezell, 1993; Jansson, 1994; Reeser & Epstein, 1990). Fears that taking stands on issues or candidates may result in the loss of agency community standing or sources of support also inhibit political activity (Richan, 1988). All these factors may be compounded by restrictions placed on political participation by state and federal legislation such as the Hatch Act (Pawlak & Flynn, 1990; Thompson, 1994). …

Preventing and Reducing Alcohol and Other Drug Use among High-Risk Youths by Increasing Family Resilience

Abstract: This study examines the effects of a community-based program designed to delay onset and reduce the frequency of alcohol and other drug (AOD) use among high-risk youths, ages 12 to 14, through strengthening family resilience. It is part of a larger five-year demonstration project funded by the Center for Substance Abuse Prevention (CSAP). The program was implemented in multiple church communities in rural, suburban, and inner-city settings. Program components of this study included parent or guardian and youth training, early intervention services, and follow-up case management services. The results show that the program produced positive direct effects on family resilience. The evaluation also found positive moderating effects on delayed onset of alcohol and other drug use and frequency of alcohol and other drug use among youths in the form of conditional relationships with changes in those family resilience factors that were targeted by the program.

Making Meaning of Alcoholics Anonymous for Social Workers: Myths, Metaphors, and Realities

Abstract: Alcoholics Anonymous (AA), the increasingly popular mutual-help program for alcoholics, is often criticized for being just another substitute addiction, emphasizing "powerlessness" to already disenfranchised groups, being a religion or cult, adhering to a medical model of disease instead of a strengths perspective, and other such areas of concern to social workers. Many of these interpretations are based on viewing AA as an alternative treatment model or a rational service delivery model. This article addresses common critiques of AA by offering a way of understanding it as a "normative narrative community," where identity transformation takes place through the use of metaphor and storytelling. The article suggests alternative meanings of key metaphors, such as "powerlessness," describes areas of program strength and potential barriers for social workers, and reviews current research on AA effectiveness.

Teenage Peer Sexual Harassment: Implications for Social Work Practice in Education

Abstract: Peer sexual harassment is an often overlooked problem for both girls and boys in the educational environment. This article provides a historical framework for defining peer sexual harassment as a sex discrimination issue and a description of peer sexual harassment as a potential mental health issue. The article also reviews the limited empirical research on teenage peer sexual harassment, which has consistently revealed that nearly four of five adolescents are the targets of sexual harassment by their peers. Finally, the authors explore a theoretical context in which to understand sexual harassment and the implications for social work practice in education.

Every Picture Tells a Story

Abstract: Most Americans educated in the last half of the 20th century are familiar with the photographs taken by the early social photographers. The stark, blunt photographs of New York's poor, taken by Jacob Riis, the carefully composed and biting images of working children and Ellis Island immigrants created by Lewis Hine, and the compelling portraits of depression migrants taken by Dorothea Lange, have entered the nation's collective memory through magazines, history books, and films (Trachtenberg, 1989). Many of the more notable social photographers were also avid social reformers who worked closely with many social work pioneers. One of the strategies commonly used by key figures in social work's history was their effective use of images. In the first few decades of the 20th century, the profession's pioneers leaned heavily on the then new technology of the camera (Squires, 1991). Early social work leaders recognized that wedding the data accumulated through their investigations and surveys to sensitive drawings and photographs made their presentations more powerful (Kellogg, 1914; Squires, 1991). However, the strong links between early social work and social photography is a piece of the profession's legacy that is in danger of being lost. Social Photographers Jacob Riis was a famous author and reform crusader of the 1880s and 1890s, who wrote a poignant description of life in New York's seamier tenements. Riis worked and collaborated with prominent social work reformers including Lillian Wald, Jane Addams, and Paul Kellogg (Chambers, 1971). Lewis Hine, the creator of a remarkable collection of images documenting working class life in the early 20th century, worked for both Florence Kelly at the Child Labor Committee and Kellogg at Survey, the social work journal (Gutman, 1967). Roy Stryker, head of the Farm Service Administration (FSA) photography team, worked his way through college as a settlement house resident. Hine taught Stryker how to mix images and text and Kellogg helped Stryker publicize the photographs his team was collecting (Hurley, 1972). Dorothea Lange, a prominent social photographer of the 1930s, was the daughter of a social worker and the wife of a relief official (Curtis, 1989). Consequently, she was well aware that her work with "dust bowl" migrants was a powerful reform tool. Her photographs of the rural refugees were largely responsible for the creation of public services to help these people (Time-Life, 1972). Lange's (1936) early work with migrants was published in Survey Graphic and she continued to contribute photo essays for that publication throughout the decade (Curtis, 1989). By the general definitions of their day, some of the early social photographers were social workers. Ironically, the names of even the leading social photographers are far better known in photography than in social work (Guimond, 1991). This situation needs to be changed. Not only did these individuals play important roles in social work's history, their work exemplified how social work can make its contemporary campaigns more effective through the use of images. What follows is a brief examination of the contributions of some early social photographers who were closest to social work and who believed that their reform impulses were as much a part of their photographs as were their skills at composition and printmaking (Goldberg, 1991). Jacob Riis - Camera Crusader (1849-1914) A man cannot be expected to live like a pig and vote like a man. - Jacob Riis Jacob Riis was a reformer and a pioneer in the field now known as documentary photography. He began using photography in the late 1880s to accompany his descriptions of the sordid conditions in the slums of New York City (Riis, 1890). He took photographs for only 10 years and claimed he was awkward with the techniques of photography. Many say his images project a power and sense of intimacy that is unique (Alland, 1974). …

Social Work on the Internet: An Introduction

Abstract: Unlimited information and global communication relevant to professional social work researchers and practitioners can be found in the world of cyberspace. What started from cold and impersonal beginnings (for scientists and military programming) has grown into a user-friendly network of exploration. The Internet (or "the Net") "is a vast global network that enables computers of all kinds to share services and correspond directly, as if they were part of one giant machine. It has the capability of changing many of the ways in which people interact and communicate" (Myrick & Sabella, 1995, p. 38). One of the most unusual features of the Internet is that it can be labeled "socially unstratified." "That is, one computer is no better than another, and no person is any better than any other person. Who you are on the net depends solely on how you present yourself through the keyboard" (Levine & Baroudi, 1994, p. 10). Traits such as age, occupation, and physical disabilities do not matter. What you type about yourself is what counts. For social workers and other human services professionals anywhere in the world, the Internet increases access to empirical and practice knowledge and also facilitates information exchange. The Internet's facilities encompass a broad range of services to augment education and practice. In addition, it can provide supports when regular services are not available or supplement existing ones. To get onto the Internet, one needs to have access to a computer or computer terminal, a modem, a telephone line, and communication software. A knowledgeable computer salesperson or consultant can help with online system requirements. Access to this domain can then be obtained through such means as electronic mail (e-mail), information retrieval, bulletin boards, online conversations, and Internet relay chats. As use of the Internet increases, it also is wise to be wary of its pitfalls. Although many writers praise the virtues of electronic information and online communities, it is important to note that this electronic frontier also may be dangerous. For example, sometimes people are not who they appear to be, because this medium provides a domain whereby people can hide their true identities. In addition, consumers must be wary of the information they obtain online. It is important to remember that like "in real life," referred to as "IRL" in cyberspeak, just because something is written or has its own Web page does not necessarily mean the information obtained is accurate. Bainbridge (1995) asserted that the Internet has the potential to enhance scientific progress, present new opportunities for research, and provide access to new science. Yet he stated, "sociologists are only beginning to become critical of the potential social harm of the universal net, however, and to take advantage of research opportunities to study net society" (p. 508). Bainbridge refers to the "virtual communities" that exist on the Net as "cyburgs," explaining that the Net effectively substitutes for traditional face-to-face relationships, collectively linking geographically dispersed people. Some people who otherwise would be socially isolated find their most important relationships through the Net. As the availability of information increases and continues to develop on the Internet, it is important to recognize that in a sense, information is becoming a commodity. Commercialism is expanding on the Net, and advertisements are finding their way through cyberspace. It may be wise to study who has access to computers and computing services, in addition to who pays the monthly charges for using the Net. Bainbridge (1995) stated that the advantage in getting and using socioeconomic data effectively may still remain with the people who have the most advanced experience or the money to hire it. Thus, commercialism raises the issue of whether the net will reduce or increase the degree of stratification among data users, and the null hypothesis would have to be no change at all. …

Improving Compliance with the Initial Outpatient Session among Discharged Inpatient Dual Diagnosis Clients

Abstract: Introduction Although poor compliance with treatment is common across a wide range of mental health, medical, and substance use disorders (Meichenbaum & Turk, 1987), it is particularly high among clients with psychiatric and comorbid substance use disorders (Booth, Cook, & Blow, 1992; Carey & Carey, 1990; Matas, Staley, & Griffin, 1992). In a quality assurance study involving 38 inpatients with major depression and a substance use disorder (MD+) and 104 inpatients with major depression without a coexisting substance use disorder (MD-), we found a significant difference [[X.sup.2] (1) = 20.52; p [less than] .001] between the rates of compliance with the initial outpatient session: MD-clients entered outpatient care at double the rate of MD+ clients (86 percent versus 43.5 percent). In reviewing data from several hundred referrals to our outpatient dual diagnosis clinic, we also found that inpatients successfully enter treatment at about half the rate of clients who come directly from the community or are referred from other outpatient programs in our medical center. Thus, dual diagnosis inpatients, who have greater symptomology and impairment compared with outpatients, are at much greater risk of outpatient treatment entry failure. Dual diagnosis clients' failure to enter, comply with, or complete treatment is associated with many adverse effects. Poorly compliant clients are more likely to experience clinical deterioration of their psychiatric condition, relapse to alcohol or other drug use, and return to the hospital as a result of severe depression, suicidality, homicidality, mania, or psychotic decompensation. Missing outpatient appointments often leads to failure to renew medication prescriptions, which in turn contributes to exacerbations of psychiatric and substance use symptoms. In addition, poor treatment compliance causes the loss of supportive relationships and contributes to frustration among family members and professionals, who find themselves watching helplessly as the client deteriorates. Moreover, because of the increased risk of rehospitalization, poor outpatient compliance leads to increased costs of care as a result of more days spent in expensive inpatient treatment facilities. Strategies to Enhance Treatment Entry, Adherence, and Completion Numerous reports suggest that a variety of strategies can enhance treatment entry, adherence, and completion rates. These include using telephone or mail reminders of the initial treatment appointment, providing reinforcers for appropriate participation in treatment activities, increasing the frequency and intensity of services offered in the early phase of outpatient care, collaborating with outpatient staff when referring a client from inpatient care, offering outpatient appointments within several days of the request for help, using specialty dual diagnosis programs for psychiatric clients who have additional substance use disorders, and using case managers (Agosti, Nunes, Stewart, & Quitkin, 1991; Hochstadt & Trybula, 1980; Kadden & Mauriello, 1991; Matas, Staley, & Griffin, 1992; Meichenbaum & Turk, 1987; Stark, Campbell, & Brinkerhoff, 1990). Even a modest improvement in treatment compliance can have a significant positive impact in addressing the costly public health problem of comorbid psychiatric and substance use disorders. Brief Motivational Session prior to Psychiatric Hospital Discharge In our open treatment outpatient dual diagnosis clinic, we have been able to increase steadily the compliance rate among recently discharged inpatients for the initial outpatient appointment by offering a single motivational therapy (MT) session several days prior to hospital discharge. This MT approach, implemented by the second author, integrates strategies from motivational enhancement therapy (MET) (Miller, Zweben, DiClemente, & Rychtarik, 1995) and dual disorders recovery counseling (DDRC) (Daley & Thase, 1994). …

Patterns, Predictors, and Situational Contexts of HIV Risk Behaviors among Homeless Men and Women

Abstract: An estimated 250,000 to 3 million Americans are homeless at any given time, and a significant number of homeless people regularly live on the streets because they lack stable shelter (Robertson & Greenblatt, 1992). For many years, an extensive body of research has identified the pressing physical and mental health, substance abuse treatment, and social services needs of homeless people. During the past several years, there also has been increasing recognition that the threat of HIV infection is disproportionately high among homeless adults and adolescents and that the homeless population is extremely vulnerable to HIV infection. Several recent HIV seroprevalence studies confirm alarming rates of infection among homeless people in large urban areas. Torres, Mani, Altholz, and Brickner (1990) found that 62 percent of injection drug users (IDUs) receiving services (predominantly men) at a New York City homeless shelter had HIV infection, and Susser, Valencia, and Conover (1990) found that 19 percent of chronically homeless men receiving services at another New York City shelter were infected. HIV seroprevalence of over 8 percent was recently reported among the homeless population in San Francisco (Zolopa et al., 1994), 5 percent has been reported among homeless adolescents in New York City (Stricoff et al., 1991), and 1 percent has been reported in a community sample of homeless African American men in Miami (Centers for Disease Control [CDC], 1991). Although HIV seroprevalence levels are likely to vary with a study's geographical location and the specific risk behaviors characteristic of the population, apparently HIV disease has become an epidemic among the United States's urban homeless population. A number of behavioral, social, and relationship factors contribute to the increased vulnerability of homeless people to HIV infection. Homeless adults are disproportionately concentrated in impoverished inner-city neighborhoods, which have high rates of drug use and greater prevalence of sexually transmitted diseases (STDs) and where HIV infection is becoming more common. As a result, people who are sexually active or those who share drug injection equipment in these neighborhoods and social networks are likely to encounter infected partners. Moreover, homeless people are likely to have unstable and transient social and sexual relationships. Patterns of "survival sex" (having sex in exchange for money, drugs, or a place to stay) are common among chronically homeless adolescents and adults (Rotheram-Borus & Koopman, 1991). Reports of coercive sex and rape are higher among the homeless population (Robertson & Greenblatt, 1992). Numerous studies have also revealed the high prevalence of severe mental illness and substance use among homeless adults (CDC, 1991; Fischer & Breakey, 1986; Foscarinis, 1991; Shore & Cohen, 1992; Toro, Trickett, Wall, & Salem, 1991). Both chronic mental illness and drug use patterns among homeless men and women may cause judgment and problem-solving difficulties, disinhibition, and vulnerability to coercion, leading to increased risk of HIV infection. Although a number of studies have established elevated HIV seroprevalence among the urban homeless population, little research has identified behavioral factors associated with HIV risk in this population. Nyamathi and her colleagues (Nyamathi, 1991; Nyamathi, Bennett, Leake, Lewis, & Flaskerud, 1993; Nyamathi & Vasquez, 1989) have studied impoverished women, women with drug addictions, and homeless women. These investigations have repeatedly identified low self-esteem, helplessness, and lack of life control and coherence as important determinants of both emotional distress and HIV risk behavior among these women. Differences in HIV risk patterns also have been demonstrated among homeless women of different ethnicities and acculturation levels (Nyamathi et al., 1993). Purpose of the Study The research presented in this article had two overarching purposes: (1) to examine the behavioral patterns that create HIV risk among inner-city homeless men and women and (2) to delineate the nature of psychological, social, and situational factors related to levels of HIV risk behavior among this population. …

A Map for You? Geographic Information Systems in the Social Services

Abstract: This article introduces social agency practitioners and administrators to geographic information systems (GIS). To illustrate the application of GIS to the social services, we describe how we used GIS recently to study the supply of child care services in Massachusetts and to examine issues related to welfare reform in Dade County (the Greater Miami area), Florida. Our work using GIS was made possible by two multiyear grants from the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services and by additional funding and resources provided by the Massachusetts Office of Child Care Services, the Florida Children's Forum, the National Science Foundation (NSF), the Florida International University Foundation in Miami, Florida, and Wellesley College in Massachusetts. The ACF grant brings together researchers, state administrators of child care, and child care resource and referral (R&R) agencies from Massachusetts, Florida, and Alabama to carry out research that helps shape child care policy and improve child care services, particularly in low-income communities. Geographic Information Systems Geographic information systems (GIS) are computer systems for capturing, storing, manipulating, analyzing, displaying, and integrating spatial (that is, geographical, or locational) and nonspatial (that is, statistical, or attribution) information (Maguire, 1991). Although professionals in various technical fields (for example, geology, geography, and urban planning) have been using GIS since the 1960s, these techniques still are little known and used in social work. The release of the 1990 census results, which included release of the U.S. Census Bureau's TIGER (Topologically Integrated Geographic Encoding and Referencing) files greatly expanded the possible uses of GIS in many fields (Sperling, 1995), including social work practice, administration, and research. The TIGER files, available in machine-readable, CD-ROM form that is fully compatible with all major GIS software, provide the spatial and administrative unit background against which the user can display administrative, census, and other databases. GIS software allows a social agency to produce meaningful, attention-grabbing maps that visually show important administrative, policy, and practice issues. The software also makes it possible for administrators and practitioners to uncover new insights (for example, gaps in service delivery, areas of low service take-up rates, transportation problems, and location of areas of new demand for services). GIS software also can help social agencies communicate more effectively to clients the spectrum of choices available, an issue of increasing importance as the use of vouchers becomes more prevalent in the delivery of services. In short, GIS software gives social services agencies a powerful new way to analyze services in relation to clients and to the communities in which they operate. Uses and Benefits of GIS in the Human Services Being able to place agency records on a map gives management and staff a whole new way of looking at data that may reveal patterns never discovered before. Specifically, GIS can improve day-to-day practice and management decisions by providing tools * to inventory, through maps, the agency's clientele, services, or any other information of interest * to assess the sociodemographic characteristics of the neighborhoods served by the agency * to assess whether the supply of services in a given community is adequate and appropriate for the target population * to forecast need or demand for additional services, given changes in the policy environment, such as the vast changes now taking place under welfare reform (For example, by using GIS, an individual can locate on a map potential employers of welfare clients and the residential areas where welfare-to-work clients are concentrated. …

Differential Effectiveness of Prevalent Social Work Practice Models: A Meta-Analysis

Abstract: Within the past few decades, an increasing number of group outcome studies on the effectiveness of social work have been published. As this has occurred, various social workers have prepared narrative review articles that critically summarize their findings. Among the reviews of this type are Segal (1972); Fischer (1973); Reid and Hanrahan (1982); Sheldon (1986); MacDonald, Sheldon, and Gillespie (1992); Rubin (1985); and Thomlison (1984). Although such reviews have certainly performed a valuable professional service, their qualitative interpretive methods are often not replicable, and so they may leave the potentially potent alternative or confound explanation of reviewer bias essentially uncontrolled. The methodological refinement of meta-analysis, which calls for the specific explication of sampling (study selection) and analytic (effect size [ES] calculations) procedures, offers some control against such reviewer bias (Cooper, 1989; Wolf, 1986). Although meta-analysis has long been used in the fields of medicine and psychology (for example, Smith & Glass, 1977), to date only two meta-analytic studies of social work practice have been published. The first of these appeared in 1988 and was prepared by Videka-Sherman. Her conclusions were comforting and generous (Videka-Sherman, 1988): "social work intervention has a positive effect on outcome (p. 328) [and] . . . An empirical basis on which to claim effectiveness of social work practice in mental health exists" (p. 329). Hogarty (1989) subsequently published a substantive critique of Videka-Sherman's study, claiming serious problems with the meta-analysis itself and inappropriate characterizations of social work practice, concluding, "this exercise not only resulted in questionable conclusions but also served to illustrate abiding problems in the design, methods, and analysis of social work research efforts" (p. 363). Given Hogarty's considerable stature as a clinical researcher in the field of chronic mental illness (Hogarty, 1991), the focal point of Videka-Sherman's study, his criticisms seemed to mute subsequent discussion of this initial meta-analytic study. More recently, Gorey (1996) published a meta-analysis of contemporary social work effectiveness studies, covering those published from 1990 to 1994. Eighty-eight studies were selected from 13 journals, eight of which were affiliated with professional social work associations. Effect sizes were estimated using a metric called the r-index, interpretable as the Pearson's linear correlation coefficient, which provides an estimate of the strength of the social work intervention-outcome relationship. The focus of Gorey's original meta-analytic report was to compare the ESs generated by internal versus external evaluations of effectiveness. A study that used social workers' assessments of the outcomes of their own practice was classified as an internal evaluation, whereas one using assessments by others unconnected with service delivery was labeled as an external evaluation. The mean r-index for all 88 studies was .356 (SD = .261, p [less than] .001), permitting the conclusion that about 78 percent (based on conversion to another ES metric, Cohen's [1988] [U.sub.3] of 77.7 percent) of the clients who received social work intervention did better than the average client who did not. Moreover, others have replicated this overall finding among unpublished social work research sources (theses, dissertations, or conference proceedings); so mere publication bias is not likely as the explanation (de Smidt & Gorey, 1997; Grenier & Gorey, in press). When the studies using internal evaluations of outcome were compared with external evaluations, it was found that although both produced positive ESs, the internal evaluations were significantly more favorable than the external [mean r of.518 compared to .186, t(86) = 7.93, p [less than] .001]. In other words, "social workers evaluating their own direct practice or their agencies' programs tended to report more favorable findings than evaluators who were not directly involved in the work" (Gorey, 1996, p. …

Marital Conflict Management: Gender and Ethnic Differences

Abstract: This article discusses how spouses in marital relationships that had lasted for more than 20 years managed conflict (Mackey & O'Brien, 1995). The focus of the discussion is on gender and ethnicity influences on modes of coping with conflict within these marriages. The couples participating were selected purposefully to represent ethnic, religious, and educational diversity. Three trends influenced the design of the research on which this article is based: 1. The United States has the highest divorce rate in the world; it reached nearly 50 percent of all marriages by the late 1980s (Billingsley, 1990; Chadwick & Heaton, 1992; Lewis, 1988). 2. Marital difficulties are one of the leading reasons people seek psychological help from social workers and other human services professionals (Cowing et al., 1985; Lewis, 1988). Given increased life expectancies of the U.S. population (Ade-Ridder, 1985), it is important to understand the relational dynamics of lasting marriages, because research suggests that couples who are both dissatisfied and satisfied with their marriages remain together (Kelly & Conley, 1987; Lewis & Spanier, 1979; Swensen & Moore, 1984). With these couples living together for longer periods of time, there may be increasing numbers of older couples seeking the services of social work practitioners. 3. Relatively little research has been reported on lasting relationships and even less on ethnically diverse marriages. Research on marriage has tended to focus on white, college-educated, middle-class couples (Lauer, Lauer, & Kerr, 1990; Levenson, Carstensen, & Gottman, 1993; Wallerstein & Blakeslee, 1995). Although findings from these studies may be helpful in treating couples with marital difficulties, the results have limitations for practice with clients from different social and ethnic groups (Billingsley, 1990; Vega, 1990; Wamboldt & Reiss, 1989). Although working-class and middle-class couples may face similar issues in their relationships, there are differences in how diverse groups resolve conflicts (Rubin, 1976). Factors important to marital stability among white, middle-class Americans may be different from those of other cultural groups (Frisbie, Bean, & Eberstein, 1980). Our research is in response to a challenge that social workers encounter in their daily practice: helping couples to manage conflicts in their relationships and to manage interpersonal differences in ways that enrich marital satisfaction. Given demographic trends, social workers increasingly will be working with ethnically diverse and older couples who may need help with these problems. The findings from our study have implications for prevention of debilitating conflicts through psychoeducational interventions informed by sensitivity to gender and ethnic differences in an older population. Framing the Dimensions of the Study As part of our research on lasting relationships, we adopted a developmental, life span perspective (Dilworth-Anderson & Burton, 1996) in exploring how spouses coped with conflict over the years. On the basis of that perspective, we organized the study to explore several dimensions of marital relationships over time. This article focuses on one of these dimensions: conflict and its management. Other dimensions included decision making, sexual relations, psychological intimacy, parenting, communication and satisfaction with relationships (Mackey & O'Brien, 1995). Levinson's (1986, 1996) hypothesis of adult life structures and transitions was useful in understanding how spouses adapted to marriage. Levinson conceptualized structures as dynamic plateaus in which modifications in various dimensions of relationships were integrated and consolidated, albeit tenuously and temporally. Transitions involved changes as people negotiated modifications in the structure of existing dimensions. In terms of marriage, the engagement period was conceptualized as a transition into the structure of early marriage. …

Mediation in Kinship Care: Another Step in the Provision of Culturally Relevant Child Welfare Services

Abstract: With rising numbers of children entering the child welfare system and declining numbers of available foster homes, the foster care system has increasingly turned to placements with relatives to meet the needs of children removed from parental custody. Nowhere is this situation more evident than in the African American community. But the child welfare system did not invent the concept of kinship care. The foundation of current mediation practice can be traced to several ancient cultures, including African culture, where the kinship network often provided mediation services in the resolution of disputes. As an ethnocentrically designed child welfare system grapples with how to best incorporate kinship care into its array of services, conflicts between kinship caregivers and the foster care system have arisen. It is suggested that the application of mediation to conflicts in agency-kinship family relationships can serve as yet another step in social workers' efforts to provide culturally relevant child welfare services.

Technology-Based Groups: A Review and Conceptual Framework for Practice

Abstract: Telephone conference call and computer-assisted groups offer the benefits of group treatment, education, and support to individuals who cannot or choose not to attend face-to-face groups. They also can expedite participation in organizational and community planning and decision making. These technology-based groups are still a novelty, however, and are rarely mentioned in texts on social work practice. Innovative practitioners who want to use technology to bring people together in groups must rely on conceptual frameworks that have been designed for groups whose members have face-to-face interactions. These frameworks often have limited applicability for work with telephone groups in which members may know each other only by their voices or for computer groups where members may only make contact through messages flashing on a screen. We address this conceptual gap in social work knowledge by presenting a framework for practice with telephone and computer groups. Our framework is grounded in existing models of social work with face-to-face groups and extends these conceptions to groups whose members are physically separated and connected only by technology. This framework draws on the experience and wisdom of human services practitioners and scholars and on theoretical explanations and research findings from social psychology. Practice with Telephone and Computer Groups Our conception of current practice with telephone and computer groups has evolved from our review of the professional and popular literature, our own experience, and a survey we conducted of group work practitioners (Galinsky, Schopler, & Abell, 1997; Schopler, Galinsky, & Abell, in press). The professional literature is predominantly descriptive and stresses the advantages related to using technology. Although some of the drawbacks are mentioned by professionals, the risks and challenges of technology are more likely to appear in the popular press. The growing literature on technology-based groups describes their use for a wide array of purposes and populations and identifies their potential benefits and challenges. Purposes and Populations Technology-based groups often are used to overcome barriers such as stigma, physical and emotional conditions, distance, lack of transportation, and conflicting responsibilities that may discourage attendance at face-to-face groups. With telephone conference call and computer technology, practitioners are reaching out to individuals in their homes or offices. During regularly scheduled meetings, members provide support, information, and practical or emotional help to each other or make decisions and complete tasks over the telephone. In computer groups, members share feelings, exchange information, develop skills, solve problems, work on tasks, and make decisions through messages they post simultaneously or asynchronously, at their convenience, at any time of the day or night. Membership in technology-based groups may be as few as three people for either type, but hundreds of people conceivably may participate in a computer group. Since the late 1970s, practitioners have used telephone groups to assist such diverse populations as blind elderly clients (Evans & Jaureguy, 1982b; Evans, Werkhoven, & Fox, 1982; Thomas & Urbano, 1993), adults with physical disabilities (Evans, Fox, Pritzl, & Halar, 1984; Evans, Halar, & Smith, 1985; Evans, Smith, Werkhoven, Fox, & Pritzl, 1986; Kennard & Shilman, 1979), people with HIV disease (Meier, Galinsky, & Rounds, 1995; Rittner & Hammons, 1992; Roffman, Beadnell, Ryan, & Downey, 1995; Rounds, Galinsky, & Despard, 1995; Rounds, Galinsky, & Stevens, 1991; Wiener, Spencer, Davidson, & Fair, 1993), cancer patients (Colon, 1995), and homebound individuals with multiple sclerosis (Stein, Rothman, & Nakanishi, 1993). More recently, social workers have shown that computer technology provides a feasible and productive way to work with groups such as caregivers of people with Alzheimer's disease and other forms of dementia (Brennan, Moore, & Smyth, 1992; Smyth & Harris, 1993), survivors of sexual abuse (Finn, 1995; Finn & Lavitt, 1994), cancer patients (Weinberg, Schmale, Uken, & Wessel, 1995, 1996), chronically ill children and youths (Ell & Reardon, 1990; Levenson & Signer, 1985), and emotionally disturbed adolescents (Zimmerman, 1987). …

Outdated Practitioner Views about Family Culpability and Severe Mental Disorders

Abstract: Current theories and research about the etiology and treatment of psychotic disorders increasingly point to the importance of biological factors. Only about two decades ago these disorders were attributed by mental health professionals and the public at large to flaws in parenting and family interactions, whereas the scientific literature now emphasizes such things as genetics, early (perhaps prenatal) physical illnesses and brain traumas, and other physiological forces that produce neurochemical abnormalities in the brain (Gottesman, 1991, 1996; Maziade & Raymond, 1995; McFarlane, 1996; Torrey, 1994). Accompanying this shift in the etiological literature has been an accumulation of evidence indicating the need to move away from treatment modalities that cause families of people with psychotic disorders to feel culpable for the causation or perpetuation of their relatives' disorders. Research has indicated that family systems therapies that tend to attribute psychotic disorders to parental or family dysfunction not only are ineffective in alleviating symptoms or preventing relapse but also may exacerbate both (Lefley, 1994; McFarlane, 1996). The latter can happen when the treatment intensifies the guilt and sense of blame felt by the family, which in turn increases family members' anxiety and preoccupation with their relative's problems. Increased anxiety and preoccupation are likely to intensify the level of expressed emotion in the family and the level of criticism and over-involvement by family members who, feeling blamed for causing the disorder, are less able to be supportive and philosophical in the face of its long-term persistence (Kuipers & Bebbington, 1990). Research has indicated that people with psychotic disorders are more vulnerable to relapse at higher levels of expressed emotion, anxiety, overinvolvement, and criticism. They are less vulnerable when family members can be more supportive and not act on needs or misunderstandings that induce unrealistic hopes for a full and early recovery (Hogarty, Reiss, & Anderson, 1990; McFarlane, 1996). In addition to illuminating the counter-therapeutic effects of standard therapies that induce a sense of blame, current research has supported the efficacy of newer treatment approaches. These approaches - generally termed family psychoeducation - provide families with support, educate them about the disorder in a way that identifies biological causation and alleviates their sense of guilt or shame, foster the development of their social support network, and train them in skills to help them cope with their relative's unusual and perhaps provocative behavior (Falloon, 1990; Gingerich & Bellack, 1996; Hogarty et al., 1990; Hugen, 1993; Leff, 1995; McFarlane, 1996; Stern & Drummond, 1991). Quite unlike refuted family systems approaches with these families, psychoeducational interventions attempt to build an alliance between the practitioner and family members (Gingerich & Bellack, 1996). McFarlane (1996) noted that family psychoeducation assumes that "family members are not only blameless but in fact secondary victims of a biological illness" and regards them "as partners in treatment and rehabilitation - a group of lay collaborators with special knowledge of the patient" (p. 12). Given all the literature that has appeared since the mid-1970s along the foregoing lines, it may seem reasonable to suppose that family members with a psychotic relative entering the mental health services delivery system today will no longer be made to feel culpable for generating or precipitating the disorder, will no longer receive debunked and ineffectual treatments, and instead will receive psychoeducational interventions consistent with current theory and research. We have encountered well-informed colleagues who scoff at the notion that mental health practitioners continue to perpetuate outdated beliefs and treatments that imply family blame for psychotic disorders. …