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PubMed1991

Eight myths on motivating social services workers: theory-based perspectives.

A combination of factors has made formal motivational and reward systems rare in human service organizations generally and virtually non-existent in social service agencies. The author reviews eight of these myths by reference to eight motivational theories which refute them: need theory, expectancy theory, feedback theory, equity theory, reinforcement theory, cognitive evaluation theory, goal setting theory, and social influence theory. Although most of these theories have been developed and applied in the private sector, relevant research has also been conducted in social service agencies. The author concludes with a summary of guidelines suggested by the eight theories for motivating human service workers.

Feedback↗
PubMed1997

A randomized controlled trial of enhanced Social Service occupational therapy for stroke patients.

OBJECTIVE: To determine whether stroke patients referred to the Social Service occupational therapy service would benefit from an enhanced service compared to the usual service. DESIGN: Randomized controlled study allocating patients to the enhanced service or the usual service. SUBJECTS: Stroke patients discharged home from hospital and referred to Social Service occupational therapy department. OUTCOME MEASURES: The sections and total score from the Nottingham Extended Activities of Daily Living Scale (EADL), the Barthel Index, the General Health Questionnaire (GHQ) and the number of pieces of equipment provided were analysed. RESULTS: One hundred and eleven stroke patients were recruited to this study. Fifty-three were randomly allocated to the enhanced service and 58 to the usual service. Patients receiving the enhanced service were seen more quickly after referral, for longer, and received significantly more visits (p < 0.01) than those receiving the usual service. Three months after entry to the study the enhanced service group had better EADL (p < 0.01) than the usual service group. This benefit remained significant in only the mobility section of the EADL at six months. Careers of the stroke patients in the enhanced group had lower GHQ scores (p < 0.05) than those in the usual group at six months. CONCLUSIONS: This trial supports the use of domiciliary occupational therapy for stroke patients after discharge from hospital in terms of improvements in functional outcomes in the short term, but the long-term benefits remain unclear.

Activities of Daily Living↗
PubMed1979

Introduction to the theme--state intervention and the social wage: the politics of social services expansion.

State intervention in the consumption process has become increasingly critical to economic growth on the one hand and to real family income on the other. The social wage thus tends to become a conflictual political issue. As a result, the articulation of state intervention with the changing requirements of economic growth is subject to continuous political challenge. This special issue examines the problematic relationship between state intervention in social services and the organization of the capitalist economy. Some contributors study the ways in which state inter ventions are structured so as to be consonant with the requirements of economic growth and profitability, as well as the difficulties such structures pose. Feshbach's analysis of the Hill-Burton Hospital Construction Program and Mollenkopf's study of San Francisco's public transit system both reflect this concern. Other contributors study the ways in which the organization of the economy constrains the development of democratically responsive social services. Sbragia's study of the capital market and public housing in Italy and Taylor's study of free medical clinics in the U.S. both reflect this concern. Finally, contributors study macroscopic transformations in the relationship between state intervention and the organization of the capitalist economy. Esping-Andersen's study of the political logic of increasing state intervention in production and Hirschhorn's analysis of the defunctionalization of social services attendent upon the disaccumulative tendencies in capitalism both reflect this concern. This introductory paper reviews four theories which attempt to explain how state intervention is insulated from democratic controls. For each theory, the mechanisms specified to perform this function are subject to weaknesses. An attempt is made to position the contributions to this volume with respect to these theoretical traditions.

Conflict, Psychological↗
PubMed2005

Health care and social service use among Chinese immigrant elders.

We explored patterns and reasons for health and social service use among Chinese immigrant elders. Interviews were conducted with 27 Chinese immigrant elders, 11 adult care giving children, and 12 health and social service providers. Content analysis of these data indicated that participants across groups agreed that Chinese elders under-utilize services because of problems related to language, transportation, cost, long waits for appointments, and because of cultural norms/values related to need for care, preference for self-over professional care, fear, and distrust of western biomedicine, and the obligation to refrain from using formal services. These problems are complicated by geographical dispersion and dialect differences in the local Chinese immigrant community.

Aged↗
PubMed1988

Social services for deaf and hearing-impaired clients: a review of the literature.

Emphasis on the social service needs of the deaf and hearing impaired has increased in the past decade. The literature that resulted from this attention is fragmented, however, and does not always offer the structure and direction that is needed. This review of the literature identifies issues related to effective service delivery with the objective of enhancing practitioners' understanding and awareness of the social service needs of the deaf community. A second objective is to stimulate interest and action in service delivery, program development, and direct service for the deaf.

Deafness↗
PubMed2005

The influence of Sekentei on family caregiving and underutilization of social services among Japanese caregivers.

The Asian family is regarded as a close-knit social unit in which elderly people are believed to occupy a highly respected position. Family members are thought to provide care for elderly parents gratefully because of filial piety. This stereotypic portrayal of Asian families, however, may not apply fully to Japanese families. This article points out misunderstandings and stereotypic views of family caregiving of Japanese elderly people. The article describes how the cultural virtue of filial piety has been incorrectly identified as the major factor influencing underutilization of social services among Japanese family caregivers. The authors provide new insights into Japanese family caregiving by describing the concept of sekentei and how this concept may influence family caregiving of elderly family members and underutilization of social services among Japanese caregivers.

Adult↗
PubMed1994

Patterns and determinants of social service utilization: comparison of the childless elderly and elderly parents living with or apart from their children.

Approximately one out of five elderly persons are childless. In the absence of children who provide important emotional and instrumental cohort , are childless elderly more likely to use social services than are elderly parents? Analysis of data from the Longitudinal Survey of Aging shows that the childless elderly were more likely to say that they lacked informal instrumental support at times of illness than were the elderly parents. Nevertheless, the childless were no more likely to use social services than were the elderly parents. Strategies to improve the childless elderly's social service use are recommended.

Activities of Daily Living↗
PubMed2002

The prevalence of victimization and perceptions of job neighborhood safety in a social service agency and the need for screening.

Because staff attitudes and affects are impediments or strengths in appropriately assessing and managing traumatized or violent patients, the authors discuss the need to explore staff's experience with trauma and violence. A survey of social service field and administrative office-based staff revealed that numerous staff had experienced traumatic events. Compared with staff based in a downtown administrative office, significantly more field-based staff were dissatisfied with their job's neighborhood and perceived their job's neighborhood as a dangerous place to work. Further, significantly more field staff perceived that their job's neighbors would be "unlikely" to intervene in observed antisocial behaviors. In our sample of primarily female, African-American, social service staff, the ratio of victimization was higher than rates in other studies. Screening social service staff for experiences of trauma and victimization and asking about their perceptions about their job's neighborhood will help leadership shape efforts to address these dynamics. By addressing staff's perceptions of their job's neighborhood, leadership can influence staff's willingness to participate in proactive community organizing and prevention activities designed to reduce violence and increase safety. Several recommendations to reduce violence in the workplace are presented.

Adult↗
PubMed2003

Predictors of social services supervision of babies of mothers with mental illness after admission to a psychiatric mother and baby unit.

BACKGROUND: There is insufficient information on the predictors of parenting difficulties in mothers with severe mental illness. Using data from mother and baby units in the UK we aimed to examine the social and clinical characteristics of mothers whose babies were supervised by social services on discharge. METHOD: A case-control study was carried out using data from mother and baby units and facilities entered onto the Marce database. RESULTS: Of 1197 mothers, 23% were discharged with their babies under some form of social services supervision. Factors independently associated with an increased risk of supervision included social class (OR 3.16, 95% CI 1.99-5.03), single marital status (OR 2.10, 95% CI 1.38-3.20), behavioural disturbance (OR 1.69, 95% CI 1.08-2.65) and psychiatric illness in the partner (OR 2.67, 95% CI 1.59-4.49). The diagnostic groups independently associated with the highest risk of having a supervised baby were schizophrenia (OR 5.16, 95% CI 2.61-10.21) and personality disorder (OR 9.29, 95% CI 3.46-24.91). CONCLUSIONS: Mothers with schizophrenia are at particularly high risk of having their baby supervised by social services. Preventative interventions should be targeted at socio-economic difficulties, early detection of psychiatric disorders postpartum and treatment of perinatal mental illness in the context of the whole family.

Adult↗
PubMed2004

Drug treatment, health, and social service utilization by substance abusing women from a community-based sample.

BACKGROUND: Substance abuse is an escalating problem among poor urban Latina women; little is known about their access to drug treatment and to needed social and health services. OBJECTIVE: Our objectives were to (1) examine the need and use of substance abuse treatment, health services, government entitlement programs, and social service programs among cocaine and heroin using Puerto Rican women and (2) identify whether service use predicts their prospective entry into drug treatment. RESEARCH DESIGN: This was a 3-wave longitudinal study of community substance abusing women evaluated on substance abuse and dependence using diagnostic measures, and hair and urine toxicological screens. Information was collected on self-reported need and receipt of substance abuse treatment, social services, general health services, and government entitlement programs. SUBJECTS: A community sample of cocaine-, crack-, and/or heroin-using women from copping areas in low-income urban centers of Puerto Rico were interviewed in 1997-1998 with 2 follow-up periods. RESULTS: Drug treatment, health, and social service utilization were low relative to need for services throughout all data waves. Social service utilization predicted prospective entry into drug treatment but not contacts with general health services or government entitlement programs. CONCLUSION: Drug-abusing women in low-income urban areas in Puerto Rico have substantial unmet substance abuse treatment, health, and social service needs. Mandated treatment by social service agencies may explain their clients' higher likelihood of entering drug treatment. Building linkages between service sectors to augment entry into drug treatment is essential for meeting the complex needs of this underserved population.

Adult↗
PubMed1995

Computer-based information collection and feedback for Norwegian municipal health and social services.

Norway is governed by a three-tier parliamentary system where each tier is governed by a popularly selected body: the national parliament, the county councils, and the municipality councils. This three-tier system is in many ways also reflected in the organization, management, and financing of health and social services. A large amount of information (e.g.,statistics and annual reports) flows between the three levels of management. In order to have a proper and efficient information flow, The Norwegian Ministry of Health and Social Affairs has, since 1992, been conducting a nation-wide project for information collection from and feedback to municipal health and social services (see Figure 1). In this presentation, we will present the basic idea behind The Wheel. We will also discuss some of the major activities in and experiences from the project of using Information Technology to implement an electronic Wheel. The following are basic issues to consider in implementing such a system, related to the following basic issues in implementing such a system [1]: Obtaining a unified information basis to: increase the data quality, and compile "definition catalogs" that contain commonly agreed-upon definitions of central concepts and data sets that are used in the municipal health and social services [2]. Achieving electronic data collection, both in terms of the automatic selection and aggregation of relevant data from operational systems in the municipalities and in terms of using Electronic Forms. Experiments with various ways of electronically feeding back the statistics and other comparative data to the municipalities. Providing the municipal users with appropriate tools for using the statistics that are fed back.

Data Collection↗
PubMed1998

Supplemental social services improve outcomes in public addiction treatment.

AIMS: To evaluate the effectiveness and value of social services added to standard addiction rehabilitation. DESIGN: A controlled, quasi-experimental, field study with repeated measures. SETTING: Conducted in two groups of publicly supported outpatient addiction treatment programs. Control programs provided standard, twice-weekly, outpatient group counseling. "Enhanced" programs provided standard counseling but also case managers to coordinate and expedite use of pre-contracted medical screenings, housing assistance, parenting classes and employment services. MEASUREMENTS: The Addiction Severity Index was used to record the nature and severity of patient problems in seven areas at treatment admission and at 6-month follow-up. Services provided during treatment were measured with the Treatment Services Review. Measures were taken on consecutive samples of patients admitted to all programs--before enhancements (wave 1, N = 431)--and at 12 months (wave 2, N = 710); and 26 months following enhancements (wave 3, N = 187). FINDINGS: There were no significant differences in patient characteristics, treatment services or 6-month outcomes of the two sets of programs in wave 1. Wave 2 and especially wave 3 enhanced programs provided significantly more social and medical services than control programs. Patients treated in enhanced programs showed significantly less substance use, fewer physical and mental health problems and better social function at 6-months than Controls. CONCLUSIONS: Adding social services to public sector programs substantially improved the outcomes of addiction treatment. Changes in "real world" systems require time to implement; early evaluations may fail to capture the full impact of those changes.

Adult↗
PubMed1996

A model to improve the utilization of health and social services in Latino communities.

There are two salient issues beginning to impact drastically on health and social services in the nation: nativist anti-immigrant hysteria among the populace and President Clinton's national health care proposal. This article is neither an examination of the nativist anti-immigrant hysteria nor of the merits of the President's health care plan. Rather, the focus here is to propose a model to improve the utilization of health and social services to Latinos despite nativism and outcome of the final health care program.

California↗
PubMed1990

Social support networks and formal help seeking: differences between applicants to social services and a nonapplicant sample.

Measures of social network strength have been shown to be positively correlated with the health and well-being of a range of populations, including older adults. This study compares the network structure and the support available to a group of elderly applicants for public social service assistance with those of a group of elderly persons who had not sought help (also taking into account predisposing characteristics and functional impairment). The applicant group was found to have significantly smaller networks and less affective support, even when controlling for age and physical capacity.

Aged↗
PubMed1995

Effect of recent health and social service policy reforms on Britain's mental health system.

The introduction of new policies in health and social services in Britain has changed the way community care is provided to seriously mentally ill people. Britain is creating the same problems that have existed in the United States, whereby clinicians struggle to provide services in an environment with multiple payers and perverse incentives. A simple system in Britain has been replaced with complicated organisational and financial structures that require almost impossible feats by local health and social service staff to coordinate care for patients for whom continuity of care is critical for their survival in the community and their wellbeing. Seriously mentally ill people are in the middle of these complicated problems. The creation of a local mental health authority that could be held responsible for community care, as exists in some American states, may be one solution.

Community Mental Health Services↗
PubMed1982

Incontinence in the Social Services' residential homes for the elderly.

The residential homes for the elderly run by the British Social Services contain approximately 25,000 frequently incontinent residents, the disorder having a prevalence of 17 per cent. Frequent incontinence has been consistently demonstrated to be the behaviour disability which best discriminates between suitable and unsuitable residents, in the staff's opinion. The Social Services' response to the problem is hampered by the inappropriate design of their accommodation, the lack of incontinence aids, the low levels and lack of training for staff, the poor primary health-care cover, the low priority given by hospital services, and by their own philosophy and policy for the elderly.

Aged↗
PubMed1975

Sample bias in patient evaluation of hospital social services.

An exploration of methodology for a follow-up system focusing on hospital patients who received social services identified significant problems of sample bias in the respondent group. Implications are raised for administrative utilization of this type of biased findings in evaluation of the effectiveness of social services, and for implementation of an ongoing system to collect evaluative data. Standardized patient follow-up by mail was judged to be a feasible means of obtaining this data which may, even under optimum response rates, offer difficulty for generalizing and assessing validity.

Adult↗