Medical care of individuals residing in substance abuse and recovery homes: an analysis of need and utilization

The current study examined medical care need and utilization patterns among a substance abusing and recovering population (n = 876), investigating factors such as employment and drug use categories (e.g., pharmaceutical use, cocaine use, heroin use, alcohol use). It was found that those who were unemployed needed and utilized greater medical care than those who were employed. Results indicated that heroin, cocaine, and/or alcohol use was not predictive of medical care need or utilization, whereas pharmaceutical drug use was predictive of medical care need and utilization. Trauma and risky use of substances were not significant predictors of medical care need or utilization whereas the suicide severity composite was significant. Potential implications for misuse of medical services (e.g., to obtain pharmaceutical drugs of use) and federal medical care expenditure allocation are discussed.     

The promise of primary prevention home visiting programs: a review of potential outcomes

Home visitation (HV) is a promising service delivery model, despite a history of mixed documented results. Compiling results on the promising family and child development outcomes in the HV literature has utility for current programs and those under development. We review traditional outcomes (e.g., child maltreatment prevention) from the literature on HV, but we also present nontraditional outcomes (e.g., community connection) that may be relevant for future evaluations. Programs that document their implementation and study their outcomes through a thoughtful, planned process may capture important and much needed information on strengthening families through HV.     

Preventing Homelessness: An Examination of the Transition Resource Action Center

Each year in the United States, as adolescents age out or are emancipated from the foster care system, they are at risk of experiencing homelessness. It is essential that services and programs focus on encouraging and supporting youth in transition from foster care to a life of independence, and The Transition Resource Action Center (TRAC) strives to provide these services. The researchers sought to determine if TRAC's residential program provides their clients with a chance of a stable life (e.g., housing, employment, health care). Findings suggest that fewer clients of TRAC became homeless and more acquired transitional or temporary housing from screening 1 to screening 2, demonstrating promise that these services have fostered change in the lives of their clients.     

Comparing social,emotional, and behavioral health risks among youth attending public versus parochial schools

Parochial schools are assumed to provide better social and academic experiences; however, few studies account for selection bias when comparing with public schools. This study contrasted public versus parochial schools using propensity score matching across a range of outcomes (e.g., perceptions of school, emotional symptoms, substance use, bullying). Using a sample of 58 public and 5 parochial high schools, the nonmatched analyses suggested a significant advantage for parochial schools students (e.g., better on 23 of 32 indicators). However, the propensity score matched analyses revealed nine differences (e.g., weapon carrying, smoking), two of which (i.e., stress and cyberbullying) favored public schools. While at first glance parochial schools generally appear to be healthier and safer learning environments, accounting for selection bias, the gap was narrowed. Students in parochial schools may struggle with issues related to social, emotional, and behavioral health risk, and thus prevention programs should also be implemented in these settings.     

Supports for Families Affected by Substance Abuse

Using an in-home services program model, Project Connect works collaboratively with the child welfare system, substance abuse treatment providers, the courts, and other community agencies to support parental recovery, enhance safety and permanency, and strengthen family relationships. Results from the most recent evaluation of the program, which used a dosage level design to examine project outcomes for 415 families, are presented here. Data indicate that the program was particularly helpful in strengthening parenting capacity. Child safety and permanency were also positively correlated with program participation.     

Identifying Potential Drinking-Driving Recidivists

Abstract

Family resource programs are a set of principles and a compendium of program characteristics that respond to today's urgent need to reorient policies and services for families. Premises underlying program development and the origins from which program concepts are defined are discussed, as are applications of family resource principles and programs at the state level, in child-focused programs, and in conjunction with medical and mental health services. Current challenges faced by program developers and policymakers are presented, with a perpective that those issues will be pivotal in shaping the future of both the family resource movement and the field of human services at large.     

Building the Evidence Base for Intensive Family Preservation Services

This article examines the state of intensive family preservation services (IFPS) research. Using studies of IFPS in five states, this article seeks to establish whether IFPS can be regarded as an evidence-based practice, an increasingly important standard for publicly funded services. While reporting rates of repeat child maltreatment, the analysis uses placement rates as the main outcome measure and compares effect sizes using Cohen's arcsine transformation for data reported as proportions. Significant differences in rates of child out-of-home placement and repeat maltreatment were found in some studies, particularly for higher risk families. The findings also underscore the difficulty of identifying which families to serve (targeting), ensuring treatment fidelity, and employing rigorous and appropriate evaluation methods. Overall, additional research is needed to move IFPS from a promising practice to an evidence-based practice.     

The Black Church and Family Support Programs

Abstract

The churches in the African American community have traditionally played many important supportive roles to families in many areas. Churches today are becoming more involved in the provision of services to the community members in response to many of the changes that are occurring in families, in employment, and in areas of increased poverty. Churches play important supportive roles by caring for children after school. Project SPIRIT is a program in which instructions are given in homework assistance, cultural continuity, African American history, and self esteem. These programs provide social support to all family members.     

Maltreated Children and Their Families in Juvenile Dependency Court II: Maltreatment Recidivism

The most serious maltreatment cases are referred to Juvenile Dependency Court. Eighty-eight court records were coded for factors related to maltreatment recidivism, including prior involvement histories, differential response, and placement changes. Seventy-two percent of caregivers had previous involvement, which correlated with family size and number of presenting concerns. When caregivers were offered voluntary services previously, 15% were completed. Children of substance-abusing caregivers were more likely to have prior involvement with the system. On average, children experienced four placement changes. Almost half of children reunified with caregivers had to be removed by the court. Recommendations and future directions are discussed.     

Service Outcomes Following Disclosure of Child Sexual Abuse During Forensic Interviews: An Exploratory Study

Few children disclose sexual abuse and participate in a formal investigation. Furthermore not all children that disclose abuse during a forensic interview receive services to address trauma or safety. Despite the importance of such outcomes little is known about which factors may influence when children will receive services. Through content analysis of 139 case records findings indicate that a child's race/ethnicity abuse-related factors and level of family support are all significant in predicting service and placement outcomes in child protection cases. Implications for social work practice include the need for ongoing engagement in culturally sensitive strengths-based practice with families     

An Examination of the Reliability,Data Screening Procedures,and Extreme Response Patterns for the Youth Risk Behavior Surveillance Survey

Abstract

This article explores psychometric characteristics of the Youth Risk Behavior Surveillance Survey (YRBS), one of the most widely used instruments to assess the prevalence of violent and other high-risk behaviors in secondary school settings. Response patterns were analyzed for a subset of 414 youths who indicated that they had carried a weapon to school six or more times during the preceding 30 days, and were compared to a matched sample of youths randomly selected from the 13,610 participants in the 2001 national administration of the YRBS. Results indicated that extreme responders to the weapon-carrying item were considerably more likely than their counterparts to respond in an extreme fashion to all YRBS items, including risk items pertaining to school (e.g., physical fights on school property) and outside school (e.g., alcohol consumption) factors, as well as positive health behaviors (e.g., healthy eating habits). Overall, the results suggest an ex-treme response bias among some participants that may impact the validity of the YRBS instrument. More specifically, presence of this response bias may inflate estimates of the prevalence of school violence and related concerns. These findings are discussed in light of the need to carefully examine individual response patterns on future administrations of the YRBS in an effort to ensure maximum instrument utility.     

The benefits of being defended: Perceived bystander participant roles and victims’ emotional and psychosocial adjustment

Despite a wealth of knowledge for factors predicting adolescent defending behaviors, it remains unknown about victims’ adjustment resulting from experiencing the presence of different bystander roles in a victimization episode. This study analyzed 209 Taiwanese adolescents’ reports of school-based peer victimization, perceived bystander actions in the event, and the victims’ emotional responses (e.g., happy, sad), emotional status following the episode (e.g., feeling better, worse), and psychosocial maladjustment (i.e., depression, loneliness, anxiety). Our results showed that bystander participant roles varied by victimization types and that defended victims adjusted better than nondefended victims both emotionally and psychologically. Moreover, adolescent victims who reported the presence of an outsider during the victimization experienced more complex and negative emotional responses than victims who reported the presence reinforcer or assistant of the bully. Implications for interventions and prevention are discussed.     

What Happened?

ABSTRACT

This article presents an overview and historical analysis of child welfare from its inception in the 19th century through the Social Security Act of 1935 and into the present. An argument is made that the historical de-professionalization of child welfare is reflected in changing societal values and resultant legislation framing investments in child welfare, as well as the influence of child welfare on the quality of services to children and families. De-professionalization has resulted in lowering the professional credentials of child welfare staff, increasing levels of employee turnover, the formulation of questionable policies, all affecting the quality of services to children and families. Implications of the findings for the re-professionalization of child welfare and for policy and practice are discussed.     

Kinship Guardianship,Adoption, and Foster Care: Outcomes from a U.S. National Sample

Using data from a national longitudinal survey of children referred to child protective services (NSCAW II), this article compares behavioral, child/caregiver relationship, and school performance outcomes for children residing in kinship and nonkinship settings. Up to three waves of data were gathered for each child. The analysis sample comprises 4,202 children and 10,881 observations. Two sets of regressions were completed. One represents family living settings using child-mean centered predictors while the other does so with dummy-coded variables. An advantage of the child-mean centered predictors is that omitted variables that vary between children but that are constant within each child do not introduce bias. The regressions using dummy-coded variables evidenced, on balance, somewhat better outcomes for kinship settings than for nonkinship ones. Good outcomes in these regressions were found for kinship adoption. Results with the child-mean centered regressions were more equivocal, though perhaps still favored kinship settings. Limitations and policy recommendations conclude the article.     

I’m From the Government and I’m Here to Help: How Can Public Health Perspectives Improve Outreach in Child Maltreatment Prevention Programs?

State and local governments are designing programs to prevent child maltreatment at an increasing rate. A relatively small portion of families offered these programs go on to engage in and complete services. Workers in a child maltreatment prevention program implemented across 21 sites in 1 state documented outreach efforts in logs maintained by program evaluators. Additionally, evaluators interviewed 23 outreach workers and supervisors who were developing and refining outreach strategies in this prevention program. Data from logs and responses to interviews speak to challenges in navigating prevention outreach with families to achieve engagement and buy-in, particularly when “cold-calling” about screened-out reports of child maltreatment. This paper presents a summary of barriers and facilitators of family engagement in outreach for prevention services, guidance from the public health literature on improving outreach strategies for at-risk populations, and suggested practice, policy, and research implications.     

Developmental Disabilities in Children Involved with Child Welfare: Correlates of Referrals for Service Provision

Using data from the National Survey of Child and Adolescent Well-being (NSCAW), this study explores the characteristics of child welfare involvement for children (N = 639; aged 3–17.5 years) with at least one developmental disability. In addition, a central focus of this exploration was to examine respective differences in how caregivers and caseworkers initiated referrals for services for children with disabilities. The sample was divided into three exclusive groups based on type of developmental disability: learning disability (weighted percentage 70.3%); Mental Retardation (now referred to as Intellectual Disability), Downs Syndrome, or; developmental delay (weighted percentage 1.8%); and presence of multiple types of disabilities, including autism (weighted percentage 27.9%). Results from the logistic regression analyses indicate children in this population who are placed in out-of-home care receive more referrals than those residing in-home with biological caregivers; older children and children with multiple disabilities are also more apt to obtain referrals to formal assessments. On the other hand, children who were considered in the “other” race category (includes children who identify as: multi-racial; Asian; Pacific Islander; Native American) were significantly less likely to be referred for a formal assessment. Regarding the association between specific maltreatment type and assessment referrals, children with reports of emotional maltreatment had significantly higher odds of being referred for formal assessments.     

A systems analysis of youth in acute and subacute therapeutic residential care

The Arkansas Department of Children and Family Services (DCFS) has reduced the use of therapeutic residential care (e.g., group homes, residential treatment centers) for youth placed in child welfare. Youth in acute or subacute congregate care for 30 or more days without Medicaid now are of particular interest. This is a longer-term psychiatric program, typically 3 to 6 months. The project team conducted a systems analysis to determine the specific characteristics and levels of need for 42 youth so that DCFS can more effectively serve these youth in the least restrictive form of treatment possible.     

外发工厂:拆分型劳动体制下留守女工的兼业生产

在产业转移和劳动力转移的大背景下,沿海地区代工产业如电子、玩具等劳动密集型订单开始向内地转移外发,吸引了大量农村留守妇女参与到生产中。这些妇女在拆分型劳动体制下不得不从打工地返回家乡,承担起照顾家庭的重任。女工的兼业工作对于建构自我认同以及提升其家庭地位和社会地位有很大的帮助。同时,妇女的兼业生产具有脆弱性,它不仅体现在订单的不稳定方面,更体现在国家和地方政府的政策保护不足方面。因此,要从根本上改变这种局面,必须落实农民工融入城市、加快农民工市民化等相关政策,推进城市政府公共服务均等化工作,让农民工家庭能够全面享受城市公共服务,以化解拆分型劳动体制所带来的社会问题。     

Risk and Protective Factors for Peer Victimization in Adolescents with ADHD

ABSTRACT

Youth with ADHD are more at-risk for peer victimization than their typically developing peers, and may not be benefiting from current interventions. Thus, we sought to examine risk (i.e., anxiety, depression, and forms of aggression) and protective (i.e., social skills and social acceptance) factors for peer victimization in this group. Participants were 123 young adolescents diagnosed with ADHD, who were attending grades six through eight. We found that relational aggression (i.e., excluding others from activities) and anxiety symptoms were among the strongest risk factors for victimization. Anxiety symptoms were associated with victimization over and above depressive symptoms. Social acceptance buffered risk conferred by the risk factors. Future work is needed to investigate the degree to which the relations among internalizing symptoms and victimization differ in youth with ADHD relative to typically developing youth, and assess causality of the relations.