Empowerment and Synergy

Abstract

This paper suggests an alternative to the commonly-held “scarcity paradigm” of thinking about valued human resources, which assumes individuals must compete because resources are scarce. The alternative-the “synergy paradigm”-is empitomized in “synergistic community,” where valued human resources are renewable and expanding, and distributed equitably to members, so that what is good for one is good for all and the whole is greater than the sum of its parts. Three field studies present cross-cultural evidence for the functioning of empowerment within a synergistic paradigm. Empowerment is considered as access to and control of valued resources; the specific valued resource focused upon is community healing. The studies suggest that community healing resources can become renewable and expanding, as can the process of empowerment which accesses them. Community members share these resources, combining conflicting resources into unexpectedly effective treatment packages. Given present inequities in resource distribution, transformative education is offered as one means to support a shift in thinking toward synergy.     

Alcohol and Other Drug Problems in Older Adults

SUMMARY

While there is considerable awareness and knowledge on the part of the health and human service community on the problems of the misuse and abuse of alcohol and other drugs in the general population, this unfortunately often does not extend to older adults, those who are 60+. Problems with alcohol and other drugs in older persons is in itself not a sudden crisis or new problem. However, as with any health problem affecting a specific demographic group, when the problem is not recognized and appropriately dealt with the repercussions pose greater risks for the individuals with the problem as well as for the larger community. This is particularly true in regard to older adults where natural physical changes and increased age related health risks can only be exacerbated by the misuse and abuse of substances.     

A Community Service for a Rural High School

Abstract

This case study illustrates a preventive consultation using the ecological paradigm to guide entry, assessment, problem solving, and collaborative intervention design and implementation in a rural high school which initially had serious reservations about working with urban academicians. The ecological paradigm's emphasis on the identification of resources, on collaborative work with community members, and on developing tailored solutions based on the strengths of the setting are discussed. A four year follow-up describing the long-term outcome and commentary from a key setting member are included.     

Developing a Graduate Program in Community Psychology

Abstract

The present health care system is fragmented, uncoordinated, and too costly for the chronically ill, elderly patient. Project OPEN provides preventive health and social services in order to reduce costs and provide more effective care. This alternative delivery system is based on a consortium brokerage model which provides functional assessment, care plan development and service coordination. A randomized sample of 338 elderly individuals participated in a time series experiment. Client functional status, service utilization, and all health costs were collected for six months. The results indicated a maintenance in functioning levels, a decrease in acute hospitalizations, and a 20% reduction in health care costs for the demonstration participants as compared to the control group. Project OPEN provided more effective care while simultaneously reducing health expenditures to the chronically ill elderly.     

Prevention of Child Abuse

Abstract

The application of the ecological paradigm to the potential prevention of child abuse is discussed, using two examples of consultation services designed to increase social support. The examples illustrate the principle of designing different interventions according to the ecologies of different communities. Principles of the ecological paradigm that guided the interventions are discussed. A follow-up assessment of the interventions, based on interview and questionnaire results obtained from participants in the projects, is presented.     

Consultation as a Preventive Intervention

Abstract

Commentary is provided on an overview of consultation guided by the ecological paradigm and four case studies of ecologically-based consultation. The case studies are used as examples in the discussion of environmental reconnaissance and the search for resources, the development of processes to mobilize and enhance resources, and the development of ways of assessing the side-effects and ripples of consultation. The evolutionary and ongoing nature of the processes of preventive interventions is also discussed.     

Effectiveness of a Cancer Education Program for Women Attending Rural Public Health Departments in North Carolina

SUMMARY

The Western North Carolina Cancer Awareness Program (CAP) was a four-year program, funded by the National Cancer Institute, to increase education and support services for the prevention and early detection of breast, cervical, and skin cancer among women receiving care in six rural county public health departments. Three health departments were selected as intervention units, and the remaining three health departments served as comparison units. Women age 20 and older were randomly selected in each health department. Women in the intervention group received a comprehensive health education program that included easy-to-read printed materials and telephone counseling dealing with breast, cervical, and skin cancer. Theoretical guidelines for development of the intervention program included the PRECEDE Model and the Health Belief Model. Overall, the results indicated that personalized education, which includes the combination of readable printed materials and telephone contact, can be effective in increasing some early detection behaviors for breast and skin cancer among women who attend public health departments. The value of telephone counseling as a comparatively inexpensive approach to individualizing health education has significant implications for the development of similar cancer education programs for underserved populations.     

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.     

One Size Does Not Fit All: Traditional Lockdown Versus Multioption Responses to School Shootings

ABSTRACT

Two paradigms inform responses to active shooting situations: a traditional lockdown approach where individuals find cover in a classroom and lock the door, and a multi-option approach where individuals evacuate the area, create barricades, and, in last resort situations, actively resist the gunman. While a majority of schools conduct active shooter drills, typically using a traditional lockdown approach, little is known about their effectiveness. Through simulations, this study sought to determine which of the two paradigms that inform active shooter drills is the most effective. Drills informed by the multi-option response paradigm were found to end more quickly and result in fewer people being shot.     

A Research Revolution in Women's Health

SUMMARY

Women's health research initiatives are emerging with evidence that there are unique diagnosis and intervention factors that provide a window into the specific health needs of women. The evidence of the need for this gender-specific research is being spurred by the establishment of The Office of Research on Women's Health by the National Institutes of Health (NIH). A review of some of the more current and salient research findings that apply to women's health and the health needs of women in different lifestyles, at different stages of the life cycle is discussed. Also considered are women's roles in the health service delivery system and where they fit into the provision of services within the context of women's styles of accessing and using health care. Self-help and other support programs will be described as they apply specifically to women and a case will be made for providing comprehensive, multi-systemic women's health services in one facility at the community level through an overview of some of the more current and successful models.     

Reactions to collective stress: Correlates of active citizen participation at love canal

Abstract

Events at Love Canal, beginning in the spring of 1978, are described as an environmental crisis leading to acute collective stress. As the crisis unfolded, Love Canal residents’ perceptions of the situation, and the actions they took, were monitored through interviews with a sample of 58 families in fall, 1978. Of these, 39 were reinterviewed in spring, 1979. Among interviewed families, 24 (41%) had at least one “activist” member, someone who became personally involved in a community organization formed to help resolve the crisis. This study compares the social characteristics of “activist families” with “non‐activist families,” their Love Canal‐related problems, sources of help, and general views of the impacts on their personal lives, and on interpersonal relations. Activists relied on government and crisis‐related organizations for help, while non‐activists had more family support. Neither group utilized the mental health services provided by the community's “crisis center.” Activists felt better about themselves, and had a stronger feeling of personal efficacy in affecting government decisions. They perceived that the crisis had brought about positive personal changes, and changes in relations with others. The major implication for intervention is that several different approaches to assisting members of a community in crisis must be undertaken.     

Factors Associated With College Students’ Responses to Rape-Disclosure Scenarios: Influence of Gender,Rape Characteristics,and Opinions About Health Professionals

ABSTRACT

Few studies examine the role of friends in victims’ decisions to seek help from health professionals. This study used a sample of college students (N = 637) to examine the factors that may influence whether students would advise a friend to seek help from health professionals. After providing an open-ended response to a vignette, students answered a series of questions about formal support providers, attitudes toward women and rape victims, and their background. Findings suggest a gender divide on the advice given, and more students who responded to an acquaintance-rape scenario recommended that a victim contact health professionals in comparison to those whose scenario depicted an intimate partner rape. Implications are discussed, focusing on the role of friends and campus policy in minimizing the impacts of victimization.     

School Mental Health's Response to Terrorism and Disaster

Abstract

The events of September 11,2001, have underscored the mental health needs of youth and families, and amplified the advantages of proactively bringing a range of mental health services to them, where they are, in natural settings such as schools. Further, there is increasing momentum for the enhancement of coordinated and comprehensive school-based approaches that seek to effectively respond to significant crises such as terrorist attacks and disaster. This article explores key themes related to school mental health's response to terrorism and disaster. Following review of background literature on child and adult reactions to trauma, we discuss the development of crisis response teams, and present a range of strategies for schools to respond to crises and disaster. The experiences of one elementary school in responding to the events of September 11 are presented, followed by review of critical challenges facing schools and school mental health programs in improving their ability to respond to significant crises.     

Chapter 5

Abstract

The present study used archival data to examine the differential growth among self-governed substance abuse recovery homes for men (N = 443) and women (N = 125). The number of these homes increased dramatically across the U.S. from 1988-1999 when state loan funds were made available to states and technical assistance was utilized by organizations developing the houses. State loan programs and the utilization of technical assistance, however, had the strongest impact on the expansion of women's houses compared to men's houses. The implications of these findings in relation to the scarcity of recovery options for women are discussed.     

Opportunities for Prevention of Domestic Neglect and Abuse of the Elderly

Abstract

Recent research has demonstrated that domestic neglect and abuse of the elderly is not uncommon in the United States. It is a social problem that has not been extensively researched, however. One of the few studies, conducted in Michigan, found that the oldest and most frail elderly were a target group of elevated risk. Victims of neglect or abuse tend to be living with adult children or other informal caretakers who become neglectful or abusive when the burdens of providing care for a frail, elderly person interact with stress, little or no preparation for providing personal care over a long time span, medical problems of the caretaker, alcohol abuse, financial difficulties, and other situational factors. Family histories of neglect or abuse and other causal hypotheses have also been investigated. Recent studies are reviewed and found to be in general agreement regarding the nature and apparent dynamics of this emerging problem among the elderly. Opportunities for prevention are discussed in terms of current models of service to the aging and redirection of other public health and social services.     

Residual Effects of Repeated Bully Victimization Before the Age of 12 on Adolescent Functioning

Abstract

In this study, data from the National Longitudinal Survey of Youth (NLSY 97) were used to examine early adolescent functioning as a result of being bullied. The NLSY 97 asked 4807 youths from age 12 to 14 whether they had been the victims of repeated bullying before the age of 12. In this study, 19.1% of the youths responded that they had experienced this repeated violence. It was found that the youth who have been bullied are exhibiting behaviors that are very different than their non-bullied peers. In every instance those individuals that admit to being repeatedly bullied before the age of 12 were less successful in negotiating various aspects of their life as a teenager. This underscores the need for programs that address bully prevention. Some programmatic initiatives aimed at reducing this victimized population are discussed.     

Mental Health Treatment Experiences and Expectations in Foster Care: A Qualitative Investigation

This study explores perspectives on mental health treatment experiences and expectations for youth in foster care and their foster parents. In-depth interviews were conducted and identified for major themes: (1) the dual stigma of foster care and mental health care; (2) the lack of engagement in mental health therapy; (3) trust issues with the therapist and other individuals; and (4) the desire to integrate mental health services with primary care services. These results have implications for mental health service delivery and suggest opportunities to improve mental health treatment through an integrated care approach.     

That I'll Be Killed

Abstract

Pre-service teachers who had completed their practicum or student teaching and in-service teachers in their first 3 years of teaching (n = 218) completed open-ended surveys about their beliefs and fears of school violence and rated their fears for such acts as use of weapons and the likelihood of those acts about their fears about schools and school violence. There were significant differences between pre-service and in-service teachers in their rankings of fearful events and the perceived likelihood of these events using t-tests to compare the groups. The informants reported being most afraid of guns or other weapons or other forms of dangerous violence (hostage taking, an outside stranger coming in and threatening their students, and so on). These fears were significantly correlated with their beliefs in the likelihood that these events would happen. Open-ended questions revealed that pre-service teachers tended to be more afraid for their personal safety and personal failure in a crisis situation and in-service classroom teachers tended to be more afraid for their students' safety. The implications for teacher education and preparing teachers to address school violence are discussed.