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PREPARATION FOR PRACTICE: A SURVEY OF SOCIAL WORKERS' PERCEPTIONS OF THE EFFECTIVENESS OF THEIR GRADUATE CURRICULUM FOR CONFLICT RESOLUTION/MEDIATION PRACTICE
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This study investigated the perceptions of social work mediators about the effectiveness of their graduate curriculum for conflict resolution/mediation practice. The study is based on a sample of 78 social work mediators from various regions in the United States. The respondents completed a questionnaire on curricula items, education, training and professional practice. The median age of participants was 46.0. The research questions related to gaps in the curriculum and knowledge, skills, and abilities required for practicing conflict resolution/mediation; additional training/education required to achieve competency; and whether the tasks of conflict resolution/mediation are viewed as generalist social work tasks or specialist conflict resolution tasks. Findings revealed that upon completion of their graduate social work education, the majority of the participants (89.7%, n=69) did not feel they were prepared to practice conflict resolution/mediation without additional training. Participants completed basic mediation training in a variety of settings and continued training in advanced specialty areas. Advanced training specializations reflect similar areas of social work practice: divorce, child custody, family, children and youth, education/school, workplace and forensics. The competency scale addressed the knowledge/skills/abilities issue of generalist vs. specialist. An unexpected finding was that 32 of 38 listed competencies, at some level, were thought to be generic skills for all social workers for a total of 86%. Correlation data revealed no relationships between a number of the socio-demographic variables and the preparation for conflict resolution/mediation practice. However, some relationships were found with specific curricula and competency areas. To conclude, the study revealed that social workers perceptions' of their graduate school curriculum did not prepare them for conflict resolution/mediation practice. Although they received the foundation for conflict resolution/mediation practice in their social work program, they gained the specific knowledge, skills, and abilities through a variety of conflict resolution/mediation training programs over a period of time. Social work mediators selected a large number of competencies that are identified as more conflict resolution/mediation specific as skills required for generalist social workers. Therefore, additional research is necessary to understand if this is a professional bias of social work mediators or consistent with the perceptions of a generalist social worker.
SUCCESSFUL IMPLEMENTATION OF SOLUTION-BASED CASEWORK; A CHILD WELFARE CASEWORK PRACTICE MODEL?
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Across the country, child welfare agencies have started to implement casework practice models in an effort to improve the safety, permanency and well-being of vulnerable children and families. In their effort to do so, child welfare systems have faced complex contextual challenges to implementation. To date, however, there has been limited empirical research describing successful implementation of these practices. Moreover, little systematic feedback exists concerning service providers' perspectives of various aspects of the implementation process. The purpose of this qualitative research study was to explore child welfare supervisors' and case workers' responses to various methods of implementation of Solution-Based Casework (SBC); a promising casework practice model recently introduced into this organizational context. For the study, case planners and supervisors were recruited within four different child welfare agencies in New York City. Participants then described their experiences with different modes of SBC implementation and efforts to adopt the model to their work in foster care and preventive services. The research applied the constructivist approach to grounded theory methodology (Charmaz, 2006). Grounded theory posits that individual perspectives and actions are fundamentally influenced by contexts and social interactions (Charmaz, 2006). The use of this methodology helped capture the organizational contexts and processes, which shaped practitioners' conceptualizations of SBC. The results showed that organizational support for SBC, on-going practical training and continuous coaching from peers greatly influenced practitioners' operationalization of SBC strategies. Findings also revealed ways in which caseworkers struggled to use the model with various client populations and how many foster care practitioners, unlike preventive caseworkers, expressed the need for additional clinical training to effectively use the model. Overall, the study highlighted critical contributions of service providers in SBC implementation and, more broadly, the importance of seeking feedback on practitioner experiences with evidence-supported model. Although data were drawn from practitioners' feedback with a specific evidence supported model, the issues uncovered and generalizations derived were consistent with other research studies on program implementation in social services. This suggests that the results may be highly transferable and strategies for improving program implementation may be applicable to a variety of settings as well as intervention approaches.
Prevalence, Predictors and Negative Outcomes Associated With Discordant Sexual Identity, Sexual Attraction and Sexual Behavior
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PREVALENCE, PREDICTORS AND NEGATIVE OUTCOMES ASSOCIATED WITH DISCORDANT SEXUAL IDENTITY, SEXUAL ATTRACTION AND SEXUAL BEHAVIOR This study assessed the prevalence, predictors and negative outcomes associated with discordant sexual identity in a national US sample of men and women who identified as heterosexual. Results were based on data collected from the 2004-2005 (wave 2) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC is a national sample of 34,653 adults aged 20 years and older comprised of 52% female, 71% white, 12% Hispanic, 11% African American, 4% Asian and 2% Native American. The prevalence of same sex orientation ranged from 1.41% to 6% in men and 1.35% to 8% in women. Of those who identified as heterosexual, women were statistically more likely to be discordant than men, yet discordance was common in both men and women (4.28% and 6.21% respectively). Discordant men had increased odds of being Black, over the age of 65, widowed, less educated, unemployed, and earning a lower individual and family income. Discordant women had increased odds of being Asian, foreign born, over the age of 65, widowed, unemployed, and earning a lower family income. Men with discordant attraction and behavior were 4 times less likely to meet criteria for alcohol use disorder but men with discordant attraction alone were 6 times more likely to have tested positive for HIV. Discordant men did not have increased risk of any other outcomes. Negative outcomes in discordant women far outweighed negative outcomes in men. Every group of discordant women demonstrated increased risk of alcohol related disorders. Risk of alcohol disorders in discordant women varied by subgroup with the greatest risk found in those with discordant sexual behavior and attraction and the least risk found in those with discordant sexual attraction alone. Some discordant women demonstrated significant risk of HIV infection and increased odds of infection ranged from 2.7 to 5.67. Overall, predictors and negative outcomes varied within each subgroup. Results highlight gender and discordant subgroup differences indicating the need for specialized prevention and intervention efforts to each subgroup. Future research should investigate all dimensions of sexual orientation and discordance to identify subgroups in need of specialized prevention and intervention efforts.
There's no place like home? The experiences of unstably housed transgender and gender non-conforming young people
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The purpose of this project is to expand knowledge about the lived experience of unstably housed transgender and gender non-conforming (TGNC) young people in order to inform programs and policies meant to address their needs and to contribute to the broader conversation regarding gender identity. Specifically, this project will generate new knowledge on the subject of housing instability among TGNC young people through an analysis of the youth's spoken and visual narratives about the meaning they assign to their gender identity and their experiences of housing instability. The goals of this exploratory project are: 1) to document the meaning and significance of gender identity/expression for unstably housed TGNC young people, 2) to examine the interplay between gender identity and the experience of housing instability among TGNC young people, with particular attention to the role that stability/instability plays in the reconfiguration of identity among TGNC young people. The knowledge gained from this project has the potential to inform social work practice on multiple levels, including program development, clinical and public policy interventions, and the broader discourse regarding what it means to be transgender or gender non-conforming as well as the shifting definition and impact of homelessness. The data collection methods employed in this qualitative inquiry include semi-structured interviews and the visual method of mapping with TGNC young people who have experienced housing instability. NVivo9 was utilized for data management and storage. The heuristic process of phenomenological inquiry guided analysis. The sample included 27 self-identified TGNC young people between the ages of 18 and 25 who have experienced housing instability within the past 18 months, but who are not currently without shelter at the time of the interview. The sample includes young people who identify as transgender men and women, in addition to those who do not identify as transgender but whose gender identity and expression are self-identified as different from traditional gender norms. Participants were recruited via study announcements posted in community spaces where LGBTQ young people congregate.
Cafeteria, Commissary and Cooking: Foodways and Negotiations of Power and Identity in a Women's Prison
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This study uses foodways theory to build knowledge about the lived experience of incarceration by analyzing women's narratives about prison food and eating. Semi-structured interviews were conducted with 30 formerly incarcerated women in New Haven, CT. The interviews were digitally recorded and transcribed. Findings explain the different ways that inmates collect, prepare, distribute and consume food, and the centrality of these activities to incarcerated life. By shedding light on these daily routines, the world of prison life comes into greater focus. Thematic analysis of the data further illuminates the prison experience by suggesting the positive and negative ways that food impacts inmate's perceptions of themselves, their social networks and the State. Negative foodways humiliated the women, accentuated their powerlessness, and reinforced their perceptions of the State as nonsensical and apathetic towards their needs. Positive foodways illustrated the inmates' capacity to resist State power, build/maintain relationships and construct positive self-narratives. Racialized foodways narratives began to reveal how food stories may be deployed to reinforce prison's racial character and construct the identities of self and other. Foodways interventions to support the rehabilitative goals of correctional facilities are proposed. These data suggest that inmates want to build positive relationships and identities and that prison food systems could do more to help women realize these intentions.
SOCIAL WORK ADMINISTERED HYPNOSIS FOR PATIENTS UNDERGOING BONE MARROW PROCEDURES: A RANDOMIZED CONTROLLED TRIAL
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SOCIAL WORK ADMINISTERED HYPNOSIS FOR PATIENTS UNDERGOING BONE MARROW PROCEDURES: A RANDOMIZED CONTROLLED TRIAL by Alison Snow Advisor: Professor Irwin Epstein This dissertation examines how a social work intervention of brief hypnosis during bone marrow procedures impacts pain and anxiety for adult patients. The study design was a randomized controlled trial with one intervention group and one control group (standard of care). Standard of care (lidocaine injection) was provided to both groups. Adult participants were eligible for participation in this study if they were over eighteen years of age, English speaking, and undergoing bone marrow biopsy and/or aspiration. Study hypotheses predicted that those patients who were randomized to the hypnosis intervention would have significantly lower levels of pain and anxiety. A sample of patients at Mount Sinai Medical Center (n = 80) provided data, which included demographic information. There were 41 patients in the intervention group and 39 in the control group. Results supported the study hypothesis that pain scores would be significantly lower among the experimental group; however, results did not support the hypothesis that hypnosis reduced anxiety associated with the procedure. Pain and anxiety were not significantly associated to demographic variables, such as, gender, ethnicity and age. Participants could not be blinded to the intervention, since the social worker was present during the procedure if the patient received hypnosis. However, the social worker administering the post procedure scales was blinded to what group the patient was randomized to. There were no adverse events or side effects as a result of participation in this study. The unusual role of the social worker as the direct provider and the researcher will be discussed as well as the implications for practice. Funding was provided by the American Cancer Society: Doctoral Training Grant in Oncology Social Work, DSW-10-096-02-SW
What Condoms Can't Cover: Do structural factors predispose Black, African American, and Latina/o Adults in Harlem and the South Bronx to Engaging in HIV Sex Risk Behaviors?
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More than thirty years into the HIV/AIDS epidemic, Black, African American, and Latina/o communities continue to demonstrate the highest rates of HIV/AIDS in the US, accounting for 64% of all new infections and 58% of all AIDS diagnoses in 2009. Despite the longevity of this public health crisis, individually-based behavioral change approaches to HIV/AIDS prevention continue to be the most widely used and funded methods of combating HIV risk in Black, African American and Latina/o communities. These methods have been proven to lower the risk of HIV transmission, but HIV incidence in the US remains high at approximately 50, 000 new infections each year. These stubbornly high new HIV infections reflect a limitation in individual and group-level HIV prevention interventions with regard to enduring behavior change. This dissertation used secondary data analysis to investigate if the structural level factors of homelessness, incarceration, and poverty predisposed Blacks, African Americans, and Latinas/os to engaging in unprotected vaginal or anal sex. Baseline data collected for a NIDA-funded randomized controlled trial that tested the efficacy of a four-session, cognitive-behavioral skills-building HIV prevention intervention with HIV-seronegative non-injection drug users and their network members in Harlem and the South Bronx, was used to assess the relationship between macro-level structural factors and micro-level individual sex risk behaviors. The baseline dataset consisted of a sample of 270 study participants between the ages of 18-59. Sex-risk behavior was measured by the Vaginal Equivalent Episode (VEE), a weighted index of each episode of unprotected oral, vaginal and anal intercourse. Univariate analyses revealed that 74% of the study participants had a history of incarceration, 54% had been homeless in the past three months, and 74% were in receipt of public assistance. Chi-square values for bivariate analyses between the three structural-level variables and unprotected sex were all statistically significant. The final model in stepwise multiple regression illustrated that for every unit increase in income from selling sex, VEE scores increased (â = .155), and for every unit increase in incarceration, VEE scores increased (â = .148) as well. An increase in income from selling sex significantly predicted more episodes of unprotected anal, vaginal and oral sex (p = .033), and an increase in the number of times in jail, prison or a detention center significantly predicted more episodes of unprotected anal, vaginal and oral sex (p = .012). These research findings illustrate a direct relationship between macro-level structures and micro-level sex risk behaviors.
Promoting Feast or Surviving Famine: The Financial Implications of Social Enterprise for Nonprofit Human Service Organizations
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PROMOTING FEAST OR SURVIVING FAMINE: THE FINANCIAL IMPLICATIONS OF SOCIAL ENTERPRISE FOR NONPROFIT HUMAN SERVICE ORGANIZATIONS By Lisa Gale Van Brackle Advisor: Professor Irwin Epstein Increasingly, social workers and line staff of nonprofit organizations are engaged in the management of financial resources (Lohmann & Lohmann, 2008). Although the literature suggests that nonprofit organizations engage in market-based social enterprise activities to generate revenue, the financial consequences of social enterprise on nonprofit organizations is unexplored in the literature. This dissertation "data mines" (Epstein, 2010) the IRS 990 forms of 166 nonprofit organizations that are self identified operators of social enterprises to explore revenue, expenses, net assets and excess/deficits of nonprofits that engage in one or more industry affiliated social enterprises. Transaction cost and resource dependence theories are used to explore how intensity and diversity of social enterprise activity are reflected in the financial disposition of these organizations. The study's findings are mixed: there is evidence that intensity of social enterprise activities and the industries affiliated with this sample of largely human service based organizations both erode and contribute to increased organizational efficiency. Throughout the study, the ability to measure financial performance of nonprofits is a continuous challenge. However, Chang & Tuckman's (1991) financial vulnerability indices prove to be a useful tool to assess the financial condition of these organizations. Both the methodology and findings offer social workers and other students of nonprofit management tools to appreciate the financial levers with nonprofit organizations and insights into the financial structure of nonprofits that engage in social enterprise.
THE INFLUENCE OF HIV RISK CO-FACTORS AND SEXUAL NETWORKS FACTORS ON HIV RISK BEHAVIORS AMONG BLACK MSM
Laurens Van Sluytman
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This project uses the theory of eco-social epidemiology to enhance the social work perspectives on social justice and person in environment to correct the tendency to focus on individual level change interventions in public health and social work in the HIV sectors. In doing so, it moves beyond a single lens exploration of risk factors to a deeper examination of the multiple relationships that exist between risk co-factors, sexual networks and high-risk behavior among Black MSM. Using secondary analysis of data collected during the quantitative phase of the CDC-funded Brothers y Hermanos (ByH) research project (2003-2006), the project explored the structural, socio-cultural, psychological, and behavioral dimensions relevant to understanding risk for transmitting or contracting HIV for 614 MSM who identified as Black among the ByH respondents, of whom 36.3% reported being negative, indeterminate or unaware of their HIV status. A quarter (24.9%) of participants were between 41-45 years of age, followed by age group 46-50 years (18.1%).63% resided in NYC for 21 years or more, with 15.3% having resided in New York for 5 years or less, and 6% residing in the region between 16 - 20 years. Path analysis was used to provide estimates of the magnitude and significance of causal connections between HIV risk cofactors sexual network factors and HIV risk behavior. The analysis found no direct or indirect interactions among HIV risk co-factors and HIV behavior risk factors (UAIr) with the specified model demonstrating poor fit (x2=187.54, df = 45, p =.000), CFI = .007, RMSEA = .072.). Additionally, the analysis found no direct or indirect interactions among HIV risk co-factors, sexual network factors and HIV behavior risk factors (x2= 191.14, df = 88, p =.000), CFI =.808, RMSEA=.044 although the model accounted for almost 81% of variance in UAIr. The findings demonstrate the need to move beyond stereotypic perceptions of Black MSM to a more dynamic appreciation of the interactive aspects of their environments. Second, the findings underscore the need for social workers to act as allies and change agents through research and problem definition. And, they reflect the need for social workers to engage in policy analysis that investigates the significance of changed policies or ineffective interventions that differentially impact poor communities in general and specific members of these communities. The interventions designed to address the disproportionate rates of sero-conversion and transmission of HIV among Black MSM must consider the complex real world phenomena that contribute to these disparities. Interventions require attention to methods and policies that are contextually driven.. Grounded in demands for social justice, it is incumbent upon social welfare to act--by organizing community and challenging existing structural and institutionalized polices. This being the case, we must conduct client assessments that surface important information concerning risks, as well as levels of functioning and interactions within the community, using tools that assist workers to identify service delivery needs over the life span, including education, histories of violence, incarceration, exposure to discrimination and substance use. Lastly, social work must begin to reconceptualize consumer participation and engagement in social work throughout their contact with consumers and engage members of all communities with whom programs are affiliated. Social workers, educators, researchers and organizations must become concerned with the past, present and future biographies of clients and their communities. Best practices must be conceptualized as launch pads to enhancing operations and require the organization to match its technology to the intersection of needs of its stakeholders and their communities.
Being With Difference: Parenting Experiences of Gay Adoptive Fathers
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Increasingly more gay men are becoming parents or desire to become parents. Families headed by openly gay fathers live in environments that are still largely homophobic and heterosexist. This study describes the challenges, opportunities, and rewards gay adoptive fathers experience at home and in their communities. In-depth phenomenological interviews were conducted with gay adoptive fathers from 20 families (18 gay couples and 2 single gay men). Fathers adopted children through both domestic and international routes. The children of the fathers ranged in age from 9 months to 22 years. Using a social constructionist lens and descriptive phenomenological analysis, themes within each interview and across interviews were identified. The men in this study became parents in a society dominated by the beliefs that all children need a female mother, gay men cannot and should not be parents, and homosexuality is morally wrong. Their parenting stories illuminate social landscapes dotted with evolving attitudes towards gay parenting, structural inequities against LGBT communities, and entrenched beliefs about gender, sexuality and family. While some fathers worked with adoption professionals who challenged these attitudes and advocated for same sex parenting, many fathers regularly encountered heteronormative biases in the adoption system. When asked what it was like to parent as gay men, fathers explained that in many respects their day to day experiences were very similar to those of heterosexual parents, and particularly to other adoptive parents. At the same time, they often faced reminders at home and in public spaces that they were not part of a heterosexual order. From sidewalk to airport, hospital to playground, classroom to café, gay fathers and their families drew attention. Fathers regularly encountered questions and comments about the nature of their family. They had to decide if and how to explain themselves or correct others' assumptions, while modeling honesty and pride about their families to their children. Research on families headed by same sex parents has largely focused on the "impacts" gay and lesbian parents have on children's social, emotional and psychological adjustment and the degree to which their families are similar to families with heterosexual parents. The stories shared in this study move beyond such questions and dive into the heart of being with difference and the meanings difference has for gay fathers, their children and those around them. The fathers provide a vivid picture of their emotional bonds with their children and the strengths and resiliencies they and their children develop living in environments that are largely homophobic and heterosexist. With the information provided by this dissertation, practitioners can challenge heteronormative biases in social work practice, education, and public policy. By revealing the insidious ways heteronormativity "shows up", the results prompt social workers to investigate their beliefs about gay male sexuality and intimacy, the primacy of the heterosexual nuclear family, and conventional notions that a child needs both a female mother and a male father. The father's experiences raise provocative practice questions about nurturing and child rearing. The stories urge practitioners to investigate complex and taken for granted notions about gender and parenthood, and help them engage more sensitively with families headed by same sex parents.