Alumni Dissertations

 

Alumni Dissertations

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  • The policy conflict between syringe exchange programs and policing practices in the United States, and its influence on the health risk behaviors of injecting drug users: a quantitative assessment

    Author:
    Daliah Heller
    Year of Dissertation:
    2010
    Program:
    Social Welfare
    Advisor:
    Mimi Abramovitz
    Abstract:

    Since the early years of the twentieth century, developments in United States (US) drug policy have cycled between tolerance for drug use, on the one hand, and restraint to prevent drug use, on the other (Musto, 1999). In the 1980s, AIDS emerged, just as neoliberalism grew to dominate the national policy agenda, reinforcing normative social standards with coercion and punishment (Abramovitz, 2004). With evidence for injecting drug users' particular vulnerability to HIV infection, advocates introduced syringe exchange programs to reduce the epidemic's escalation. A conflict in drug policy persists for these programs, however. Most programs operate in states where syringes remain criminalized, and where syringe possession is authorized only as a public health emergency. The results of this conflict are evident `on the streets,' in encounters between police officers and injecting drug users participating in syringe exchange programs. This study examines the experiences of injecting drug users with police `on the streets,' aiming to understand which individual characteristics of injecting drug users influence the likelihood for and severity of police encounters. The literature suggests the negative influence of these encounters on the health risks experienced by this population. Secondary analysis was conducted with an existing dataset of injecting drug users participating in US syringe exchange programs. Three characteristics of respondents - recent homelessness (street, and `other place') and recent illegal income - were leading predictors for two scales assessing police encounters, measuring the likelihood and severity of encounters, respectively. Findings from this analysis suggest opportunities for policy development. In some cities, law enforcement has become involved with human services partnerships, addressing homelessness as a social problem rather than a crime. Introducing syringe exchange programs into these `helping' relationships could radically improve the experiences of homeless injecting drug users, while re-shaping the social environment developed by US drug policy. Syringe deregulation could accomplish this goal at the structural level, with legislative change.

  • I Didn't Consent to That: secondary analysis of discrimination against BDSM identified individuals

    Author:
    Larry Iannotti
    Year of Dissertation:
    2014
    Program:
    Social Welfare
    Advisor:
    Sara Jane Dodd
    Abstract:

    Sadomasochism (BDSM) sexual behavior is an understudied phenomenon within the social sciences generally, and social work in particular. While BESM sexuality encompasses a wide variety of activities a community of individuals interested in BDSM is identifiable and has coalesced around organized groups, events, political activism, and shared sexual interests. This community has experienced discrimination, violence, and harassment (DVH) as a result of social approbation and stigma associated with BDSM practices. The study examines results of a secondary analysis of data from the Survey of Violence & Discrimination against Sexual Minorities, conducted in 2008. Severity and frequency of various types of DVH are explored and relationships between demographic characteristics, BDSM activities, and frequencies of DVH are examined. An emancipatory social work frame is used to contextualize the results of the analysis and implications for both practice and policy are discussed.

  • Older Adult Sexuality: Measuring Healthcare Provider Knowledge, Attitudes, and Behaviors

    Author:
    Stephanie Jacobson
    Year of Dissertation:
    2013
    Program:
    Social Welfare
    Advisor:
    Harriet Goodman
    Abstract:

    Healthcare provider practices around older adult sexuality are increasingly the focus of scholarship. Researchers use available scales to study health worker knowledge and behavior in their research. This dissertation argues the need for a new scale, because the available measures are dated and do not account for changes in attitudes and medical advances over three decades. After a review of the increasing role of physicians, social workers, and other health workers providing care for sexual issues throughout history, I describe available scales for measuring knowledge and behaviors about older adult sexuality and review research that employs them. The purpose of the dissertation was to develop a contemporary measure regarding older adult sexuality practices among health workers. I utilized a two-phase plan following Bowen and Guo's 12-step mixed-method approach for scale development (2012). Phase I included a literature review and qualitative interviews with experts on older adult sexuality regarding the construct. Then I created a universe of items, reviewed them with the experts, and revised items. In Phase II, I tested the items with 155 healthcare providers and conducted analysis for reliability and validity. Based on the analysis, I culled items to create a shortened scale. I proposed a scale consisting of 52 items with three subscales: a 25-item Knowledge subscale, a 13-item Attitude subscale, and a 14-item Behavior subscale. The Knowledge subscale showed poor internal reliability (KR-20 = .625). The Attitudes (α = .825), and Behavior (α = .837) subscales showed good internal reliability. I also evaluated content validity and criterion-related validity for the subscales. Flaws in the methods and analysis make the 52-item proposed scale conceptually unsound. Limitations in generating the pool of items, evaluating the items, and testing reliability and validity did not produce a viable scale. I analyze problems with the methodological approach and propose a redesign that corrects for flaws in the approach employed here. I will use an inductive, social justice model that expands scale development to include interviews with practitioners and older adults. I conclude with a number of research, practice, and policy implications that will result from a redesigned scale.

  • Becoming a Transdisciplinary Practitioner: Paradigms and Potlatches

    Author:
    Richard Kahn
    Year of Dissertation:
    2012
    Program:
    Social Welfare
    Advisor:
    Irwin Epstein
    Abstract:

    Abstract BECOMING A TRANSDISCIPLINARY PRACTITONER: PARADIGMS AND POTLATCHES By: Richard Kahn Adviser: Professor Irwin Epstein The goal of the dissertation is to show how biomedically trained allied health professionals, nurses and a physician learned how to integrate psychological paradigms into their biomedical practice paradigms to become transdisciplinary practitioners. Semi-structured recorded interviews were held with 14 graduates of the Infant-Parent Study Center of the Jewish Board of Family and Children Services (IPSC). The interviews were conducted using a constructivist approach. The responses were organized into a narrative. A new definition of transdisciplinarity had to be created in order to describe the learning process. Prior to enrolling in the IPSC, the respondents had conscious and unconscious drives to practice clinical psychology which led to professional isolation, some training in psychology, mentors and peak experiences about integrating mind and body. Respondents first felt alienated by the specialized psychological knowledge and discourse of the teachers and the majority of students. They kept silent until they discovered that they possessed specialized knowledge needed by the mental health workers. Peak experiences related to training occurred. After graduating, the respondents felt part of a practice community. They acquired the ability to think in two epistemological, physical and psychological, to understand and treat complex clinical problems. Graduates also became organizational change agents in line practice, universities and social service systems. Peak experiences appear to have ceased upon realization of psychologized practice. The learning process entails creating a dual paradigm mindset that concurrently accommodates biomedical and psychological epistemologies rather than a single transdisciplinary viewpoint as anticipated by the IPSC. The learning process at the IPSC can be compared to a First Nation Haida potlatch exchange ritual. Biomedical practitioners being trained in clinical psychology need support in crossing the epistemological divide that separates biomedical from psychological practice. The transition will be faster if; 1: trainers encourage biomedically trained to students to value their own professional experience before taking on the new information thought process; and, 2) tell students from biomedical professions that mental health professionals use a contrasting practice paradigm .

  • A Systematic Review of the Literature on the Effects Of School Bullying from the Framework of Jurgen Habermas's Theory of Communicative Action

    Author:
    Gary Kogan
    Year of Dissertation:
    2011
    Program:
    Social Welfare
    Advisor:
    Mimi Abramovitz
    Abstract:

    This project is a systematic review of the US quantitative, empirical studies on the effects of school bullying for the purpose of determining the degree to which Jurgen Habermas's social theory, the theory of communicative action, can be used to understand the constellation of measured effects. School bullying is defined as a systematic abuse of power: the empirical literature on school bullying, therefore, provides a large data set on the abuse of power. The review finds strong consistency between the theory and the results of selected studies suggesting that Habermas's theory of communicative action can explain and predict the mechanisms through which the bullying experience can affect the targeted child.

  • Social Worker Attitudes Towards Recovery Among People With Serious Mental Illness

    Author:
    Debra Kram-Fernandez
    Year of Dissertation:
    2011
    Program:
    Social Welfare
    Advisor:
    Harriet Goodman
    Abstract:

    Growing numbers of researchers are studying mental health practitioners' adoption of the Recovery Perspective and its operational model, Psychiatric Rehabilitation. However, they have not studied social workers, even though they provide the majority of services to seriously mentally ill consumers (SMI). This study examined social worker's practices, goals, and adoption of the Recovery Perspective and Psychiatric Rehabilitation. From a random sample of 3,000 National Association of Social Work (NASW) New York State members, 441 completed paper and pencil surveys that included two measures, the Recovery Knowledge Inventory (Bedregal, Davidson & O'Connell, 2006) and the Psychiatric Rehabilitation: Beliefs, Goals and Practices Scale, (Casper & Oursler, 2003). The majority of subjects (67%) worked with SMIs for over ten years. Only 21% reported employment in restrictive settings including in-patient, day hospital, or continuing day treatment; over 100% reported primary or secondary employment in less restrictive settings including clinics, private practice, or other. Sixty-one percent had a close friend or family member with SMI. Pluralities reported subscribing to a psychodynamic (42%) or cognitive-behavioral (47%) theoretical frame of reference. I found a high level of positive response consistent with the Psychiatric Rehabilitation and Recovery Perspectives. Those who selected "Other" as their theoretical framework endorsed the models more than those who selected "Psycho-dynamic." Private practitioners were less likely to endorse the models; those working in Continuing Day Treatment Program were more likely to endorse them. Sub-scales in the two instruments suggested that New York State NASW social workers embraced the ideals of both models, but were less likely to practice in recovery-oriented ways. In New York State, social workers adhere to model's ideals, but may not practice according to their principles. Those more inclined to practice from these principles were not in mainstream treatment roles, but employed approaches that are more flexible. Social workers in clinics, where New York State promotes this type of treatment, were least likely to practice this way. Implications for social work education are profound, since schools are the locus of professional preparation. Particularly since younger workers were less likely to endorse the models, current educational practices appear inconsistent with regulatory regulations.

  • Multidisciplinary Clinical Consultation in Child Protection: Contextual Influences and Stakeholder Perceptions of Best Practices

    Author:
    Marina Lalayants
    Year of Dissertation:
    2010
    Program:
    Social Welfare
    Advisor:
    Irwin Epstein
    Abstract:

    Presented in this study are "best practices" drawn from a multi-method examination of an innovative multidisciplinary clinical consultation program in a large, governmental child protection agency. Experiences of multiple key stakeholders (N=90) were studied through in-depth qualitative face-to-face interviews and were combined with quantitative data-mining of available consultation records (N=1,455) and ethnographic observation in order to derive organizational dimensions and practices associated with successful program implementation. Using the program development theory by Tripodi, Fellin, and Epstein (1977) and Bielawski and Epstein (1984), the study described and evaluated the evolution of the multidisciplinary clinical consultation practice through the four stages of program initiation, contact, implementation, and stabilization. More specifically, this organizational case study portrays the collaborative process between clinical consultation teams, comprised of domestic violence, substance abuse, and mental health consultants and a team coordinator, and child protective caseworkers and supervisors; knowledge integration of domestic violence, mental health, and substance abuse in child protective work; contextual, structural, and organizational differences and influences; impact of collaboration on child protective staff and their decision-making about the cases; factors contributing to and inhibiting collaborations; strategies for overcoming the challenges in collaborations; and implications for practice. The study findings suggest that multidisciplinary collaboration is multidimensional, interactional, and developmental. Many factors contribute to shaping "best practice" in multidisciplinary collaboration in child protection. These factors are interactional in nature and may facilitate or undermine collaborative practices. Synthesizing data from the study findings, six factors were identified as most important in achieving a best practice: preplanning, commitment, communication, strong leadership, understanding the cultures of collaborating agencies, and structural supports and adequate resources for collaboration. The strategies to achieve them must include efforts at dual levels: individual and organizational. Although the data were drawn from only one program, the issues uncovered and generalizations drawn are consistent with research in other organizational environments suggesting that the types of difficulties experienced in the collaborative process may be highly transferable and strategies for improving collaborative practices may be applicable to a variety of settings.

  • Multidisciplinary Clinical Consultation in Child Protection: Contextual Influences and Stakeholder Perceptions of Best Practices

    Author:
    Marina Lalayants
    Year of Dissertation:
    2010
    Program:
    Social Welfare
    Advisor:
    Irwin Epstein
    Abstract:

    Presented in this study are "best practices" drawn from a multi-method examination of an innovative multidisciplinary clinical consultation program in a large, governmental child protection agency. Experiences of multiple key stakeholders (N=90) were studied through in-depth qualitative face-to-face interviews and were combined with quantitative data-mining of available consultation records (N=1,455) and ethnographic observation in order to derive organizational dimensions and practices associated with successful program implementation. Using the program development theory by Tripodi, Fellin, and Epstein (1977) and Bielawski and Epstein (1984), the study described and evaluated the evolution of the multidisciplinary clinical consultation practice through the four stages of program initiation, contact, implementation, and stabilization. More specifically, this organizational case study portrays the collaborative process between clinical consultation teams, comprised of domestic violence, substance abuse, and mental health consultants and a team coordinator, and child protective caseworkers and supervisors; knowledge integration of domestic violence, mental health, and substance abuse in child protective work; contextual, structural, and organizational differences and influences; impact of collaboration on child protective staff and their decision-making about the cases; factors contributing to and inhibiting collaborations; strategies for overcoming the challenges in collaborations; and implications for practice. The study findings suggest that multidisciplinary collaboration is multidimensional, interactional, and developmental. Many factors contribute to shaping "best practice" in multidisciplinary collaboration in child protection. These factors are interactional in nature and may facilitate or undermine collaborative practices. Synthesizing data from the study findings, six factors were identified as most important in achieving a best practice: preplanning, commitment, communication, strong leadership, understanding the cultures of collaborating agencies, and structural supports and adequate resources for collaboration. The strategies to achieve them must include efforts at dual levels: individual and organizational. Although the data were drawn from only one program, the issues uncovered and generalizations drawn are consistent with research in other organizational environments suggesting that the types of difficulties experienced in the collaborative process may be highly transferable and strategies for improving collaborative practices may be applicable to a variety of settings.

  • Social workers facing stress and the coping strategies they use: A secondary analysis

    Author:
    Nilde Leo
    Year of Dissertation:
    2011
    Program:
    Social Welfare
    Advisor:
    Irwin Epstein
    Abstract:

    In the immense literature on stress in healthcare, social workers have been poorly represented. This dissertation examines the relationship between stress, perception of stress at work (PSW), and coping strategies through the analysis of a secondary data gathered from a national sample of social workers participating in the NASW 2007 national survey. Several coping strategies (i.e., complimentary alternative medicine (CAM) or meditation/yoga, exercise, therapy/medication and avoidance) are examined as potential moderators of the relationship between stress and PSW. Results indicate that over 50% of social workers in this study report the experience of stress on the job and that the stress is significantly related to perceived organizational stressors and safety concerns at work. The literature in mindfulness based stress reduction (MBSR) research supports engagement in meditation and yoga as a means to reduce levels of overall stress. However, this was not supported by the current study. Bi-variate and multivariate analyses were conducted to explore the relationship between these variables and their association to stress. At the multivariate level, hierachical binary logistic regression indicated that CAM did not moderate the relationship between stress and PSW at a statistically significant level. However, an analysis of main effects did reveal that exercise held a negative association to stress while considering PSW. However, when safety concern was controlled for in the model, exercise no longer provided a buffering effect to stress in the presence of PSW. This study supports the notion that stress related to work conditions does indeed exist for practicing social workers and that the coping strategies they use are not providing enough of a relief from this stress. Further research related to organizational interventions and individual strategies to cope with stressors needs to be conducted in order to insure a healthier workforce.

  • INTERGROUP DIALOGUE: AN EVALUATION OF A PEDAGOGICAL MODEL FOR TEACHING CULTURAL COMPETENCE WITHIN A FRAMEWORK OF SOCIAL JUSTICE IN SOCIAL WORK PROGRAMS

    Author:
    Mayra Lopez-Humphreys
    Year of Dissertation:
    2011
    Program:
    Social Welfare
    Advisor:
    Mimi Abramovitz
    Abstract:

    A quasi-experimental, non-equivalent comparison group design with pre, post and follow-up survey data was used to evaluate the effectiveness of an intergroup dialogue intervention on bachelor of social work (BSW) students' levels of cultural competence and social justice behaviors. The sample of convenience consisted of 115 who identified as social-work majors and participated in diversity courses, 76 were intergroup dialogue participants (Site IGD) and 39 were not (Site non-IGD). Five specific questions were explored in the study. All 115 participants completed Lum's (2007) Social Work Cultural Competencies Self-Assessment and the Confidence in Confronting Injustice Sub-Scale (Multi-University Intergroup Dialogue Research project Guidebook, n.d.) at the beginning and end of the course. Intergroup dialogue participants also completed Nagda, Kim, and Truelove's (2005) Enlightenment and Encounter scale at the end of the course, as well the Roper's Political Questions and the Confidence in Confronting Injustice Sub-Scale at the end of the course and one year later. The students who received the intergroup dialogue model displayed significantly greater improvement in the cultural competence area of awareness than students who did not receive the intervention. Students who received the intergroup dialogue model also showed a significant increase in social justice behavioral outcomes a year after course participation. The cultural competence area of knowledge acquisition showed change scores that were greater than Non-IGD participants, although not at a significant level. Lastly, mean confidence in confronting social justice changes scores were also higher for the IGD group, although the differences were not significant. The study offers empirical research in determining effective teaching strategies for improved cultural competence within a social justice framework, highlighting the intergroup dialogue model. The data suggests that through enhanced educational experiences with models of intergroup dialogue, levels of culturally competence and social justice behavioral outcomes among social work students will improve.