Screening of Substance Abuse in Public Welfare and Child Protective Service Clients

The study focuses on the intersection of public education and child protection. The school performance of children in the public education system is strongly influenced by the social environment from which they come to school. The starting point of the research is the legislative background. A comparative analysis of relevant sections of the Public Education Act and the Child Protection Act, examining their synchronization and the enforcement of children's rights, raises questions regarding the extent to which children's rights are upheld in the current legal environment. The historical legal approach of the study highlights that, despite regulatory changes affecting the field of child protection, coherence in terminology between public education and child protection has not been achieved. Children in child protection services, with foster parents, in children's homes, particularly those with special or dual needs, are in a multiply disadvantaged position compared to their peers living in families. Therefore, it is necessary and justified to provide services that, through interprofessional cooperation, can help improve their school performance and resilience. In Hungary, social assistance in kindergartens and schools has been a special social basic service since 2018. The aim of the study is also to draw attention to the current shortages related to specific child needs (e.g., the decreasing number of foster parents) and the possibilities of harmonizing these with child welfare basic services.

<i>Stretched Thin: Poor Families, Welfare Work, and Welfare Reform</i>. By Sandra Morgen, Joan Acker, and Jill Weigt. Ithaca, NY: Cornell University Press, 2010. Pp. 256. $59.95 (cloth); $22.95 (paper).

The purpose of this research was to examine the impact of innovative training for public welfare workers on training outcomes, as well as the individual and organizational mediators of these outcomes. This study surveyed 623 public welfare workers on training satisfaction, knowledge, transfer, individual variables such as personality and learning readiness, and organizational variables such as team and supervisor support of learning. Results indicate that public welfare workers experienced a significant increase of knowledge from pre- to post-training, reaching a mastery level of knowledge. Personality and organizational support of learning were related to training satisfaction, while personality and learning readiness were related to self-reported training transfer. Given the ever-changing policy and practice context of public welfare, training is an essential organizational strategy to promote best practice.

In this chapter, our goal is to discuss the screening tools that currently exist for identifying substance abuse, how they play a role in helping the clinician formulate a diagnosis, as well as their limitations. We will outline key definitions that are important to understand when discussing substance abuse. Ultimately, we hope to increase awareness of the challenges that exist when screening for substance abuse and recognize the need for an efficient, evidence-based algorithm to help guide the clinician.

Although inadequate treatment of pain is a problem for hospice patients, increases in the medical use of opioids have been accompanied by increasing levels of abuse and diversion in the community. Balancing pain relief with concerns about abuse and diversion is a difficult issue for hospices. The aim of this study was to determine policies and practices in Virginia hospices regarding substance abuse and diversion in patients and their families. A survey was conducted of Virginia hospices about policies, perceptions, and training regarding substance abuse and diversion. Twenty-three of 63 hospice agencies responded (36.5%). Less than half (43.8%) required mandatory substance abuse training. Only 43.5% had policies regarding screening for substance abuse in patients; 30.4% had a policy regarding screening for substance abuse in family members. Policies regarding screening for diversion in patients (21.7%), and families (17.4%) were rare. Policies regarding opioid use in patients with a history of substance abuse or diversion were uncommon (33.3%, 30.4%, respectively); 30.4% had policies regarding use of opioids in patients whose family members had a history of diversion or abuse. Thirty-eight percent of hospices agreed that substance abuse and diversion was a problem for their agency, and these agencies were more likely to have written policies or mandatory training. Most Virginia hospices lack mandatory training and policies regarding substance abuse and diversion in patients and family members. More than one-third felt that abuse and diversion were problems in their agencies. A national conversation regarding policies toward substance abuse and diversion in hospice agencies is needed.

The relationship between poverty and child maltreatment has long been addressed in the literature. Disproportionally, children, especially those of color, are more likely to live in poverty than adults. It has been established that the risk of child maltreatment increases the longer impoverishment is experienced. Thus, the likelihood that racial disproportionality may have negative impact upon the child welfare system is potentially increased. Much attention has been given to the overrepresentation of certain children of color within the child welfare system when cared to their representation within the general population. This study explores the intersection of poverty and race upon child maltreatment through the lens of economically disadvantaged families of various racial backgrounds. Implementing a phenomenological approach, focus groups were conducted with economically disadvantaged families sharing their first-hand experiences of parenting with limited means and their views on the intersection of poverty, race, and child maltreatment. The findings point to three primary areas: (1) The strain of managing life with inadequate financial means results in significant strain on poor families; (2) In spite of the ongoing challenges, poor parents exert great efforts to care for their children; and (3) Adding to their challenges, poor families face additional stressors when having to engage with either the public welfare or child welfare systems. Results further indicate six underlying issues adding to the stressors of living in poverty: (1) Challenges of single parenting; (2) Impact of race and racism on poor families of color; (3) Impact of limited funding and other resources within the community; (4) Living with mental health and disabilities; (5) A constant fear of child welfare intervention; and (6) Biased and inconsistent practices within the public welfare and child welfare systems. Finally findings suggest a negative impact to racial disproportionality when child welfare fails to properly understand how to best serve poor families of color.

Simple SummaryHead and neck cancer and its treatment can lead to various functional impairments. We developed and validated an instrument for rapid physician-rated assessment of basic functional outcomes in HNC patients referred to as “head and neck functional integrity scales” (HNC-FIT scales). Six basic HNC-relevant functions were identified and assigned to verbal ratings based on observable criteria. Face and content validity levels were judged adequate in systematic review by 15 experts. Validity, reliability, and responsiveness were assessed in 37 healthy controls and 84 HNC patients. All domains correlated closely with the outcome of corresponding scales of the reference questionnaire, indicating good construct and criterion validity. For all domains, interrater reliability and retest reliability were ≥0.90 and responsiveness was ≥0.15 (p < 0.01). Median completion time for the HNC-FIT scales was <80 s. Thus, the HNC-FIT scale appeared to be a rapid tool for physician-rated assessment of basic functional outcomes in HNC patients with good validity, reliability, and responsiveness.Head and neck cancer (HNC) and its treatment can lead to various functional impairments. We developed and validated an instrument for rapid physician-rated assessment of basic functional outcomes in HNC patients. HNC-relevant functional domains were identified through a literature review and assigned to verbal ratings based on observable criteria. The instrument draft was subjected to systematic expert review to assess its face and content validity. Finally, the empirical validity, reliability, and responsiveness of the expert-adapted Functional Integrity in Head and Neck Cancer (HNC-FIT) scales were assessed in healthy controls and in HNC patients. A matrix of the 6 functional domains of oral food intake, respiration, speech, pain, mood, and neck and shoulder mobility was created, each with 5 verbal rating levels. Face and content validity levels of the HNC-FIT scales were judged to be adequate by 17 experts. In 37 control subjects, 24 patients with HNC before treatment, and in 60 HNC patients after treatment, the HNC-FIT ratings in the 3 groups behaved as expected and functional domains correlated closely with the outcome of corresponding scales of the EORTC-HN35-QoL questionnaire, indicating good construct and criterion validity. Interrater reliability (rICC) was ≥0.9 for all functional domains and retest reliability (rICC) was ≥0.93 for all domains except mood (rICC = 0.71). The treatment effect size (eta-square) as a measure of responsiveness was ≥0.15 (p < 0.01) for fall domains except for breathing and neck and shoulder mobility. The median HNC-FIT scale completion time was 1 min 17 s. The HNC-FIT scale is a rapid tool for physician-rated assessment of functional outcomes in HNC patients with good validity, reliability, and responsiveness.

Kinship caregiving as a paradigm in the United States (US) is historically linked to slavery subcultural practices. Over time, dominant US systems have vacillated in demonstrating formal acknowledgement of kinship as an acceptable family unit and in availing resources to support kinship caregiving. The patterns and practices of these variations pertaining to kinship caregiving as a paradigm has received little attention despite documentation of its increased utilization in public child welfare and welfare systems. This exploratory case study responds to the paucity of knowledge regarding the systemic shifts towards the kinship caregiving paradigm and the perspectives of kinship caregivers who interface with public child welfare and welfare systems during their relative caring episodes. Critical theory is used to explore the impact of privilege and oppression as relates to the variations of the paradigm over time within these systems, as well as to the kinship families’ interactions with the child welfare and welfare systems. Kinship caregivers’ recommendations for child welfare and welfare systems’ improvements are also included in this study. Information gained from this study may assist policy makers, trainers, educators, and practitioners involved in child welfare and welfare agencies enhance these systems towards policies and practices that are culturally responsive and improve services to sustain kinship families.

Objective: This paper presents a clear methodological example for practitioners' evaluation of rapid assessment instruments' psychometric error. Participants: One hundred and twenty nine incarcerated multiple offender drunk drivers were administered 3 rapid assessment instruments. The average age was 39, males comprised 83% and 81% were white. Thirty percent were married; 45% had never married. Method: Receiver Operating Characteristics analysis compared instrument scores to a criterion diagnosis. False positive and false negative rates were graphed, tabled and examined. Findings: All three instruments were reliable (alpha > .85) but subject to false positive and/or false negative diagnostic rates in excess of 14%. Conclusion: Receiver Operating Characteristics analysis is an effective practical methodology for evaluating the performance of rapid assessment instruments in clinical settings allowing practitioners to knowingly manage psychometric error.

To address the question of what social workers employed in public welfare know about group dynamics, which is related to group work, a survey research study was conducted in a major city in Israel. The study's findings showed that in regard to groups the social workers' prior course work, knowledge base in and use of theory, practice experience, and peer consultation were modest. Furthermore, the social workers received little support for studying group dynamics and little inservice training was available. The findings of the study are consistent with those of related studies of social work practitioners' knowledge. The study points to a need for better education and training in public welfare social work in the area of knowledge about group dynamics.

The effect of the availability of Rapid Assessment Instrument (RAI) (1) computer scoring, and (2) computer administration on: (3) counselor behavior, and (4) client outcome was inspected. Counselors without computer assistance employed fewest RAIs with their clients; those with computer scoring available employed more RAIs, and those with computer administration available employed RAIs most frequently. When more RAis were employed, clients improved more in counseling, terminated against medical advice less frequently, and were also more satisfied with their counseling experience.

Accurate measurement is essential for effective social work practice, but doing it well can be difficult. One solution is to use rapid assessment instruments (RAIs), which are brief scales that typically require less than 15 minutes to complete. Some are administered by practitioners, but most are self-administered on paper or electronically. RAIs are available for screening, initial assessment, monitoring of service progress, and outcome evaluation. Some require author permission, others are sold commercially, and many more are free and in the public domain. Selection of an RAI should be based first on its psychometric strength, including content, concurrent, and known-groups validity, as well as on types of reliability such as internal consistency, but practical criteria such as readability are also important. And when used in practice settings, RAIs should be part of a well-rounded measurement plan that also includes behavioral observations, client logs, unobtrusive measures, and other approaches.

Places universal basic income (UBI) in perspective by comparing it to other social assistance interventions, clarifying the analytical and practical differences between various options—including benefit and tax-based measures, and both wage- and nonwage-oriented schemes—then comparing and reviewing benefit structures and identifying comparative advantages and limitations. Social assistance can intend to (1) cover everyone who needs support; (2) provide adequate transfers to households or individuals; (3) prove manageable to finance and administer; (4) garner sufficient societal consensus to maintain political support; and (5) create as many positive and as few negative side effects as possible. But tensions exist among these objectives, and no program scores highly on all. The trade-offs and difficult balance across dimensions account for part of why social assistance remains so varied in different contexts, and why it remains an ongoing area of fervent debate. A UBI offers a possible new social protection system, but its exact definition remains contested.

Child protection or professional self-preservation by the baby nurses? Public health nurses and child protection in Ireland

In this article, the sociological and historical approaches and literatures are synthesized to present the historical background of the treatment that child-abusing and child-killing parents are receiving in the legal system today. The roots of the formation of contemporary institutional responses to severe child abuse and child homicide are traced and latest developments are examined critically. Durkheim’s insights regarding the functions of law are highlighted by pointing out how, throughout history, crimes against children become stand-ins for larger societal problem. The latest innovations in the criminal branch of child protection consist of the specialized prosecution bureaus and court parts dealing with physical and sexual violence against children. Integral to the new developments in child protection are ‘‘multidisciplinary,’’ comprehensive approaches to the processing of criminal cases, involving teams consisting of representatives from the police, the prosecution, public and private social work and child protection agencies, and psychiatric, pediatric, and other medical practitioners and community partners. These developments exemplify heightened focus on criminal prosecution of parental crimes against children, inevitably leading to questions and policy concerns regarding resources geared toward punishment rather than prevention.