Human Service Sector Research Articles

Burnout among employees in human service work: design and baseline findings of the PUMA study

To present the theoretical framework, design, methods, and baseline findings of the first Danish study on determinants and consequences of burnout, and the impact of workplace interventions in human service work organizations. A 5-year prospective intervention study comprising 2,391 employees from different organizations in the human service sector: social security offices, psychiatric prison, institutions for severely disabled, hospitals, and homecare services. Data were collected at baseline and at two follow-ups. The authors developed a new burnout tool (the Copenhagen Burnout Inventory) covering work-related, client-related, and personal burnout. The study includes potential determinants of burnout (e.g. the psychosocial work environment, social relations outside work, lifestyle factors, and personality aspects) and consequences of burnout (e.g. poor health, low job satisfaction, turnover, and absenteeism). Here, the focus is on the description of the study population at baseline, including associations of work burnout with psychosocial work environment scales and absence. Response rate at baseline was 80.1%. Midwives and homecare workers had high levels on both work- and client-related burnout. Prison officers had the highest level on client-related burnout. Supervisors and office assistants had low levels on both scales. Work burnout showed the highest correlations with job satisfaction (r = -0.51), quantitative demands (r = 0.48), role-conflicts (r = 0.44), and emotional demands (r = 0.42). Sickness absence was 13.9 vs 6.0 days among participants in the highest and lowest work burnout quartile, respectively. The findings indicate that study design and methods are adequate for the upcoming prospective analyses of aetiology and consequences of burnout and of the impact of workplace interventions.

Psychosocial Work Characteristics as Predictors for Burnout: Findings From 3-Year Follow Up of the PUMA Study

The objective of this study was to investigate the impact of psychosocial work characteristics on burnout. A total of 1772 participants in different human service sector organizations were eligible for the cross-sectional analyses (baseline) and 952 for the prospective analyses. We measured 14 psychosocial work characteristics and three types of burnout. Linear regression models were used for analyzing associations between psychosocial work characteristics at baseline and burnout at baseline and at 3 years of follow up. Low possibilities for development, high meaning of work, low predictability, high quality of leadership, low role clarity, and high role conflicts predicted burnout at 3 years of follow up after the psychosocial work characteristics were adjusted for each other, potential confounders, and burnout level at baseline. Psychosocial work characteristics were prospectively associated with burnout, suggesting that improving the psychosocial work environment may reduce future burnout in human service work.

Use of Substance Abuse Services by Young Uninsured American Adults

This study examined the prevalence and correlates of substance abuse service use among uninsured young adults aged 18 to 34 years (N=24,282). Data were drawn from the 1999 National Household Survey on Drug Abuse. Logistic regression was used to identify correlates of substance abuse service use among persons who met DSM-IV criteria for dependence. Among uninsured young adults (N=5,067), 66 percent lacked any health care coverage for at least one year. In this uninsured group, 72 percent were past-year users of alcohol or drugs (N=2,335). Among past-year alcohol users (N=2,273), 12 percent met criteria for alcohol dependence; among past-year drug users (N=864), 21 percent met dependence criteria. Eighty-seven percent of the uninsured young adults with alcohol or drug dependence did not receive any substance abuse treatment services in the previous year. In the uninsured substance-dependent group, women, blacks, and Hispanics were less likely than men and whites to use substance abuse services. Among those with substance dependence, uninsured persons were more likely than privately insured persons to receive substance abuse services from the self-help or human service (nonmedical) sector. Racial, ethnic, and gender disparities in the use of substance abuse services are notable among young adults who lack health insurance.

The Copenhagen Burnout Inventory: A new tool for the assessment of burnout

So far, the large majority of studies on burnout in the international literature have employed the Maslach Burnout Inventory (MBI). In this paper we criticize the MBI on a number of points and present a new tool for the measurement of burnout: the Copenhagen Burnout Inventory (CBI). The CBI consists of three scales measuring personal burnout, work-related burnout, and client-related burnout, for use in different domains. On the basis of an ongoing prospective study of burnout in employees in the human service sector, the PUMA study (Project on Burnout, Motivation and Job Satisfaction; N=1914 at baseline), we analysed the validity and reliability of the CBI. All three scales were found to have very high internal reliability, and non-response rates were small. The scales differentiated well between occupational groups in the human service sector, and the expected pattern with regard to correlations with other measures of fatigue and psychological well-being was found. Furthermore, the three scales predicted future sickness absence, sleep problems, use of pain-killers, and intention to quit. Analyses of changes over time showed that substantial proportions of the employees changed with regard to burnout levels. It is concluded that the analyses indicate very satisfactory reliability and validity for the CBI instrument. The CBI is being used in a number of countries and translations into eight languages are available.

Unique issues in research and evaluation in rural and remote locations: Is there a place for specific research training?

There is increased interest in building research capacity in rural health research in Australia and internationally. In Australia, the Primary Health Care Research Evaluation and Development program funded by the Australian Government has supported this move. Overall this program aims to build the quantum of primary healthcare research to underpin clinical practice, health systems improvement, and policy. In order to achieve this objective, one strand of the program aims to build research capacity among practitioners. In implementing this program in rural and remote areas of the west of South Australia, the Spencer Gulf Rural Health School has identified methodological and research design issues faced by practitioners who are researching in their communities. These issues include problems encountered in living and researching in the same location and accessing small-scale statistical information. We were interested to know whether there was interest in a formal course (Rural Research and Evaluation) that would address these issues and provide information about community-based research designs. A cross-sectional anonymous survey was designed and sent to 141 organisations in the health, human service, and local government sectors in regional South Australia. Respondents were asked to evaluate the demand and interest for a new course--Rural Research and Evaluation. The term 'rural' was used to refer to both rural and remote locations. Information was sought on the respondent's role in the organisation, current level of research participation, views about the proposed course content, and factors that the respondent thought would facilitate or inhibit their participation. The majority of questions were close-ended. Sixty surveys were returned giving a 42.5% response rate. Data were analysed using descriptive statistics. A high level of research and evaluation activity was reported with 80% of respondents undertaking research or evaluation as part of their professional role. There was also agreement that all the proposed topics were important to be included in a course. Each of the topics was ranked at four or five on a five-point scale by at least 58% of respondents. The topic 'understanding evaluation methodologies' was ranked at four or five by 85% of respondents, making it the most highly ranked topic. There was also consensus about the features respondents thought would make the course attractive for them to study. Over half (62%) of the respondents ranked having lecturers with a broad rural research background at five, very important, on a five-point scale. Almost half (48%) of the respondents ranked online delivery at five, a very important factor in making the course attractive to study. Those interested in research and evaluation may have been more likely to return the survey and there may have been respondent bias in this regard. Therefore the results must be interpreted with caution. However, the level of agreement with the proposed course topics may suggest that these reflect important issues in undertaking research and evaluation in rural and remote locations. If this is the case there is value in discussion about how these issues are dealt with in different contexts in order to overcome some of the barriers to effective research.

Meeting the Needs of Rural Families in Times of Crisis

In 2003 qualitative research investigated the role of Rural Family Support Worker (RFSW) within Central Queensland. Catalyst for the study was the perception that Departmental funding criteria were not keeping abreast of community needs and expectations. The findings from this project offer an ideal opportunity to review the funder/ purchaser/provider model in practice in Australia. Key issues arising are: the appropriateness of this model for service delivery in rural communities and its effectiveness in meeting the expectations of all the stakeholders connected to the Rural Family Support (RFS) system.This paper examines views espoused in the literature and perspectives put forward by a range of Human Service Sector Professionals, Departmental staff, clients of the RFSWs and the RFSWs themselves. It identifies areas where a more proactive and collaborative approach between contractual partners will ensure the RFS program can better meet the needs of rural families in times of crisis.

What Factors Affect the Entry and Exit of Nonprofit Human Service Organizations in Metropolitan Areas?

The goal of this article is to advance the literature on nonprofit organizational adaptation by assessing the factors that significantly contribute to the entry and exit of human service organizations in metropolitan areas. More specifically, this study uses nonprofit, economic and demographic data and information on welfare reform implementation patterns to examine the causes of the formation and deaths of groups in the nonprofit human service sector from 1992 to 1996. This time frame marked the widespread implementation of welfare reform under the federal Aid to Families With Dependent Children (AFDC) waiver program. This study found that organizational size, age, and service activities are the key determinants in the failure of human service nonprofits, whereas environmental factors such as AFDC waiver implementation relate to the widespread formation of nonprofit providers.

Capacity building in human service organizations

AbstractThe health and vitality of the human service sector will be shaped much less by external trends and crises and much more by the ability of boards and executives to develop new visions of leadership and organizational capacity.

Organizational Response in an Era of Welfare Reform: Exit and Entry Patterns of Human Service Providers

Predicated on the tenets of program devolution and privatization, welfare reform initiatives increasingly shift the responsibility for providing human services to the private sector. But they also implicitly rely on the effective adaptation of private organizations to new environmental conditions. To achieve the policy goals of welfare reform, nonprofit human service providers are expected to adjust to changing funding and service regimes. But nonprofit responses to welfare reform initiatives have largely escaped examination, even though reform plans raise important questions for the stability, capacity, and composition of the nonprofit human service sector. Given that human service nonprofits are vital in moving people from welfare to work, analyzing the responsiveness of the nonprofit human service sector to welfare policy shifts is critically important. This research advances the literature on organizational responsiveness by assessing the adaptive strategies of the nonprofit human service sector to welfare reform. More specifically, the study uses nonprofit, economic, and demographic data, along with information on welfare reform implementation patterns, to examine the entry and exit of organizations in the nonprofit human service sector from 1992 to 1996. This time frame marked the widespread implementation of welfare reforms under the federal Aid to Families with Dependent Children (AFDC) waiver program. Using as the units of analysis large, intrastate metropolitan areas to study rates of nonprofit entry, and individual nonprofits to assess determinants of organizational exit, the research explores several key questions pertaining to the response of human service nonprofits to welfare reform experimentation. The research yields several important findings regarding the changing composition of nonprofit human service sectors in metropolitan areas. First, the nonprofit human service field grew dramatically between 1992 and 1996 and had a growth rate that substantially outpaced the expansion of the rest of

Hospital restructuring in smaller urban Ontario settings: unwritten rules and uncertain relations

Important changes are underway in the management and provision of welfare service activities in advanced capitalist societies as governments scale back their responsibilities and commitments to social security and health care. In order to understand the processes by which the reform imperatives of the central state are implemented at the local level, it is necessary to account for particular organizational and place-based contingencies which influence decision making and strategic response. This paper presents a framework for understanding the context of executive decision making in the human services sector and uses the framework to illustrate issues of locally designed hospital restructuring in smaller urban centres in the province of Ontario, Canada. Specific experiences of the Chief Executive Officers of two non-metropolitan hospital settings are examined to explore the unwritten rules of hospital conduct and the relations of uncertainty that characterize efforts to restructure hospital services through formal arrangements with other independently governed hospitals and health care delivery organizations.

Violent women: questions for feminist theory, practice and policy

Women who enact violence, by their very existence, pose a number of challenges for feminist theory, direct service practice and policy development and delivery in the human service sector. This article presents a number of issues on violent women that emerged from a series of focus groups and individual interviews with human service workers. 1The article explores the theoretical, practice and policy issues which were identified by workers. It begins from a position of honouring the knowledge and skills of workers, while not seeking to offer definitive conclusions as to appropriate service responses to women who are violent. The article suggests that future theoretical engagements and policy responses to violent women could benefit from critical engagement with the many issues raised by workers.

The demand-control model : specific demands, specific control and well-defined groups

The purpose of this study was to test the Demand-Control Model (DCM), accompanied by three goals. Firstly, we used alternative, more focused, and multifaceted measures of both job demands and job control that are relevant and applicable to today's working contexts. Secondly, this study intended to focus on particular demands in human services work and to incorporate these demands in the DCM. Finally, this occupation-based study investigated relatively large well-defined subgroups compared to a total sample. Workers from five human service sectors (n = 2,485) were included in a cross-sectional survey (i.e., health care, transport, bank/insurance, retail trade, and warehouse). Results showed that job demands and job control are able to show several interaction effects on employee well-being and health, but only in specific occupational groups. In conclusion, the current findings provide renewed empirical support for the view that high-strain jobs (high demand, low control) are conducive to ill health (i.e., emotional exhaustion, psychosomatic health complaints). Further, it appears that active jobs (high demands, high control) give rise to positive outcomes (i.e., job challenge, job satisfaction).

Internal Control and Accountability in Non‐profit Human Service Organisations

The welfare state regime operative in Australia is highly dependent on the non‐profit human services sector. The sector, as an organisational field, has had a series of characteristics applied to it, which assume its superiority over government in many aspects of service delivery. Nevertheless, knowledge about the internal functioning of non‐profits is poor. This article presents an initial exploration into one aspect of internal functioning, internal monitoring and control, suggesting that internal mechanisms for control are weak. As welfare state regimes in Europe and North America are restructured, different models of service financing and delivery are being imported into Australia. This article begins to sketch the organisational conditions onto which developing models are being applied, providing an initial base for informed commentary and evaluation.

Singer, services and software

It is more than 40 years ago that Hans Singer published his celebrated paper on the “Distribution of Gains between the Investing and Borrowing Countries”. This article reexamines his hypothesis that the gains from foreign investment tend to be distributed heavily in favor of the investing countries in the context of India's fast-growing computer software sector. It identifies the proximate reasons for the birth and growth of a human capital-intensive service sector in a poor country and raises issues concerning its costs and benefits to the economy. It suggests that investments in services, such as software, too can result in export enclaves with very little forward and backward linkages with the rest of the economy in which they are located.

DEINSTITUTIONALISED OR REINSTITUTIONALISED? DEVELOPMENTS IN THE NONPROFIT HUMAN SERVICES SECTOR

Recent developments in the environment surrounding the nonprofit human services sector in Australia have been viewed with some concern, especially given the role of the sector within the Australian welfare state. This paper reviews these developments, noting that some are less visible than others, and that the process of change is more widespread than often perceived. By explicitly employing a theoretical framework derived from organisational theory the paper argues that the contemporary experience of the sector, characterised as the existing institutional order of the field, is set to undergo substantial revision as it is incorporated within an emerging new institutional order of the market and the state as market.

Strategic Administration of Nonprofit Human Service Organizations

Rapid and unprecedented changes in our modern society have created extremely turbulent environments for nonprofit human service organizations. These changes threaten to transform the very nature of our business in ways difficult to predict and prepare for. The author examines the collective views of 21 purposely sampled executive directors in the city of Baltimore, Maryland on the future of the nonprofit human services sector. In 1 hour face-to-face interviews, subjects were asked to respond to three questions. What major trends will impact the nonprofit sector in the near future? What potential impact do you see these trends having on the nonprofit sector? What strategies would you recommend that executive directors take today to ensure success of their organization in the future? Narrative responses to each question were aggregated, organized into dominant views, and summarized. Subjects identified a host of social, political, economic, and technological trends that will have major effects on the future of the nonprofit sector. Subjects recommend a variety of tactics for helping an agency respond successfully to these forces. These tactics emphasize three critical areas of strategic administration: planning, management, and leadership.

Perspectives on Racism and the Human Services Sector: A Case for Change

Perspectives on Racism and the Human Services Sector: A Case for Change

Children's mental health service use across service sectors.

This DataWatch explores the roles of human service sectors (mental health, education, health, child welfare, and juvenile justice) in providing mental health services for children. The data are from the first wave of the Great Smoky Mountains Study of Youth, a population-based study of psychopathology and mental health service use among children. The results show somewhat higher rates of mental health service use than has been reported previously, while continuing to show a substantial amount of unmet need, even among children with both a psychiatric diagnosis and functional impairment. The findings point to a significant role for the education sector, suggesting that schools may function as the de facto mental health system for children and adolescents.

The Changing Character of Behavioral Assessment and Treatment: A Historical Introduction and Review of Functional Analysis Research

This paper presents a brief introduction to the historical development of functional analysis as an important pretreatment assessment and analysis strategy for treating academic and social behavior problems. Studies considered to be seminal or influential are reviewed to highlight the historical and contemporary refinement of functional analysis methodologies. Conclusions are presented in terms of functional analysis' conceptual and methodological impact on behavioral assessment and treatment, and its advancement into various human service sectors concerned with the care of individuals with special needs.

Organizational Image Assessment in the Health and Human Services Sector1

Five studies were conducted from 1976 to 1984 in southcentral Pennsylvania to evaluate the potential of bipolar ratings by adult user populations for assessing the general agency and/ or specific program image of service organizations in the not‐for‐profit sector. Statistically reliable differences in mean ratings on scales such as staff qualifications, physical accessibility, and so forth were found to distinguish image profiles and the clarity of image of three human service agencies within the same region of service, to detect change over a 6‐year period in the image of individual agencies, and to be sensitive to the effects of management actions designed to modify the image of an in‐patient psychiatric facility within a region. The demonstration that specific management interventions over a 2‐year period were detectable by ratings along specifically relevant dimensions encourages the immediate application of this inexpensive feedback device by managers of human service agencies and the further investigation of user image ratings as a system output potentially amenable to control system analyses.