Paraprofessional Group Research Articles

Family support in practice: voices from the field

ABSTRACTThis paper revisits core family support messages for social work practice in working with children and families, linking to findings from high-profile child protection cases in the UK and the Republic of Ireland. Drawing on a comparative study where these identified practice messages were explored through the lens of testimony of family support workers in the UK and Ireland, these core messages are examined. Operating with hard-to-engage children and parents, we hear how families and family support worker colleagues now view the core functions of child and family work across both jurisdictions (Ireland and England). The authors argue that by naming a more detailed set of practices that are deemed as most useful by families, based on the benefits and challenges of intensive family support work, key messages arise that have major resonance for social work and multiagency practice into the future. A basic message from this study is that valuable lessons on engagement and intervention with families can be drawn for professionals by examining the practice elements of this group of paraprofessionals in the child and family arena. This paper adds to debates on the role of support and intervention in social work and family support work.

The paradox of higher vocational education: the teaching assistant game, the pursuit of capital and the self

This article discusses the reasons offered by one group of paraprofessionals to explain their decision to study for a work-related higher education programme. It reports on an ethnographically inspired piece of research that aimed to capture the initial motives that a group of teaching assistants had for studying for a Foundation degree at a post-1992 university. This group of students were largely female mature students, who were also overwhelmingly mothers with dependent children. It is suggested that Bourdieu’s concepts of field, capital, habitus and illusio can be utilised to understand why these learners become motivated to enter higher vocational education. Workplace change and the pursuit of capital are highlighted as being a catalyst for the fracturing of illusio, career switching and undergraduate study. Somewhat counterintuitively, virtually all the students indicated that they had decided to study for a qualification that was primarily designed to help them succeed in their existing employment role as a means of acquiring a new occupational role and version of self.

Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in South Africa

Children and families affected by HIV are at considerable risk for psychological distress. Community-based home visiting is a common mechanism for providing basic counseling and other services to HIV-affected families. While programs emphasize home visitor training and compensation as means to promote high-quality service delivery, whether these efforts result in measurable gains in beneficiaries' well-being remains largely unanswered. This study employs a longitudinal quasi-experimental design to explore whether these kinds of investments yield concomitant gains in psychological outcomes among beneficiaries. Baseline and follow-up data were collected over a two-year period from children aged 10–17 at the time of program enrollment and their caregivers, with 80% retention. In this sample of 1487 children and 918 caregivers, the psychological health outcomes of those enrolled in programs with home visitors who receive intensive training, organizational support, and regular compensation (termed “paraprofessional”) were compared to those enrolled in programs offering limited home visiting services from lay volunteers. Applying multilevel logistic regression, no measurable improvements were found among paraprofessional enrollees, and three outcomes were significantly worse at follow-up regardless of program model. Children's behavior problems became more prevalent even after adjusting for other factors, increasing from 29% to 35% in girls and from 28% to 43% in boys. Nearly one-quarter of girl and boys reported high levels of depression at follow-up, and this was a significant rise over time for boys. Rates of poor family functioning also significantly worsened over time, rising from 30% to 59%. About one-third of caregivers reported high levels of negative feelings at follow-up, with no improvements observed in the paraprofessional group. Results highlight that children's and caregivers' psychological outcomes may be relatively impervious to change even in paraprofessional home visiting models. Findings underscore the need for programs serving HIV-affected families to add focused evidence-based psychological interventions to supplement traditional home visiting.

The learning experiences of health and social care paraprofessionals on a foundation degree

Foundation degrees have been developed in the UK as a means of meeting the learning needs of paraprofessionals in health and social care and the services within which they work in a cost‐effective fashion. Workplace learning is an intrinsic component to these degrees. Taking a socio‐cultural perspective, this paper examines how the students’ workplaces, life circumstances and sense of career trajectory shaped their learning experience and motivation. A small‐scale evaluation study, using semi‐structured interviews, focused on the learning experiences of a group of paraprofessionals enrolled in a foundation degree in health and social care. Data revealed fragmented employment patterns, underpinned by consistent vocational drives. While the study resonated with vocation, participants were ambivalent or lacked information about career progression. Workplace conditions, relationships and limited time shaped learning and coping strategies. A strategic and focused approach to student learning is required and includes attention to career pathways, workforce development strategy, the requirements of a range of stakeholders, workplace supervision and support for learning.

Trained to Kill: Soldiers at Warby Theodore Nadelson, M.A., M.D.; Baltimore, Johns Hopkins University Press, 2005, 208 pages, $25

Trained to Kill: Soldiers at Warby Theodore Nadelson, M.A., M.D.; Baltimore, Johns Hopkins University Press, 2005, 208 pages, $25

Trained to Kill: Soldiers at War

Trained to Kill: Soldiers at War

Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions.

Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions.

Group Therapies for Homosexuals Seeking Change

The purpose of this article is to review the literature on group therapies for homosexuals who report distress concerning their experience of same-sex attraction. There are a number of methodological limitations to the research published between the 1950s and 1970s, and it is misleading to present this research as decisive evidence that sexual orientation can be changed. In addition, various contemporary professional and religion-based paraprofessional groups have been designed to bring about change of orientation, but few provide outcome data to support their claims of successful change. Psychologists should not dismiss these studies and programs as irrelevant to those who experience same-sex attraction and seek change, but they are challenged to design interventions and collaborate with existing programs to demonstrate efficacy and to clarify precisely what various interventions, programs, and support groups can accomplish.

Professionalization through CPD: is it realistic for achieving our goals?

Recent transformations within the health-care sector and the advent of the internal market have been accompanied by remarkable changes in terms of expectations of role among those responsible for health-care delivery. Even among the more established professional groups (Watkins et al, 1992), there is an acknowledgement of the challenge to occupational boundaries that have traditionally separated the various disciplines. Coupled with the uncertainty facing the health-care market,this has sparked a resurgence of interest in professionalization. While some disciplines have attempted to ring-fence their existing roles and accountabilities, there has been notable movement by some para-professional groups* to expand and extend their horizons, seeking to establish new professional groups through education, specialization and claimed expertise. This article examines the issues affecting the extension of practice for para-professionals and comments on the effectiveness of efforts currently under way to achieve credible and lasting increased professional status.

A Study of Divorce Adjustment Among Paraprofessional Group Leaders and Group Participants

The primary purpose of this study was to measure the comparative effects on paraprofessional group leaders who facilitated a Beginning Experience Workshop (BE), a group marathon workshop for divorce adjustment. Secondly, this study sought to replicate an earlier study (Byrne, in press) which measured the comparative effectiveness of the BE Workshop. Two experiments are described: in Experiment 1, BE Team Members (n=18) were compared to participants in a Support Workshop (n=21) and an Information Workshop (n=9); in Experiment 2, participants in a BE Workshop (n=11) were compared to participants in the Support and Information Workshops. A pretest, posttest, 10-week follow-up, quasi-experimental design was employed. The instruments included: 1. The Fisher Divorce Adjustment Scale (Fisher, 1978) 2. The Interpersonal Distance Measure (Engebretson, 1969) 3. A Personal Information Form The results indicated that the BE Team Members improved significantly more than participants in the Information Workshop. The results also indicated that the BE Workshop was significantly more effective than either the Support or information Workshops in facilitating divorce adjustment. Post hoc analysis indicated that participants in the BE Workshop improved significantly more than the BE Team Members. Additional findings which may be of interest to both researchers and clinicians are also reported.

Job analysis of paraprofessional practice in Israel

This article deals with the issue of job analysis of two paraprofessional groups in Israel. The subjects—37 street gang workers and 31 homemakers—were randomly chosen from a list of social service workers in Israel. Using a revised job analysis questionnaire (Teare, 1981), subjects were required to indicate what they did and to assess the importance of their roles. The results indicated the level of the involvement of these two groups in a wide range of roles in the social services. The nature of the activities is determined in some degree by the standing of the groups in the professional hierarchy. In some cases, paraprofessionals perform roles other than those that were expected, a circumstance that reflects their aspirations toward higher professional status

Training Paraprofessional Group Counseling Leaders in the Federal Prison System

Abstract This article reports a program in which in-service training in rational-behavioral group counseling was delivered to “frontline” Bureau of Prisons staff by institution psychologists and consultants from the local community. Training focused on conducting time-limited, structured groups. After 21 sessions, paraprofessionals had attained a skill level adequate for conducting their own groups. Changes in inmate scores on the Irrational Beliefs Test were noted, indicating positive results of the group intervention. The article concludes with a discussion of the applicability of these procedures in training paraprofessionals to conduct other types of time-limited, structured groups.

Psychotherapists' perceptions of clients' satisfaction following termination.

The present investigation sought to examine psychotherapists' perception of client's satisfaction following termination. During a 6-mo. period, 86 clients who terminated treatment at a large mental health center were asked to evaluate the service that they had received from their therapists. Therapists were also asked to predict how their clients would evaluate them. Results indicated that clients were favorably impressed with the services provided by their therapists and therapists tended to underestimate the worth of their services. Further conclusions, which at this point can only be speculative due to the limited sample, were that there were no differences in reported satisfaction of clients among psychiatrists, psychologists, psychiatric social workers and para-professional groups, but psychiatrists predicted significantly greater satisfication by satisfaction by clients than the other groups. They were the only group which predicted more satisfaction by clients then was actually reported.

An Analysis of Quantitative and Qualitative Changes in the Composition of the Soviet Professional and Paraprofessional Group in Latvia

The general tendency toward increasing social homogeneity in Soviet society, the uniformity in type of processes of change in the social and class structure of all the Soviet republics, and the leveling out of the proportions of the principal social groups also make themselves felt in processes of quantitative and qualitative changes in the Soviet professional and paraprofessional group [intelligentsia], both in each republic and in the USSR as a whole.

PEER GROUP COUNSELING FOR OLDER PEOPLE

>For a variety of reasons, psychological services are largely unavailable for older people who want help in coping with their interpersonal problems. Group counseling, when it is used, proves to be an effective and efficient method for meeting their needs. It also addresses the reality of the limited numbers of gerontologically trained professionals currently available in the field. A readily attainable, and largely untapped, resource for working with this population is older people themselves. The Continuum Center of Oakland University selects, trains, and supervises older men and women, who serve as paraprofessional group leaders in a self‐exploration program offered in a variety of community centers in the Detroit metropolitan area. The service and training programs, and some of the outcomes for clients and group leaders, are briefly described.

The decline of the medical hegemony: A review of government reports during the N.H.S.

The medical profession emerged from the negotiations surrounding the creation of the National Health Service in 1948 in a strong position: besides gaining acceptance for their general demands [l], they also received acknowledgement of their position of dominance in the health field. As the Minister of Health noted: “It is obvious that the (health) auxiliaries must remain under the supervision and tutelage of the general medical profession. Only in that way can we ensure that the craft is kept in proper order” [2]. The medical hegemony over other paramedical occupations thus became confirmed and legitimated by State patronage. This paper argues however that despite this initial ratification of medical dominance there is evidence of a gradual decline in the strength of the medical hegemony over the last twentyfive years. This decline has been a continuous process and its course is often difficult to disentangle among the conflicting claims of the various professional and paraprofessional groups themselves. These claims, are therefore for the most part ignored. Instead, this paper concentrates on the evolving relationship between doctor and para-medical worker as seen through government reports published since the inception of the N.H.S. This course is pursued, not on the grounds that such reports necessarily represent the true state of the relationship under study, for they are invariably authored by representatives of the skill groups themselves, but rather because they represent the relative positions the various skill groups have achieved through official recognition of the legitimacy of their claims.

Abandoning the mentally ill.

Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years. Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives. The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.