Social Work Commons^™

Black Males, Trauma, And Mental Health Service Use: A Systematic Review., Robert Motley, Andrae Banks

Brown School Faculty Publications

Objective: To systematically review the evidence of and synthesize results from relevant studies that have examined barriers and facilitators to professional mental health service use for Black male trauma survivors ages 18 and older.

Methods: A thorough search of selected databases that included EBSCO, ProQuest, and Web of Science Core Collection and careful consideration of inclusion and exclusion criteria yielded a final six studies for detailed review.

Results: Black male trauma survivors were significantly less likely to be utilizing mental health services than other sex-ethnic groups. High levels of daily crises, a lack of knowledge of steps to …

Review Brief: Social Exclusion Within Education Systems In Low And Middle Income Countries, Jean Francois Trani

Brown School Faculty Publications

No abstract provided.

U.S. Commentary: Implications From The Family Options Study For Homeless And Child Welfare Services, Patrick J. Fowler

Brown School Faculty Publications

The Family Options Study provides an unprecedented opportunity to investigate the troubling link between family homelessness and child maltreatment. The rigorous design uses multiple methods to probe the impact of housing interventions on family preservation and reunification and the underlying mechanisms. Results show that ending homelessness keeps families together; however, once separated, families continue to struggle to reunify with children. Permanent housing subsidies represent a more efficient approach to promoting family stability among homeless families compared with temporary housing with supportive services. Results introduce a new phase of family homeless research, practice, and policy; further investigation must consider broad scale …

Community Based System Dynamic As An Approach For Understanding And Acting On Messy Problems: A Case Study For Global Mental Health Intervention In Afghanistan, Jean-Francois Trani, Ellis Ballard, Parul Bakhshi, Peter Hovmand

Brown School Faculty Publications

Background: Afghanistan lacks suitable specialized mental healthcare services despite high prevalence of severe mental health disorders which are aggravated by the conflict and numerous daily stressors. Recent studies have shown that Afghans with mental illness are not only deprived of care but are vulnerable in many other ways. Innovative participatory approaches to the design of mental healthcare policies and programs are needed in such challenging context. Methods: We employed community based system dynamics to examine interactions between multiple factors and actors to examine the problem of persistently low service utilization for people with mental illness. Group model building sessions, designed …

Disabled Women’S Attendance At Community Women’S Groups In Rural Nepal, J. Morrison, T. Colbourn, B. Budhathoki, A. Sen, D. Adhikari, J. Bamjan, S. Pathak, A. Basnet, J. F. Trani, A. Costello, D. Manandhar, N. Groce

Brown School Faculty Publications

There is strong evidence that participatory approaches to health and participatory women’s groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women’s participation in women’s groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world’s population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women’s groups is particularly important. We used a mixed methods approach to describe attendance …

Factors Influencing The Implementation Of A Brief Alcohol Screening And Educational Intervention In Social Settings Not Specializing In Addiction Services, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd

Brown School Faculty Publications

Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers.

Development And Validation Of The 34-Item Disability Screening Questionnaire (Dsq-34) For Use In Low And Middle Income Countries Epidemiological And Development Surveys, Jean-Francois Trani, Ganesh M. Babulal, Parul Bakhshi

Brown School Faculty Publications

Background: Although 80% of persons with disabilities live in low and middle-income countries, there is still a lack of comprehensive, cross-culturally validated tools to identify persons facing activity limitations and functioning difficulties in these settings. In absence of such a tool, disability estimates vary considerably according to the methodology used, and policies are based on unreliable estimates Methods and Findings: The Disability Screening Questionnaire composed of 27 items (DSQ-27) was initially designed by a group of international experts in survey development and disability in Afghanistan for a national survey. Items were selected based on major domains of activity limitations and …

Mental Illness, Poverty And Stigma In India: A Case-Control Study, Jean-Francois Trani, Parul Bakhshi, Jill A. Kuhlberg, Sreelatha S. Narayanan, Hemalatha Venkataraman, Nagendra N. Mishra, Nora E. Groce, Sushrut Jadhav, Smita Deshpande

Brown School Faculty Publications

Objective: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mentalillness(PSMI) in Delhi, India, controlling for gender, age and caste. Design: Matching case(hospital)–control(population) study. Setting:University Hospital (cases) and National Capital Region (controls),India. Participants: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophreniaor affective disorders were recruited and 647 individuals of same age,sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Main outcome measures: Higher risk of poverty due to stigma among …

Time-Limited Case Management For Homeless Mothers With Mental Health Problems: Effects On Caregiver Mental Health., Judith Samuels, Patrick J. Fowler, Andrea Ault-Brutus, Dein-In Tang, Katherine Marcal

Brown School Faculty Publications

Objective: In this study we test the effect of a time-limited case management model targeting homeless mothers who are experiencing mental health problems. Adapted from an empirically informed intervention to prevent recurrent homelessness among individuals, the Family Critical Time Intervention (FCTI) supports mothers with children for a 9-month period as they move from homeless shelters into affordable housing. The case management team uses a structured intervention to encourage mothers to create and maintain necessary connections in the community for key family supports. Method: We use a longitudinal randomized controlled trial (N = 210) to test whether homeless mothers referred to …

Mental Illness, Poverty And Stigma In India: A Case–Control Study, Jean-Francois Trani, Parul Bakhshi, Jill Kuhlberg, Sreelatha S. Narayanan, Hemalatha Venkataraman, Nagendra N. Mishra, Nora E. Groce, Sushrut Jadhav, Smita Deshpande

Brown School Faculty Publications

Objective: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste.Design: Matching case (hospital)–control (population) study.Setting: University Hospital (cases) and National Capital Region (controls), India.Participants: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded.Main outcome measures: Higher risk of poverty …

Measuring Participation For Persons With Mental Illness: A Systematic Review Assessing Relevance Of Existing Scales For Low And Middle Income Countries, Ganesh M. Babulal, Parul Bakhshi, Sunyata Kopriva, Sarah A. Ali, Susan A. Goette, Jean-Francois Trani

Brown School Faculty Publications

Background: Participation is increasingly becoming an important outcome for assessment in many fields, including development, disability and policy implementation. However, selecting specific instruments to measure participation has been a significant problem due to overlapping conceptual definitions and use of different theories. The objective of this paper is to identify participation instruments, examine theories/definition supporting their use and highlight scales for use in low and middle-income countries for persons with mental illness. Methods: A systematic literature review was conducted to identify instruments intended to measure participation for individuals with severe mental illness. The search was limited to peer-reviewed articles published in …

Implementing Outside The Box: Community-Based Social Service Provider Experiences With Using An Alcohol Screening And Intervention, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Alex T. Ramsey, Carissa Van Den Berk-Clark

Brown School Faculty Publications

Objective: The aim of this study is better understand perceptions of front-line social service workers who are not addiction specialists, but have to address addiction-related issues during their standard services. Method: Six social service organizations implemented a validated alcohol assessment and brief education intervention. After a 3-month trial implementation period, a convenience sample of 64 front-line providers participated in six focus groups to examine barriers and facilitators to the implementation of an alcohol screening and brief intervention. Results: Three themes emerged: (1) usefulness of the intervention, (2) intervention being an appropriate fit with the agency and client population, and (3) …

The Effectiveness Of Community-Based Rehabilitation Programmes: An Impact Evaluation Of Quasi-Randomised Trial, Mauro Vincnzo, Mario Biggeri, Sunil Deepak, Jean-Francois Trani

Brown School Faculty Publications

Background Community based rehabilitation (CBR) programs have been described as highly effective means of promoting the rights and opportunities of persons with disabilities (PwD). Although CBR are often the main way in which PwDs in low and middle income countries access rehabilitation services, there is little literature providing rigorous evaluation of their impact on people’s well-being. Methods Data was collected in the Mandya and Ramanagara Districts of Karnataka state, India, between December 2009 and May 2010. 2,540 PwD were identified and interviewed using stratified random sampling: 1,919 CBR beneficiaries (who joined the program between 1997 and 2009) and 621 persons …

Organizational Leaders’ And Staff Members’ Appraisals Of Their Work Environment Within A Children’S Social Service System, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd, John Keesler, Byron James Powell

Brown School Faculty Publications

Several studies have demonstrated the effect of an organization’s culture and climate on the delivery of services to clients and the success of clinical outcomes. Workers’ perceptions are integral components of organizational social context, and in order to create a positive organizational culture and climate, managers and frontline staff need to have a shared understanding of the social context. The existing literature does not adequately address that discrepancies in perceptions of culture and climate between frontline staff and managers impact the implementation of policies and services. The purpose of this study is to compare the workgroup-level culture and climate of …

Alcohol Screening And Brief Intervention As Standard Practice In Indian Country, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Bonnie Duran, Catherine N. Dulmus Phd, Amy R. Manning

Brown School Faculty Publications

Alcohol use and the resulting problems associated with high-risk drinking in the American Indian/Native Alaskan (AI/NA) population are well-documented, as alcohol misuse has taken an incredible toll on many AI/NA communities. Presently, both overall health issues and alcohol use occur disproportionately within this population. This article provides an updated overview of the impact of alcohol use in the United States and within AI/NA communities specifically. It also provides recommendations for an alcohol-related screening and brief intervention instrument that social workers can begin using in their practice and can be utilized within the AI/NA community.

What Are The Ideal Characteristics Of Empirically Supported Treatment Adopters?, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd

Brown School Faculty Publications

There has been a clear and consistent shift in social work practice from offering treatment as usual to implementing empirically supported treatments (ESTs). As social work researchers and practitioners continue to evaluate the effectiveness of ESTs, their impact on clinical outcomes, and the various obstacles to their adoption, a developing literature could offer some guidance on characteristics of EST adopters. This paper provides a beginning discussion of the ideal characteristics of EST adopters both at the organizational and individual-levels. While this is a developing area of study, there are some important findings that could better serve community-based organizations, its work …

Refining The Evidence-Based Practice Attitude Scale (Ebpas): An Alternative Confirmatory Factor Analysis, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd, Nicole Fava

Brown School Faculty Publications

Barriers to adopting evidence-based practices into real-world mental health organizations have received considerable attention and study. One particular attempt is Aarons’s Evidence- Based Practice Attitude Scale (EBPAS), which measures a worker’s attitudes toward adopting new treatments, interventions, and practices. This study follows Aarons’s work by conducting a confirmatory factor analysis of the EBPAS administered in a large child and family human service agency in New York state (N = 1,273). Replicating Aarons et al.’s four-factor model of the EBPAS, the authors found that, within the model, the pattern of factor loadings that was apparent in previous investigations held for their …

Do Organizational Culture And Climate Matter For Successful Client Outcomes?, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd, Maria Cristalli

Brown School Faculty Publications

Objectives: The existing literature on the impact of workplace conditions on client care suggests that good cultures and climates provide the best outcomes for clients. The primary purpose of this study was to investigate the relationship between organizational culture and climate and the proportion of children and youth successfully discharged from a large organization in New York State. Method: Thirty-three child and youth programs with existing culture and climate data evaluated outcome information from 1,336 clients exiting its services. Results: Programs reported as having bad culture and climate yielded superior client outcomes, measured as discharge to a lower level of …

Social Ecological Constraints To Park Use In Communities With Proximate Park Access, J. Aaron Hipp, Deepti Adlakha, Ravikumar Chockalingam

Brown School Faculty Publications

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, but with proximate access to underutilized parks. The authors used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed …

Barriers To Depression Treatment Among Low-Income, Latino Emergency Department Patients, Anjanette A. Wells, Isabel T. Lagomasino M.D., Lawrence A. Palinkas, Jennifer Green, Diana Gonzalez Msw

Brown School Faculty Publications

Objectives. Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. Methods. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79% female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Results. Although most patients acknowledged signs of depression, there …

Factors Influencing Worker Morale: Evaluating Provider Demographics, Workplace Environment And Using Ests, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd, Maria Cristalli

Brown School Faculty Publications

Objectives: Mental health organizations are strongly encouraged to implement empirically supported treatments (ESTs), however little is known about their working environments. The present study investigated how provider demographics, workplace environment and whether ESTs were used affected the worker morale. Methods: Front-line workers (N = 1,273) from 55 different programs in a single, large organization completed a measure of organizational culture and climate (OCC) and worker morale. A multilevel regression analysis used worker demographics to predict worker morale at level 1 and EST use and OCC scales to predict program level worker morale. Results: Worker morale was significantly negatively correlated with …

Individual Worker Level Attitudes Toward Empirically Supported Treatments, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Eugene Maguin Phd, Catherine N. Dulmus Phd, Bruce C. Nisbet

Brown School Faculty Publications

Objectives: There is a growing literature indicating that organizational and individual worker-level factors affect decisions about whether or not empirically-supported treatments (EST’s) are adopted within health care agencies. The purpose of this pilot study is to further investigate and measure worker’s attitudes within a community organization. Methods: A small organization participated in the study due to their diversity in services offered. Of the 92 workers eligible for participation in the study, 66 (72%) completed the Evidence-Based Practice Attitude Scale (EBPAS) survey. Results: Multivariate analyses revealed that female workers scored higher on both Openness and total score; workers with nursing, education …

Vulnerability And Mental Health In Afghanistan: Looking Beyond War Exposure, Jean-Francois Trani, Parul Bakhshi

Brown School Faculty Publications

This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 non-disabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared …

Child Poverty In A Conflict Situation: A Multidimensional Profile And An Identification Of The Poorest Children In Western Darfur, Jean-Francois Trani, Timothy I. Cannings

Brown School Faculty Publications

Darfur is currently in a very complex situation making humanitarian intervention a very challenging endeavour. The civilian population is caught in the middle of armed confrontation resulting in massive forced displacement as well as in food shortage, lack of access to safe source of water and sanitation facilities, shelter, essential health services. Children are particularly vulnerable in conflict situation as they are higher risk of physical and sexual violence or emotional abuse. Applying the Alkire and Foster index of multidimensional poverty to a selected set of dimensions of deprivation identified through a large scale household survey in Western Darfur carried …

Gender, Difference And Urban Change: Implications For Promotion Of Well-Being?, Julian Walker, Alexandre A. Frediani, Jean-Francois Trani

Brown School Faculty Publications

This article examines the impacts of urban change on the well-being of women and men, and girls and boys, living in cities, and explores how gender intersects with other social relations to differentiate these impacts. It then considers the implications of intersectionality for organisations aiming to promote the interests of specific social groups (such as women, or people with disabilities) vis-a-vis urban change by looking at the experience of Leonard Cheshire’s Asha project, working with girls and boys with disabilities in Mumbai. It concludes that organisations working to promote the interest of identity based constituents should (a) base their strategies …

Is Openness To Using Empirically Supported Treatments Related To Organizational Culture And Climate?, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd

Brown School Faculty Publications

An established literature indicates that organizational factors such as culture and climate can impede the implementation of empirically supported treatments (ESTs) in real world practice. What remains unclear is whether certain worker attitudes create barriers to implementing ESTs and how these attitudes might impact the working culture and climate within an organization. The overall purpose of this study is to investigate workers’ openness towards implementing a new EST and whether the workers’ openness scores relate to their workplace culture and climate scores. Participants in this study (N=1273) worked in a total of 55 different programs in a large child and …

Does Corporate Social Responsibility Contribute To Human Development In Developing Countries? Evidence From Nigeria, Kevin Lompo, Jean-Francois Trani

Brown School Faculty Publications

Oil companies have been facing criticism linked to their activities in developing countries from various human rights organisations as well as NGOs and the media. To change this negative perception, companies have been increasingly promoting corporate social responsibility (CSR) initiatives, which aim at improving living conditions of local communities in oil exploitation areas. In this paper, we explore the impact on the well-being of communities of two kinds of CSR initiatives implemented in two areas of the Niger Delta region of Nigeria. Using multidimensional exploratory methods and checking for robustness using binary logistic regression, we investigate the outcome of CSR …

'Delivering' Education; Maintaining Inequality. The Case Of Children With Disabilities In Afghanistan, Jean-Francois Trani, Parul Bakhshi, Anand Nandipati

Brown School Faculty Publications

Education for children with disabilities in Afghanistan, particularly disabled girls, continues to lag behind despite laudable efforts of the Ministry of Education to promote universal access for all. The opportunity for education constitutes not just a means of achieving learning outcomes but also a space for social interaction, individual development and psychosocial support, which are paramount in Conflict Affected Fragile States (CAFS). However, many persisting barriers still need to be overcome in Afghanistan to allow education for all and change negative attitudes towards education of children with disabilities. In this paper we argue that viewing education as a basic commodity, …

Empirically Supported Treatments Impact On Organizational Culture And Climate, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Catherine N. Dulmus Phd, Eugene Maguin Phd

Brown School Faculty Publications

Objectives: With the continued push to implement empirically supported treatments (ESTs) into community based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the working conditions in programs that currently use ESTs. Methods: This study compared the culture and climate scores of a large organization’s programs that use ESTs and those programs indicating no EST usage. Results: Of the total 55 different programs (1,273 front-line workers), 27 programs used ESTs. Results indicate that the programs offering an …

Poverty And Disability: A Vicious Circle? Evidence From Afghanistan And Zambia, Jean-Francois Trani, Mitchell M. Loeb

Brown School Faculty Publications

Disability and poverty have a complex and interdependent relationship. It is commonly understood that persons with disabilities are more likely to be poor and that poverty may contribute to sustaining disability. This interdependency is revealed not only through an examination of poverty in terms of income but also on a broader scale through other poverty related dimensions. Just how robust is this link? This paper compares data collected from household surveys in Afghanistan and Zambia, and explores the potential link between multidimensional poverty and disability. We find evidence of lower access to health care, education and labour market for people …