Social Work Commons^™

Attachment: The Antidote To Trauma, Joshua Straub

Faculty Publications and Presentations

Trauma and loss in life are inevitable. And all too often the traumatic experience itself can be enough to paralyze the mental, emotional, and spiritual state of any given person. Unable to interpret the traumatic experience, many instead are left defined by it. Helping clients discern the objective experience and their subjective reactions to it will help free them from the emotions and beliefs that subsequently control their lives. Based on the most relevant attachment theory research and clinical techniques, this workshop teaches the attentional strategies necessary to helping clients overcome trauma.

Beliefs And Behaviors Regarding Substance Use And Hiv Risk Among Men Who Have Sex With Men (Msm) In A Mid-Sized U.S. Community, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Martin Hall Mssw, Seana Golder Phd

Brown School Faculty Publications

This paper explores the beliefs and behaviors surrounding substance use and HIV risk among a convenience sample of 98 MSM in a mid-size community located in the central U.S. Several interesting patterns were identified in the descriptive analyses. Multivariate analysis identified two variables, belief that recreational drug use made sexual experiences better and reports that most MSM friends drank alcohol or took recreational drugs that were significant predictors of engagement in substance using behavior. Models accounted for 24% of the variance in drinking behavior and 15% of the variance in drug using behavior. Suggestions for HIV/AIDS prevention and intervention and …

“But Who Can I Talk To?” Psychological Services For The Parents And Children Of Apdk, Jessica Steinke

Independent Study Project (ISP) Collection

This is a study examining the adequacy of the psychological services and support offered by the Association for the Physically Disabled of Kenya, APDK, to the children in its care and the families who utilize the centre. First and foremost this study examined the psychological effect physical disabilities have on children and their families to determine what services are necessary for these individuals. The availability of mental health services was then analyzed in the context of the need for them as expressed by children at APDK and parents of disabled children. It was discovered that very few services are available …

Breast Cancer Survival In Ontario And California, 1998-2006: Socioeconomic Inequity Remains Much Greater In The United States, Kevin M. Gorey

Social Work Publications

This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998-2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care.

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Wait Times For Surgical And Adjuvant Radiation Treatment Of Breast Cancer In Canada And The United States: Greater Socioeconomic Inequity In America, Kevin M. Gorey

Social Work Publications

PURPOSE: The demand for cancer care has increased among aging North American populations as cancer treatment innovations have proliferated. Gaps between supply and demand may be growing. This study examined whether socioeconomic status has a differential effect on waits for surgical and adjuvant radiation treatment (RT) of breast cancer in Canada and the US.

METHODS: Ontario and California cancer registries provided 929 and 984 breast cancer cases diagnosed between 1998 and 2000 in diverse urban and rural places. Residence-based socioeconomic data were taken from censuses. Cancer care variables were reliably abstracted from health records: stage, receipt of surgery and RT, …

Associations Of Physician Supplies With Breast Cancer Stage At Diagnosis And Survival In Ontario, 1988 To 2006, Kevin M. Gorey

Social Work Publications

BACKGROUND: The authors examined whether the supply of primary care physicians had protective effects on breast cancer stage and survival in Ontario and whether supply losses during the 1990s were associated with diminished protection.

METHODS: Random samples of the Ontario Cancer Registry, respectively, provided 879 women and 951 women who were diagnosed with breast cancer between 1988 and 1990 (followed until 1996) and 1998 and 2000 (followed until 2006), respectively. Active physician supply data (1991 and 2001) joined to each woman's census division of residence was taken from the Scott's Medical Database.

RESULTS: Protective thresholds were observed among the earlier …

Handbook On Sensitive Practice For Health Care Practitioners: Lessons From Adult Survivors Of Childhood Sexual Abuse, Candice L. Schachter, Carol Stalker, Eli Teram, Gerri C. Lasiuk, Alanna Danilkewich

Lyle S. Hallman Social Work Faculty Publications

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse.

The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. …

State Agency Promising Practice: Delaware’S Early Start To Supported Employment Pilot Project, Suzzanne Freeze, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Early Start to Supported Employment (ESSE) pilot started in 2005 with the goal of providing a more seamless transition for students who would benefit from supported employment services when leaving school and entering the adult workforce. An interagency project team was established to guide the pilot work and ensure all required parties knew their role and shared information and equal responsibility within the project.

State Agency Promising Practice: Connecticut Showcases Creative Jobs With “Employment Idol”, Monica Cox, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 2007, the State of Connecticut’s Department of Developmental Services (DDS) partnered with the self-advocacy group People First of Connecticut to develop Employment Idol, an innovative project for promoting employment as the preferred outcome for individuals with intellectual/developmental disabilities (ID/DD) in the state. Spinning off the concept of the popular television show American Idol, Connecticut’s Employment Idol showcases the employment success stories of a select group of individuals with ID/DD.

State Agency Promising Practice: Oklahoma’S Outcomes-Based Rate Setting System, Susanne Freeze, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Oklahoma’s Developmental Disabilities Services Division (DDSD) realized the need for increased attention towards the goal of community-based employment for individuals they served. Initially, rates were based on a vendor’s costs of providing direct services such as job development and job coaching. It became increasingly apparent that claims for vocational services oftentimes reflected staff activities (e.g., job development, client assessment, and service delivery documentation), which may have been occurring without the direct involvement of the service recipient. In some situations, this resulted in long-term job development with little success in actually acquiring a job. In 1995, DDSD elected to focus on …

State Agency Promising Practices: Using Employment Data To Create Area-Specific Employment Goals In Massachusetts, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 2002, the Massachusetts Department of Developmental Services (DDS) developed a contractual requirement that employment service provider performance be tracked through outcome measures. As a result, DDS shaped its employment data collection system to focus on what it viewed as key outcomes for measuring success around employment. A confluence of factors including participation in the National Core Indicator project, a new Request for Responses (RFR) for Employment Support Services that emphasized performance measurement, and DDS’s intrinsic commitment to greater community employment supported the development of an employment data system that focused on individual outcomes. Data from this effort is now …

State Agency Promising Practice: Mandatory Situational Assessments In Tennessee, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Tennessee implemented its Employment First initiative in 2002 with a goal of making employment the first day service option for adults receiving supports from the Department of Mental Retardation Services. As part of the Employment First initiative, the state requires a periodic community-based work assessment for all individuals not currently employed in the community. State-contracted and independent individualized support coordinators ensure that individuals who are not in integrated employment participate in a community-based work assessment at least every three years. Since December 2005, employment providers can be trained in conducting situational job assessments and the importance of providing these opportunities.

State Agency Promising Practices: Reaching Target Employment Goals - The Five-Year Initiative From Florida’S Agency For Persons With Disabilities (Apd), Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The state of Florida has implemented a five-year employment initiative for people with ID/DD. The goal is to enable at least 50% of adults (ages 18 to 55) receiving APD-funded day services as of July 1, 2004, to achieve community employment by July 1, 2009. APD-funded services include adult day training, supported employment, and non-residential supports and services. Florida is specifically targeting a total of 25% of individuals who were in Adult Day Training (ADT) on July 1, 2004, to be employed by July 1, 2009. The impetus for this five-year initiative was multifold. Governor Jeb Bush created a Blue …

State Agency Promising Practices: The Maine Employment Curriculum - Delivering Best Practices For Employment Support Professionals, John Butterworth, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The University of Maine’s Center for Community Inclusion and Disability Studies (CCIDS), along with the Maine Department of Behavioral and Developmental Services (BDS) and the Bureau of Rehabilitation Services, developed the Maine Employment Curriculum (MEC). The comprehensive curriculum fosters best practices in employment supports for people with disabilities statewide by using a cadre of trainers who are supported by the Maine Employment Curriculum project staff. The Maine Employment Curriculum ultimately seeks an increase in the number of integrated, communitybased supports available and builds the capacity of the employment support provider community to achieve this goal.

State Agency Promising Practice: Maine’S Peer- Support Training - Helping People With Id/Dd Transition Out Of Sheltered Workshops, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 2006, a new Maine law mandated the creation of a waiver program that promotes the expansion of supported employment programs for people with intellectual and developmental disabilities (ID/DD). As a result, state funding for sheltered workshops was reduced for seven workshops and approximately 220 individuals throughout Maine. These individuals received funding under the new waiver program for community supports and supported employment services. As a result, Maine’s Department of Health and Human Service’s (DHHS) Office of Adults with Cognitive and Physical Disabilities (OACPD) developed a comprehensive work plan. A pilot project, which was included in this plan, focused on …

State Agency Promising Practice: Working Together - Collaboration Between Colorado’S Developmental Disabilities Division And Division Of Vocational Rehabilitation, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In Colorado, counselors from the Division of Vocational Rehabilitation are housed on-site in Community Centered Board1 offices so they can provide direct services to individuals with intellectual and developmental disabilities (ID/DD). The goal of the project was to serve 240 customers with ID/DD and provide 134 successful employment outcomes over a two-year period2. Streamlined services and enhanced communication emerged through a unique collaborative effort between the two entities.

Predicting Juvenile Delinquency: The Nexus Of Childhood Maltreatment, Depression And Bipolar Disorder, Christopher A. Mallett, Patricia A. Stoddard Dare, Mamadou M. Seck

Social Work Faculty Publications

Background It is important to identify and provide preventative interventions for youth who are most at risk for offending behaviour, but the connection between early childhood or adolescent experiences and later delinquency adjudication is complicated. Aim To test for associations between specified mental disorders or maltreatment and later delinquency adjudication. Method Participants were a random sample of youth before the juvenile courts in two Northeast Ohio counties in the USA (n = 555) over a 4-year time frame (2003 to 2006). Results Logistic regression analysis identified a lifetime diagnosis of depression and/or bipolar disorder to be predictive of later youth …

Violence Against Women Raises Risk Of Cervical Cancer, Ann L. Coker, Claudia Hopenhayn, Christopher P. Desimone, Heather M. Bush, Leslie Crofford

CRVAW Faculty Journal Articles

Background: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer.

Methods: Women aged 18–88 who joined the Kentucky Women’s Health Registry (2006–2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, …

Ethnic Disparities In Cervical Cancer Survival Among Medicare Eligible Women In A Multiethnic Population, Ann L. Coker, Katherine S. Eggleston, Xianglin L. Du, Lois Ramondetta

CRVAW Faculty Journal Articles

To determine predictors of cervical cancer survival by socioeconomic status (SES), urbanization, race/ethnicity, comorbid conditions, and treatment among elderly Medicare-eligible women whose conditions were diagnosed with cervical cancer in a multiethnic population.

Methods: A total of 538 women with cervical cancer aged 65 years or older were identified from 1999 to 2001 from the Texas Cancer Registry and were linked with the state Medicare data and Texas Vital Records to determine survival times. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of SES was created using census tract-level data as was urbanization. Treatment and …

Increased Racial Differences On Breast Cancer Care And Survival In America: Historical Evidence Consistent With A Health Insurance Hypothesis, 1975-2001, Kevin M. Gorey

Social Work Publications

PURPOSE: This study examined whether race/ethnicity had differential effects on breast cancer care and survival across age strata and cohorts within stages of disease.

METHODS: The Detroit Cancer Registry provided 25,997 breast cancer cases. African American and non-Hispanic white, older Medicare-eligible and younger non-eligible women were compared. Successive historical cohorts (1975-1980 and 1990-1995) were, respectively, followed until 1986 and 2001.

RESULTS: African American disadvantages on survival and treatments increased significantly, particularly among younger women who were much more likely to be uninsured. Within node positive disease all treatment disadvantages among younger African American women disappeared with socioeconomic adjustment.

CONCLUSIONS: Growth …

State Agency Promising Practice: Washington - Promoting Public Sector Jobs For People With Intellectual And Developmental Disabilities, Jean Winsor, Allison C. Hall, John Butterworth, Dana Scott Gilmore, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

King County’s program to employ people with disabilities in county jobs is an example of Washington’s commitment to the use of innovative approaches to increase integrated employment. In 1989, a training resource funded by Washington State and the county Division of Developmental Disabilities, O’Neill and Associates, submitted a grant application to the Rehabilitation Services Administration to develop public sector jobs for people with developmental disabilities within the state. These jobs were to be concentrated in King County (Seattle area) government because of the availability of high-paying jobs with benefits. With the political assistance of a King County councilor, the County …

State Agency Promising Practice: Community Employment Training By And For Individuals With Intellectual And Developmental Disabilities In Tennessee, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Project Income was a joint venture between the Tennessee Microboards Association (statewide organization that supports individual microboards, which procure and oversee supports and services) and People First of Tennessee (a statewide selfadvocacy organization for people with intellectual and developmental disabilities). The focus of the project was to educate people with intellectual and developmental disabilities (ID/DD) and their families about the benefits of and opportunities for community employment.

State Agency Promising Practice: Pennsylvania’S Employment Newsletter - A Communication Strategy To Promote Employment, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The State of Pennsylvania’s Office of Developmental Programs (ODP) created a monthly newsletter called The Employment Update, which covers state- and nationwide news about the employment of people with disabilities, including intellectual/developmental disabilities. The Employment Update is sent via email to state agency contacts and a large stakeholder community, including individuals with disabilities, service providers, state associations, employers, advocacy groups, family members, representatives from academia and others. The Employment Update contains information about employment trends, employment policy, trainings and conferences throughout Pennsylvania and nationwide. The newsletter also contains information about employment grants and project activities, including links to articles covering …

State Agency Promising Practices: North Carolina - Using An Outcomes-Based Long-Term Vocational Services Funding Model, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In North Carolina, counties have been consolidated into Local Management Entities (LMEs). These entities contract for services with community providers and provide oversight on access, utilization, best practices, and community collaborations. The Mecklenberg County LME established the Best Practices Community Committee, comprising service providers, individuals and family members, advocacy agencies, community partners, interested community volunteers, and LME staff. Sub-committees addressed several areas, including employment. Based on their recommendations, a pilot project that uses an outcome-based funding model for follow-along employment services was developed. Follow-along employment supports are ongoing supports that are necessary to assist a person with an intellectual/developmental disability …

State Agency Promising Practice: Delaware’S Early Start To Supported Employment Pilot Project, Susanne Freeze, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Early Start to Supported Employment (ESSE) pilot started in 2005 with the goal of providing a more seamless transition for students who would benefit from supported employment services when leaving school and entering the adult workforce. An interagency project team was established to guide the pilot work and ensure all required parties knew their role and shared information and equal responsibility within the project.

State Agency Promising Practice: Oklahoma - Contracting With Industry For The Provision Of Job Coaching Supports, Monica Cox, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Contracts with Industry, implemented in the 1990s as the Natural Supports Initiative, is a program option that allows the Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services Division (DDSD) to contract directly with businesses to provide job coaching supports that become a part of the natural workplace. Individuals participating in this program are employed by a business and are paid minimum wage or better. The name change to Contracts with Industry was an effort to distinguish the program from other DDSD employment options that involve employment service providers and paid job coaches.

Rudd Chair Annual Report, 2008-2009, Harold D. Grotevant

Rudd Adoption Research Program Annual Reports

The first Annual Report of the activities of the Rudd Chair for 2008 - 2009