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This study investigated the outcomes of a demonstration project that provided free medical coverage to former Aid to Families with Dependent Children (AFDC) recipients who were holding jobs with limited or no health benefits. Data were collected on the Medicaid expenditures of 54 eligible participants and their dependents for up to two years before they exited welfare; the expenditures averaged 56 percent less for adults and 45 percent less for children than the respective AFDC averages for the county. Because only 22 percent of the eligible participants took advantage of the program, telephone interviews also were conducted with 24 people who did not participate in or dropped out of the health plan. The main reasons cited for not enrolling were a misunderstanding of the program, a claim that no notification of the program was received, and a lack of interest. These results and their policy implications are presented in the context of the Family Support Act's mandate that states extend medical assistance coverage to AFDC recipients whose cases are closed because of employment. © 1991 by the National Association of Social Workers, Inc.
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The studies reviewed here reflect many important aspects of the onset, course, and outcome of schizophrenia; that is, premorbid factors, childhood and late-life onset, the positive-negative syndrome dichotomy, co-occurring substance abuse, outcome research, and theoretical issues. Unsurprisingly, heterogeneity of course and outcome emerges as a major theme., (C) Lippincott-Raven Publishers.
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Increasingly, grandmothers are parenting grandchildren in homes where parental presence is sporadic or nonexistent. A disproportionate percentage of African American grandparents fall in this category. The author reviews the literature on the African American grandmother in the context of the African American family and describes a practice model for service provision to those women who seek support as they “parent again.”
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Mental health professionals and researchers have emphasized the importance of conducting outreach to locate homeless persons with mental illness, and of creatively engaging these persons into a therapeutic relationship. These outreach and engagement activities raise challenging issues in the areas of client-staff boundaries, professional ethics, and staff safety. While several issues in each of these three key areas have received attention in the growing literature on homelessness, certain issues within each area remain unexplored. The authors draw from the street experiences of outreach staff in a federally funded homeless outreach project to further explore each of these areas, and suggest that experiences of outreach workers are essential in shaping and redefining work activities in these, and other important areas.
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This paper examines the factors surrounding the use of alcohol among Latino males. Prevention and treatment strategies for the provision of culturally competent treatment services are proposed, based on an analysis of the literature.
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This article reports data collected from a national survey of all accredited social work programs conducted between December 1995 and February 1996. The purpose was to assess current usage of distance learning in social work education. The findings suggest that the use of distance learning has increased, and that the most prevalent issues reported by educators involve adapting instructional material for course presentation and faculty preparation. Implications of the study findings for social work education are also discussed.
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Normalization is the use of culturally valued means to enable people with disabilities to live culturally valued lives. In this article, the authors describe an effort to bring normalization practices to acute psychiatric care. They describe a day hospital/crisis respite diversion program that serves as an alternative to acute inpatient hospitalization and sketch the research project that fostered it. The authors argue that a day hospital/crisis respite provides effective clinical care comparable to inpatient hospitalization but achieves greater potential for recovery through a normalizing philosophy and practice. An implication of this finding is that such programs based on the principle of normalization may be both cost effective as well as more empowering for patients.
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It is important that the delivery of health and mental health prevention and treatment services within Latino communities be culturally sensitive. This article outlines several ways in which agencies can develop programs that can meet the needs of Latino communities. The most important aspect of the provision of health prevention and treatment services is that the organization integrates itself into the community through outreach, recruitment, and inclusion in decision-making. In addition, the organization needs to be structured so communication and participation from the community and health professionals are open and mixed. Otherwise, the likelihood of success of the provision of services in the community will be diminished. © 1996 Taylor & Francis Group, LLC.
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The numbers of children at risk who are referred to child treatment programs are on the rise. This article explores the therapeutic relationship as it develops with such a child, and questions the impact managed care will have on that treatment. Concepts of a holding environment, personalization (the development of self-love, a necessary precursor to object love), the good-enough mother and Else of the therapist as a real person. who furthers development, are highlighted via case material.
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