Welfare Workers' Responses to Domestic Violence Cases: The Effects of Training and Worker Characteristics

Copyright 2006 Alliance for Children and FamiliesThis study evaluated a one-day domestic violence training for Temporary Assistance for Needy Families (TANF) workers and analyzed the relationship between worker characteristics and the use of work exemptions. In a post-only evaluation, trained workers reported a greater tendency than untrained workers to refer clients to couples counseling, make a safety plan, and file a report to child protection services. In a pre/post evaluation, workers reported after training that they would be less likely to refer clients to couples counseling, and more likely to ask about the emotional and physical impact of abuse, make a safety plan, and ask about access to weapons. Workers most likely to offer a waiver from work requirements reported a higher likelihood of making referrals for a variety o f services

A Coding System to Measure Elements of Shared Decision Making During Psychiatric Visits

Objective: Shared decision making is widely recognized to facilitate effective health care. The purpose of this study was to assess the applicability and usefulness of a scale to measure the presence and extent of shared decision making in clinical decisions in psychiatric practice. Methods: A coding scheme assessing shared decision making in general medical settings was adapted to mental health settings, and a manual for using the scheme was created. Trained raters used the adapted scale to analyze 170 audio-recordings of medication check-up visits with either psychiatrists or nurse practitioners. The scale assessed the level of shared decision making based on the presence of nine specific elements. Interrater reliability was examined, and the frequency with which elements of shared decision making were observed was documented. The association between visit length and extent of shared decision making was also examined. Results: Interrater reliability among three raters on a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of the nine elements of shared decision making and 100% for the agreement between provider and consumer on decisions made. Of the 170 sessions, 128 (75%) included a clinical decision. Just over half of the decisions (53%) met minimum criteria for shared decision making. Shared decision making was not related to visit length after the analysis controlled for the complexity of the decision. Conclusions: The rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts

The Comparative Effectiveness of a Model of Job Development versus Treatment as Usual

Job development is critical to assisting people with serious disabilities to obtain jobs, but little is known about the actual methods that make job development effective. Using a post-only quasi-experimental design, this study examined the effects of the Conceptual Selling® method on the number of job development contacts and number of job placements. By controlling for employment specialists' characteristics (age, length of time in current position, years of human service experience, and years of business experience), the authors determined that the employment specialists trained in the Conceptual Selling® method had more job development contacts per employer, leading to more effective job placements for employers contacted, than the control group

Measuring Shared Decision Making in Psychiatric Care

The official published article is available online at http://doi.org/10.1176/appi.ps.201100496.OBJECTIVE: Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. METHODS: A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. RESULTS: Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. CONCLUSIONS: The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts

Consumer Outcomes After Implementing CommonGround as an Approach to Shared Decision Making

Objective: The authors examined consumer outcomes before and after implementing CommonGround, a computer-based shared decision-making program. Methods: Consumers with severe mental illness (N=167) were interviewed prior to implementation and 12 and 18 months later to assess changes in active treatment involvement, symptoms, and recovery-related attitudes. Providers also rated consumers on level of treatment involvement. Results: Most consumers used CommonGround at least once (67%), but few used the program regularly. Mixed-effects regression analyses showed improvement in self-reported symptoms and recovery attitudes. Self-reported treatment involvement did not change; however, for a subset of consumers with the same providers over time (N=83), the providers rated consumers as more active in treatment. Conclusions: This study adds to the growing literature on tools to support shared decision making, showing the potential benefits of CommonGround for improving recovery outcomes. More work is needed to better engage consumers in CommonGround and to test the approach with more rigorous methods

Critical Ingredients of Consumer Run Services: Results of a National Survey

Fidelity criteria are increasingly used in program monitoring and evaluation, but are difficult to derive for emerging models (i.e., those not based on theory or a research demonstration project). We describe steps used to develop and operationalize fidelity criteria for consumer-run (CR) mental health services: articulating and operationalizing criteria based on published literature, then revising and validating the criteria through expert judgments using a modified Delphi method. Respondents rated highest those structural and process components emphasizing the value of consumerism: consumer control, consumer choices and opportunities for decision-making, voluntary participation (and the absence of coercion), and respect for members by staff.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44316/1/10597_2004_Article_480623.pd

Nat Genet

The function of the majority of genes in the mouse and human genomes remains unknown. The mouse embryonic stem cell knockout resource provides a basis for the characterization of relationships between genes and phenotypes. The EUMODIC consortium developed and validated robust methodologies for the broad-based phenotyping of knockouts through a pipeline comprising 20 disease-oriented platforms. We developed new statistical methods for pipeline design and data analysis aimed at detecting reproducible phenotypes with high power. We acquired phenotype data from 449 mutant alleles, representing 320 unique genes, of which half had no previous functional annotation. We captured data from over 27,000 mice, finding that 83% of the mutant lines are phenodeviant, with 65% demonstrating pleiotropy. Surprisingly, we found significant differences in phenotype annotation according to zygosity. New phenotypes were uncovered for many genes with previously unknown function, providing a powerful basis for hypothesis generation and further investigation in diverse systems.Comment in : Genetic differential calculus. [Nat Genet. 2015] Comment in : Scaling up phenotyping studies. [Nat Biotechnol. 2015

TANF Workers’ Responses to Battered Women and the Impact of Brief Worker Training: What Survivors Report

Battered women (n = 159) report on their experiences with their Temporary Assistance to Needy Families (TANF) caseworkers.Workers most often ask about physical harm, feelings of fear, and police involvement. They least often create a safety plan, give information about work exemptions, and ask whether the partner had a gun.Women’smajor reasons for not talking about abuse are that the worker did not ask and a fear of negative outcomes.Workers who attended a 1-day training are more likely than untrained workers to discuss the women’s fear and physical harm, to help develop a safety plan, and to be viewed as generally helpful.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90018/1/Saunders DG et al 2005 TANF Workers’ Responses to Battered Women and the Impact of Brief Worker Training VAW.pd

Welfare workers’ responses to domestic violence cases: The effects of training and worker characteristics

This study evaluated a one-day domestic violence training for Temporary Assistance for Needy Families (TANF) workers and analyzed the relationship between worker characteristics and the use of work exemptions. In a post-only evaluation, trained workers reported a greater tendency than untrained workers to refer clients to couples counseling, make a safety plan, and file a report to child protection services. In a pre/post evaluation, workers reported after training that they would be less likely to refer clients to couples counseling, and more likely to ask about the emotional and physical impact of abuse, make a safety plan, and ask about access to weapons. Workers most likely to offer a waiver from work requirements reported a higher likelihood of making referrals for a variety of services.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90016/1/Saunders et al 2006 Welfare worker's responses to domestic violence - Families in Society.pd