Servizi Sociali Territoriali e Università: Esempi di Sinergie Possibili per un Percorso di Qualità

Although – or because – social work education in Italy has for some 15 years now been exclusively in the domain of the university the relationship between the academic world and that of practice has been highly tenuous. Research is indeed being conducted by universities, but rarely on issues that are of immediate practice relevance. This means that forms of practice develop and become established habitually which are not checked against rigorous standards of research and that the creation of knowledge at academic level pays scant attention to the practice implications of social changes. This situation has been made even worse by the dwindling resources both in social services and at the level of the universities which means that bureaucratic procedures or imports of specialisations from other disciplines frequently dominate the development of practice instead of a theory-based approach to methodology. This development does not do justice to the actual requirements of Italian society faced with ever increasing post-modern complexity which is reflected also in the nature of social problems because it implies a continuation of a faith in modernity with its idea of technical, clear-cut solutions while social relations have decidedly moved beyond that belief. This discrepancy puts even greater strain on the personnel of welfare agencies and does ultimately not satisfy the ever increasing demands for quality and accountability of services on the part of users and the general public. Social workers badly lack fundamental theoretical reference points which could guide them in their difficult work to arrive at autonomous, situation-specific methodological answers not based on procedures but on analytical knowledge. Thirty years ago, in 1977, a Presidential Decree created the legal basis for the establishment of social service departments at the level of municipalities which created opportunities for the direct involvement of the community in the fight against exclusion. For this potential to be fully utilized it would have required the bringing together of three dimensions, the organizational structure, the opportunities for learning and research in the territory and the contribution by the professional community. As this did not occur social services in Italy still often retain the character of charity which does not concern itself with the actual causes of poverty and exclusion. This in turn affects the relationship with citizens in general who cannot develop trust in those services. Through uncritical processes of interaction Edgar Morin’s dictum manifests itself which is that without resorting to critical reflection on complexity interventions can often have an effect that totally the opposite to the original intention. An important element in setting up a dynamic interchange between academia and practice is the placement on professional social work courses. Here the looping of theory to practice and back to theory etc. can actually take place under the right organizational and conceptual conditions, more so than in abstract, and for practitioners often useless debates about the theory-practice connection. Furthermore, research projects at the University of Florence Social Work Department for instance aim at fostering theoretical reflection at the level of and with the involvement of municipal social service agencies. With a general constructive disposition towards research and some financial investment students were facilitated to undertake social service practice related research for their degree theses for instance in the city of Pistoia. In this way it was also possible to strengthen the confidence and professional identity of social workers as they became aware of the contribution their own discipline can make to practice-relevant research instead of having to move over to disciplines like psychology for those purposes. Examples of this fruitful collaboration were presented at a conference in Pistoia on 25 June 2007. One example is a thesis entitled ‘The object of social work’ and examines the difficult development of definitions of social work and comes to the conclusion that ‘nothing is more practical than a theory’. Another is on coping abilities as a necessary precondition for the utilization of resources supplied by social services in exceptional circumstances. Others deal with the actual sequence of interventions in crisis situations, and one very interestingly looks at time and how it is being constructed often differently by professionals and clients. At the same time as this collaboration on research gathers momentum in the Toscana, supervision is also being demanded more forcefully as complementary to research and with the same aim of profiling more strongly the professional identity of social work. Collaboration between university and social service filed is for mutual benefit. At a time when professional practice is under threat of being defined from the outside through bureaucratic prescriptions a sound grounding in theory is a necessary precondition for competent practice.

The Deprofessionalisation Thesis, Accountability and Professional Character

It is said that the deprofessionalisation of social work and other welfare occupations reduces workers' professional discretion and autonomy, and thus their capacity to act in the best interests of their client. Without necessarily regarding the deprofessionalisation thesis as conclusive, this paper will ask how the state's control of the role and task of social workers impacts on their role-implicated obligations as professionals. If workers are reduced (as claimed) to the status of mere functionaries in systems they neither approve of nor control, does this exonerate them from bad outcomes or service failures? How should we view the dramatic increase in formal regulation now seen in the UK - as professionalisation or deprofessionalisation? The paper will argue that whatever the drift of policy, workers remain in some measure personally accountable. Service failures imply faults of practical reason that are partly attributable to the moral and intellectual character of professionals as individuals. It is therefore up to professionals, and their organisations, to attend to the improvement of professional character.

Professionalism and Information Technology: Positioning and Mediation

The starting point of this paper is the assumption that - on the one hand - information technology (IT) is increasingly shaping the professional knowledge base and on the other the relation between organisation and profession. IT is changing the role, responsibilities and practices of social workers and therefore it is important to deal with the impact of IT on social work (representative for many: Harlow and Webb 2003; Burton and van den Broek 2008). Hence, the general aim of this paper is to stimulate a basic discussion on “IT application in social work“, or rather, in a more general way, on „technology and professions“. Secondly, it is about an analytical differentiation of the process of informatisation, respectively formalisation. Thirdly we want to discuss the assumption and overall combination of efficiency, effectiveness and IT. Therefore this paper is arranged as follows: After some opening remarks (chapter 1) we outline case management systems as research object (2). Further on, we confront the approach of reflexive professionalism (3) with the process of formalization (4). Subsequently, we touch on the debate of “technologies of care” (5) and conclude with some short remarks on a research program (6).

Edna Chamberlain (1921 -2005): A Leader through Times of Transition and Change

Professor Edna Chamberlain was an outstanding leader in Australian social work. She contributed extensively to social work education at the University of Queensland, the social work profession through her leadership of the Australian Association of Social Workers and to the community through advocacy for progressive social policies. Her life experiences were influential is shaping her career and her particular teaching and research interests. Early in her life, Chamberlain was exposed to individual deprivation as a result of the Great Depression. This provided the incentive for a career in social work. She worked as a social work practitioner for some years and entered the academic world until after the death of her husband. In the university and profession, she was confronted by conflict between traditionalists and those wanting immediate reform. In managing these tensions, she tried to find the common ground but these tensions also moderated and changed her views about the purpose and practice of social work. Her rich practice and later research and teaching background provided a strong basis for her professional leadership, research activities and curriculum initiatives. Whilst social casework methods were influential early in her career she sought in later years to integrate the private pain of individuals with social policy and community planning by focusing on the purpose of social work – demonstrating her commitment to the disadvantaged in the context of social justice.

Defending Democratic Youth Work

The UK's liberal-cum-democratic welfare regime has led to a more developed state-sponsored youth work than in the majority of continental Europe, where a corporatist welfare regime has held sway (Esping Andersen 1990). To this extent British Youth Work has been more susceptible to governmental intervention. Nevertheless the ascendancy of neo-liberalism across the last three decades has disturbed significantly all models of the Welfare State, expressed in the impact of 'New Managerialism'. Thus we are seeing a convergence towards an imposed, instrumental, output-driven approach to the delivery of both education and welfare. In both the UK and continental Europe youth workers and social workers are confronted with intrusive interventions and demands from governments, which are utterly at odds with their shared desire to start from 'where young people are at'. In this paper we sketch the emergence of a campaign within Youth Work, which seeks to oppose and resist its transformation into an agency of social engineering. In contrast we stand for an emancipatory Youth Work committed to social change. In telling our story thus far we hope to reach out to and make alliances with workers across Europe sympathetic to our cause.

The Integration of Formal and Non-formal Education: The Dutch “brede school”

The Dutch “brede school” (BS) development originates in the 1990s and has spread unevenly since: quicker in the primary than secondary educational sector. In 2007, there were about 1000 primary and 350 secondary BS schools and it is the intention of the government as well as the individual municipalities to extend that number and make the BS the dominant school form of the near future. In the primary sector, a BS cooperates with crèche and preschool facilities, besides possible other neighborhood partners. The main targets are, first, to enhance educational opportunities, particularly for children with little (western-) cultural capital, and secondly to increase women’s labor market participation by providing extra familial care for babies and small children. All primary schools are now obliged to provide such care. In the secondary sector, a BS is less neighborhood-orientated than a primary BS because those schools are bigger and more often located in different buildings. As in the primary sector, there are broad and more narrow BS, the first profile cooperating with many non-formal and other partners and facilities and the second with few. On the whole, there is a wide variety of BS schools, with different profiles and objectives, dependent on the needs and wishes of the initiators and the neighborhood. A BS is always the result of initiatives of the respective school and its partners: parents, other neighborhood associations, municipality etc. BS schools are not enforced by the government although the general trend will be that existing school organizations transform into BS. The integration of formal and non-formal education and learning is more advanced in primary than secondary schools. In secondary education, vocational as well as general, there is a clear dominance of formal education; the non-formal curriculum serves mainly two lines and objectives: first, provide attractive leisure activities and second provide compensatory courses and support for under-achievers who are often students with migrant background. In both sectors, primary and secondary, it is the formal school organization with its professionals which determines the character of a BS; there is no full integration of formal and non-formal education resulting in one non-disruptive learning trajectory, nor is there the intention to go in that direction. Non-formal pedagogues are partly professionals, like youth- and social workers, partly volunteers, like parents, partly non-educational partners, like school-police, psycho-medical help or commercial leisure providers. Besides that, the BS is regarded by government educational and social policy as a potential partner and anchor for community development. It is too early to make reliable statements about the effects of the BS movement in the Netherlands concerning the educational opportunities for disadvantaged children and their families, especially those with migrant background, and combat further segregation. Evaluation studies made so far are moderately positive but also point to problems of overly bureaucratized structures and layers, lack of sufficient financial resources and, again, are uncertain about long-term effects.

Optimizing Triage and Hospitalization in Adult General Medical Emergency Patients. The Triage Project

Background: Patients presenting to the emergency department (ED) currently face inacceptable delays in initial treatment, and long, costly hospital stays due to suboptimal initial triage and site-of-care decisions. Accurate ED triage should focus not only on initial treatment priority, but also on prediction of medical risk and nursing needs to improve site-of-care decisions and to simplify early discharge management. Different triage scores have been proposed, such as the Manchester triage system (MTS). Yet, these scores focus only on treatment priority, have suboptimal performance and lack validation in the Swiss health care system. Because the MTS will be introduced into clinical routine at the Kantonsspital Aarau, we propose a large prospective cohort study to optimize initial patient triage. Specifically, the aim of this trial is to derive a three-part triage algorithm to better predict (a) treatment priority; (b) medical risk and thus need for in-hospital treatment; (c) post-acute care needs of patients at the most proximal time point of ED admission. Methods/design: Prospective, observational, multicenter, multi-national cohort study. We will include all consecutive medical patients seeking ED care into this observational registry. There will be no exclusions except for non-adult and non-medical patients. Vital signs will be recorded and left over blood samples will be stored for later batch analysis of blood markers. Upon ED admission, the post-acute care discharge score (PACD) will be recorded. Attending ED physicians will adjudicate triage priority based on all available results at the time of ED discharge to the medical ward. Patients will be reassessed daily during the hospital course for medical stability and readiness for discharge from the nurses and if involved social workers perspective. To assess outcomes, data from electronic medical records will be used and all patients will be contacted 30 days after hospital admission to assess vital and functional status, re-hospitalization, satisfaction with care and quality of life measures. We aim to include between 5000 and 7000 patients over one year of recruitment to derive the three-part triage algorithm. The respective main endpoints were defined as (a) initial triage priority (high vs. low priority) adjudicated by the attending ED physician at ED discharge, (b) adverse 30 day outcome (death or intensive care unit admission) within 30 days following ED admission to assess patients risk and thus need for in-hospital treatment and (c) post acute care needs after hospital discharge, defined as transfer of patients to a post-acute care institution, for early recognition and planning of post-acute care needs. Other outcomes are time to first physician contact, time to initiation of adequate medical therapy, time to social worker involvement, length of hospital stay, reasons fordischarge delays, patient’s satisfaction with care, overall hospital costs and patients care needs after returning home. Discussion: Using a reliable initial triage system for estimating initial treatment priority, need for in-hospital treatment and post-acute care needs is an innovative and persuasive approach for a more targeted and efficient management of medical patients in the ED. The proposed interdisciplinary , multi-national project has unprecedented potential to improve initial triage decisions and optimize resource allocation to the sickest patients from admission to discharge. The algorithms derived in this study will be compared in a later randomized controlled trial against a usual care control group in terms of resource use, length of hospital stay, overall costs and patient’s outcomes in terms of mortality, re-hospitalization, quality of life and satisfaction with care.

Evaluation of an inventory for the assessment of critical incidents involving football fans

Introduction: Fan violence is a frequent occurrence in Swiss football (Bundesamt für Polizei, 2015) leading to high costs for prevention and control (Mensch & Maurer, 2014). Various theories put forward an explanation of fan violence, such as the Elaborated Social Identity Model (Drury & Reicher, 2000)and the Aggravation Mitigation Model (Hylander & Guvå, 2010). Important observations from these theories are the multi-dimensional understanding of fan violence and the Dynamics occurring in the fan group. Nevertheless, none of them deal with critical incidents (CIs) which involve a tense atmosphere combined with a higher risk of fan violence. Schumacher Dimech, Brechbühl and Seiler (2015) tackled this gap in research and explored CIs where 43 defining criteria were identified and compiled in an integrated model of CIs. The defining criteria were categorised in four higher-order themes “antecedents” (e.g. a documented history of fan rivalry), “triggers” (e.g. the arrest of a fan), “reactions” (e.g. fans masking themselves) and “consequences” (e.g. fans avoiding communication with fan social workers). Methods: An inventory based on this model is being developed including these 43 criteria. In an exploratory phase, this inventory was presented as an online questionnaire and was completed by 143 individuals. Three main questions are examined: Firstly, the individual items are tested using descriptive analyses. An item analysis is conducted to test reliability, item difficulty and discriminatory power. Secondly, the model’s four higher-order themes are tested using exploratory factor analysis (EFA). Thirdly, differences between sub -groups are explored, such as gender and age-related differences. Results: Respondents rated the items’ importance as high and the quota of incomplete responses was not systematic. Two items were removed from the inventory because of low mean or a high rate of “don’t know”-responses. EFA produced a six-factor solution grouping items into match-related factors, repressive measures, fans’ delinquent behaviour, intra-group behaviour, communication and control and inter-group factors. The item “fans consume alcohol” could not be ordered into any category but was retained since literature accentuates this factor’s influence on fan violence. Analyses examining possible differences between groups are underway. Discussion: Results exploring the adequacy of this inventory assessing defining criteria of CIs in football are promising and thus further evaluative investigation is recommended. This inventory can be used in two ways: as a standardised instrument of assessment for experts evaluating specific CIs and as an instrument for exploring differences in perception and assessment of a CI e.g. gender and age differences, differences between interest groups and stakeholders.

Evaluation of an inventory for the assessment of critical incidents involving football fans

Introduction: Fan violence is a frequent occurrence in Swiss football (Bundesamt für Polizei, 2015) leading to high costs for prevention and control (Mensch & Maurer, 2014). Various theories put forward an explanation of fan violence, such as the Elaborated Social Identity Model (Drury & Reicher, 2000) and the Aggravation Mitigation Model (Hylander & Guvå, 2010). Important observations from these theories are the multi-dimensional understanding of fan violence and the dynamics occurring in the fan group. Nevertheless, none of them deal with critical incidents (CIs) which involve a tense atmosphere combined with a higher risk of fan violence. Schumacher Dimech, Brechbühl and Seiler (2015) tackled this gap in research and explored CIs where 43 defining criteria were identified and compiled in an integrated model of CIs. The defining criteria were categorised in four higher-order themes “antecedents” (e.g. a documented history of fan rivalry), “triggers” (e.g. the arrest of a fan), “reactions” (e.g. fans masking themselves) and “consequences” (e.g. fans avoiding communication with fan social workers). Methods: An inventory based on this model is being developed including these 43 criteria. In an exploratory phase, this inventory was presented as an online questionnaire and was completed by 143 individuals. Three main questions are examined: Firstly, the individual items are tested using descriptive analyses. An item analysis is conducted to test reliability, item difficulty and discriminatory power. Secondly, the model’s four higher-order themes are tested using exploratory factor analysis (EFA). Thirdly, differences between sub-groups are explored, such as gender and agerelated differences. Results: Respondents rated the items’ importance as high and the quota of incomplete responses was not systematic. Two items were removed from the inventory because of low mean or a high rate of “don’t know”-responses. EFA produced a six-factor solution grouping items into match-related factors, repressive measures, fans’ delinquent behaviour, intra-group behaviour, communication and control and inter-group factors. The item “fans consume alcohol” could not be ordered into any category but was retained since literature accentuates this factor’s influence on fan violence. Analyses examining possible differences between groups are underway. Discussion: Results exploring the adequacy of this inventory assessing defining criteria of CIs in football are promising and thus further evaluative investigation is recommended. This inventory can be used in two ways: as a standardised instrument of assessment for experts evaluating specific CIs and as an instrument for exploring differences in perception and assessment of a CI e.g. gender and age differences, differences between interest groups and stakeholders. References: Bundesamt für Polizei. (2015). Jahresbericht 2014. Kriminalitätsbekämpfung Bund. Lage, Massnahmen und Mittel [Electronic Version]. Drury, J., & Reicher, S. (2000). Collective action and psychological change. The emergence of new social identities. British Journal of Social Psychology, 39, 579-604. Hylander, I., & Guvå, G. (2010). Misunderstanding of out-group behaviour: Different interpretations of the same crowd events among police officers and demonstrators. Nordic Psychology, 62, 25-47. Schumacher-Dimech, A., Brechbühl, A. &, Seiler, R. (2016). Dynamics of critical incidents with potentially violent outcomes involving ultra fans: an explorative study. Sport in Society. Advance online publication. doi: 10.1080/17430437.2015.1133597

Evaluation of web-based resources for pregnant and parenting teens

Current teen pregnancy and repeat pregnancy rates reveal that there is a pressing need for comprehensive care for pregnant and parenting teens to address their unique needs. The Internet has become a source of various types of information and as a result, several efforts have begun to assess the quality of health information provided on websites. The objective of this study was to assess the functionality and quality of websites containing health information and resources for pregnant and parenting teens. The three most widely used search engines currently: Google, MSN, and Yahoo were searched using three general search terms “teen pregnancy”, “pregnant teen”, and “teen parent”. The first 5 pages of each search were reviewed and categorized to yield 12 websites which met inclusion criteria for content evaluation. The 12 websites were rated using a pre-existing instrument encompassing two domains: functionality and content analysis. Within the functionality domain, this sample highlighted the need to improve accessibility and credibility for the target population. The content analysis revealed that among the topics which are recommended for pregnant and parenting teens, the topics most commonly covered were mental health and primary and preventive health care. The majority of websites neglected sexual health topics including STI’s and family planning. This study provides the first glimpse into health information and resources for pregnant and parenting teens on the Internet. Researchers, health care providers, social workers, health educators, and website sponsors can use these results to maintain and recommend websites which offer easily accessible, accurate, and practical information for pregnant and parenting teens.^

A COMPARISON OF COUNTY HOSPITAL UTILIZATION BEFORE AND AFTER INTERVENTION BY THE HOSPITAL'S ALCOHOLISM SERVICES PROGRAM

This study examines the reduction in hospital utilization of 393 public hospital patients who were referred to the hospital's alcoholism screening program for intervention. The 393 patients were the total patient population of the alcoholism screening program for the period of September through December, 1982. Medical records of these patients were investigated to assess the total number of hospital days six months before and six months after intervention. The findings support the hypothesis of decreased utilization. The total number of hospital days for 393 patients before intervention of the alcoholism program was 3,458, with a mean length of stay of 8.80 days. The total number of hospital days after intervention was 458 days, with a mean length of stay of 6.50 days. The average individual difference (decrease) was 7.63 days for one year. From a total of 393 patients counseled by the alcoholism program, 106 (27%) went to treatment for their alcoholism. Other aims were to examine the referral sources (physicians, nurses, social workers and the MAST); study the impact of familial history of alcoholism on referrals, and explore the MAST scores of patients successfully referred. Implications of the study are that it would benefit the public hospital, with their disproportionate numbers of alcoholics, to intervene in the behavioral patterns of alcoholism. Such intervention would be a factor in reducing the overall hospitalization of the alcoholic. ^

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

Family Preservation Journal, 2003, Volume 7. (Entire issue)

Entire issue (large pdf file) Articles include: Social Workers' Perceptions of Family Preservation Programs. Elaine M Maccio, David Skiba, Howard J Doueck, Karen A. Randolph, Elisabeth A. Weston, and Lorie E. Anderson Targeting Special Populations for Family Preservation: The Influence of Worker Competence and Organizational Culture. Ramona W: Denby, Keith A. Alford, and Carla M Curtis Understanding and Fostering Family Resilience. Robert G. Blair Walking Our Talk in the Neighborhoods: Building Professional/Natural Helper Partnerships. Jill Kinney and Margaret Trent Intersystem Collaboration: A Statewide Initiative to Support Families. Elizabeth M Tracy, David E. Biegel, Ann C. Rebeck, and Jeffrey A. Johnsen

Supporting Families through Short-Term Foster Care: An Essay Review

Aldgate, J. and Bradley, M. (1999). Supporting families through short-term fostering. London: The Stationery Office. This essay reviews a British qualitative study of short-term foster care from the perspectives of birth parents, children, foster parents, and social workers. Respondents highlighted the value of short-term foster care as a family support service and also offered many recommendations for improving service delivery. The study provides useful implications for restructuring child welfare services in the United States and for promoting cross-national collaboration in future research activities in the area of child and family services.

"Excluidos en el malestar" : reflexiones sobre el malestar en las prácticas profesionales y preprofesionales de los trabajadores sociales

Este trabajo se propone describir y analizar el malestar en las prácticas profesionales y preprofesionales de los trabajadores sociales. Estas reflexiones las hacemos en el marco Carrera de Trabajo Social de la UNCuyo pero consideramos que pueden generalizarse a similares espacios académicos y profesionales. Ofrecemos una tipificación de las figuras posibles del malestar así como de las salidas frecuentes al mismo. Proponemos un análisis del mito originario del trabajador social y los significante que comandan su práctica tomando insumos del psicoanálisis lacaniano como la teoría de los cuatro discursos, de Lacan, o la lógica del todo y la lógica del no-todo. Tratamos de objetivar los nombres de ese malestar entre alumnos, docentes y graduados, deconstruir lo mitos originarios y proponer dispositivos para pensar -renombrar- ese malestar.