Presenters:
Stress and Coping among Latinos Caring for Elderly Relatives
Blanca Ramos
School of Social Welfare
University at Albany
135 Western Avenue
Albany NY 12222
phone: 518 442- 5365
fax: 518 442 5380
e-mail: ramos@albany.edu
Barriers To Primary Care For Women With HIV Who Have Parenting Responsibilities
Starr Wood
School of Social Welfare
University at Albany
State University of New York
135 Western Avenue
Albany NY 12222
phone: 518 437-3680
fax: 518 442 5380
e-mail: sawood@albany.edu
The Use of Human and Social Capital Among TANF Single Parent Students
Sandra Austin
School of Social Welfare
University at Albany
State University of New York
35 Western Avenue
Albany NY 12222
phone: 518 591-8751
fax: 518 442 5380
e-mail: saustin@albany.edu
Ethnic and Gender Differences in Perceptions of Mental Health Among
Korean and American Counseling Students
Zvi Gellis
School of Social Welfare
University at Albany
State University of New York
135 Western Avenue
Albany NY 12222
phone: 518 442- 5152
fax: 518 442 5380
e-mail: gellis@albany.edu
Julian Chun-Chung Chow
School of Social Welfare
University of California at Berkeley
319 Haviland Hall
Berkeley, CA 94720-7400
phone 510 643-9288
fax 510 643-6126
e-mail: jchow99@uclink.berkeley.edu
JongChun Kim
School of Social Welfare
State University of New York at Albany
Enhancing Psychosocial Competence Among Black Women: An Innovative Psycho-Educational
Group Work Approach
Lani Jones
School of Social Welfare
University at Albany
135 Western Avenue
Albany NY 12222
phone: (519) 442-5267
fax: 518 442 5380
e-mail: ljones@albany.edu
Despite improvements in social services for culturally diverse client
groups, many of their needs and service issues are poorly understood.
This symposium presents results of qualitative and quantitative research
on mental health needs and service delivery issues among several diverse
groups, including Latinos, African-Americans, and Koreans.
Three papers address ways that women from several groups deal with stressors and barriers to services associated with caregiving under various circumstances. One paper addresses stresses and coping mechanisms among Latinos caring for elderly relatives. A second investigates barriers to care for Latina, African-American and Euro-American women who have HIV/AIDS and who are primary caregivers to children. The third looks at how TANF single parent students manage social support sufficient to enable them to complete college.
A fourth paper focuses on attitudes of future service providers, looking at the perceptions of mental health among Korean and American students preparing to be counselors and social workers. The final paper reports the results of a controlled experiment with a culturally-specific psycho-educational group approach with African-American women at risk for mental health problems.
The results of each study include unique cultural aspects, the effects of culture on the participants’ definitions of the issues, and implications for culturally competent social work practice with the populations studied.
Methods. We examined the impact of culture and ethnicity, and their interrelationships, on the stress and coping process among Spanish speaking Latino primary caregivers. Data were collected using eight semi-structured focus groups (N = 80) conducted by a bilingual, bicultural MSW in community settings in Latino neighborhoods. Discussion guidelines included six broad, open-ended questions with structured probes, which served as a basis for coding. Patterns were identified across groups and respondents with similar demographic characteristics and acculturation level.
Results. Caregiving was perceived by the caregivers as an opportunity to willfully demonstrate affection, gratitude, and respect for elder relatives. Financial hardships made caregiving especially burdensome. Women expressed difficulties attending to their own needs over familial relationships. Many felt guilty and inadequate about their effectiveness as caregivers. Fatalistic and religious beliefs strongly influenced appraisal and coping. Participants relied primarily on emotion-focused responses such as resignacion, controlarse, and sobreponerse.
Implications. The findings can help inform culturally relevant practice with Latino caregivers. The meanings ascribed to caregiving may be key in understanding how Latino caregivers perceive and respond to caregiving stress. Social workers can act as culture brokers using empowerment strategies that affirm Latinas’ traditional nurturing qualities while emphasizing the urgency of attending to their own needs. They can also help expand coping choices to include solution-focused responses. As the numbers of culturally diverse elderly grow rapidly, the influence of culture and ethnicity in family caregiving must be considered in social work practice and research.
Methods. A total of 43 Latina, African American and Euro-American
women living in 6 areas of a Northeastern state were asked closed and open-ended
questions regarding their experiences with access to health care, medication
adherence, cultural competency, family responsibilities, and care of HIV-positive
children. The women were also asked about mental health, substance
abuse and coping concerns.
Both medical care providers and social service organizations participated
in publicizing the study among women who had different levels of engagement/retention
in care. Outreach interviews were conducted in English and Spanish. In
addition, 4 providers were also asked to reflect on their experiences regarding
the needs of HIV positive mothers.
Results and implications: Although the women generally felt that quality primary health care services, access to appointments and to medication were available to them in the state, they did not always access needed care. The women discussed their patterns in seeking health care as well as their successes and difficulties in adhering to treatment. They suggested that informal and formal supports for coping with stress are key elements for successful engagement and retention in care. Recommendations for engagement and retention are made.
References
McMahon,T; Winkel.; Suchman, N; Suniya, S. (2002) Drug dependence;
parenting responsibilities, and treatment histories: Why doesn’t
mom go for help? Drug and Alcohol Dependence. 65(2): 105-114.
Melchior, L; Hughes, C; Brown, V; and Huba, G., (2000) Practical issues
in evaluating a self-structured psychosocial and medical support program
for women with HIV/AIDS. Drugs and Society. 16(1-2): 163-184.
Weissman, G., Melchior, L; Huba, G; Smereck, G., (1995) Women living
with drug abuse and HIV disease: Drug abuse treatment access and
secondary prevention issues. Journal of Psychoactive Drugs 27(4): 401-411.
Methods: One to one and half hour semi-structured interviews were conducted with a snowball sample of 14 TANF single parents who were currently or previously enrolled in a flagship Northeastern university. The auto-taped interviews probed the supports acquired from friends, family, faculty, social workers, and university administrators to sustain TANF compliance and college enrollment. Grounded theory methodology informed the selection and coding process and the analysis, which concluded with the emergence of several themes.
Results: The study revealed the parents’ perception of the limitation of the TANF policy and their coping strategies to overcome the policy’s limitations and maintain a healthy equilibrium. The parents’ objectives were decidedly different from the specific policy objectives. Parents replaced Work First with the development of human and social capital strategies that addressed their primary objectives of completing school while staying within the parameters of TANF’s work requirements. Thus, they were able to resolve potential psychological conflicts.
Implications for Social Work Practice and Research: The outcome supports the need for social workers to assist clients in exploring human and social capital development in order to facilitate long term self sufficiency from TANF. Further research should examine the role of higher education in the welfare to work policy. These qualitative findings also have implications for informing the development of quantitative investigations on coping strategies for poor college students and on the role of higher education in welfare to work policy.
Method: Cultural differences between 104 Korean and 107 Caucasian American counseling students is investigated in the way mental health is conceptualized using the Mental Health Values Questionnaire (MHVQ). The objective of the paper is to describe cultural and gender differences and similarities between the two groups.
Findings. Notable differences between Koreans and Americans were found on the MHVQ subscales of negative traits, achievement, affective control, untrustworthiness, and unconventional reality. Female Korean students perceived a stronger relationship with poor mental health on the negative traits, untrustworthiness, and unconventional reality scales than their American counterparts. Americans reported lower scores on the achievement and affective control subscales than the Korean students.
Implications. Discussion will include interpretations from a cultural perspective about mental health practice.
References
Cho, M., Nam, J., & Suh, G. (1998). Prevalence of symptoms of depression
in a nationwide sample of Korean adults. Psychiatry Research, 81, 341-352.
Gellis, Z. D. (2001). Using a participatory research approach to mobilize
immigrant minority family caregivers. Journal of Social Work Research and
Evaluation, 2(2), 267-282.
Kirmayer, L., Smith, A., & Dao, T. (1998). Somatization and psychologization:
Understanding cultural idioms of distress. In S. Okpaku (Ed.), Clinical
methods in transcultural psychiatry (pp.72-84). Washington: American Psychiatric
Press.
Methods. Utilizing an experimental design with pre/post measures and a control group, this study examined the effectiveness of a culture specific, psycho-educational group intervention model with 60 Black women aimed at reducing psychological stress and enhancing psychosocial competence. This study modifies Tyler’s (1978) model of psychosocial competence which focuses on self-attitudes and behavioral attributes to include the cultural perspective of Black women. It also and incorporates the use literary works, as an innovative tool, for enhancing the group process.
Results. Findings of this study indicate the usefulness of the group intervention model with Black women in reducing self reported stress, gaining external locus of control, and increasing active coping.
Implications. The results support the development of culture appropriate clinical and non-clinical group interventions as a viable and cost effective method for stress reduction and psychosocial competence enhancement for Black women experiencing depression related risk factors.
References
Francis-Spence, M. (1994). Group work and black women viewing
networks as groups: Black women meeting together for affirmation and empowerment.
Group Work, 7(2), 109-116.
Hopps, J.G. & Pinderhughes, E.B. (1999). Group work with
overwhelmed clients. New York: Free Press.
Jones, L.V. (2000). Enhancing Psychosocial Competence Among Black
Women Through an Innovative Psycho-educational Group Intervention.
Ann Arbor, MI: UMI Publishing-Bell & Howell.
Lewis, E. & Ford, B. (1991). The network utilization project:
incorporating traditional strengths of african-american families into group
work practice. Social Work with Groups, 13(4) 7-22.
Mays, V. (1995). Black women, work, stress, and perceived discrimination:
the focused support group model as an intervention for stress reduction.
Cultural Diversity and Mental Health, 1, 1, 53-65.
Miller, J.B. (1988). Connections, disconnections, and violations.
Work in Progress, 33, Wellesley, MA.: Stone Center Working Paper Series.
Padgett, D., Patrick, C., Burns, B. & Schlesinger, H. (1994).
Women and outpatient mental health services: use by black, hispanic, and
white women in a national insured population. The Journal of Mental
Health Administaration, 21(4), 347-360.
Tyler, F.B. (1978). Individual psychosocial competence: A personality
configuration. Education & Psychological measurements, 38, 309-323.