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Transcending the Professional-Client Divide: Supporting Young People with Complex Support Needs Through Transitions.

ABSTRACT: Young people with complex support needs frequently experience multiple intersecting forms of disadvantage including experiences of violence, abuse and neglect, housing instability and homelessness, problematic substance use, exclusion from education, and contact with the criminal justice system. Many of these young people have mental health, cognitive disability and/or other health issues that also impact on their lives. These young people need to navigate multiple, diverse, and often difficult transitions between services, adding to the existing chaos in their lives. This article explores the experiences of young people with complex support needs in transition, specifically young people's viewpoints and experiences of supports they receive from paid professionals. This qualitative study used body mapping research methods and in-depth interviews with 38 young people aged 16 to 26 years in three Australian states. Helpful and trusting paid relationships could serve as an anchor to young people during complex transitions and other highly turbulent life periods. These relationships were contingent on a deep and non-judgmental knowing of the young person, contributed constructive outcomes and stability in young people's lives, and for some young people, had 'life-saving' effects. These findings present opportunities and challenges for policymakers and practitioners to balance the tensions between authentic relationship-based work with young people and risk-averse, economically-driven imperatives in contemporary youth service provision.

SUBMITTER: Ellem K

PROVIDER: S-EPMC7223451 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Transcending the Professional-Client Divide: Supporting Young People with Complex Support Needs Through Transitions.

Ellem Kathy K Smith Louisa L Baidawi Susan S McGhee Adrienne A Dowse Leanne L

Child & adolescent social work journal : C & A 20200119 2

Young people with complex support needs frequently experience multiple intersecting forms of disadvantage including experiences of violence, abuse and neglect, housing instability and homelessness, problematic substance use, exclusion from education, and contact with the criminal justice system. Many of these young people have mental health, cognitive disability and/or other health issues that also impact on their lives. These young people need to navigate multiple, diverse, and often difficult ...[more]

PMID: 32435082

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Project description:BackgroundAdolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible.MethodsWe recruited 105 young persons (17-21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups.ResultsParticipants' reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services.ConclusionsA better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context.

Project description:BackgroundStudies continually show benefits of active learning in college classrooms, yet it is difficult to get faculty to adopt these methods. Particularly challenging is the final step of the instructional change process, "refreezing," when after making initial changes in instructional methods, instructors decide whether to continue with new instructional methods or return to their previous methods. Though this stage is important, it is not well studied. Most available studies about ongoing support following professional development on teaching merely state that facilitators made an effort to offer support, or report how frequently participants engaged with online support mechanisms through counting postings on listservs or message boards. Such measures do not show evidence that participants actually received positive reinforcement or intellectual and emotional support, which are crucial to refreezing, nor do these frequency analyses help other professional developers learn how to create productive ongoing support mechanisms that yield high participant engagement.ResultsThis workshop for 35 college mathematics instructors used online and in-person communities to provide support to participants during the post-workshop period of "refreezing." Almost all workshop attendees participated in "e-mentoring" (94%), primarily through a productive, engaging group email listserv. By combining qualitative coding of message content with the techniques of social network analysis, we reveal how facilitators and participants on the group listserv provided intellectual and emotional support, as well as positive reinforcement through feedback loops. The analysis also shows how the facilitators made this a helpful group and maintained participant engagement through frequent encouragement, deliberate community building, and thoughtfully timed responses.ConclusionsThough many professional development workshops offer online support through email listservs, there is little evidence that these listservs successfully engage and support participants. Applying the analytic approach of social network analysis allowed us to model the conversation threads in one highly engaged and supportive listserv following a mathematics professional development workshop. This method revealed the processes of ongoing support in ways that traditional frequency-based analyses cannot. This method also revealed lessons for how other professional developers can create productive, helpful online support listservs. Since this is an innovative application of social network analysis, we describe the method in detail.

Project description:Attendance at professional society meetings facilitates networking, collaboration, and success in academic/scientific fields. Insufficient funds, support, or resources for caregiving can inhibit attendance for parents/caretakers, who may become professionally disadvantaged by not attending professional society conferences. The American Society for Nutrition (ASN) offered a family support grant for caregiving needs during the annual conference (maximum: $750); however, the perceived impact of caregiving funds on attendance outcomes is unknown. The objective of this study was to assess the need of family support for attendance to the ASN annual conference among applicants and to assess recipients' experience and usage of funds. Applicants completed a pre-conference survey assessing requested funds, out-of-pocket caregiving expenses to attend the meeting, the influence of receiving the grant on attendance, and additional factors. Recipients completed a post-conference survey assessing use of the funds and impact of the grant on attending/participating. Grant applications (n = 110) were majority women, aged 26-45 y, married, at the trainee or assistant professor level, from diverse racial/ethnic backgrounds, and with parenting noted as the primary responsibility. Thirty-seven percent of applicants were currently lactating or expressing milk. The average amount requested was $650 US dollars, and >60% of respondents indicated plans to use funds to bring a family member/friend to the conference. Seventy-seven percent of respondents indicated that receiving the grant would influence their attendance. The post-conference survey (n = 25) indicated that recipients felt that receiving the grant was helpful in attending the conference (92%), specifically attending scientific sessions (96%) and poster sessions (80%). Recipients indicated the grant helped them network with attendees (88%), visit the exhibitor hall (72%), and participate in career development activities (64%). The ASN family support grant aided attendance and supported recipients' participation in conference activities, particularly early-career women who are parents, with the goal of supporting diversity and inclusivity in scientific/academic fields. This trial was registered at www.clinicaltrials.gov as NCT03432585.

Project description:BackgroundHealth care systems are increasingly moving towards more integrated approaches. Shared decision making (SDM) is central to these models but may be complicated by the need to negotiate and communicate decisions between multiple providers, as well as patients and their family carers; particularly for older people with complex needs. The aim of this review was to provide a context relevant understanding of how interventions to facilitate SDM might work for older people with multiple health and care needs, and how they might be applied in integrated care models.MethodsIterative, stakeholder driven, realist synthesis following RAMESES publication standards. It involved: 1) scoping literature and stakeholder interviews (n = 13) to develop initial programme theory/ies, 2) systematic searches for evidence to test and develop the theories, and 3) validation of programme theory/ies with stakeholders (n = 11). We searched PubMed, The Cochrane Library, Scopus, Google, Google Scholar, and undertook lateral searches. All types of evidence were included.ResultsWe included 88 papers; 29 focused on older people or people with complex needs. We identified four context-mechanism-outcome configurations that together provide an account of what needs to be in place for SDM to work for older people with complex needs. This includes: understanding and assessing patient and carer values and capacity to access and use care, organising systems to support and prioritise SDM, supporting and preparing patients and family carers to engage in SDM and a person-centred culture of which SDM is a part. Programmes likely to be successful in promoting SDM are those that allow older people to feel that they are respected and understood, and that engender confidence to engage in SDM.ConclusionsTo embed SDM in practice requires a radical shift from a biomedical focus to a more person-centred ethos. Service providers will need support to change their professional behaviour and to better organise and deliver services. Face to face interactions, permission and space to discuss options, and continuity of patient-professional relationships are key in supporting older people with complex needs to engage in SDM. Future research needs to focus on inter-professional approaches to SDM and how families and carers are involved.

Dataset Information

Transcending the Professional-Client Divide: Supporting Young People with Complex Support Needs Through Transitions.

Publications

Transcending the Professional-Client Divide: Supporting Young People with Complex Support Needs Through Transitions.

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