The Impact of Human Service Provider Quality on the Personal Outcomes of People With Intellectual and Developmental Disabilities

BackgroundQuality of life is multidimensional—influenced by individual, organizational, and environmental factors. As such, when examining personal outcomes, it is also important to consider meso and macro factors that contribute to people with intellectual and developmental disabilities' (IDD's) quality of life. While it is widely acknowledged that organizational factors contribute to people's quality of life, there is less research directly examining how the quality of human service providers contributes to people with IDD's personal outcomes. For these reasons, the aim of this study was to explore the relationship between provider quality and people with IDD's personal quality of life outcomes.MethodsUsing a multilevel linear regression we analyzed secondary Personal Outcome Measures® (personal outcomes) and Basic Assurances® (provider quality) data from 2,900 people with IDD served by 331 human service providers.ResultsPeople with IDD's personal outcomes, regardless of their support needs or other demographics, were significantly impacted by the quality of the human service providers they received services from—the higher the quality of the provider, the more personal outcomes they had present. In addition, the following demographic covariates were correlated with personal outcomes: gender; race; complex support needs; residence type; and organizations that offered therapy services.DiscussionWhile quality improvement initiatives may require a great deal of cost and time commitment from providers, our findings suggest the effort translates to improved personal outcomes among people with IDD. The ultimate goal of service providers should be improvement of quality of life among those they support.

Bridge Builders and Boundary Spanners: Intersectoral, Interorganizational, and Interprofessional Education

The needs of individuals aging with intellectual and developmental disabilities (IDD) and their families do not fall neatly within defined policies, programs, and professions. They comprise complex challenges based on medical, psychological, social, environmental, economic and familial dimensions. These needs pose a challenge for providers in developing solutions at three levels: (1) different policies and programs create barriers based on different funding sources, eligibility requirements, and administrative restrictions; (2) clinical and community-based programs embody the gap between healthcare and human service providers; and (3) different professions are trained in their own methods of assessment and care plan development that impede the design of integrated approaches to defining and solving problems. This paper proposes an intersectoral, interorganizational, and interprofessional framework for addressing these problems based on networking and collaborative practice principles embodying bridge-building, boundary-spanning, and team-working as a basis for provider education. Implications for expanded education in this field are explored.

Introduction

This chapter introduces the volume “Sexuality in Emerging Adulthood” and offers a overview of the five organizing sections of the book: conceptualization and foundational perspectives, methodological trends, contexts and socializing agents, flourishing and floundering, and practical applications. Each of the five sections within the volume review empirical work that collectively examines the diversity of experiences and outcomes of sexuality in emerging adults. The goal of the volume as a whole is to provide a comprehensive and nuanced review of what we know about sexuality in emerging adulthood to inform both the broader study of sexuality and that of emerging adulthood. Indeed, the collective chapters offer strong evidence that emerging adulthood can afford the opportunity to establish both productive and destructive sexual trajectories; the identification of factors associated with each of these trajectors should prove useful for application by educators, health professionals, human service providers, and policymakers.

Interpersonal and structural complexities among women experiencing homelessness in a U.S.-Mexico border community

The life complexities of women experiencing homelessness warrants further exploration as there is insufficient information on their life’s interpersonal and structural challenges. The aim of this study is multifold: to explore the experiences of unhoused women in El Paso, Texas, a city that borders with Ciudad Juarez Mexico, to identify barriers to health and social services, to promote agency, and improve access to care. Recruitment of participants was done through partner agencies in selecting a sample of 15 Hispanic and 15 Non-Hispanic women who were experiencing homelessness and residing in local shelters in the spring of 2019. The Beck Depression Inventory II, General Self-Efficacy (GSE), and Adverse Childhood Experiences (ACE) scales were administered to enhance understanding and knowledge on the characteristics of women with a lived experience of homelessness to learn about their interpersonal and adverse experiences and future outlook. Feminist perspective was employed as part of the theoretical framework to further explore the interpersonal and structural realities of women experiencing homelessness. Three major themes emerged: relational adversity and intimate partner violence; lack of social support; and challenges related to transitioning out of homelessness. Implications highlighted in the findings will inform health and human service providers, and decision makers about the needs of women and the importance of person-centered carer for this population. It is critical that social workers, human service practitioners, policy makers, researchers, and the general public pause, listen and understand the realities that women experiencing homelessness face and their resiliency to ensure quality services to support them transition and end homelessness.

A Scoping Review of Vicarious Trauma Interventions for Service Providers Working With People Who Have Experienced Traumatic Events

Health and human service providers who aid traumatized individuals frequently experience vicarious trauma (VT). Although VT plays a critical role in service providers’ mental health and well-being, as well as in the quality of their service provision, little information is available concerning the development and implementation of VT interventions for service providers. To advance the development of evidence in this area, we undertook a scoping review in which we reviewed existing interventions intended to address VT among service providers working with traumatized clients. Searches of electronic databases were conducted to identify studies published in peer-reviewed journals, with no date restrictions. Over 1,315 citations were reviewed, and a total of 27 studies were included in the final review. The findings show that VT interventions in the literature can be divided broadly into four categories: psychoeducation, mindfulness intervention, art and recreational programs, and alternative medicine therapy. The VT interventions reviewed generally showed promise in their key outcomes, including reductions in secondary trauma stress, compassion fatigue, burnout, and other mental health outcomes. However, the current body of research is lacking both in rigor and in specificity regarding the definition of VT. Furthermore, existing VT interventions are generally self-care based and tend to focus on general stress management rather than addressing the specific effects of VT. Therefore, we call for an increase in efforts to tailor VT interventions to different service settings and participant characteristics, as well as greater attention to developing primary VT interventions at the organizational level.

A Transformational Approach to Developing Cultural Humility in the Classroom

Introduction: Undergraduate psychology programs offer opportunities for the development of knowledge and specialized skills in order to equip students to work with diverse populations. Statement of the Problem: It is crucial for psychology clinicians and other human service providers to understand and be responsive to the scope of cultural diversity. To be effective, they must demonstrate cultural humility through an anti-bias approach. Literature Review: We review research pertaining to cultural diversity, cultural humility, and the social and pedagogical implications associated with these constructs. Teaching Implications: We offer one approach for fostering the development of cultural humility through a 6-week Cultural Humility Learning Module that capitalizes on the principles of diversity, privilege and bias, cultural humility, fairness, and social justice. Conclusion: Through piloting and refining the learning module in our own classrooms, we believe that this approach shows promise of transformational learning. We offer the reader potential ways to assess the effectiveness of the module.

Dog Welfare, Well-Being and Behavior: Considerations for Selection, Evaluation and Suitability for Animal-Assisted Therapy

Health care and human service providers may include dogs in formal intervention settings to positively impact human physical, cognitive and psychosocial domains. Dogs working within this context are asked to cope with a multitude of variables including settings, populations, activities, and schedules. In this article, the authors highlight how both the preparation and operation of dogs within animal-assisted therapy (AAT) differs from less structured animal-assisted activities (AAA) and more exclusive assistance animal work; the authors highlight the gaps in our knowledge in this regard, and propose an ethically sound framework for pragmatic solutions. This framework also emphasizes the need for good dog welfare to safeguard all participants. If dogs are not properly matched to a job or handler, they may be subjected to unnecessary stress, anxiety, and miscommunication that can lead to disinterest in the work, overt problematic behavioral or health outcomes, or general unsuitability. Such issues can have catastrophic outcomes for the AAT. The authors propose standards for best practices for selection, humane-based preparation and training, and ongoing evaluation to ensure the health, welfare and well-being of dogs working in AAT, which will have concomitant benefits for clients and the professionalism of the field.