The phenomenon of work stress is ubiquitous and has been the source of considerable attention over the past few decades. Work stress is a common problem in human services, particularly in the area of rehabilitation. The prevalence of this problem for rehabilitation has, however, been fuelled over the last two decades by the rapid growth of the insurance-based rehabilitation sector in Australia. The expansion of this sector has created a major market for rehabilitation practitioners. Using a qualitative research paradigm, the current study examined the insurance-based rehabilitation context in Australia. Specifically, this study explored the influence of this context on the experience of work stress for rehabilitation professionals. Although attempts to account for work stress usually focus on the qualities of the individual and organizational factors, the current study has responded to the call in occupational stress literature to examine this phenomenon at a broader, contextual level. Twenty-five rehabilitation professionals were asked to provide visual representations to illustrate their experience of the insurance-based rehabilitation work context. Interviews were conducted with each participant to elicit a more in-depth understanding of this experience. The findings revealed that the insurance-context appears to be characterized by inconsistency, chaos, confusion, and a strong focus on profit and cost effectiveness as depicted by the themes Maelstrom, Co-dependent Liaisons, Implosion of Responsibility, Legislative Pluralism, External Trumping and Greed. The deleterious influence of this context on rehabilitation professionals manifested in several ways as represented by the themes Impotence, Cynicism, Going Through the Motions, and Betrayal. A metaphor of a virus was used to provide a context for understanding how rehabilitation professionals were infected by the stressors inherent in the unhealthy contextual environment of the insurance sector. The results of this study have important implications for informing future policy, practice and research within the rehabilitation industry. Clearly, the health of the insurance sector needs to improve to ensure the well-being of rehabilitation professionals such as those who participated in this study. Improved health of this sector must include a greater respect for the profession of rehabilitation. Also crucial to the improved health of the sector is consistency in legislation and procedures that underpin rehabilitation. In addition, rehabilitation professionals must accept responsibility for enhancing their core competencies if they are to inoculate themselves against the harmful influence of the broader insurance context. Strategies to inoculate rehabilitation professionals against the infiltration of these contextual stressors must include an understanding of business administration and policy. Finally, the findings suggest that unless the health of the sector and the rehabilitation professionals improve, poor rehabilitation outcomes are likely to continue to plague the insurance industry and the experience of work stress and turnover among rehabilitation professionals will remain unacceptably high.

Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

This descriptive research project is a survey and analysis of nineteen community mediation programs in the State of Oregon. These programs were evaluated to determine their responsiveness to issues of culture and ethnicity. Data was gathered by face-to-face and telephone interviews with community program staff members and administrators. Information was written on cards or tape recorded for analysis. General questions were asked about kinds of services, target groups, and minority use of services provided. Other questions related to information about training, mediator selection, intake, and the mediation process. A review of selected authors, such as Hall, Hofstede and others, forms a background for cultural issues related to mediation. Cultural factors included in this study highlight the characteristics and variables of cultural and conflict. The literature review includes current thinking regarding the nature, merit and challenges of community mediation programs and a description of mediation in the State of Oregon. The findings of the research indicate that most community mediation programs in Oregon do not service minority communities. The need for adequate funding, personnel, time, and solutions to serve diverse populations within their neighborhoods produces a constant tension affecting the extent to which programs are responsive to diversity issues. Outreach to develop community awareness and recruit volunteers varies significantly. Very little outreach is specific to minority communities. Most advertising is in English. Training programs differ from location to location, but aspects related to culture are minimal. The intake process for each program varies only slightly. Usually procedures and techniques remain consistent regardless of the cultural or ethnic backgrounds of disputants. With the exception of language considerations, the mediation process also remains the same for all cases. Recommendations are included to strengthen the development of programs to be more responsive and open to the cultural needs of minorities. / Graduation date: 1999

Thesis (Ph. D.)--University of Hong Kong, 2007. / Also available online.

Mindfulness-based wellness education (MBWE) is an 8-week program teaching formal mindfulness practices as a foundation for cultivating an awareness of one’s health or ill-health in the physical, social, emotional, ecological, vocational, mental and spiritual domains of human existence. It is designed as a health promotion intervention for individuals who are at risk of developing stress related problems, such as is the case of human services professionals. This dissertation focuses on teachers-in-training. Two groups of teacher trainees completed MBWE as part of an elective course focusing on stress and burnout. In comparison to control participants, who completed other optional courses, MBWE participants experienced improvements in mindfulness, health, and teaching self-efficacy. In one group, the intervention was also effective in reducing psychological distress and augmenting satisfaction with life. Interviews with participants after graduation revealed that although they struggled with independent mindfulness practice, they benefited from their participation in the class, which led to specific health behavior changes such as increased physical activity. Some participants reported that they relied on their mindfulness practices in times of crisis; others shared the knowledge they learned with their students and observed that this was an effective and beneficial response to the needs of their classrooms. Ideas for future inquiries include the need to explore factors influencing participants’ responses to the MBWE program and how to support on-going practice.

Mindfulness-based wellness education (MBWE) is an 8-week program teaching formal mindfulness practices as a foundation for cultivating an awareness of one’s health or ill-health in the physical, social, emotional, ecological, vocational, mental and spiritual domains of human existence. It is designed as a health promotion intervention for individuals who are at risk of developing stress related problems, such as is the case of human services professionals. This dissertation focuses on teachers-in-training. Two groups of teacher trainees completed MBWE as part of an elective course focusing on stress and burnout. In comparison to control participants, who completed other optional courses, MBWE participants experienced improvements in mindfulness, health, and teaching self-efficacy. In one group, the intervention was also effective in reducing psychological distress and augmenting satisfaction with life. Interviews with participants after graduation revealed that although they struggled with independent mindfulness practice, they benefited from their participation in the class, which led to specific health behavior changes such as increased physical activity. Some participants reported that they relied on their mindfulness practices in times of crisis; others shared the knowledge they learned with their students and observed that this was an effective and beneficial response to the needs of their classrooms. Ideas for future inquiries include the need to explore factors influencing participants’ responses to the MBWE program and how to support on-going practice.

Thesis (Ph. D.)--Virginia Commonwealth University, 2003. / Prepared for: School of Social Work. Includes bibliographical references (leaves 268-279). Also available online via the Internet.

dissertation examines the role of civil society actors in the social service sectors of two cities in the eastern Democratic Republic of Congo. Although existing scholarship addresses the nature of state-society relations in collapsed states, less is known about how local institutions act to maintain "state" structures even when the state is absent. My project contributes to this literature by explaining why, in a failed state, some civil society organizations (CSO's) are more successful at providing social services than others. I hypothesize that variations in internal organizational cohesion account for these differences. Using an historical institutional approach, I examine the history, level of engagement with the state, ethnic composition, and level of international support of various CSO's in the eastern D.R. Congo as indicators of a CSO's level of organizational cohesion. I then compare fifteen structural indicators to determine each CSO's level of success in organizing social services, and conclude that CSO's with higher levels of internal organizational cohesion are more likely to successfully organize health and education structures in situations of state collapse. In addition, the portion of the study that addresses ethnic fragmentation in CSO's suggests that certain institutional arrangements can help local groups to overcome the well-documented barriers to inter-ethnic cooperation in public goods provision. / text

The Affordable Care Act (ACA) seeks to increase the low-income population’s access to health care coverage by expanding Medicaid eligibility and providing subsidies to individuals meeting certain income thresholds. The citizens of Texas would benefit greatly from the ACA provisions, as the state offers limited opportunities for individuals to access insurance, evidenced by the 6.3 million residents without health care coverage. But political leaders in Texas have a long-standing commitment to limited government, low taxes, and states’ rights in a federal system of government. In the 1990s, Texas legislators, with bipartisan support, laid the groundwork over the last decade for the minimal, yet significant preparations that administration used to coordinate ACA implementation. Yet legislators’ commitment to limited government and states’ rights placed additional constraints on the ability of the Texas Health and Human Services Commission (HHSC) to implement ACA provisions by refusing to utilize the 82nd legislative session to prepare the state for impending deadlines. Instead, administrators developed an interagency effort, the Eligibility Modernization Project (EMP), to streamline eligibility determinations and increase clients’ access to information and services. EMP’s initiatives mirror ACA provisions, but also seeks to achieve policy goals that both Republican and Democratic legislators support, such as providing effective and efficient eligibility determinations. Nevertheless, legislators and administrators must go beyond EMP’s efforts to adequately prepare the eligibility system for impending ACA deadlines. Policy recommendations include further streamlining and integrating the health subsidy system with a state-based health insurance exchange, increasing access to coverage by expanding Medicaid eligibility, adequately preparing the workforce for changes, and promoting long-term planning. These solutions will provide a sounder infrastructure for HHSC to prepare for ACA coordination and implementation, while increasing access to health care coverage for the low-income population. / text

published_or_final_version / Social Work and Social Administration / Master / Master of Philosophy