The study design called for a longitudinal evaluation of one hundred subjects enrolled in a vocational counseling program for recovering alcoholics. Due to CETA stipend cuts, and slowing of referrals, eighty subjects were studied. Subjects were administered two questionnaires, one at program entry, the second at a six month follow-up point. The study's primary purpose was to identify those factors associated with success. Success was defined as diminution or elimination of the problem drinking pattern and employment at follow-up. A number of hypotheses were tested. The study was carried out over the course of twenty-three months. The mean age for subjects was 41. There were sixty-one men and nineteen women, 28% were members of a minority group. Subjects were typical of clinical treatment samples, more socially and psychologically impaired than a cross-section of the general drinking population. The majority were referred to the program by out-patient treatment facilities. Seventy-seven percent of the subjects mailed in their follow-up questionnaire. At follow-up the rate of employment was 56%. Employment was associated with the following factors: Program completion, younger age, some college education or beyond, abstinence or controlled drinking, higher rates of religious participation. Women and minority members were as successful in securing jobs as white males. The majority of the subjects were abstinent, with 13% problem drinking. Abstinence or controlled drinking was associated with the following factors: Employment, older age, minority group membership, no use of other drugs. Comparing employed with unemployed subjects, we found the unemployed were more likely to be drinking, and were experiencing higher rates of depression. Few subjects had strong family or friendship ties. Counselors' predictions of subject performance reflected a favorable bias toward subjects with particular characteristics. Predictions had a high rate of accuracy, raising questions about the effect of counselor bias on subject performance. Overall, subjects rated the impact of the program high to moderately high.

This dissertation employs qualitative and quantitative methods to examine the relationship between religion and sexual HIV risk among 1,342 male migrant workers from Kyrgyzstan, Tajikistan, Uzbekistan, and Kazakhstan, employed in Baraholka Market, located in Almaty, Kazakhstan. Drawing on a conceptual theoretical framework which incorporates decision-making, social support, and gender and power theories, research questions examine how religion contributes to engagement in or avoidance of sexual HIV risks through the mechanisms of decision-making, social supports, and gendered norms; whether affiliation and religiosity are associated with sexual HIV risks; and whether changes in religiosity over time are associated with sexual HIV risks. Study findings identified that most men were Muslim and religious norms contributed to their understanding of sexual relationships. Some associations with protective behavior were found for men who were Muslim, men with higher levels of religiosity, and men who maintained higher than average religiosity over time. Men with higher than average religiosity were more likely to consider themselves protected from acquiring HIV. Study findings have a number of implications for HIV prevention efforts in Central Asia.

This is an exploratory study designed to examine the contracting process with respect to specific variables thought to be related to contract negotiation. Research questions pertaining to contract negotiation include a focus on those issues which are vulnerable to disagreement between paired caseworkers and clients. The study is deigned to find associations between the following variables and high and low contract status between actual casework-client pairs: (1) Client Perception of the Relationship; (2) Verbal Participation in the Contracting Process; (3) Relationship Communication and (4) Background Characteristics of Workers and Clients. The study sample is comprised of fifteen client-worker pairs drawn from a Veterans Administration outpatient medical and psychiatric clinic. Two main sources of data are used: (1) Worker and Client Questionnaires distributed to clients and workers after the first three casework interviews and (2) Audiotape recordings of the first three interviews which were subject to content and process analysis of communication. Findings concerning contract status show a statistically significant correlation between agreement on worker role and other dimensions of the contract (client needs and tasks), suggesting that an understanding of the worker's tasks are pivotal to successful contract negotiation. However, the client's needs and tasks are underdeveloped aspects of contract negotiations and do not develop in relation to one another. Though in this study worker and client consensus on expectations of each other was fairly high, disagreement, when it occurred, was generally in the direction of clients wanting to lean more on the workers for concrete help and workers wanting clients to take more initiative and be more introspective. At the same time, the preferred role positions of the majority of clients (10 out of 15) was for equal status with their workers, and an overwhelming majority of workers (14 out of 15) favored hierarchical position of authority. These findings suggest an inherent contradiction between consciously held expectations and unarticulated role positions, which do not reconcile each other and thus prevent workers and clients from working collaboratively. Findings on Client Perception of the Relationship were not significant, suggesting that whether the client perceives the worker as caring, genuine and/or empathic is independent of contract status. Findings on Verbal Participation indicate that workers carry major responsibility for contracting, that clients follow workers in the rhythm and pacing of contracting and that most contracting activity occurs in the first interview. Findings on the Relationship Communication Variable showed a statistically significant association between successful contract negotiation, and role negotiation, with reciprocity of role position achieved in high contract pairs. Moreover, workers tend to prefer relationship positions indicating a hierarchical position of authority; worker-client pairs who achieved role reciprocity were characterized by worker-up client-down role complementarity. Findings on Background Characteristics were found to be independent of contract status.

Previous research has shown that adult children are the predominant service and health care providers to the impaired elderly. However, relatively little is known about the conditions under which caregiving is either enhanced or hindered. Therefore, the purpose of this study was to systematically examine the caregiving relationship in order to better understand its causes and consequences. Data were collected via in-depth structured interviews with a sample of adult children (n = 131) identified as the primary caregiving relative to an older parent currently receiving home care or day care services. Bivariate and multivariate analytic techniques were utilized to identify the most salient variables associated with the two dependent variables of interest: caregiving involvement (the task and time commitment) and caregiving consequences (the perceived impact of providing care). Study findings indicate that the typical caregiving child is a late middle-aged daughter who holds concurrent responsibilities to other family members as well as working outside the home. Emotional support was the most universal caregiving activity although substantial proportions also assisted with linkage tasks, instrumental services as well as financial assistance. The primary strains of caregiving were found to be the result of the emotional aspects of providing care and the restrictions on time and freedom necessitated by caregiving responsibilities. The most salient independent predictors of caregiving involvement were: the parent's level of impairment; the quality of the parent-child affective relationship; the child's sex and marital status; and the degree of anticipatory planning for caregiving. Contrary to expectations, the child's employment status did not impinge upon fulfilling caregiving responsibilities. The significant variables predicting perceived negative consequences included: the extent of caregiving involvement; the parent's level of impairment; the perception of unmet service needs; the quality of the parent-child affective relationship; and the child's social class, sex, and health status. The extent of formal service utilization did not emerge as a significant predictor of caregiving consequences although the qualitative data gave support to the hypothesis that service input reduced caregiving strains. Implications for policy, practice, and service delivery in support of families caring for frail older relatives are discussed.

Emerging studies have identified a specific kind of stress called social defeat, which occurs when a person is dominated, humiliated, and oppressed by another person or group. The sense of social defeat might play an important role in the development of psychosis. Meanwhile, scholars have increasingly studied the occurrence of Psychotic Experiences, which are expressions of psychosis that manifest in the general population without causing significant distress or functional impairment. Very few studies have examined the relationship between social defeat and Psychotic Experiences in the United States, and I utilize the Collaborative Psychiatric Epidemiological Surveys to examine three facets of social defeat, which are (1) everyday discrimination, (2) major discriminatory events, and (3) immigrant status, and I explore whether they predict risk for Psychotic Experiences. In the first paper, I analyzed the National Latino and Asian American Survey and the National Survey of American Life, and found that among Latino-, Asian-, and Black- Americans, everyday discrimination was associated with increased risk for Psychotic Experiences in a dose-response fashion after adjusting for demographics and socioeconomic status. Discrimination perpetrated at the interpersonal level seems to impart a profound sense of defeat that raises risk for psychosis. In the second paper, I analyzed the National Survey of American Life and found that among Black Americans, certain major discriminatory events (being denied a loan, receiving unusually bad service, and police abuse) were associated with increased risk for Psychotic Experiences after controlling for demographics and socioeconomic status. Major events seem to capture a distal source of distress stemming from the institutions and structures of society, elevating risk for psychosis among Black Americans. In the final paper, I examined the National Comorbidity Survey Replication, the National Latino and Asian American Survey, and the National Survey of American Life, and found that immigration was not associated with increased risk for Psychotic Experiences in the United States, supporting the extant literature that suggests immigrants are paradoxically healthier than native-born populations. I discuss theoretical and practical implications of my findings, and present future directions for research.

In a democracy, the concept of citizen participation is the essence of that system: it may not be an overstatement to declare that without citizen participation there is no democracy. The concept plays an important role in the study reported here. The writer examines a major element in the implementation of Title XX of the Social Security Act in New York City. The aim is to critically assess the perceived impact of the implementation of the citizen participation process of Title XX in New York City from 1979-1981. To accomplish this task, a survey focuses on citizen participation as this was acted out during July and August 1981. The information acquired illuminates the matter of who participated in the process, why they participated and what was the perceived impact of their participation. Citizen participation and decentralization are issues which have become salient during historical periods. Clearly during the 1960s it characterized the thrust of southern blacks who demanded greater respect for their voting rights. It also had its echo in the cry for community control of schools in Brooklyn. There is no doubt that the concept of citizen participation was on the national agenda. By 1975 it was not clear if the two concepts, citizen participation and decentralization, had the same meaning as they did during the 1960s. This study investigates the New York City Title XX citizen participation process, in general, the public hearings in particular. A total sample population of (47) made up of public officials (9), voluntary organization leaders (26), and community based advisory chairpersons (12) was examined through the use of quantitative and qualitative methodology. All respondents were interviewed, the interviews were tape recorded, the tapes were codified and a quotation bank was developed. The findings suggest that a strong ambivalence tone is present. This perception transcends both the respondents' classification and race. On the manifest or decision making level the process was perceived as not efficacious. However, on the latent level long run benefits are viewed as a possibility. While the ambivalence, quantitatively, transcended race; qualitatively the black and white ambivalence appears to emerge from different perspectives. In sum, this study shed some light on the Title XX citizen participation process from the point of view of those actively involved.

This study explores help seeking patterns of Black women in Black churches. The intent of the study, is to examine use of a historically vital component of the Black community and to ascertain its role in the support system of a population. The theory of shared functions is used to look at the utilization of different support systems, and to understand the role of the church as a bureaucratic institution with primary characteristics and functions. The data was collected over a six month period, at six Black churches in the Essex County area of New Jersey. The information is derived from a questionnaire administered to 196 women. In the analysis of the data, participants are grouped by socioeconomic status and size of church they attend. The hypotheses are: (1) The lower the socioeconomic status of the church member, the more likely the minister will be selected for help. (2) members of smaller churches are more likely to select the minister as a vehicle for help, than those in larger churches. (3) The minister is more likely to be selected for help with concerns classified as non-uniform. (4) The more active a woman is in church life, the more likely she is to choose the minister as a help source. The findings confirm, women classified as low income and those active in church life, utilize their pastor more than other women in the study. The findings do not confirm, hypothesis 2 and 3, but show that women from large churches utilize the minister more than women in smaller churches and that the minister is selected as a help source in a range of concerns. The data highlights, that women see the minister as the primary source for help and that for many, the pastor is as important, as the relative or professional counselor in seeking assistance. The implications of this study suggest the profession of social work, seek avenues of collaboration with local ministers to offer support and information on the concerns members bring. The findings also suggest the profession find ways to accurately access client's church involvement and support from the religious community.

Job satisfaction and burnout are important areas of study because of the social and economic effects of job satisfaction and the damaging physical/psychological impacts of burnout. 200 family/children and psychiatric workers of seven social service organizations were surveyed in the spring of 1990. Instruments used were the Minnesota Satisfaction Questionnaire, the Maslach Burnout Inventory, and the Staff Burnout Scale for Health Professionals. Reported levels of job satisfaction and burnout are within normal limits. Psychiatric and family/children workers report equal job satisfaction levels, but the latter group reports significantly higher burnout levels. Both groups are particularly satisfied with the amount of praise delivered by supervisors and are reportedly dissatisfied with salary levels and promotional opportunities. Praise delivered by supervisors, promotional opportunities, and salary satisfaction are strongly associated with job satisfaction levels of both groups. Correlates of burnout for psychiatric workers are dissatisfaction with amount of praise delivered by supervisors and dissatisfaction with salary; correlates for family/children workers are limited social services employment and dissatisfaction with amount of praise. Findings have practical implications for social service administrators and practitioners. Correlates of satisfaction and burnout can be altered in order to maintain employee satisfaction and reduce burnout, absenteeism and turnover.

This study explored trust in the professional relationship from the perspective of social workers employed in a large voluntary mental health agency. Its purpose was to provide a systematic understanding of social workers' judgments of the function of trust in the professional helping process. Barber's (1983) theoretical formulations provided the framework within which this study examined social workers' understanding of the significance of trust in the professional relationship and the relative importance of professional competence and commitment to serving clients' best interests in the development of trust. The study's questionnaire was completed by 118 social workers in 18 community-based programs, with supplemental information gathered by interviews with 25 social workers in these and other settings. Variables of interest included demographic and agency practice data as well as social workers' judgments about various components of trust as measured by a series of Likert scale response items. Findings indicated that social workers judged professional commitment to serving clients' best interests to be significantly more important than competence in three aspects of the helping process: development of client trust, client cooperation with workers' suggestions or recommendations, and client decisions regarding transfers to other professionals. A factor analysis of data resulted in the identification of four trust-related factors: match, or fit, between client and worker; clients' emotional/attitudinal system; case status; and, political/economic conditions. A one-way analysis of variance indicated no significant differences in social workers' judgments of the importance of competence and commitment in relation to workers' agency practices. Correlational analysis of data also indicated weak relationships among variables. Findings suggest that social workers perceive trust development as related to the interplay among client, worker, agency, and public policy variables. Although workers may see themselves, to some extent, as active agents in the generation of trust, they emphasize the importance of client-centered factors, such as, clinical diagnosis, in the development of trust in the professional relationship. Further research is needed to compare respondents' judgments about the development of trust with perceptions held by clients, social workers in other fields of practice, and/or professionals in other disciplines.

Parents are central to adolescents’ lives and extensive research shows that parents can influence adolescent and young adults’ sexual decision-making in positive ways. However, the ability of interventions to help parents influence their children’s sexual health has been modest. In many cases, interventions for parents have not been guided by theory or strong research and many interventions for parents are based on only a general sense that more communication between parents and their children on topics related to sexuality is helpful. Currently, millions of dollars in public funding in the United States are designated for programs to reduce teen pregnancy and prevent sexually transmitted diseases. In addition, many foundations and individuals contribute significant funds to organizations that implement programs that strive to improve adolescent sexual health. Increasingly, there is an interest in including program components for parents in order to help them to positively influence their teens’ sexual decision-making. At this time, few interventions for parents related to influencing their teens sexual decision-making and behavior have been developed that have resulted in positive outcomes, with the notable exceptions of Families Talking Together and Get Real: Comprehensive Sex Education that Works, which have both been added to the United States Department of Health and Human Services list of evidence-based programs in the last 18 months. In order to develop additional interventions of benefit to parents and adolescents and to ensure that policy and practice are strengthened, up-to-date information from large, diverse samples about the frequency and content of family communication about sexuality currently taking place between parents and teens is critical. Few studies have allowed for direct comparison of African American, Hispanic and White families in terms of communication about sexuality and parental monitoring of adolescents. Understanding both similarities and differences can help with tailoring interventions to have more positive effects on teen sexual decision-making and behavior. One challenge to better understanding the influence of parental communication on adolescent sexual health is the wide variety of measures used in research, with some studies relying only on single item measures of communication. Without consistent measurement of communication and its many facets, it is difficult to ascertain which aspects of communication may be the drivers of behavior or to compare results across studies. Scales with strong psychometric properties are needed to strengthen the consistency and quality of research on parent-child communication about sexuality. Further, these scales must be tested with samples that include participants that are racially and ethnically diverse and samples that include fathers and mothers, as well as teen males and females to allow for scales to be validated by gender and race/ethnicity and for both parents and teens. The current study resulted in the development of three new scales with strong psychometric properties, which can now be used in research on parent-child communication about sexuality. This study also allowed for an examination of current barriers to communication about sexuality including the ways that those barriers differ and influence communication for African American, Latino and White parents and teens. Further, understanding the role that monitoring can play in promoting teens’ sexual health also merits up to date exploration as well as greater understanding of whether monitoring practices vary in diverse families or for teen males compared to females is needed to increase awareness of opportunities for positive influence on young people’s sexual development. The current study is particularly valuable given that many data sets do not allow for direct comparisons of African American, Latino and White teens and parents. The extent to which family communication or monitoring practices differ may suggest ways that interventions should be tailored for various populations or may suggest positive practices that can be promoted across groups. In addition, a current understanding of how communication and monitoring may vary with sons compared to daughters can provide awareness and insight to both parents and program developers about the types of parenting behaviors that might be addressed by programs and improved in order to make a difference in the lives of young people. The papers in this dissertation utilize data collected from 1,663 parent-child dyads in July, 2014 by Gfk, Inc. Gfk, Inc. has constructed a large, diverse panel of adults in the United States. They recruit their panel using a combination of random digit dial phone techniques and address-based sampling. More information on the construction of the overall Gfk, Inc. panel is available at: http://www.gfk.com/us/Pages/default.aspx. For this study, parents were sampled from the broader Gfk, Inc. panel using e-mail invitations and were asked to consent on behalf of themselves and one of their children between the ages of 9 and 21. For non-Latino White parents, a random selection of parents were invited. All Latino and African American parents in the panel were invited to participate. An algorithm was used to request which of the parent’s children to invite when a parent had more than one child in the eligible age group which was age 9-21. The organization requesting the data had a particular interest in 15-19 year olds and the algorithm was constructed accordingly. Within a household, when there was more than 1 child in the 9-21 year old age range, 15-19 year olds were selected at a 3:1 ratio (e.g. when there was a 15-19 year old and a 9-14 year old or a 20-21 year old in the same household, for every three times a 15-19 year old was selected, a non-15-19 year old was selected one time). The final sample included 749 teens ages 14 and younger, 740 teens ages 15-19, and 174 teens ages 20-21. In addition to parental consent, teens assented for their participation in the study. The parent questionnaire contained 91 items and the teen questionnaire contained 46 items. The median completion time was 17 minutes. Seven hundred eleven Whites, 300 African Americans and 652 Latino dyads completed the surveys. One thousand eighty one mothers and 582 fathers completed the surveys and 801 girls and 862 boys completed the surveys. Surveys for parents were customized using the name of the child that parents stated would take the survey and teen surveys were customized to include the term father or mother based on which parent had completed the survey. I completed a preliminary analysis of the demographics of the study sample compared to available nationally representative data prior to beginning the research for the dissertation. That analysis immediately follows this introduction. The three papers follow. Paper 1 is a confirmatory factor analysis on five potential scales for measuring parent-child communication about sexuality and barriers to communication. Paper 2 explores parent-child communication about sexuality related topics including differences in communication by race/ethnicity, gender and age and whether communication is associated with changes in the likelihood of adolescents’ ever having engaged in any sexual behavior, ever having engaged in oral sex, ever having engaged in vaginal sex, consistency of condom use in the past 3 months and/or consistency of birth control use (other than condoms) in the past 3 months. Paper 3 examines parent and teen reports of parental monitoring and the association between monitoring and sexual behavior outcomes as well as differences in monitoring among African American, Latino and White families and of sons compared to daughters. Conclusions and implications follow the third paper.