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Thesis advisor: Thomas O'Hare / Two primary community-based programs currently in use for people who suffer from severe, persistent mental illnesses are staffed group-homes, or intensive outreach residential programs, where the consumer lives independently and services are provided in vivo. This study utilized a cross-sectional relational design and employed a consumer survey to examine how the well-being of people with severe and persistent mental illness and who receive one of these residential services. Well-being refers to the general quality of a person’s life and living situation, including their own perceptions of the quality of their life. For the purposes of this study, well-being was operationalized as the product of three domains: 1). demographic/diagnostic characteristics, including age, gender, race, length of service, educational level, marital status, diagnosis, and intensity of residential support; 2). objective life satisfaction indicators, such as immediate social network, extended social network, independent living/self care, working/productivity, global functioning, freedom from crisis/hospitalization; and 3). subjective life satisfaction indicators, including satisfaction with living arrangements, money, leisure time, family, social life, and health. An analysis of demographic and diagnostic variables indicated that with the exception of education level, respondents living in group homes are very similar to their counterparts receiving supported housing. Independent functioning ability was significantly higher for respondents receiving supported housing services in eight areas, including cooking, shopping, housekeeping, personal finances, use of medications, active use of services, pursuit of recovery goals, and ability to find and use health care. Group home residents were significantly more likely to have substance abuse problems than respondents receiving supported housing, and were more likely to have problems that could put them or others at risk. Respondents living independently with supported housing services reported higher satisfaction with their living situation and with their relationship to their family. Group home residents were more satisfied about the availability of money for leisure activities. Exploratory analysis of the data using logistic regression suggested that such an analysis might be useful in identifying which qualities of applicants for residential services would provide a better “fit” to a particular model of treatment. Implications for policy, practice, and future research are addressed. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Digitalisering är i dagsläget ett aktuellt ämne i samhället och inom socialt arbete. Boendestöd är en insats som erbjuds av socialtjänsten till bland annat människor med funktionsnedsättning. Boendestödet innefattar ett praktiskt och socialt stöd, där målet är att klienten ska kunna leva ett självständigt liv. Med hänsyn till digitalisering var det av relevans att undersöka hur det kan påverka boendestödet och organisationen, professionen samt relationen till klienten. Därför var syftet med studien att undersöka digitalisering av boendestödsverksamheter i Halmstad kommun för att skapa djupgående förståelse av digitaliseringens möjligheter och svårigheter för verksamheterna och målgruppen. Vidare var syftet att undersöka vilka synsätt de som arbetar med boendestöd eller digitalisering, har till digitalisering av boendestödsinsatser. Studien hade sin utgångspunkt i en kvalitativ forskningsansats, där nio semi-strukturerade intervjuer genomfördes. Urvalet bestod av två digitaliserings-experter, fyra enhetschefer och tre boendestödjare. Resultatet visade en mängd möjligheter och svårigheter och vilka synsätt som finns till digitalisering av boendestödet. En svårighet var kunskapen som boendestödjaren behöver besitta om välfärdsteknik. En möjlighet var att använda digitala verktyg för att effektivisera resursfördelningen i verksamheten. En slutsats som framkom i studien var att teknikens användande och komplettering av arbetssätt påverkas av klientens intresse, kunskap, funktionsnedsättning och ålder. Andra slutsatser var att det behövs mer utbildning för boendestödjare kring tekniken, en mer enhetlig samsyn kring digitalisering och skapas flera samt nya tillvägagångssätt i boendestödet. / Digitization is today a current topic in society and social work. Residential support is an  intervention  offered  by  social  services  to  people  with  disabilities,  among  other groups. Residential support includes practical and social support with the goal being that the client can live an independent life. With regards to digitization it were relevant to investigate how it can affect the residential support and the organization, profession and relation to the client. Thus the purpose of this study was to investigate digitization  of  residential  support  organizations  in  the  municipality  of  Halmstad  to produce a thorough understanding of possibilities and difficulties in digitization for the  organization  and  target  group.  The  purpose  was  also  to  investigate  what  stances those  who  work  with  residential  support  or  digitization  have  towards  digitization  of residential support.This  study  had  a  qualitative  approach,  where  nine  semi-structured  interviews  took place. The sample of the study included two digitization experts, four managers and three  residential  support  employees.  The  studies  result  showed  a  variation  of possibilities and difficulties as well as what stances that exists towards digitization of residential  support.  Knowledge  for  the  residential  supporter  of welfare  technology was a difficulty. The use of digital technology to streamline the use of resources in the organization was a possibility. The study concluded that the use of digital technology and its supplement of work methods can be influenced by factors such as the client’s interest,  knowledge,  disability  and  age.  Additional  conclusions  were  the  need  for more  education  about  digital  technology  for  the  residential  supporter,  the  need  of consensus  in  regards  of  digitization  and  the  creation  of  several  and  new  approaches in residential support.

Although Code of Maryland policy mandates multidisciplinary, integrated teams for residential service provider organizations (RPOs) for an intellectual/developmental disabilities (IDD) population, alignment criteria to identify and evaluate the functional characteristics of such teams do not exist. This ambiguity has resulted in potential conflict in the goals of service delivery, as well as misaligned quality assessment and policy development criteria. The intent of this general qualitative study was to use complex adaptive systems theory and Vitkiene's work on corporate ethos to determine whether the services provided by a single RPO were consistent and aligned with the regulatory mandate set by the state. Data were acquired from the Maryland Office of Health Care Quality, for the years 2010-2015 that consisted of compliance inspections, reports, citations, as well as responses and corrective actions made by the IDD-RPO. Data were deductively coded according to Vitkiene's 3 ethos principles: economy (profit), procedure (task completion), and beneficence (customer service) and then subjected to a content analysis procedure. The study affirmed the lack of alignment criteria within the RPO by demonstrating ambiguity in how services were measured. Findings identified beneficence as most likely to be associated with a multidisciplinary team. Positive social change implications stem from recommendations to repurpose public health compliance data to address issues of misalignment in institutional service delivery; these findings may also be used by policy makers to focus on ethos as a means to focus on realigning policy objectives, the regulatory environment, and the work done at the RPO level to encourage better quality of life for individuals diagnosed with IDD.

The purpose of my study is to describe the relationship between housing supporters and clients based on the experience of the residential support. Six semi-structured interviews were analyzed and as shown in the results, personal qualities such as empathy, ability to listen, respect and skills and professional approach are building blocks in the creation of the relationship between housing supporters and clients. Further on, the result has been analyzed by using theories in symbolic interactionism and dramaturgical perspective for finding new angles and perspectives in the result. The result of this study is that a relationship between housing supporters and clients is important and requires both the client's and housing support’s involvement. The study is relevant to social work by increasing awareness that housing support is an important social initiative that helps people with mental disabilities.