Abstracts of Volume Five of Computers in Human Services, 1989

Volume 5 (1/2), 1989

Introduction: Social Work Practice and Information Technology--An Unestablished Link by Ram A. Cnaan

ABSTRACT: This opening chapter is aimed at assessing the relationship of social work practice and information technology. The low level application of information technology to social work practice is viewed in terms of its etiology as well as its potential cost to the profession. It is concluded that a major investment should be made to incorporate information technology into social work practice. This perspective informs the remaining chapters.

Computers and Social Diagnosis: The Client's Perspective by Paula S. Nurius and Walter W. Hudson

ABSTRACT: This paper addresses ways in which computers are now and will likely continue to influence social diagnosis within direct practice. Social diagnosis is first defined followed by an overview of current and emerging uses of and issues about computers from the perspective of the client. One currently available computerized clinical assessment system is provided as an illustration followed by discussion of expected future directions and of the need for social workers to take an active and informed role in shaping these developments.

Capturing Expertise in Clinical Information Processing by Raymond W. Carlson

ABSTRACT: Expert systems have been developed to allow those lacking in experience and/or knowledge base to benefit from the insights experts have developed. In medicine, such systems have not lived up to initial expectations because of difficulty in moving beyond rules to reasoning. Expertise's primary benefit may be in broadening thinking rather than providing solutions. Social work can take advantage of this experience by placing more emphasis on identifying clusters of connected problems and on alternative interventions with demonstrated effectiveness. The impact should be a higher quality of assessment and intervention planning in social work practice.

BRIEFER: An Expert System for Clinical Practice by Hannah Goodman, Wallace J. Gingerich, and Steve de Shazer

ABSTRACT: Expert systems are computer programs which embody the expertise of a human expert in order to consult on a specific problem. This article describes our experience in developing BRIEFER, a prototype expert system designed to advise brief family therapists on what intervention to give clients at the conclusion of the first session. Excerpts from a sample consultation with BRIEFER are provided, and we discuss the impact BRIEFER has had on our clinical practice. Our experience suggests that it is feasible and practical to develop expert systems for a variety of clinical uses. We conclude by discussing some of the ways we think expert systems will be used in clinical practice, and we consider some issues related to their use by clinicians.

Designing Computerized Clinical Information Systems to Monitor Interventions on the Agency Level by Rami Bentenishty

ABSTRACT: The aim of this paper is to suggest an approach to the design of computerized clinical information systems to help meet the information needs of practitioners in social service agencies. The focus here is on the aspects that are directly related to clinical interventions, and not on the administrative needs of agencies. Further, the interest is in data that can and should be collected as integral part of practice and not as part of one-shot research endeavors. This paper presents a brief analysis of what outputs a clinical information system should produce in order to meet information needs of clinicians, and suggests guidelines for the design of such systems. Two applications of information systems based on these guidelines are presented and discussed. In the discussion, the paper identifies the need for programming tools which would facilitate the interface between practitioners and data base programs. Finally, the implications of the availability of this information technology for clinical judgment and for individualized interventions are briefly discussed.

Computer Games and the Human Services by Hy Resnick and Moshe Sherer

ABSTRACT: Games have been a part of human service practice for many years, especially with young people and the elderly. Computers increase the power, sophistication and possibilities of using games in the human services. This paper reviews a number of these computer games currently available for use in the field. A distinction is made between purpose designed and commercial or off-the-shelf, computer games. Computer games in the helping and healing arts are viewed as a useful tool which will make an increasing contribution to the human services as human service practitioners and scholars interested in games, become more familiar with computers.

Using Computers for Better Administration of Social Services Departments by Richard Lingham and Mark Law

ABSTRACT: The task faced in computerizing social services records is considered and the early attempts outlined. The need for national policy and the contributions of LAMSAC to developing one are considered with reference to significant factors for organization, management and social work professionals. The aims and content of a major national consortium project are described and the present stage of development considered for its implications for the future.

Developing an Integrated Computerized Case Management System for the Israeli Defense Forces-An Evolutionary Approach by Menachem Monnickendam and Anat Morris

ABSTRACT: A computerized Case Management System should be able to provide relevant individual client information as well as standardized and flexibly aggregated data to a large variety of end users. The design and implementation of such a system is often a laborious and lengthy process. The design of such a system is affected by the concept the initiators originally have in mind. The computerized case management system in the Mental Health Department of the Israel Defense Forces was designed as a means to provide clinicians with relevant data and thus improve service delivery. The system developed through four consecutive attempts from initiation to completion. The comparative analysis of these iterations produced a set of guidelines for the development and implementation of similar systems. This paper will analyze the evolution of the system and the way this process was affected by the original concept.

Computers, Confidentiality and Privation by David Watson

ABSTRACT: Advances in information technology provide a new context in which our commitments to confidentiality and autonomy must be reviewed. Individualist ideology is our main resource for such review, and implies a conditional commitment to confidentiality. Personal information, on this account, may be disclosed against the subject's wishes, though only as necessary to protect the overriding interests of others; and a subject may be given access to personal information confided by a third party, against the third party's wishes, though only as necessary to protect the subject's overriding interests. This is inconsistent with the limitations on subject access available in the United Kingdom legislation under the Social Work Order of 1987, but in any case, there are grounds for thinking that confidentiality often marks a retreat in the face of social which we might more honorably resist.

An Example of Serendipity: The Unintended Impact of Computers on Social Work Practice by Phyllida Parsloe

ABSTRACT: The article argues that computers are forcing changes upon social work practice and social service delivery which go far beyond computerization itself. Recent events in Britain concerning subject access, data protection and confidentiality are outlined and some of their implications for practice examined.

An Approach to Integrating Technology in Human Service Situations by Brian Petheram

ABSTRACT: It is argued that some aspects of human-centered organizations are different from commercial operations which have been the focus for most effort in the introduction of new technology. They need an alternative approach. The one suggested draws upon complementary in which a system is based upon the strengths of both humans and computers. The system thus consists of both the computers and the humans that use it and an example drawn from the treatment of aphasia sufferers is given.

Technology, Computerization, and the Conceptualization of Service Delivery John W. Murphy John T. Pardeck

ABSTRACT: Mostly computers are considered to be tools by practitioners. Contrary to this view, computerization is not a value-free activity, but a conceptual process. Accordingly computers may shape or socialize their users, thereby altering significantly the delivery of social services. The purpose of this paper is to outline the conceptual or cognitive side of computer use, in order to illustrate how knowledge, reason, and problem solving are defined as a consequence of computerization. Following this theoretical maneuver, the odds improve that computers will be used in a socially responsible manner.

Volume 5 (1/2), 1989

Using Computer Simulations in Behavior Therapy Training by Matthew E. Lambert

ABSTRACT: This paper describes four computerized case simulations designed for use as an adjunct to behavior therapy training. The cases simulate the assessment, diagnostic, and treatment decision-making processes involved in treating various clinical problems: agoraphobia, chronic headache pain, bulimia, and cocaine abuse, from a behavioral perspective. Initial information for three simulations tested within a Clinical Psychology doctoral program and a Master of Social Work program are discussed. Structured evaluations of the simulations by the students in each program are also discussed. Finally, it is suggested how simulations of this type may be integrated into both lecture and practicum courses.

The AGENCY Computer Simulation Model by Gary B. Cox, David Erickson, Hubert Armstrong and Philip Harrison

ABSTRACT: AGENCY is a computer simulation model developed to emulate service delivery in a mental health center, but broadly applicable to most human service delivery organizations. Definition of the service providing agency is input to the program from a separate data file, so the program is extremely flexible and general. Initial validation results are positive. The program is written in SlMULA to run on a DEC-10.

Sexual Abuse Assessment Training: Developing CAI in Child Welfare by Robert J. MacFadden

ABSTRACT: This article describes computer-assisted instruction (CAI) and four instructional models: drill and practice, tutorial, Socratic and simulation. The advantages of CAI are discussed including the issue of effectiveness followed by examples of CAI applications in human services. A CAI program developed by the author and students to train new child protection workers in child sexual abuse assessment is presented. The three technologies employed to develop CAI are highlighted: instructional, content and computer. The article concludes with a vision of the future for CAI in human services.

Prediction and Decision Making in Child Welfare by Fiore Sicoly

ABSTRACT: Use of computer-based statistical models to support decision making may reduce the subjectivity and uncertainty in this process to more acceptable levels. Multivariate procedures capture the collective experience of many workers by integrating information from a large number of variables and cases. Once a predictive model has been developed and validated, the profile of new cases can be compared to cases already on the data base. The probability of critical case events such as admission to care, occurrence of abuse, and placement breakdown can be identified. Such capabilities could also be incorporated into the development of computerized information systems. This would facilitate case planning and a more equitable and effective match between client needs and resource utilization.

Development of a Management Information System for a Purchase of Service Setting by Matthew G. Hile and James L. Hedlund

ABSTRACT: In spite of the fact that a Purchase of Services (POS) approach has become a dominant method of funding social services in recent years, there is little systematic evidence to support the assumption that this is a cost-effective method of funding. The present paper describes the development and implementation of a clinical management information system (C/MIS) in a community based facility operating under POS funding. The C/MIS was specifically designed to allow the Center's staff to monitor and evaluate the services provided by over 70 vendors utilized by the facility, and to assess the cost-effectiveness of POS systems.

Information: The Hydra-Headed Concept in the Human Services by Norman J. Smith and Floyd H. Bolitho

ABSTRACT: Information technology is increasingly being used in the human services, but reports suggest that some professionals are resisting its introduction. Some accounts for this resistance emphasize the role of the technology's physical attributes. It may, however, be due more to mistaken assumptions by some professionals about the role of the technology in generating information in human service contexts. Information as a concept has different interpretations according to its usage. It is the authors' contention that there has been a failure to differentiate between the use of the concept in different settings and this is a possible causal factor in producing resistance. This paper examines information as used in communication theory and the human services and emphasizes the need for a thorough examination of the role of information in professional social work education and practice.

The Use of the Computer in Counseling College Students by Consuelo Arbona and Philip A. Perrone

ABSTRACT: The purpose of this study was to examine the usefulness of a computer program in helping clients clarify their concerns and identify goals for behavior change, prior to their first session with a counselor. A counseling treatment consisting of three initial computer-interaction sessions, followed by two sessions with a counselor, was compared to a treatment consisting of five sessions with a counselor and no computer interaction, and to a no-contact control group. Participants were 46 college students. The two treatment groups achieved their self-determined goals, as measured by the Goal Attainment Scale (Kiresuk & Sherman, 1968?, and reported similar levels of satisfaction at the end of counseling. However, following the three initial sessions, students working with the counselor reported higher levels of satisfaction with counseling than students working with the computer-based counseling system. It was concluded that computers may be effectively used as part of the counseling process, allowing for a more efficient use of the counselor's time. however, more research is needed to identify the type of counselor intervention needed to facilitate the acceptance of these systems by students.

The Electronic Workstation: A New Resource for Human Service Professionals by Robert J. MacFadden

ABSTRACT: Microcomputers in human services promise to enlarge and enhance professional practice through the development and utilization of an electronic workstation. An electronic workstation incorporates a computer and related technology to organize and focus professional activities. This paper discusses the nature of a professional workstation, describes a working example, and explores the development, benefits and limitations of this new resource for human service professionals.

Automated Faculty Merit Reviews by Walter W. Hudson

ABSTRACT: This article raises discussion about the possibility of using the microcomputer as the basis for a totally automated annual merit review system for faculty performance within university settings. The purpose of the article is to introduce the possibility of automated merit reviews, examine some of the potential benefits and discuss some of the potential hazards. The article illustrates the possibilities through examples taken from the "Academic Merit System" software.

AIDS Prevention via Computer-Based Intervention ny Steven P. Schinke, Mario A. Orlandi, Adam N. Gordon, R. Eric Weston, Michael S. Moncher and Clifford A. Parms

ABSTRACT: The dangers posed by AIDS and the human immunodeficiency virus (HIV) are well known. Government, media, and medical organizations have provided extensive information on AIDS and on how to protect oneself against infection. Nevertheless, this fatal and irreversible disease continues to claim new victims. Clearly, there is an urgent need to develop new methods of educating the public about AIDS prevention.

Using the Personal Computer in Disaster Intervention by Lennis G. Echteritng and Kevin Hoschar

ABSTRACT: We describe in this paper the contributions of the personal computer to a rural mental health program designed to address disaster-induced psychological problems following a flood. The computer served a vital role In several areas. First, we were able to use the computer in desktop publication of pamphlets for disaster survivors. Second, we used the computer for managing data to assess the needs of survivors, set priorities, plan interventions, keep records, evaluate effectiveness, and generate reports. And third, we used the computer to mail letters to all survivors, providing them with updated Information regarding available services and continuing concerns. In evaluating the success of the program, we conclude that the computer enabled us to implement a program that was inexpensive, responsive, efficient and effective.

Computer-Assisted Diagnosis of Alcoholism by Robert Malcolm, Ellie T. Sturgis, Raymond F. Anton and Linda Williams

ABSTRACT: The use of computer-assisted interviews in the diagnosis of psychiatric conditions has increased since research has shown such interviews to have adequate psychometric properties and to be acceptable to patients. This study uses a computer-assisted format to assess drinking behaviors and alcohol-related symptoms in 50 veterans hospitalized for alcohol dependence. A computerized version of the Michigan Alcohol Screening Test (C-MAST) is compared to the standardized MAST, substantiating the earlier finding that individuals are more willing to reveal negatively-sanctioned behaviors to a computer than to an individual or on a questionnaire. The usefulness of such an assessment tool in general practice is discussed.

Computerized Collection of Mental Health Information from Emotionally Disturbed Adolescents by Amy Kight-Law, Kenneth S. Mathisen, Frank Calandra, Frederick J. Evans and Carmine A. Salierno

ABSTRACT: The first objective of this study was to assess the attitudes of emotionally disturbed adolescents (N - 65) toward a computerized version of the Diagnostic Interview Schedule (DIS; Robms, Helzer, Croughan, & Ratcliff, 1981) and to compare these attitudes to those of adult psychiatric inpatients (N = 135). The second objective was to determine whether mental health information collected by this method of assessment would correspond to data collected by a self-administered questionnaire designed to measure various aspects of psychological distress [Revised Symptom Checklist-90 (SCL-90-R; Derogatis, 1977)]. The results indicate that like adult psychiatric inpatients, emotionally disturbed adolescents respond well to computerized diagnostic assessment. A comparison between the DIS and the SCL-90-R indicates a high level of agreement between these two instruments on depressive, panic, phobic, and overall psychiatric symptomatology.

Two Automated Systems for Behavioral Assessment of Clients with Mental Retardation or Developmental Disabilities by Matthew G. Hile

ABSTRACT: In 1982 the Missouri State Department of Mental Health, Division of Mental Retardation or Developmental Disabilities, developed an automated version of the American Association on Mental Retardation's Adaptive Behavior Scale. While it met some important needs, it had some significant deficiencies. A microcomputer version was developed for use in the field that could deal with those deficiencies. This version allows individual institutions and their living units to have access to previously unavailable client data on adaptive and maladaptive behaviors, providing information useful in the development of individual rehabilitation plans, the evaluation of different programs, and monitoring the effectiveness of an institution as a whole. The development of these systems is described in light of goal conflicts between the system's user constituencies.

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