Social Work Research: Using Multiple Assessments

Lucille is a 68-year-old, Caucasian female. Her husband of 43 years passed away 4 years ago after a long and debilitating illness during which Lucille was his primary caregiver. During their marriage, he worked at the sanitation department, and she was a homemaker. She continues to live in the house where she and her husband raised their three children. Lucille receives a limited income of approximately $2,100/month from her husband’s retirement pension and Social Security; she owns her home and has no major outstanding debts. She receives Medicare to cover her major medical expenses and a small supplemental health plan to cover any outstanding medical costs. Her physical health is good, and she has not had any major illnesses or surgeries, although she has not had a complete physical in over two years. Her favorite hobbies are gardening and cooking. Lucille has two sons and one daughter, each living away from home with their own families. Lucille’s daughter and one son reside in the local area; her other son lives in another state.

Lucille’s major concern is about her daughter, Alice (33), who has battled substance abuse and alcoholism since adolescence. At present, Alice is not employed and has had several encounters with law enforcement for drug possession and intent to sell illegal substances. Alice has admitted that she has used cocaine as well as other substances in the past. She has made several attempts to go into drug rehabilitation, but she has never completed a program. Her siblings have essentially disowned her. Alice has three children, Michael (6), Rachael (4), and Randy (18 months), who was recently diagnosed with fetal alcohol effects (FAE). Lucille is not certain who is the father of her grandchildren; it is a subject Alice refuses to discuss. Alice has repeatedly left her children alone for several hours in their tiny apartment, and once she was gone for several days. Child Welfare has interceded, but Alice continues to have custody of her children. Whenever Lucille visits her daughter and grandchildren, the living conditions are filthy, there is little food in the house, and there is talk of constant “visitors” to the house well into the night. Because of Alice’s instability, Lucille has taken physical custody of her grandchildren without any redress from Alice. Lucille’s family members are not aware of the stress Lucille is feeling about possibly having to spend the rest of her life raising her grandchildren, including one with a disability. This causes Lucille to often feel “down in the dumps,” resulting in overeating because, as she stated, “comfort food makes me feel better.” Within 2 months, she gained 15 pounds.

Lucille heard about a counseling program at the local community center for grandparents raising grandchildren. The program provides support, group meetings, parenting classes, individual counseling sessions with a social worker, and referrals for other supporting services. At first, Lucille was skeptical about attending the program. She was embarrassed to tell others about her family circumstances; she was particularly fearful that others would blame her for her daughter’s lifestyle and wonder how she could now care for her grandchildren if she could not raise her daughter properly. She already blamed herself for her daughter’s actions, which made her bouts of depression more frequent and difficult to overcome.

Eventually, Lucille came to the community center after some encouragement from her neighbor. Lucille is quite concerned about the fate of her daughter. Fearing the worst, she is constantly worried she will get a late night phone call that her daughter was found dead somewhere from a drug overdose or something related to her drug life. She once believed caring for her grandchildren was a temporary arrangement but more recently believes this will become permanent. Although Lucille loves her grandchildren, she is afraid that she will have to raise them alone and is angry with her daughter for putting her in this position. She does not know if she can do it at her age. Her youngest grandchild will need many resources over the years, and she does not even know where to begin to access them. She admits feeling overwhelmed and depressed frequently, but she does not have a wide circle of family or friends to talk to about her concerns. She spoke to her church minister once about her family circumstances but did not feel she got much out of it. “He just did not seem to understand what I was talking about,” she stated, “so I never went back.” She stated she was feeling unable to manage her family needs and that “I just want to get control of the ship again.”

After a thorough psychological assessment, the agency psychiatrist determined that medication was not necessary for her bouts of depression. After our initial talk, I administered a series of baseline measures on her emotional and physical functioning, specifically the Center for Epidemiologic Studies—Depressed Mood Scale (CES-D), Family Resource Scale, Family Support Scale, and the Medical Outcome Survey, SF-12v2. Our plan is to administer these measures at 3-month intervals for 1 year to assess her emotional functioning and social progress. Using a strengths-based approach to problem solving, I collaborated with Lucille on a biweekly basis to define personal goals that focused on helping her address feelings of depression and broaden her support network for managing family challenges. She attended monthly support group meetings with other grandparents who discussed their challenges and celebrated their triumphs. Lucille never missed a meeting. I made two home visits per month to observe Lucille in her home environment. Our individual sessions included assessing strengths, defining/redefining needs, targeting problems and goals, identifying resources to address needs, and monitoring goal progress. A nutritionist also conducted two home visits to help her with food options for herself and her grandchildren. Lucille is an excellent cook, and the nutritionist showed her how to reduce calories without sacrificing taste. Within four weeks, Lucille was able to make small changes in her everyday life. She began walking her grandchildren to the local park for playtime, preparing her front yard for spring flowers, and preparing Sunday dinners to reengage her family. She also visited her family physician and learned that she has high blood pressure, which can be controlled with proper diet and exercise, and she has asked her son and daughter-in-law for respite once per month so she can have some “down time.”

After 6 months, I facilitated a family group conference with Lucille and her sons and their wives. The focus of the meeting was to plan how the family would support Lucille as the primary caregiver for her grandchildren and to define the role other family members would play in assisting in raising Alice’s children. There was family agreement that it was in the children’s best interest for Lucille to seek legal counsel so she could establish temporary custody for her grandchildren, as well as learn the options for a more permanent relationship, such as adoption. She also applied for disability benefits for her youngest grandchild. Later, the family would meet to conduct permanency planning for the grandchildren. After 9 months, Lucille’s emotional health improved, and we decided to suspend individual counseling, but she continues to participate in the weekly support group meetings where she can have her blood pressure checked by the program nurse. After 12 months in the program, Lucille has a positive perception of her support network, including her family; familiarity with community resources and how to access them; a positive emotional state; and she has lost 10 pounds and her blood pressure is normal. Lucille has even initiated a grandparent mentoring service for new custodial grandparents who want to partner with a “seasoned” grandparent caregiver. Last week, Lucille found out her daughter Alice, who she has not seen in nearly a year, is 6 months pregnant.

The Logan Family

Eboni Logan is a 16-year-old biracial African American/Caucasian female in 11th grade. She is an honors student, has been taking Advanced Placement courses, and runs track. Eboni plans to go to college and major in nursing. She is also active in choir and is a member of the National Honor Society and the student council. For the last 6 months, Eboni has been working 10 hours a week at a fast food restaurant. She recently passed her driver’s test and has received her license.

Eboni states that she believes in God, but she and her mother do not belong to any organized religion. Her father attends a Catholic church regularly and takes Eboni with him on the weekends that she visits him.

Eboni does not smoke and denies any regular alcohol or drug usage. She does admit to occasionally drinking when she is at parties with her friends, but denies ever being drunk. There is no criminal history. She has had no major health problems.

Eboni has been dating Darian for the past 4 months. He is a 17-year-old African American male. According to Eboni, Darian is also on the track team and does well in school. He is a B student and would like to go to college, possibly for something computer related. Darian works at a grocery store 10–15 hours a week. He is healthy and has no criminal issues. Darian also denies smoking or regular alcohol or drug usage. He has been drunk a few times, but Eboni reports that he does not think it is a problem. Eboni and Darian became sexually active soon after they started dating, and they were using withdrawal for birth control.

Eboni’s mother, Darlene, is 34 years old and also biracial African American/Caucasian. She works as an administrative assistant for a local manufacturing company. Eboni has lived with her mother and her maternal grandmother, May, from the time she was born. May is a 55-year-old African American woman who works as a paraprofessional in an elementary school. They still live in the same apartment where May raised Darlene.

Darlene met Eboni’s father, Anthony, when she was 17, the summer before their senior year in high school. Anthony is 34 years old and Caucasian. They casually dated for about a month, and after they broke up, Darlene discovered she was pregnant and opted to keep the baby. Although they never married each other, Anthony has been married twice and divorced once. He has four other children in addition to Eboni. She visits her father and stepmother every other weekend. Anthony works as a mechanic and pays child support to Darlene.

Recently, Eboni took a pregnancy test and learned that she is 2 months pregnant. She actually did not know she was pregnant because her periods were not always consistent and she thought she had just skipped a couple of months. Eboni immediately told her best friend, Brandy, and then Darian about her pregnancy. He was shocked at first and suggested that it might be best to terminate. Darian has not told her explicitly to get an abortion, but he feels he cannot provide for her and the baby as he would like and thinks they should wait to have children. He eventually told her he would support her in any way he could, whatever she decides. Brandy encouraged Eboni to meet with the school social worker.

During our first meeting, Eboni told me that she had taken a pregnancy test the previous week and it was positive. At that moment, the only people who knew she was pregnant were her best friend and boyfriend. She had not told her parents and was not sure how to tell them. She was very scared about what they would say to her. We talked about how she could tell them and discussed various responses she might receive. Eboni agreed she would tell her parents over the weekend and see me the following Monday. During our meeting I asked her if she used contraception, and she told me that she used the withdrawal method.

Eboni met with me that following Monday, as planned, and she was very tearful. She had told her parents and grandmother over the weekend. Eboni shared that her mother and grandmother had become visibly upset when they learned of the pregnancy, and Darlene had yelled and called her a slut. Darlene told Eboni she wanted her to have a different life than she had had and told her she should have an abortion. May cried and held Eboni in her arms for a long time. When Eboni told her father, he was shocked and just kept shaking his head back and forth, not saying a word. Then he told her that she had to have this child because abortion was a sin. He offered to help her and suggested that she move in with him and her stepmother.

Darlene did not speak to Eboni for the rest of the weekend. Her grandmother said she was scheduling an appointment with the doctor to make sure she really was pregnant. Eboni was apprehensive about going to the doctor, so we discussed what the first appointment usually entails. I approached the topic of choices and decisions if it was confirmed that she was pregnant, and she said she had no idea what she would do.

Two days later, Eboni came to see me with the results of her doctor’s appointment. The doctor confirmed the pregnancy, said her hormone levels were good, and placed her on prenatal vitamins. Eboni had had little morning sickness and no overt issues due to the pregnancy. Her grandmother went with her to the appointment, but her mother was still not speaking to her. Eboni was very upset about the situation with her mother. At one point she commented that parents are supposed to support their kids when they are in trouble and that she would never treat her daughter the way her mother was treating her. I offered to meet with Eboni and her mother to discuss the situation. Although apprehensive, Eboni gave me permission to call her mother and set up an appointment.

The Logan Family

May Logan: mother of Darlene, 55

Darlene Logan: mother, 34

Anthony Jennings: father, 34

Eboni Logan: daughter, 16

Darian: Eboni’s boyfriend, 17

I left a message for Darlene to contact me about scheduling a meeting. She called back and agreed to meet with Eboni and me. When I informed Eboni of the scheduled meeting, she thanked me. She told me that she was going to spend the upcoming weekend with her father, and that she was apprehensive about how it would go. When I approached the topic of a decision about the pregnancy, she stated that she was not certain but was leaning in one direction, which she did not share with me. I suggested we get together before the meeting with her mother to discuss the weekend with her father.

At our next session, Eboni said she thought she knew what to do but after spending the weekend with her father was still confused. Eboni said her father went on at length about how God gives life, and that if she had an abortion, she would go to hell. Eboni was very scared. Anthony had taken her to church and told the priest that Eboni was pregnant and asked him to pray for her. Eboni said this made her feel uncomfortable.

When I met with Eboni and her mother, Darlene shared her thoughts about Eboni’s pregnancy and her belief that she should have an abortion. She said she knows how hard it is to be a single mother and does not want this for Eboni. She believes that because Eboni is so young, she should do as she says. Eboni was very quiet during the session, and when asked what she thought, said she did not know. At the end of the session, nothing was resolved between Eboni and her mother.

When I met with Eboni the next day to process the session, she said that when they got home, she and her mother talked without any yelling. Her mother told Eboni she loved her and wanted what was best for her. May said she would support Eboni no matter what she decided and would help her if she kept the baby.

Eboni was concerned because she thought she was beginning to look pregnant and her morning sickness had gotten worse. I addressed her overall health, and she said that she wanted to sleep all the time, and that when she was not nauseated, all she did was eat. Eboni is taking her prenatal vitamins in case she decides to have the baby. Only a couple of her friends know about the pregnancy, and they had different thoughts on what they thought she should do. One friend even bought her a onesie. In addition, Eboni was concerned that her grades were being affected by the situation, possibly affecting her ability to attend college. She was also worried about how a pregnancy or baby would affect her chances of getting a track scholarship. In response to her many concerns, I educated her on stress-reduction methods.

Eboni asked me what I thought she should do, and I told her it was her decision to make for herself and that she should not let others tell her what to do. However, I also stated that it was important for her to know all the options. We discussed at length what it would mean for her to keep the baby versus terminating the pregnancy. I mentioned adoption and the possibility of an open adoption, but Eboni said she was not sure she could have a baby and then give it away. We discussed the pros and cons of adoption, and she stated she was even more confused. I reminded her that she did not have much time to make her decision if she was going to terminate. She said she wanted a few days to really consider all her options.

Eboni scheduled a time to meet with me. When she entered my office, she told me she had had a long talk with her mother and grandmother the night before about what she was going to do. She had also called her father and Darian and told them what she had decided. Eboni told me she knows she has made the right decision.

Discussion: Research Questions and Literature Reviews

In this week’s video, you meet Eboni Logan, a teenager who reveals that she is pregnant. Eboni explains to her social worker that no one at her school talks about methods of birth control, as their only focus is on abstinence. Imagine that you are a social worker in Eboni’s school and you begin to notice an increase in teen pregnancy. This causes you to wonder about the effectiveness of abstinence-only education. This curiosity propels you to investigate further, but you are not sure what you should do first—develop a research question or conduct a literature review.

For this Discussion, review the literature on abstinence education. View the Sessions episode on the Eboni Logan case.

By Day 3

Post your explanation about what should come first—the development of a research question or a thorough literature review. Justify your answer by adding your thoughts about which process you believe to be more realistic and/or appropriate, and why. Finally, describe potential consequences of deciding on a research question without conducting a review of the literature. Please use the resources to support your answer.

By Day 5

Respond to a colleague’s post by suggesting two ways of avoiding the consequences he or she described. Please use the resources to support your post.

Assignment: Introduction to Research Proposals

Just because you thought of an interesting research question and have a desire to conduct research does not mean that your research will automatically be supported by faculty or funded by an organization. In order to gain stakeholder approval, you must submit a research proposal. Much like an outline of a paper or a treatment of a movie script, the research proposal contains several parts that begin with a research question and end with a literature review. For this Assignment, you compile a research proposal that includes a research problem, research question, and a literature review.

For this Assignment, choose between the case studies entitled “Social Work Research: Couple Counseling” and “Social Work Research: Using Multiple Assessments.” Consider how you might select among the issues presented to formulate a research proposal.

Be sure to consult the outline in Chapter 14 the Yegidis et al. text for content suggestions for the sections of a research proposal. As you review existing research studies, notice how the authors identify a problem, focus the research question, and summarize relevant literature. These can provide you with a model for your research proposal.

By Day 7

Submit a 5- to 6-page research proposal stating both a research problem and a broad research question (may be either qualitative or quantitative). Use 6–10 of the most relevant literature resources to support the need for the study, define concepts, and define variables relevant to the question. Include a literature review explaining what previous research has found in relation to your problem and question. The literature review should also include a description of methods used by previous researchers. Finally, be sure to explain how your proposed study addresses a gap in existing knowledge.

Discussion: Research Questions and Literature Reviews

Diane Sharkey

Explanation about what should come first—the development of a research question or a thorough literature review.

I feel like I’m answering the age-old “chicken or egg” question. However, I believe a thorough literature review should come before the development of a research question. Granted, a researcher or practitioner must have a problem or some broad questions in mind before conducting a literature review. However, that question can be modified and adjusted as the researcher reviews the literature and finds that certain areas of a problem have been studied enough or discovers gaps in the information. Yegidis, Weinbach, and Myers (2018) support this by stating “for every research problem and its related research questions, there is an existing body of knowledge that can guide a researcher” (p. 73).

Justify your answer by adding your thoughts about which process you believe to be more realistic and/or appropriate, and why.

Completing a literature review first is more appropriate than creating a specific research question because “researchers do not know to what degree answers to the question already existed, what methods had been used to study it, or what other researchers had learned in the process of conducting their research” (Yegidis et al., 2018, p. 84). Once a researcher begins to research a broad topic, he/she can use the information found to help narrow the focus of the question and future research. Additionally, a literature review helps determine the variables, further narrowing the proposed question(s)  (Yegidis et al., 2018).

Finally, describe potential consequences of deciding on a research question without conducting a review of the literature.

Without conducting a review of the literature, researchers don’t know what they don’t know (or what they do know, for that matter). Plus, deciding on a research question without conducting a review of the literature can be a waste of time if it is something that has been studied in depth and has a multitude of data (Yegidis et al., 2018). Moreover, Yegidis et al. (2018) discuss the importance of using data from the literature review to help formulate hypotheses with supportive data about the specific research questions.

Reference