Perspectives on engagement

Two articles in this month's Social Work Research look at an important issue in providing social work services: which clients will "hook up" with services. Each article describes populations that are difficult to serve: child welfare families using recommended services after Intensive Family Preservation and homeless adults accepting outpatient case management services. A third article addresses factors associated with adolescent pregnancy and parenting status. A fourth examines commitment to long-term partner relationships among African American men and women. Finally, an article on methodology explores issues and solutions in conducting research with lesbians and gay men as participants. Intensive Family Preservation Services for families at risk of removal of a child often end with recommendations for additional services. Staudt looks at how 101 families follow up on such recommended services, using Andersen's (1995) social context framework to assess the importance of need for service versus predisposing (demographic) or enabling factors. Need, measured by child functioning or by family functioning, was related to how much a family used service and to the proportion of recommended mental health services used. The predisposing and enabling factors did not increase the explanatory power of the hierarchical ordinary least squares regression models. However, overall the factors were not good predictors of use of service, explaining between 4 percent and 18 percent of variance. Homeless clients often present complex problems that make getting them into sustained treatment difficult. Sosin and Bruni test two perspectives on why homeless people reject offered services. The personal attributes perspective suggests that special personal characteristics, such as personal problems or disaffiliation, reduce motivation or ability to use services. The situational perspective suggests that people reject treatment because of immediate situational factors such as previous experience with treatment programs or how the program is presented to them. Two hundred eighty-five homeless clients from three short-term in-patient programs in Chicago were invited to participate in an outpatient service program (as part of a larger experiment). Nearly two-thirds "rejected" the intervention--did not make or attend an initial appointment or did not return after one appointment. A logistic regression model with personal attributes predicting rejection was not very powerful, and only military experience and conflict with friends and relatives predicted rejection of treatment. The logistic regression model with situational factors was more powerful: Clients rejected treatment less often if they had more previous experience with drug treatment programs, if they did not have access to other treatment programs, if recruitment workers were trained in presenting the treatment program clearly, and if recruitment workers did not emphasize recreation as part of the program. With all predictors combined, five situational factors and only one personal attribute were significant. The study suggests strong support that homeless clients reject service on the basis of situational factors rather than personal characteristics. Which adolescents become pregnant? …