Applying a Novel Approach to Understanding Social Worker Job Retention during the Pandemic.

The job demands-resources (JD-R) theory explicates factors that facilitated social worker burnout prepandemic. Authors believe the JD-R theory can illustrate how certain factors facilitated social worker job retention in the novel context of the pandemic because a sizable group of social workers resisted burnout-related turnover. Disseminating these factors can benefit the profession. Qualitative cross-sectional data were elicited from a semistructured interview about experiences of U.S. Department of Veterans Affairs (VA) outpatient social workers (N = 13) who provided care during the pandemic. Authors conducted content analysis and coded the text into six themes of factors that facilitated retention: (1) commitment to serving veteran population, (2) job flexibility, (3) supportive colleagues, (4) leadership support, (5) maintaining normal routines, and (6) trusting in scientific/evidence-based practices. Application of the JD-R theory illustrated how social workers utilized specific resources that balanced job demands during the pandemic and facilitated job retention. Future work should apply the JD-R theory among larger samples of VA social workers, as well as non-VA social workers, in the context of the pandemic, for comparative purposes. Authors conclude with policy implications related to the impact of permanently allowing telework options and job flexibility options among social workers.

Examining Strategies among Veterans Affairs Outpatient Social Workers to Facilitate Job Retention and Emotional Well-Being during the COVID-19 Pandemic.

The social work profession is dealing with an increased rate of turnover, due largely in part to the pandemic. A recent study showed that U.S. Department of Veterans Affairs (VA) inpatient social workers utilized strategies of "emotional preparedness" to retain their job during the pandemic. The aim of this current study is to explore if outpatient social workers utilized similar strategies for their own job retention. There may be differences in the strategies utilized because outpatient and inpatient social workers tend to work in different environments. In this qualitative study, authors conducted interviews with (N = 13) outpatient social workers from a VA site in the Southwestern region of the United States. Findings were analyzed thematically. Authors conducted open coding and applied a priori themes/strategies from extant research among VA inpatient social workers. Most of the a priori themes/strategies were prevalent among outpatient social workers, and two emerging themes were (1) acknowledging shared trauma and (2) human connection to overcome isolation. Strategies of emotional preparedness should be implemented on a grander scale to facilitate job retention since there is an expected deficit in the social work workforce until at least 2030.

"The Yo-Yo Effect": U.S. Department of Veterans Affairs Social Workers' Experiences with Job Flexibility during the Pandemic.

Social work turnover from the emotional overload of providing care during the pandemic has created staff shortages and exposed many gaps in service delivery. Those social workers who sustained employment during this pandemic are asked to take on flexible/additional roles to fill in those gaps in services to their most vulnerable clients. This qualitative study (N = 12) of U.S. Department of Veterans Affairs (VA) inpatient social workers at two sites across the country assesses their experiences of taking on additional roles at their respective VA facility. Three research questions were addressed to the participants: (1) Describe your roles and responsibilities during the COVID-19 pandemic? (2) How did those responsibilities change/evolve over time? and (3) Did you receive training for your new roles or tasks? Thematic analysis revealed six themes that would facilitate effectiveness and continuity of care: (1) recognizing insufficient training to handle a pandemic, (2) meeting the demand for care, (3) responding to unexpected aspects of flexibility, (4) adjusting to new roles over time, (5) adaptation and support, and (6) additional resources to simplify efforts. With COVID rates stabilizing across much of the United States, now is the time to implement trainings and education about job flexibility in the future instance of a pandemic.

Social Workers Being Effective in Disaster Settings.

Research about social workers' impact during disasters is not widely recognized. Among the various roles social workers play during disasters are to handle asurge of clients and to support peers and leaders in their respective departments by filling in gaps in services. Dissemination of social workers' best practice approaches during actual disasters is important because their collective contributions facilitate their own resilience and improve their ability to care for their clients, which could inform other fields in the helping professions as well. Qualitative findings from (N = 8) US Department of Veterans Affairs social workers and social work leaders across the nation in regions that experienced hurricanes during 2017 and 2018 suggested the following best practices during disasters:1) adapting new roles;2) collaboration and organizational support; and3) practicing self-care. Findings suggest the need to enhance content in social work education and training with the knowledge and skills pertaining to providing services in disaster settings. During disasters, it is important for social workers to both collaborate with their team and to practice self-care in order to be most effective for their clients.

The Application of a Self-Labeling Approach among Military-Connected Adolescents in a Public School Setting.

The contextual factors and individual responses to the labeling of military-connected adolescents as "being in a military family" is an understudied yet important phenomenon. Minimal research construes the experience of being in a military family as a label applied to military-connected populations by people in society. However, social environmental factors associated with school setting among military-connected adolescents being in a military family have common components to the process of self-labeling. This article seeks to explore the concept and application of self-labeling by (a) providing a literature review of self-labeling among military-connected adolescents and (b) relying on modified labeling theory to identify any consistencies or potential nuances. The analysis of the process is strictly hypothetical, but could help to account for widely varying responses, sequence of events, and underlying reasons for the behaviors among some military-connected adolescents identified in the literature review and in light of the U.S. protracted military involvement in Iraq and Afghanistan. Authors conclude by highlighting the need for future research to assess the adequacy of this self-labeling framework to ensure the healthy development of military-connected youths.

"We Are Disaster Response Experts": A Qualitative Study on the Mental Health Impact of Volunteering in Disaster Settings Among Combat Veterans.

Volunteers serving in a disaster context may experience harmful mental health effects that could impede rescue operations. Exploratory research suggests that combat veterans who volunteer in Team Rubicon (TR)-a disaster relief social service organization with the mission of uniting the skills and experiences of military Veterans with first responders to rapidly deploy emergency response teams-have positive mental health responses when providing disaster relief. The objective of this qualitative study was to identify those nuances associated with combat veterans' mental health response in TR. The study consisted of (N = 9) male combat Veterans who volunteered with TR. Data was thematically analyzed. Results suggested that members did not experience negative mental health effects because of prior military training and preparedness relevant to disaster situations. Positive outcomes in mental health were associated with the uniqueness of peer support in TR and applying skills from military training. Veterans in TR reported that providing disaster relief afforded them the opportunity to continue serving others after having served in the military. Implications for public health social work are discussed as well as the need for further research.

An Engagement Intervention for Young Adults with Serious Mental Health Conditions.

Young adults with serious mental health conditions (SMHCs) often do not engage continuously with mental health services, and there are few engagement interventions designed for them. This qualitative study presents a blueprint for conceptualizing and developing an engagement intervention designed for young adults with SMHCs. The blueprint includes the following activities: (1) establishing a strong theoretical basis, (2) designing an initial manual based on previous research and practice, (3) systematically examining feedback on the manual from stakeholders, and (4) examining the feasibility, acceptability, and implementation demands of the intervention. Interviews, group discussions, and journaling were utilized to collect information from young adult participant-researchers, intervention facilitators (i.e., recovery role models and clinicians), and additional stakeholders (e.g., clinic staff and administrators) (N = 43). Analyses were performed with multiple coders using constant comparative methods. Results revealed critical information to improve the intervention, while also suggesting that the engagement intervention for young adults with SMHCs has promise.

Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making.

PROBLEM: Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. METHODS: Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. RESULTS: The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. CONCLUSIONS: Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.

A qualitative investigation of self-stigma among adolescents taking psychiatric medication.

OBJECTIVE: The extant literature describes stigma in two forms, public stigma and self-stigma. Public stigma pertains to negative social behaviors, reactions, attitudes, and beliefs directed toward people with mental illness and among persons with mental illness. Self-stigma concerns the internalized effects of public stigma. Although both types of stigma have negative impacts on people with mental illness, they produce different effects. In particular, self-stigma can negatively affect self-esteem, social relationships, willingness to engage in life opportunities, and adherence to psychiatric services. Few adult stigma models represent self-stigma, and no models exist that examine self-stigma among adolescents with a mental illness. Because of developmental differences, adolescent self-stigma may be distinct from that of adults. This study aimed to develop a self-stigma model to elucidate youths' responses to mental illness labels and how psychiatric services affect self-image and self-efficacy. METHODS: The qualitative study included a sample of 27 adolescents between the ages of 12 and 17 who took psychiatric medication for a mental illness diagnosis. A semistructured interview, the Teen Subjective Experience Medication Interview, was used to query adolescents about their perceptions of having a psychiatric diagnosis and of taking psychiatric medication. The analytic strategy identified a sequence of narrative plot components that illustrated a self-stigma process among adolescents. RESULTS: The findings revealed a self-stigma model comprising three narrative components: stereotype, differentiate, and protect. CONCLUSIONS: The adolescent model was similar to yet distinct from the adult model, and developmental differences may contribute to the variation. The need for future research to validate an adolescent self-stigma model is discussed.

Adolescent experience of psychotropic treatment.

Despite growing concern over the treatment of adolescents with psychiatric medications, little research has examined youth understandings and interpretations of mental illness and psychotropic treatment. This article reports the exploratory findings of semi-structured and open-ended interviews carried out with 20 adolescents diagnosed with one or more psychiatric disorders, and who were currently prescribed psychiatric medications. Grounded theory coding procedures were used to identify themes related to adolescent subjective experience with psychiatric medications. The categories identified are interpreted as different points of view through which adolescents understand and take action upon their illness concerns; their need for medication treatment; their perceptions of how medications work; their responses to parental and other influences upon medication treatment; and, their everyday management activities.