The potential for substance use to interfere with initial maternal-infant contact and attachment ... more The potential for substance use to interfere with initial maternal-infant contact and attachment was examined. Data were collected from confidential interviews with pregnant women and reviews of the medical charts of these women and their infants. Substance users (N = 60) were found to experience significantly (p = .03) more maternal-infant separation at birth than nonusers (N = 22), most often due to health concerns for mother and/or infant. Substance using mothers scored negatively more frequently than nonusing mothers on variables of attachment. Reasons for these differences are explored and some strategies for dealing with this population in the hospital milieu are suggested.
This study explores the perinatal care experiences of disadvantaged women of color in a wealthy U... more This study explores the perinatal care experiences of disadvantaged women of color in a wealthy U.S. suburb. The women were asked to discuss the availability of health and social services during pregnancy, continuity of provider and/or treatment, communication issues with their providers, and the amount and type of support and resources available. Many of the questions covered in literature on urban poverty emerged as well in this suburban sample, including economic and psychosocial barriers, and continuity and communication issues between low-income/minority women and providers of health and social services. Additional barriers in the suburbs were also discussed, including problems of access to care and services, with health insurance/reimbursement or financial accessibility, transportation and housing, and getting needed information. Overall findings support the argument that suburban poverty is an overlooked issue contributing to health disparities in infant mortality.
Objective: This research was done as part of a needs assessment commissioned by a countywide peri... more Objective: This research was done as part of a needs assessment commissioned by a countywide perinatal services network. The goals of the research were to identify barriers to care for economically disadvantaged women, explore their experiences of care and determine which care needs were frequently met and unmet. Of particular concern were issues of communication with health care providers, and whether communication led to appropriate and needed services or care. Method: The sponsoring perinatal organization sent flyers to all member agencies to recruit their clients; clients then volunteered through the member agencies. Data were collected via six semi-structured focus group interviews with 8-10 members each. Audiotapes of groups were transcribed verbatim, and coded by both authors. Analysis was based in grounded theory methodology, using open and then focused coding in iterative steps. Results: The two biggest factors in the women's perception of the quality of their care were...
The Society for Social Work Administrators in Health Care and NASW collaborated on a national stu... more The Society for Social Work Administrators in Health Care and NASW collaborated on a national study of the changes affecting social work services in a sample of 340 hospitals drawn from the member list of the American Hospital Association. The findings suggest that the changes affecting social work need to be viewed within the context of the dramatic changes occurring in the hospital and health care field. Although social work departments are experiencing decreases, these decreases often are not occurring at the same rate as those within the hospital overall. Growth is occurring in the types and scope of services. Social work is not being singled out for change, but it is critical that these trends continue to be monitored and proactive strategies used to enhance social work viability within a changing hospital environment.
This is the first qualitative study of the perceptions of hospital-based social work supervisees ... more This is the first qualitative study of the perceptions of hospital-based social work supervisees regarding their hospital supervision. Seventeen social workers were recruited using a national listserv and snowball sampling techniques. According to the perception of the clinical social workers participating in the study, hospital social work supervision is organizationally driven rather than worker-focused. Implications for social work education and
As hospitals attempt to decrease their costs to survive in today's health care market, th... more As hospitals attempt to decrease their costs to survive in today's health care market, they are implementing resizing strategies that promise greater efficiency. A by-product has been the elimination of many management and supervisory positions. A self-administered questionnaire was sent to a stratified random sample of 750 hospitals (yielding a 46% return rate) to study the types of supervisory models being utilized and the factors associated with their differential use. While concern is expressed about the erosion of clinical supervision, the data suggests that the majority of social workers are receiving supervision from a social worker.
Market forces continue to shape the health care environment, producing radical changes within the... more Market forces continue to shape the health care environment, producing radical changes within the hospital. These changes are affecting social work structure, staffing, and processes within the hospital setting, particularly in the area of social work staffing. This paper examines the changes impacting hospital settings over three fiscal years. A primary question is whether or not social work staffing is being negatively impacted by these hospital changes, and what factors predict the downsizing of social work staff.
This paper describes a flexible, relational database management system designed explicitly with t... more This paper describes a flexible, relational database management system designed explicitly with the needs and realities of social work in health care settings in mind. A variety of broad-based applications as well as organizational factors influencing implementation of automated information system are also discussed.
A multitude of social, economic, and health factors are forcing the health care industry to exami... more A multitude of social, economic, and health factors are forcing the health care industry to examine the effectiveness and efficiency of health and mental health care delivery. Managed care has emerged in this environment of cost containment, as a viable distributive mechanism for the allocation of health care resources. Schools of social work must consider additions and/or revisions to their curriculum, in order to adequately prepare social workers to practice in a managed care environment. A major barrier is the negative attitude held by many practitioners and educators towards managed care. This paper discusses the evolution of managed care, and the challenges to social work education, including the necessity for developing a more balanced view of managed care. Suggested curricular revisions are provided for two major content areas: policy and research.
The health care system is undergoing dramatic change in auspice, structure, and services delivery... more The health care system is undergoing dramatic change in auspice, structure, and services delivery in response to an emphasis on market-driven, cost-containment strategies. Consequently, many hospital social work directors either have lost some of their administrative responsibilities or have expanded their span of control beyond social work services. This article examines the responses of social work administrators to the breadth of changes occurring throughout their hospitals; the major accomplishments of social work services within their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. As a result of examining the relationship between their actual and anticipated behavior and changes in the hospital and external environment, the authors found that social work leaders in hospitals understand the complexities and challenges of the world around them. Overall, they have exhibited commitment, competence, and confidence in shaping organizational change.
This article examines the responses of social work administrators to the changes occurring throug... more This article examines the responses of social work administrators to the changes occurring throughout their hospitals over three time periods in the 1990s; the major accomplishments of social work services in their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. It compares the reports of social work director cohorts on the changes they experienced over an eight-year period with what they had expected in their settings. It also analyzes their perceptions over time of obstacles and opportunities for hospital social work administrators in response to these changes. The authors present the ways in which social work administrators understand and address the complexities they face.
As Coser (1962) demonstrated in her landmark hospital study, a humor is one of the great tools of... more As Coser (1962) demonstrated in her landmark hospital study, a humor is one of the great tools of reassurance on the hospital ward. After all, if something is ridiculous, how can it be threatening? In this study, the authors examine the role of humor in medical interactions, ...
The potential for substance use to interfere with initial maternal-infant contact and attachment ... more The potential for substance use to interfere with initial maternal-infant contact and attachment was examined. Data were collected from confidential interviews with pregnant women and reviews of the medical charts of these women and their infants. Substance users (N = 60) were found to experience significantly (p = .03) more maternal-infant separation at birth than nonusers (N = 22), most often due to health concerns for mother and/or infant. Substance using mothers scored negatively more frequently than nonusing mothers on variables of attachment. Reasons for these differences are explored and some strategies for dealing with this population in the hospital milieu are suggested.
This study explores the perinatal care experiences of disadvantaged women of color in a wealthy U... more This study explores the perinatal care experiences of disadvantaged women of color in a wealthy U.S. suburb. The women were asked to discuss the availability of health and social services during pregnancy, continuity of provider and/or treatment, communication issues with their providers, and the amount and type of support and resources available. Many of the questions covered in literature on urban poverty emerged as well in this suburban sample, including economic and psychosocial barriers, and continuity and communication issues between low-income/minority women and providers of health and social services. Additional barriers in the suburbs were also discussed, including problems of access to care and services, with health insurance/reimbursement or financial accessibility, transportation and housing, and getting needed information. Overall findings support the argument that suburban poverty is an overlooked issue contributing to health disparities in infant mortality.
Objective: This research was done as part of a needs assessment commissioned by a countywide peri... more Objective: This research was done as part of a needs assessment commissioned by a countywide perinatal services network. The goals of the research were to identify barriers to care for economically disadvantaged women, explore their experiences of care and determine which care needs were frequently met and unmet. Of particular concern were issues of communication with health care providers, and whether communication led to appropriate and needed services or care. Method: The sponsoring perinatal organization sent flyers to all member agencies to recruit their clients; clients then volunteered through the member agencies. Data were collected via six semi-structured focus group interviews with 8-10 members each. Audiotapes of groups were transcribed verbatim, and coded by both authors. Analysis was based in grounded theory methodology, using open and then focused coding in iterative steps. Results: The two biggest factors in the women's perception of the quality of their care were...
The Society for Social Work Administrators in Health Care and NASW collaborated on a national stu... more The Society for Social Work Administrators in Health Care and NASW collaborated on a national study of the changes affecting social work services in a sample of 340 hospitals drawn from the member list of the American Hospital Association. The findings suggest that the changes affecting social work need to be viewed within the context of the dramatic changes occurring in the hospital and health care field. Although social work departments are experiencing decreases, these decreases often are not occurring at the same rate as those within the hospital overall. Growth is occurring in the types and scope of services. Social work is not being singled out for change, but it is critical that these trends continue to be monitored and proactive strategies used to enhance social work viability within a changing hospital environment.
This is the first qualitative study of the perceptions of hospital-based social work supervisees ... more This is the first qualitative study of the perceptions of hospital-based social work supervisees regarding their hospital supervision. Seventeen social workers were recruited using a national listserv and snowball sampling techniques. According to the perception of the clinical social workers participating in the study, hospital social work supervision is organizationally driven rather than worker-focused. Implications for social work education and
As hospitals attempt to decrease their costs to survive in today's health care market, th... more As hospitals attempt to decrease their costs to survive in today's health care market, they are implementing resizing strategies that promise greater efficiency. A by-product has been the elimination of many management and supervisory positions. A self-administered questionnaire was sent to a stratified random sample of 750 hospitals (yielding a 46% return rate) to study the types of supervisory models being utilized and the factors associated with their differential use. While concern is expressed about the erosion of clinical supervision, the data suggests that the majority of social workers are receiving supervision from a social worker.
Market forces continue to shape the health care environment, producing radical changes within the... more Market forces continue to shape the health care environment, producing radical changes within the hospital. These changes are affecting social work structure, staffing, and processes within the hospital setting, particularly in the area of social work staffing. This paper examines the changes impacting hospital settings over three fiscal years. A primary question is whether or not social work staffing is being negatively impacted by these hospital changes, and what factors predict the downsizing of social work staff.
This paper describes a flexible, relational database management system designed explicitly with t... more This paper describes a flexible, relational database management system designed explicitly with the needs and realities of social work in health care settings in mind. A variety of broad-based applications as well as organizational factors influencing implementation of automated information system are also discussed.
A multitude of social, economic, and health factors are forcing the health care industry to exami... more A multitude of social, economic, and health factors are forcing the health care industry to examine the effectiveness and efficiency of health and mental health care delivery. Managed care has emerged in this environment of cost containment, as a viable distributive mechanism for the allocation of health care resources. Schools of social work must consider additions and/or revisions to their curriculum, in order to adequately prepare social workers to practice in a managed care environment. A major barrier is the negative attitude held by many practitioners and educators towards managed care. This paper discusses the evolution of managed care, and the challenges to social work education, including the necessity for developing a more balanced view of managed care. Suggested curricular revisions are provided for two major content areas: policy and research.
The health care system is undergoing dramatic change in auspice, structure, and services delivery... more The health care system is undergoing dramatic change in auspice, structure, and services delivery in response to an emphasis on market-driven, cost-containment strategies. Consequently, many hospital social work directors either have lost some of their administrative responsibilities or have expanded their span of control beyond social work services. This article examines the responses of social work administrators to the breadth of changes occurring throughout their hospitals; the major accomplishments of social work services within their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. As a result of examining the relationship between their actual and anticipated behavior and changes in the hospital and external environment, the authors found that social work leaders in hospitals understand the complexities and challenges of the world around them. Overall, they have exhibited commitment, competence, and confidence in shaping organizational change.
This article examines the responses of social work administrators to the changes occurring throug... more This article examines the responses of social work administrators to the changes occurring throughout their hospitals over three time periods in the 1990s; the major accomplishments of social work services in their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. It compares the reports of social work director cohorts on the changes they experienced over an eight-year period with what they had expected in their settings. It also analyzes their perceptions over time of obstacles and opportunities for hospital social work administrators in response to these changes. The authors present the ways in which social work administrators understand and address the complexities they face.
As Coser (1962) demonstrated in her landmark hospital study, a humor is one of the great tools of... more As Coser (1962) demonstrated in her landmark hospital study, a humor is one of the great tools of reassurance on the hospital ward. After all, if something is ridiculous, how can it be threatening? In this study, the authors examine the role of humor in medical interactions, ...
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Papers by Candyce Berger