Even with the loss of our petroleum resources, the number of people who have jobs in the oil industry is still high. That means the community needs to be better equipped to provide jobs and training for those leaving the industry, and it also means learning how to support the new energy generation with clean fossil fuels.
Scourging the community for stories of success stories can reveal many lessons. Learning about a group of children or adults who have succeeded highlights what an amazing difference hard work and community care makes. It also helps us learn that if we have the right resources, it can make all the difference.
I have learned that the single most important lesson I have learned is the value of evidence-based practice in the community mental health services context. As an administrator, I have learned that I need to do more than just give lip service to the importance of providing evidence-based practice.
I also need to tailor my communication to make it as relevant as possible in the clinical setting. In a recent workshop, organized by a statewide network of child mental health agencies, we heard about the importance of knowing our audiences’ language.
Contextual factors such as terminology are not easy to change. However, we know that changing our language can have a tremendous effect on how our clients perceive our work, how our providers interact with them, and how they learn more about our services.
Researchers know that most of the differences they find in effectiveness studies are because of local differences. In my experience as a clinical social worker and community mental health services provider, I have seen that psychologists, social workers, and other researchers commonly ignore these local context differences.
In research, for example, I have seen that clinicians in one clinic did an event-study design where they documented findings from “control” groups only, without taking into account any of the local contextual factors that might affect their findings.
The research did not look at whether or not there were any environmental variables that might account for the difference in outcomes between the two groups.
So, what was learned was that clinicians in that particular clinic had different experiences and thought that treatment for their patients was more effective when they visited the therapists who were in their “control group.”
Most often, researchers only consider what happens within a given “zone of influence” when they evaluate differences in effectiveness across many studies. Unfortunately, those studying behavior problems miss the very factors that contribute to problem behaviors: the interpersonal relationships between family contextual factors and child behavioral problems.
These contextual factors are usually not taken into account, even though they likely contribute to or result in certain behaviors. If the child’s behavioral problems are not dealt with or attended to, they will only continue to get worse over time, regardless of the efforts that are made to address them.
That’s why family contextual factors are so important. Community Care has been used for decades, but it’s only now getting the attention that it truly deserves. Most current efficiencies studies are focused on using case management methods (which many families already do).
This focus has been on improving service delivery efficiency within hospitals. It is not, however, based on thinking about the unique needs of individuals and families that live in settings that are housed within health care facilities.
There’s no reason that clinicians and other researchers should not include this type of care in future evaluations and feasibility studies. What is needed now is a concerted effort by researchers, clinicians, and families alike to address the unique needs of children with psychiatric disorders.
Until such efforts are undertaken, it will be difficult for clinicians and other researchers to evaluate the effects of local social contexts on child behavioral problems. Only through research can we find the most effective ways to strengthen community-based mental health services.
In sum, there are several parent perspectives out there on the subject of contextual neglect. They are important because they highlight the unique needs that children with psychiatric disorders face. They also point to the need for future studies of how to effectively deal with these issues.
If you’re a clinician or a researcher, you should definitely consider all of these perspectives. They provide a useful starting point for assessing the effectiveness of community-based child treatment interventions.