Human services

Abstract: Job burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined here by the three dimensions of exhaustion, cynicism, and sense of inefficacy. Its presence as a social problem in many human services professions was the impetus for the research that is now taking place in many countries. That research has established the complexity of the problem and has examined the individual stress experience within a larger social and organizational context of people's response to their work. The framework, which focuses attention on the interpersonal dynamics between the worker and other people in the workplace, has yielded new insights into the sources of stress, but effective interventions have yet to be developed and evaluated.

Abstract: The critical role of street-level bureaucrats -- Street-level bureaucrats as policy makers -- The problem of resources -- Goals and performance measures -- Relations with clients -- Advocacy and alienation in street-level work -- Rationing services : limitation of access and demand -- Rationing services : inequality in administration -- Controlling clients and the work situation -- The client-processing mentality -- The assault on human services : bureaucratic control, accountability, and the fiscal crisis -- The broader context of bureaucratic relations -- Support for human services : notes for reform and reconstruction -- On managing street-level bureaucracy.

Abstract: In the past few years several major reports highlighted the gap between our knowledge of effective treatments and services currently being received by consumers. These reports agree that we know much about interventions that are effective but make little use of them to help achieve important behavioral health outcomes for children families and adults nationally. This theme is repeated in reports by the Surgeon General (United States Department of Health and Human Services 1999; 2001) the National Institute of Mental Health [NIMH] National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment (2001) Bernfeld Farrington & Leschied (2001) Institute of Medicine (2001) and the Presidents New Freedom Commission on Mental Health (2003). The authors call for applied research to better understand service delivery processes and contextual factors to improve the efficiency and effectiveness of program implementation at local state and national levels. Our understanding of how to develop and evaluate evidence-based intervention programs has been furthered by on-going efforts to research and refine programs and practices to define "evidence bases" and to designate and catalogue "evidence-based programs or practices". However the factors involved in successful implementation of these programs are not as well understood. Current views of implementation are based on the scholarly foundations prepared by Pressman & Wildavskys (1973) study of policy implementation Havelock & Havelocks (1973) classic curriculum for training change agents and Rogers (1983; 1995) series of analyses of factors influencing decisions to choose a given innovation. These foundations were tested and further informed by the experience base generated by pioneering attempts to implement Fairweather Lodges and National Follow-Through education models among others. Petersilia (1990) concluded that "The ideas embodied in innovative social programs are not self-executing." Instead what is needed is an "implementation perspective on innovation--an approach that views postadoption events as crucial and focuses on the actions of those who convert it into practice as the key to success or failure". (excerpt)