• Addressing the needs of older adults receiving alcohol treatment during the Covid-19 pandemic: a qualitative study

      Seddon, Jennifer L.; Trevena, Paulina; Wadd, Sarah; Elliott, Lawrie; Dutton, Maureen; McCann, Michelle; Willmott, Sarah; Breslin, Julie; Glasgow Caledonian University; University of Bedfordshire (Drink Wise Age Well, 2020-12-09)
      This study aims to better understand the impact of the pandemic on older alcohol service users aged 55+ and alcohol service providers. The key aims of the study are to: 1 Explore the consequences of the Covid-19 pandemic and lockdown on older service users, including on their alcohol consumption. 2 Identify how alcohol services have adapted and supported older service users, and how staff experienced these changes. 3 Identify the short and long-term implications for service provision, and how service responses could be improved.
    • Factors influencing routine cognitive impairment screening in older at-risk drinkers: findings from a qualitative study in the United Kingdom

      Madoc-Jones, Iolo; Wadd, Sarah; Elliott, Lawrie; Whittaker, Anne; Adnum, Laura; Close, Ciara; Seddon, Jennifer L.; Dutton, Maureen; McCann, Michelle; Wilson, Fiona (Wiley, 2020-07-14)
      Cognitive Impairment (CI) screening is recommended for those engaged in harmful levels of alcohol use. However, there is a lack of evidence on implementation. This paper explores the barriers and facilitators to CI screening experienced across a service specifically for older drinkers. The findings draw on data gathered as part of an evaluation of a multilevel programme to reduce alcohol-related harm in adults aged 50 and over in five demonstration areas across the United Kingdom. It is based on qualitative interviews and focus groups with 14 service providers and 22 service users. Findings are presented thematically under the section headings: acceptability of screening, interpretation and making sense of screening and treatment options. It is suggested that engagement with CI screening is most likely when its fit with agency culture and its purpose is clear; where service providers have the technical skills to administer and discuss the results of screening with service users; and where those undertaking screening have had the opportunity to reflect on their own experience of being screened. Engagement with CI screening is also most likely where specific intervention pathways and engagement practices can be accessed to respond to assessed need.
    • A randomized controlled trial of training in Motivational Interviewing for child protection.

      Forrester, Donald; Westlake, David; Killian, Mike; Antonopoulou, Vivi; McCann, Michelle; Thomas, Roma; Waits, Charlotte; Whittaker, Charlotte E.; Hutchison, Dougal; Thurnham, Angela; et al. (Elsevier, 2018-02-12)
      There has been interest in developing more evidence-based approaches to child and family social work in the UK in recent years. This study examines the impact of a skills development package of training and supervision in Motivational Interviewing (MI) on the skills of social workers and the engagement of parents through a randomized controlled trial. All workers in one local authority were randomly assigned to receive the package (n = 28) or control (n = 33). Families were then randomized to trained (n = 67) or untrained (n = 98) workers. Family meetings with the worker shortly after allocation were evaluated for MI skill. Research interviews gathered data including the WAI. Follow-up interviews 20 weeks later repeated the WAI, and other outcome measures including Goal Attainment Scaling (GAS) and rating of family life. Between group analysis found statistically significant difference in MI skills, though these were not substantial (2.49 in control, 2.91 MI trained, p = .049). There was no statistically significant difference between groups in any other outcome measures. The package of training and supervision did not create sufficient increase in MI skills to influence engagement or outcomes. Implications for understanding the relationship between skills, engagement and organizational change are discussed.
    • 'Wet' care homes for older people with refractory alcohol problems: a qualitative study

      McCann, Michelle; Wadd, Sarah; Crofts, Gill; University of Bedfordshire (Alcohol Research UK, 2017-08-04)
      Background This study describes a registered care home in England and a registered nursing home in Norway which provide permanent care for alcohol-dependent older people who are unable or unwilling to stop drinking and cannot maintain an adequate standard of self-care and/or live independently. Prior to admission, most residents have been living unsafely in their own home or were homeless. They have high levels of contact with health, social and criminal justice services and complex needs as a result of mental illness, poor physical health and physical disabilities. Most have lost contact with their families. The aim is to stabilise drinking, physical and mental health and improve quality of life. The homes are based on a harm reduction philosophy, that is, they focus on strategies to reduce harm from high-risk alcohol use, rather than insisting on abstinence. Residents can drink as much alcohol as they want on the premises but staff encourage them to drink less and in a less harmful way (e.g. spreading drinking throughout the day and having ‘dry’ days). Method We carried out interviews and focus groups with staff and residents, observed verbal exchanges, experiences and routines in communal areas, took field notes during staff rounds and analysed documents such as care plans for individual residents. Key findings • Most residents’ drinking, physical and mental health stabilises and their use of health, social and criminal justice services reduces following admission. • This is achieved by encouraging less harmful drinking, providing on-site health care, assistance with medication and self-care and provision of nutritious meals and social activities. • Wet care homes are viewed by some residents as a safe refuge which has improved their quality of life. • Other residents are frustrated by a lack of personal autonomy. • Suitable outcomes include improved hygiene and nutrition, increased self-esteem, better compliance with healthcare, healthier living which is not entirely alcohol focused and more hope for the future. • Homes should have processes in place to collect quantitative measures which provide clear evidence of impact.          
    • What is the relationship between worker skills and outcomes for families in child and family social work?

      Forrester, Donald; Westlake, David; Killian, Mike; Antonopoulou, Vivi; McCann, Michelle; Thurnham, Angela; Thomas, Roma; Waits, Charlotte; Whittaker, Charlotte E.; Hutchison, Douglas (Oxford University Press (OUP), 2019-01-28)
      Communication skills are fundamental to social work, yet few studies have directly evaluated their impact. In this study, we explore the relationship between skills and outcomes in 127 families. An observation of practice was undertaken on the second or third meeting with a family. Practice quality was evaluated in relation to seven skills, which were grouped into three dimensions: relationship building, good authority and evocation of intrinsic motivation. Outcomes at approximately six months were parent-reported engagement (Working Alliance Inventory), Goal Attainment Scaling (GAS), an eleven-point family life satisfaction rating, the Family Environment Scale and General Health Questionnaire and service outcomes from agency records including children entering care. Relationship-building skills predicted parent-reported engagement, although good authority and evocation had stronger relationships with outcome measures. Where workers visited families more often, relationships between skills and outcomes were stronger, in part because workers had more involvement and in part because these families were more likely to have significant problems. The relationship between skills and outcomes was complicated, although the findings provide encouraging evidence that key social work skills have an influence on outcomes for families.