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What APS Can Learn From Other Human Service Fields

October 7, 2013 | Nichole Carlisle, Program Associate, NCCD

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Anecdotally, it seems human beings are primed to borrow things and ideas from one another. We do it with recipes, stock tips, and office supplies. We encourage our children to share with one another just as we try to emulate this process ourselves. And yet, when it comes to professional spheres, we are often reluctant to borrow from one sphere in order to benefit another.

Anecdotally, it seems human beings are primed to borrow things and ideas from one another. We do it with recipes, stock tips, and office supplies. We encourage our children to share with one another just as we try to emulate this process ourselves. And yet, when it comes to professional spheres, we are often reluctant to borrow from one sphere in order to benefit another.

Running counter to these desires for originality and living on the cutting edge of professional development is the need to do much with little. Especially in the context of human services, we are often faced with increasing mandates in a time of dwindling resources. How can we improve practice when there is so little money for services for the people we serve, not to mention lack of resources for research and improvement of practices? 

One answer may come in the guise of “borrowing” from other fields. We may ask ourselves what it is that other fields are doing, in terms of effective interventions and services, which may be borrowed and adapted to serve the needs of our own unique population. The National Adult Protective Services Resource Center (NAPSRC), in looking to enhance practice in the field of adult protective services (APS), has done just that. They have raised the call to expand how professionals think of borrowing, and to do so in a systematic way that teases apart interventions in order to determine which aspects, if any, may be applicable to practice in the realm of APS. 

NCCD, in conjunction with the NAPSRC, has looked at literature from the fields of child protection, substance abuse, and public health and have identified several practice aspects that may be applicable to the populations served by APS. Here we present an overview of our findings on effective interventions for populations that are different from those served by APS, but which may be applicable in the APS service realm. In doing this, we ask that you approach these findings with a mind open to how these interventions can be tailored to the unique needs of those served by APS.

Broadly, we have found that there are several types of interventions that are effective. Those types of interventions fall within the following categories: victim-focused therapeutic interventions, under which we find things like multi-systemic therapy and informational interventions; caregiver-focused preventive interventions; and caregiver-focused therapeutic interventions. We have also uncovered research on potential risk factors for abuse and neglect. While these factors have been derived from the field of child protection, they are salient to APS as they help identify factors which put families and individuals at risk for abuse, neglect or exploitation. 

What we found was that informational/educational interventions are effective at changing an individual’s cognitions about certain topics yet are not sufficient for behavioral change. Thus, we would expect to see that providing people with more information about elder maltreatment would not be sufficient to change the behavior of those who are abusive or neglectful, but may be sufficient for spreading awareness and increasing the reporting of elder maltreatment. This effect extends to caregivers, who are shown to be more responsive to interventions that are behaviorally based as opposed to those that are purely educational in nature. 

The literature also indicates that it is important to embed interventions into existing relationships in order to enhance the effectiveness of the interventions. In practice, as in all good social work, this would mean that APS workers build a strong relational foundation with an individual and then leverage that relationship in helping the individual to access and use services. This approach is effective not just when working with individuals and families, but also when taking a public health approach to elder maltreatment by conducting workshops or engaging entire communities in prevention efforts. 

It is also beneficial to engage the entire family in interventions that occur post-mistreatment. This is especially true when the incidence of mistreatment has occurred in the family context, such that a family caregiver is also the (alleged) perpetrator. Again, in these findings, the importance of behaviorally focused interventions was emphasized. It was found that educational interventions only, such as those that discuss the ramifications of maltreatment for the victim, were not as effective as interventions that sought to interrupt negative behaviors or improve relationships between the caregiver the victim.

The literature also revealed the potential importance of addressing caregiver social isolation as a means of preventing mistreatment recurrence. Many studies identified, and many interventions sought to address, the role that lack of social supports for caregivers plays in the occurrence of mistreatment. Low social support was identified in numerous studies as a risk factor for elder abuse. In recognizing that this may be a risk factor for elder mistreatment, we can begin to build support around caregivers in a way that is preventive in nature. And, hopefully, we can begin to realize that, in supporting caregivers, we also support those that are potential clients of the APS system.

Follow this link to the full report:

http://www.napsa-now.org/resource-center/research/evidence-based-practices/

Nichole Carlisle is a Program Associate at NCCD.