This instrument was developed for the Report to Congress on Supply and Demand of Social Workers in Long-Term Care: Listening Sessions. This project was conducted by the New York Academy of Medicine under contract for the Department of Health and Human Services (HHS) Office of Disability, Aging and Long-Term Care Policy. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. The e-mail address is: webmaster.DALTCP@hhs.gov. The DALTCP Project Officer was Linda Bergofsky.
| NOTE: This is a recreation of this form. See the PDF version for a scanned version of the actual form. |
The National Association of Social Workers (NASW) and the Center for Health Workforce Studies at the University at Albany (CHSW) are conducting a national study to obtain information about the education, job settings, and work activities of licensed social work professionals. This study also examines the roles and experiences of social workers providing services to older adults and to children and their families. Your responses will be confidential and reported only in national, regional, and other tabulations and summaries.
| MARKING INSTRUCTIONS |
- Use a No. 2 pencil or blue or black ink pen only.
- Do not use pens with ink that soaks through the paper.
- Make no stray makes on this form.
- Do not fold, tear, or mutilate this form.
- Make solid marks that fill the oval completely.
CORRECT 
INCORRECT
| I. BACKGROUND |
1. Age:
(___) 25 & under
(___) 26-34
(___) 35-44
(___) 45-54
(___) 55-64
(___) 65 & over
2. Gender:
(___) Male
(___) Female
3. Race/ethnic status: Please make only one.
(___) Asian/Pacific Islander
(___) Black/African-American
(___) 35-44
(___) Hispanic/Latino
(___) White (Non-Hispanic)
(___) Native American/Alaskan Native
(___) Other: _________________________
4. What formal education programs have you completed. Please mark all that apply.
Social Work
MajorOther (___) (___) Associate Degree (___) (___) Bachelor's Degree (___) (___) Master's Degree (___) (___) Doctoral Degree (___) (___) Other: _________________________
5. Are you now enrolled in a degree program in social work?
(___) None
(___) BSW
(___) MSW
(___) DSW/PhD
6. Please mark all social work certifications you currently hold.
(___) Case management
(___) Children, youth & family
(___) Clinical social work
(___) Geriatrics
(___) Health Care
(___) Independent practice/ACSW
(___) School social work
(___) Substance abuse/chemical dependency
(___) Other: _________________________
(___) None of the above
7. Do you hold social work licenses in more than one state?
(___) Yes
(___) No
8. Are you licensed to provide chemical dependency treatment in your state?
(___) Yes
(___) No
9a. Year of graduation (e.g. 1992=92)
BSW B.A./B.S. MSW ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 9 ) ( 9 ) ( 9 ) ( 9 ) ( 9 ) ( 9 )
9B. Years practicing as . . .
BSW MSW ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 9 ) ( 9 ) ( 9 ) ( 9 )
10. What social work continuing education/training have you participated in during the last 2 years? Please mark all that apply.
(___) Courses offering academic credit
(___) Short courses/workshops
(___) Certificate programs
(___) Professional association programs
(___) Supervised clinical practice
(___) Distance learning programs
(___) Conferences
(___) Supervised practice
(___) On-the-job training
(___) Other: _________________________
(___) None
11a. In what areas of social work would you like to pursue further education/training?
(___) Best practices
(___) Care management
(___) Clinical practice
(___) Community organizing
(___) Cultural compentency
(___) Delivering services in rural communities
(___) Interdisciplinary practice
(___) Administration
(___) Medication use
(___) Paperwork management
(___) Professional ethics
(___) Program development
(___) Specialty practice area
(___) Substance abuse
(___) Telehealth
(___) Trauma/Disaster preparedness
(___) Other: _________________________
(___) None
11b. How would you describe the availability of social work continuing education programs that interest you?
Unavailable (___) (___) (___) (___) (___) Many Choices
12. Did your previous training prepare you adequately for roles you perform as a social worker?
Not at All Very Well Social work degree program (___) (___) (___) (___) (___) Post-degree continuing education/training (___) (___) (___) (___) (___)
| II. SOCIAL WORK PRACTICE |
13. What is your employment status? Mark all that apply.
FT PT (___) (___) Employed/self employed in a social work position (___) (___) Employed/self employed in a non-social work position (___) (___) Not currently employed
14. If you do not currently work as a social worker, please mark all that apply and proceed to Question 47.
(___) Few social work positions available
(___) Prefer other type of work
(___) Convenience of hours
(___) Convenience of locations
(___) Level of pay
(___) Personal reasons
(___) Retired
(___) Other: _________________________
15. For how many employers do you currently work as a social worker? Include self-employment.
(___) 1
(___) 2
(___) 3
(___) 4
(___) 5+
16. How many hours per week do you perform the following roles in all social work employment? Please mark on in each row.
None 1-9 10-19 20-29 30-39 40+ (___) (___) (___) (___) (___) (___) Administration/Mgmt (___) (___) (___) (___) (___) (___) Community organizing (___) (___) (___) (___) (___) (___) Consultation (___) (___) (___) (___) (___) (___) Direct services (___) (___) (___) (___) (___) (___) Planning (___) (___) (___) (___) (___) (___) Policy development (___) (___) (___) (___) (___) (___) Research (___) (___) (___) (___) (___) (___) Supervision (___) (___) (___) (___) (___) (___) Teaching (___) (___) (___) (___) (___) (___) Training/Education (___) (___) (___) (___) (___) (___) Other
17. What bed describes the sector of your primary and secondary employers? Please mark one for each employer.
Primary Secondary (___) (___) Private for-profit (includes private practice) (___) (___) Private not-for-profit (___) (___) Federal government (___) (___) State government (___) (___) Local government (___) (___) Military
18. Which best describes the setting of your primary and secondary social work employment? Please mark one for each category.
Primary Secondary (___) (___) Private solo practice (___) (___) Private group practice (___) (___) Hospital/medical center (___) (___) Psychiatric hospital (___) (___) Health clinic/Outpatient facility (___) (___) Home health agency (___) (___) Behavioral health clinic/outpatient facility (___) (___) Social service agency (___) (___) Case management agency--older adults (___) (___) Case management agency--other (___) (___) Nursing home (___) (___) Assisted living facility (___) (___) Hospice (___) (___) Group home--adult (___) (___) School (___) (___) Child guidance clinic (___) (___) Group homes--children/adolescents (___) (___) Resource center (___) (___) Information and referral service (___) (___) Insurance company/HMO (___) (___) Criminal justice agency (e.g. court) (___) (___) Public health agency (___) (___) Other government agency (___) (___) Business (___) (___) Higher education (___) (___) Other: _________________________
19. What best describes the focus of your social work practice area in your primary and secondary employment? Please mark only one selection for each employer.
Primary Secondary (___) (___) Addictions (___) (___) Adolescents (___) (___) Aging (___) (___) Child welfare/family (___) (___) Community development (___) (___) Criminal justice (___) (___) Developmental disabilities (___) (___) Higher education (___) (___) Homeless/displaced persons (___) (___) Income assistance (___) (___) Medical health (___) (___) Mental health (___) (___) Occupational social work (___) (___) School social work (___) (___) Other
20a. How many total hours do you work for pay per week in your primary and secondary social work jobs?
Total Hours Primary Secondary ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 9 ) ( 9 ) ( 9 ) ( 9 )
20b. How many hours per week do you spend providing direct services to clients in your primary and secondary social work jobs?
Direct Service Hours Primary Secondary ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 9 ) ( 9 ) ( 9 ) ( 9 )
21. ZIP code of your primary work setting:
( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 0 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 2 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 3 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 4 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 5 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 6 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 7 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 8 ) ( 9 ) ( 9 ) ( 9 ) ( 9 ) ( 9 )
22. How many years have you worked for your primary employer?
(___) 1
(___) 1-5
(___) 6-10
(___) 11-15
(___) 16+
23. Does your primary position require that you hold a social work license?
(___) Yes
(___) No
24. Is your supervisor in your primary position a social worker?
(___) Yes
(___) No
(___) Not applicable
25. How many other social workers are employed in your primary work setting?
(___) None
(___) 1-5
(___) 6-10
(___) 11+
26. How would you describe your total compensation package from all social work employment?
Very
LimitedLimited Adequate Very
Adequate(___) (___) (___) (___) Wages/salary (___) (___) (___) (___) Benefits
27. What are your estiamted annual gross wages/salary from all social work positions?
(___) Less than $15,000
(___) $15,000-$19,999
(___) $20,000-$24,999
(___) $25,000-$29,999
(___) $30,000-$34,999
(___) $35,000-$39,999
(___) $40,000-$49,999
(___) $50,000-$59,999
(___) $60,000-$69,999
(___) $70,000-$79,999
(___) $80,000-$99,999
(___) $100,000 or more
28. What benefits are included in your social work compensation packages? Please mark all that apply.
(___) Health insurance
(___) Dental insurance
(___) Life insurance
(___) Pension
(___) Tuition reimbursement
(___) Flexible working hours
(___) Other
| III. SERVICES TO CLIENTS If you currently have responsibilities related to providing direct services to clients within your PRIMARY or SECONDARY employment settings, proceed with #29. If you do not have responsibilities for direct services, go to #42. |
29. What % of time do you spend per week on the following activities related to delivering services to clients? Mark one in each row.
0% 1-10% 11-25% 26-50% 51-75% 76+% (___) (___) (___) (___) (___) (___) Information and Referral (___) (___) (___) (___) (___) (___) Screening and Assessments (___) (___) (___) (___) (___) (___) Treatment Planning (___) (___) (___) (___) (___) (___) Crisis Intervention (___) (___) (___) (___) (___) (___) Case Management Counseling (___) (___) (___) (___) (___) (___) ... Individual (___) (___) (___) (___) (___) (___) ... Group (___) (___) (___) (___) (___) (___) ... Family (___) (___) (___) (___) (___) (___) ... Couples (___) (___) (___) (___) (___) (___) Medication Adherence (___) (___) (___) (___) (___) (___) Advocacy/Community Organizing (___) (___) (___) (___) (___) (___) Psychtherapy (___) (___) (___) (___) (___) (___) Psycheducation (___) (___) (___) (___) (___) (___) Client Education (___) (___) (___) (___) (___) (___) Supervision of Staff (___) (___) (___) (___) (___) (___) Program Development (___) (___) (___) (___) (___) (___) Program Management (___) (___) (___) (___) (___) (___) Discharge Planning (___) (___) (___) (___) (___) (___) Home Visits (___) (___) (___) (___) (___) (___) Other: _________________________
30. What is the approximate size of your current caseload?
0 1-10 11-15 26-50 51-75 76-100 100% (___) (___) (___) (___) (___) (___) (___) Primary (___) (___) (___) (___) (___) (___) (___) Secondary
31. What % of your total caseload is female?
None 1-25% 26-50% 51-75% 75+% (___) (___) (___) (___) (___)
32. What % of your total caseload falls into the following age groups? Please mark one in each row.
None 1-10% 11-25% 26-50% 50+% (___) (___) (___) (___) (___) Children (0-12) (___) (___) (___) (___) (___) Adolescents (13-21) (___) (___) (___) (___) (___) Adults (22-54) (___) (___) (___) (___) (___) Older Adults (55+)
33. What % of your total caseload falls into the following racial/ethnic groups? Please mark one in each row.
None 1-5% 6-10% 11-25% 26-50% 51+% (___) (___) (___) (___) (___) (___) Asian/Pacific Islander (___) (___) (___) (___) (___) (___) Black/African-American (not Hispanic) (___) (___) (___) (___) (___) (___) Hispanic/Latino (___) (___) (___) (___) (___) (___) Native American/Alaskan Native (___) (___) (___) (___) (___) (___) White (not Hispanic) (___) (___) (___) (___) (___) (___) Other
34. What is the most common source of health coverage among the clients you serve? Please mark only one.
(___) Medicaid
(___) Medicare
(___) Private insurance
(___) Private pay
(___) Not insured
(___) Don't know
35. How many of your clients have the following conditions? Please mark one in each row.
None Few Some Many (___) (___) (___) (___) Mental illness (___) (___) (___) (___) Affective conditions (___) (___) (___) (___) Neurological conditions (___) (___) (___) (___) Developmental disabilities (___) (___) (___) (___) Physical disabilities (___) (___) (___) (___) Substance abuse conditions (___) (___) (___) (___) Acute medical conditions (___) (___) (___) (___) Psychosocial stressors (___) (___) (___) (___) Chronic medical conditions (___) (___) (___) (___) Co-occurring conditions
| IV. WORKPLACE ISSUES |
36. To what extent has the practice of social work changed in the past two years in your primary employment setting? Please mark one in each row.
Decreased Increased N/A (___) (___) (___) (___) (___) (___) Caseload size (___) (___) (___) (___) (___) (___) Severity of client problems (___) (___) (___) (___) (___) (___) Waiting lists for services (___) (___) (___) (___) (___) (___) Levels of reimbursement (___) (___) (___) (___) (___) (___) Coordination with community agencies (___) (___) (___) (___) (___) (___) Paperwork (___) (___) (___) (___) (___) (___) Staffing levels--social workers (___) (___) (___) (___) (___) (___) Staffing levels--other (___) (___) (___) (___) (___) (___) Job security (___) (___) (___) (___) (___) (___) Level of outcome monitoring/oversight (___) (___) (___) (___) (___) (___) Availability of social work supervision (___) (___) (___) (___) (___) (___) Assignment of non-social work tasks (___) (___) (___) (___) (___) (___) Availability of professional training
37. To what extent has the service delivery system available to support clients changed in the past two years? Please mark one in each row.
Decreased Increased N/A (___) (___) (___) (___) (___) (___) Number of clients eligible for services (___) (___) (___) (___) (___) (___) Eligibility requirements for clients to receive services (___) (___) (___) (___) (___) (___) Range of services available (___) (___) (___) (___) (___) (___) Number of services available (___) (___) (___) (___) (___) (___) Services eligible for funding (___) (___) (___) (___) (___) (___) Clients receiving services for reasons other than personal choice (e.g. court-mandated)
38. Indicate your agreement with the following statements. Please mark one in each row.
Never Always N/A (___) (___) (___) (___) (___) (___) I help improve the quality of life of my clients. (___) (___) (___) (___) (___) (___) In help clients meet their objectives to change their situations. (___) (___) (___) (___) (___) (___) I help clients address a range of problems, including psychological, medical, and social issues. (___) (___) (___) (___) (___) (___) I help clients address one or two key problems that will improve their lives. (___) (___) (___) (___) (___) (___) I help clients resolve crisis situations (___) (___) (___) (___) (___) (___) I help families respond to client needs. (___) (___) (___) (___) (___) (___) I am satisfied with my ability to help clients navigate through the social services system. (___) (___) (___) (___) (___) (___) I am satisfied with my ability to coordinate care between the medical and mental health community to address the needs of clients. (___) (___) (___) (___) (___) (___) I can effectively respond to the number of requests for assistance made by clients and their families. (___) (___) (___) (___) (___) (___) I work with community organizations to adapt our service delivery system. (___) (___) (___) (___) (___) (___) I am satisfied with my ability to address complex and chronic care problems of clients. (___) (___) (___) (___) (___) (___) I am satisfied with the amount of time I spend with clients. (___) (___) (___) (___) (___) (___) I am satisfied with my ability to respond to cultural differences among the clients I serve. (___) (___) (___) (___) (___) (___) I am satisfied with my ability to influence the design of services to better meet client needs.
39. Are the majority of the tasks you perform appropriate to your level of training and skills obtained through your social work education and post-graduate professional development?
Below my training (___) (___) (___) (___) (___) Above my training
40. How satisfied are you with your ability to access services for clients? Please mark one in each row.
Not at All Very N/A (___) (___) (___) (___) (___) (___) Agency services (___) (___) (___) (___) (___) (___) Community resources (___) (___) (___) (___) (___) (___) Approrpiate medication (___) (___) (___) (___) (___) (___) Appropriate medical care (___) (___) (___) (___) (___) (___) Appropriate mental health care
41. How satisfied are you with the amount of time available for the following? Please mark one in each row.
Not at All Very N/A (___) (___) (___) (___) (___) (___) Addressing clients' presenting problems (___) (___) (___) (___) (___) (___) Accessing basic services (e.g. housing, food, transporation) (___) (___) (___) (___) (___) (___) Providing services to clients' families (___) (___) (___) (___) (___) (___) Addressing severity of client problems (___) (___) (___) (___) (___) (___) Addressing breadth of client problems (___) (___) (___) (___) (___) (___) Addressing service delivery issues (___) (___) (___) (___) (___) (___) Providing clinical services to clients (___) (___) (___) (___) (___) (___) Conducting investigations (___) (___) (___) (___) (___) (___) Participating in training (___) (___) (___) (___) (___) (___) Performing administrative tasks
42. Does your agency participate in any of the following? Please mark all that apply.
(___) Demonstration programs
(___) Clinical research
(___) Student internships
(___) Best practices training
(___) Program evaluation research
(___) Professional development programs for staff
43. Are vacancies in social work positions common in your primary setting?
Yes Somewhat No N/A Common (___) (___) (___) (___) Difficult to fill (___) (___) (___) (___)
44. Does your primary employer:
Yes No Don't
KnowRecruit individuals who don not have social degrees to fill social work vacancies (___) (___) (___) Outsource any social work functions (___) (___) (___)
45. Please answer the following about job safety:
Yes No Are you faced with personal safety issues in your primary employment practice? (___) (___) If yes, do you feel that safety issues are appropriately addressed by your employer? (___) (___)
46. Please indicate your agreement with the following:
Strongly
DisagreeStrongly
AgreeN/A (___) (___) (___) (___) (___) (___) There is respect/support for social work services within my agency. (___) (___) (___) (___) (___) (___) I receive support and guidance from my supervisor. (___) (___) (___) (___) (___) (___) I receive and/or provide assistance on issues of ethical practice in the workplace.
47. What are your career plans in the next two years? Please mark all that apply.
(___) Remain in current position
(___) Pursue additional social work degree
(___) Pursue additional non-social work degree
(___) Pursue non-degree training in social work
(___) Seek new opportunity/promotion as a social worker
(___) Increase hours working as a social worker
(___) Decrease hours working as a social worker
(___) Re-enter social work, if not currently a social worker
(___) Leave social work field, but continue working
(___) Retire
(___) Stop working
(___) Other: _________________________
48. What are the five most important factors that would influence a decision to change your current position? Please mark only 5.
(___) Higher salary
(___) More interesting work
(___) Increased career mobility
(___) Different supervisor/management
(___) Opportunities for training/education
(___) Location
(___) Lifestyle/family concerns
(___) Agency mission
(___) Peer support
(___) Lighter workload
(___) Increased responsibility
(___) Quality of supervision
(___) Personal reasons
(___) Ethical challenges
(___) Stress of current job
(___) Better benefits
(___) Other: _________________________
| The following two sections examine experiences to social workers who provide services to older adults and/or to children and their families. Please proceed to Section V. Services for Older Adults if you provide any services to individual 55 years or older. If not, please proceed to SectionIV, #63. Please complete Section VI. Services for Children and Families if you provide any services to individuals 21 years of age or under. |
| V. SERVICES FOR OLDER ADULTS |
49. What % of your total caseload falls into the following age groups?
None 1-5% 6-10% 11-25% 26-50% 51-75% 76+% (___) (___) (___) (___) (___) (___) (___) Birth to 54 (___) (___) (___) (___) (___) (___) (___) 55-64 (___) (___) (___) (___) (___) (___) (___) 65-74 (___) (___) (___) (___) (___) (___) (___) 75-84 (___) (___) (___) (___) (___) (___) (___) 85 and older
50. For how many years have you provided services to older adults and their caregivers?
(___) Less than 1
(___) 1-5
(___) 6-10
(___) 11-15
(___) 16+
51. Have you participated in education or training programs specifically addressing geriatric and/or long-term care issues? Please mark all that apply.
(___) Courses in social work school
(___) Courses in other higher education programs
(___) Interdisciplinary seminars, workshops
(___) Supervised clinical practice
(___) On-th-job training
(___) Conferences
(___) Seminars/workshops
(___) Certificate programs
(___) Field placements in agency setting
(___) Distance learning
(___) Other: _________________________
52. Please indicate the frequency of the following presenting problems among your older adult clients: Please mark one in each row.
Never Always (___) (___) (___) (___) (___) (___) Physical disability (___) (___) (___) (___) (___) (___) Disease--Acute (___) (___) (___) (___) (___) (___) Disease--Chronic (___) (___) (___) (___) (___) (___) Dementia issues (___) (___) (___) (___) (___) (___) Mental illness (___) (___) (___) (___) (___) (___) Substance abuse issues (___) (___) (___) (___) (___) (___) End-of-life/Palliative care issues (___) (___) (___) (___) (___) (___) Grief and bereavement issues (___) (___) (___) (___) (___) (___) Residential--placement/housing (___) (___) (___) (___) (___) (___) Socioeconomic disadvantage (___) (___) (___) (___) (___) (___) Financial issues (___) (___) (___) (___) (___) (___) Psychosocial issues (___) (___) (___) (___) (___) (___) Developmental disabilities (___) (___) (___) (___) (___) (___) Caregiver issues (care, for elderly) (___) (___) (___) (___) (___) (___) Caregiver issues (care by elderly) (___) (___) (___) (___) (___) (___) Abuse/Victimization (___) (___) (___) (___) (___) (___) Long-term care financing/planning (___) (___) (___) (___) (___) (___) Marriage and family counseling (___) (___) (___) (___) (___) (___) Other: _________________________
53. How would you characterize the severity of problems of your older adult clients?
None 1-5% 6-10% 11-25% 26-50% 51-75% 76+% (___) (___) (___) (___) (___) (___) (___) Mild (___) (___) (___) (___) (___) (___) (___) Moderate (___) (___) (___) (___) (___) (___) (___) Severe
54. Do your older adult clients present with multiple problems?
Never (___) (___) (___) (___) (___) Always
55. In providing services to older adults, how often do you:
Never Always Participate in interdisciplinary activities on behalf of clients (___) (___) (___) (___) (___) Communicate with families (___) (___) (___) (___) (___) Use agency resources (___) (___) (___) (___) (___) Use community resources (___) (___) (___) (___) (___) Act as advocate for client (___) (___) (___) (___) (___) Participate in research (___) (___) (___) (___) (___) Train social work studies (___) (___) (___) (___) (___)
56. How would you describe your ability to provide services for older adult clients and their caregivers?
Low High N/A Skill Level (___) (___) (___) (___) (___) (___) Psychosocial assessment (___) (___) (___) (___) (___) (___) Treatment and service planning (___) (___) (___) (___) (___) (___) Direct service/Interventions (___) (___) (___) (___) (___) (___) End-of-life/Palliative care (___) (___) (___) (___) (___) (___) Case management
Low High N/A Knowledge Level (___) (___) (___) (___) (___) (___) Theories of aging (___) (___) (___) (___) (___) (___) Cultural differences (___) (___) (___) (___) (___) (___) Aging policies (___) (___) (___) (___) (___) (___) Psychopharmocology
57. Would you like to participate in additional geriatric/long-term care training?
(___) Yes
(___) No
58. To what extent is training readily available to you that addresses provision of care to older adults?
None Few Some Many Training for new workers (___) (___) (___) (___) On-the-job training (___) (___) (___) (___) Workshops (___) (___) (___) (___) Courses (___) (___) (___) (___) Conferences (___) (___) (___) (___) Distance learning (___) (___) (___) (___) Other (___) (___) (___) (___)
59. Which professions do you routinely work with when providing services to older adults? Mark one in each row.
Never Always Attorneys (___) (___) (___) (___) (___) Clergy (___) (___) (___) (___) (___) Home health professionals (___) (___) (___) (___) (___) Nurses (___) (___) (___) (___) (___) Nutritionists (___) (___) (___) (___) (___) Occupational therapists (___) (___) (___) (___) (___) Physical therapists (___) (___) (___) (___) (___) Physicians (___) (___) (___) (___) (___) Police (___) (___) (___) (___) (___) Social workers (___) (___) (___) (___) (___) Other: _________________________ (___) (___) (___) (___) (___)
60. How do you see yourself working with older adults and their caregivers in the next 5 years?
(___) No change
(___) Increase time
(___) Reduce time
(___) No future work with this population
(___) Unsure
61. Do you expect opportunities to work with older adults to increase in the future?
(___) Yes
(___) No
62. How do you assess the importance of the following in assisting you to improve care provided to older adults? Please mark one in each row.
Not at All Very Training/education (___) (___) (___) (___) (___) Supervision (___) (___) (___) (___) (___) Organizational support for social work services (___) (___) (___) (___) (___) Appropriate caseload size (___) (___) (___) (___) (___) Resource centers (___) (___) (___) (___) (___) Interagency coordination (___) (___) (___) (___) (___) Availability of services (___) (___) (___) (___) (___) More time (___) (___) (___) (___) (___) Manageable paperwork (___) (___) (___) (___) (___) Improved third-party reimbursement (___) (___) (___) (___) (___) Adequate staffing (___) (___) (___) (___) (___) Improved compensation (___) (___) (___) (___) (___) Better career opportunities (___) (___) (___) (___) (___) Other: _________________________ (___) (___) (___) (___) (___)
| Please complete Section VI. Services for Children and Families if you provide any services for individuals 21 years of age or under. |
| VI. SERVICES FOR CHILDREN AND FAMILIES |
63. What percentage of your total caseload falls into the following age groups?
None 1-5% 6-10% 11-25% 26-50% 51-75% 76+% (___) (___) (___) (___) (___) (___) (___) 0-5 (___) (___) (___) (___) (___) (___) (___) 6-12 (___) (___) (___) (___) (___) (___) (___) 13-17 (___) (___) (___) (___) (___) (___) (___) 18-21 (___) (___) (___) (___) (___) (___) (___) 22+
64. For how many years have you provided services to children and their families?
(___) Less than 1
(___) 1-5
(___) 6-10
(___) 11-15
(___) 16+
65. Have you participated in education or training programs specifically addressing needs of children and families? Please mark all that apply.
(___) Courses in social work school
(___) Courses in other higher education programs
(___) Interdisciplinary seminars, workshops
(___) Supervised clinical practice
(___) Conferences
(___) Field placement in agency setting
(___) Distance learning
(___) On-the-job training
(___) Seminars/workshops
(___) Other: _________________________
66. Would you like to participate in future training addressing issues related to children and families?
(___) Yes
(___) No
67. Please indicate the frequency of the following presenting problems among the children in your caseload: Please mark one in each row.
Never Always Abuse/Neglect (___) (___) (___) (___) (___) Adoption/Reunification (___) (___) (___) (___) (___) Disability (___) (___) (___) (___) (___) End of life/Palliative care (___) (___) (___) (___) (___) Family functioning (___) (___) (___) (___) (___) Foster care (___) (___) (___) (___) (___) Juvenile justice (___) (___) (___) (___) (___) Medical conditions (___) (___) (___) (___) (___) Mental health conditions (___) (___) (___) (___) (___) School problems (___) (___) (___) (___) (___) Socioeconomic disadvantage (___) (___) (___) (___) (___) Substance abuse (___) (___) (___) (___) (___) Other: _________________________ (___) (___) (___) (___) (___)
68. How would you characterize the problems experienced by children within your caseload? Please mark one in each row.
None 1-10% 11-25% 26-50% 51-75% 76+% (___) (___) (___) (___) (___) (___) Very complex (___) (___) (___) (___) (___) (___) Complex (___) (___) (___) (___) (___) (___) Not complex
69. Indicate the four (4) systems with which you interact most frequently on behalf of children: Please mark only four.
(___) Courts
(___) Foster care
(___) Health
(___) Income maintenance
(___) Legal aid/Attorneys
(___) Mental health
(___) Police/Criminal justice
(___) Protective services
(___) School
(___) Social/recreational
(___) Supplemental services
(___) Other: _________________________
70. In providing services to childre, how frequently do you: Please mark one in each row.
Never Always Communicate with other social workers (___) (___) (___) (___) (___) Communicate with other professions (___) (___) (___) (___) (___) Communicate with families (___) (___) (___) (___) (___) Use agency resources (___) (___) (___) (___) (___) Use community resources (___) (___) (___) (___) (___) Act as advocate for client (___) (___) (___) (___) (___) Participate in research (___) (___) (___) (___) (___)
71. How would you describe your ability to provide services to children and their families? Please mark one in each row.
Low High N/A Skill Level (___) (___) (___) (___) (___) (___) Psychosocial assessment (___) (___) (___) (___) (___) (___) Treatment and service planning (___) (___) (___) (___) (___) (___) Conduct investigations (___) (___) (___) (___) (___) (___) Conduct home visits (___) (___) (___) (___) (___) (___) Involve families (___) (___) (___) (___) (___) (___) Share information with other professionals/agencies (___) (___) (___) (___) (___) (___) Case management
Low High N/A Knowledge Level (___) (___) (___) (___) (___) (___) Theories of child development (___) (___) (___) (___) (___) (___) Cultural differences (___) (___) (___) (___) (___) (___) Children and families policies (___) (___) (___) (___) (___) (___) Psychopharmocology
72. To what extent is training readily available to you that addresses child and family issues?
None Much Training for new workers (___) (___) (___) (___) (___) On-the-job training (___) (___) (___) (___) (___) Workshops (___) (___) (___) (___) (___) Courses (___) (___) (___) (___) (___) Conferences (___) (___) (___) (___) (___) Distance learning (___) (___) (___) (___) (___) Other (___) (___) (___) (___) (___)
73. How do you see yourself working with children and their families in the next 5 years?
(___) No change
(___) Increase time
(___) Reduce time
(___) No future work with theis population
(___) Unsure
74. Do you expect opportunities to work with children and families to increase in the future?
(___) Yes
(___) No
75. How do you assess the importance of the following in assisting you to improve care provided to children and their families? Please mark one in each row.
Not at All Very Training/education (___) (___) (___) (___) (___) Supervision (___) (___) (___) (___) (___) Organizational support for social work services (___) (___) (___) (___) (___) Appropriate caseload size (___) (___) (___) (___) (___) Resource centers (___) (___) (___) (___) (___) Interagency coordination (___) (___) (___) (___) (___) Availability of services (___) (___) (___) (___) (___) More time (___) (___) (___) (___) (___) Management paperwork (___) (___) (___) (___) (___) Improved third-party reimbursement (___) (___) (___) (___) (___) Adequate staffing (___) (___) (___) (___) (___) Improved compensation (___) (___) (___) (___) (___) Better career opportunities (___) (___) (___) (___) (___) Other: _________________________ (___) (___) (___) (___) (___)
| Thank you for your particiaption in this important survey! Please put completed questionnaire in enclosed envelope and drop in the mail. Center for Health Workforce Studies |
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