Abstract
This study explores the experiences and perspectives of service providers with regard to the process of psychological self-sufficiency (PSS) among students in the Health Profession Opportunity Grants (HPOG) program. Based on a social work theory of PSS as our organizing framework, combined qualitative content analysis (inductive to deductive) was conducted with two service provider focus groups (n = 16) and three student focus groups (n = 27). The overarching theme of nontraditional, student-centered, holistic staff approaches which lead to the pathway from uncovering perceived employment barriers to discovering employment hope emerged with four phenomenological categories. The findings supported the adaptations of service providers’ different roles when providing student-centered approach in service delivery to reach maximal PSS for a better outcome in case management.
Keywords
In policy, research, and practice, self-sufficiency (SS) is defined in terms of economic self-sufficiency (ESS; Goudy & Pearlmutter, 1993; P. Y. P. Hong, 2013; P. Y. P. Hong, 2016; P. Y. P. Hong, Sheriff, & Naeger, 2009). Various definitions of ESS consider it as a labor market outcome dependent on earned income sufficiency to preclude the need for external financial support (P. Y. P. Hong et al., 2009), particularly governmental support (Long, 2001). This view of SS solely as a function of market performance is limiting, focusing on if ESS has been achieved instead of how one achieves ESS.
Defined as the dynamic process of overcoming perceived employment barriers and developing hope of employment for career goals (P. Y. P. Hong, 2013; P. Y. P. Hong, Polanin, Key, & Choi, 2014, p. 693), the concept of psychological self-sufficiency (PSS) addresses the question of how one can achieve ESS. PSS provides a human-centered ecology of social work perspective that focuses on the bottom-up process of “developing the workforce” from the workers’ perspectives (Daugherty & Barber, 2001) by honoring one’s empowerment, strength, self-determination, motivation, and growth. For the past decade, this bottom-up definition of PSS has been rigorously evaluated with low-income individuals in workforce development both qualitatively (P. Y. P. Hong, 2013; P. Y. P. Hong, Hong, & Williams, 2018; P. Y. P. Hong et al., 2009) and quantitatively (P. Y. P. Hong, 2016; P. Y. P. Hong, Choi, & Polanin, 2014; P. Y. P. Hong, Lewis, & Choi, 2014; P. Y. P. Hong, Polanin, et al., 2014; P. Y. P. Hong, Polanin, & Pigott, 2012; P. Y. P. Hong, Song, Choi, & Park, 2016, 2018; P. Y. P. Hong, Stokar, & Choi, 2016), becoming a core concept of an emerging social work theory of PSS (P. Y. P. Hong, Choi, & Key, 2018; R. Hong, Northcut, Spira, & Hong, 2019). Research has found that in the process of balancing employment hope and perceived employment barriers, PSS acts as a conduit for achieving ESS and SS among low-income individuals (P. Y. P. Hong, Choi, & Key, 2018; P. Y. P. Hong, Stokar, & Choi, 2016).
Though the perspectives and experiences of clients have contributed to the development PSS theory, it is critical to understand the views and experiences of service providers on how to increase PSS in service delivery. As the primary service providers for “people who are vulnerable, oppressed, and living in poverty” (National Association of Social Workers [NASW], 2017, p. 1), social workers work with high-needs groups that accentuate strength and empowerment to resolve the personal and structural barriers they face (Parsons, 2013). Therefore, the experiences and perspectives of service providers are essential to augmenting quality assurance to service delivery. As part of the evaluation of Health Profession Opportunity Grant (HPOG) University Partnership Research Grant 1.0, the authors sought to explore the perspectives and experiences of service providers (staff, instructors, academic advisors, and administrators) in service delivery to low-income participants in the HPOG-funded programs in Illinois and Wisconsin. With the goal of SS, HPOG participants received advanced education, training, and case management service to obtain a health care career. This study was intended to explore the core components of the HPOG program and to understand the extent to which PSS leads to satisfactory participant employment success in the views of service providers. The findings were compared with the experiences and perspectives of service users (current participants and graduates of the program) to determine whether they are aligned with those of service users.
Literature Review
Health Profession Opportunity Grant (HPOG 1.0)
The HPOG 1.0 program was an initiative of the Patient Protection and Affordable Care Act of 2010. The Administration for Children and Families (ACF) and the Office of Family Assistance (OFA) within the U.S. Department of Health and Human Services (HHS) authorized HPOG to help Temporary Assistance for Needy Families (TANF) recipients and low-income individuals achieve ESS through “Pathways for Advancing Careers and Education (PACE)” in the health care market (U.S. Department of Health and Human Services, Administration for Children and Families, Office of Family Assistance, 2015). By training and educating low-income individuals for a health care career, HPOGs were intended to meet the high demand for health care workers and to offer better-paying health care jobs to low-income individuals. Thirty-two organizations across 23 states and five tribal organizations received funding in the grant cycle of 2011-2014, and five universities were awarded for HPOG University Partnership Research Grants to support organizations’ program research and evaluation from 2011 to 2016. Each HPOG awardee convened to create a workforce development program that combined support services (i.e., case management and counseling), with innovative education and training services to motivate and prepare HPOG participants for entering the health care profession.
Based on the final evaluative report on national implementation of HPOG 1.0 program by Werner, Schwartz, Koralek Loprest, and Sick (2018), HPOG was determined to be successful. For instance, more than 36,000 individuals were trained in health care jobs; 73% of individuals completed training within 18 months of entering the HPOG program; TANF recipients who were in the HPOG program for 2 to 3 years showed a 112% increase in employment; and 72% of those were engaged in the health care profession (Werner et al., 2018).
PSS
The Work Incentive program of the Family Support Act of 1988 initially viewed the concept of SS merely as a means to decrease the number of people in the welfare system (Gowdy & Pearlmutter, 1993). However, this view excluded the perspectives and experiences of participants who received welfare and discounted psychological components of SS, overlooking its complex nature (Gowdy & Pearlmutter, 1993). By analyzing the perspectives and experiences of job seekers enrolled in the job readiness training and education program at the Metropolitan Education and Training (MET) center in St. Louis, P. Y. P. Hong and his colleagues (2009) expanded the meaning of SS. Their investigations led to identifying a complex, bottom-up definition of PSS, which became a central construct of the theory of PSS.
While evaluating the “process” of gaining SS with staff and participants, they found correlations between employment hope and perceived employment barriers, which are constructs of PSS (P. Y. P. Hong, 2013). Employment hope was shown to directly affect perceived employment barriers and mediated the path between perceived employment barriers and ESS among ex-offenders (P. Y. P. Hong, Lewis, & Choi, 2014), low-income job seekers (Hong, Hodge, & Choi, 2015), and low-income job seekers with physical disabilities (P. Y. P. Hong, Stokar, & Choi, 2016). These results proved PSS to be a crucial function in achieving ESS among low-income job seekers (P. Y. P. Hong, Choi, & Key, 2018). From a theoretical standpoint, PSS can be used to explain how one can create internal resilience to bounce back up after failed challenges experienced in life.
Professional Relationships in Case Management
Since the inception of social work practice, one integral core ethical principle of the Code of Ethics of the National Association of Social Workers stresses the importance of developing relationships between the social worker and the client (NASW, 2017; Richmond, 1917). Regardless of practice settings or roles of the worker, building a good working relationship with the client is an ethical responsibility in service delivery. Studies have revealed a positive correlation between therapeutic effects of building strong relationships and client outcomes in psychotherapy (Barber et al., 1999; Farrelly et al., 2014; Gehrs & Goering, 1994; Horvath, 2001; Martin, Garske, & Davis, 2000; Priebe & McCabe, 2008). A study by Barber et al. (1999) found therapeutic relationships to be an independent healing factor in therapy while controlling for the effects of other factors. Horvath (2001) found that therapeutic relationship factors improved the effect of therapy by more than 50%. The results of the study of relationships between clients and case managers correlate with research on therapeutic relationships in clinical practice (Chinman, Rosenheck, & Lam, 2000; Howgego, Yellowlees, Owen, Meldrum, & Dark, 2003; Neale & Rosenheck, 1995; Solomon, Draine, & Delaney, 1995). Research has found that the quality alliance between clients who were homeless and their case managers significantly increased positive outcomes in general life satisfaction and reduced homelessness (Chinman et al., 2000). A study by Howgego et al. (2003) confirmed the value of this partnership in promoting effective outcomes among clients with mental illnesses and suggested the use of relationship strategies as a clinical tool for greater results. While the quality of relationships between the worker and client is a central determinant helping clients make positive changes in their overall functioning, it is imperative to decode the complex and intricate nature within the confines of the helping relationship.
Method
After obtaining Institutional Review Board approval from the authors’ institution, the authors have partnered with two HPOG grantees since 2010 to evaluate their HPOG programs. As part of the evaluation, all program participants were asked to take part in four surveys (preprogram, middle, end of the program, 6 months after program completion) with PSS measures. Focus groups provided feedback on the HPOG programs, including what motivated their participants to complete or continue the pursuit of a career in health care.
Following the recommendation to conduct between one and six focus groups for increased reliability (Sim, 1998), a total of five focus groups (N = 43 individuals) were conducted at HPOG training facilities in November-December 2013. Participation in the focus groups was voluntary, and all parties submitted signed consent forms. Two focus groups (n = 16) included service providers recruited from one focus group per each agency and consisted of the HPOG program administrators, instructors, counselors, and case managers. Twenty-seven service users were recruited from two agency sites, resulting in three focus groups. The participants were either currently enrolled students or graduates of the HPOG programs. Graduates were employed as a health care provider or were continuing a higher HPOG program, such as training to be a registered nurse. Refreshments were provided, and participants were rewarded with a $30 gift card at the end of the focus group.
The focus groups lasted approximately 60 to 90 minutes. Topics selected for the focus groups, listed in the Appendix, included characteristics of the HPOG programs, career successes, goals, motivation, barriers, and hope. Focus groups were both audio-recorded and included note-taking by a doctoral student who transcribed them verbatim. Data were analyzed using combined qualitative content analysis (inductive to deductive) for methodological flexibility, depending on research purpose in qualitative content analysis (Elo & Kyngäs, 2008). According to the Elo and Kyngäs (2008) description, the process of qualitative content analysis is not “linear” and that there is no “right” method of doing it as long as the meaning of the content is analyzed systematically (p. 113).
Prioritizing the experiences and perspectives of service providers for this study, the research team, which consisted of the authors and one doctoral student, followed three phases. In the first phase, the authors independently and systematically analyzed the transcripts in three steps: open coding, segmenting the codes into the meaning units, and categorizing based on the similarity of semantic and conceptual classifications. The authors met to compare and discuss their analyses and to place data into conceptual and key categories. The codebook was derived at the end of the first phase.
In the second phase, the transcripts of service users were deductively analyzed. The second author of this study and a doctoral student independently analyzed the transcripts of service users using the codebook derived from service providers. Through careful review and in-depth discussion, the authors and a doctoral student achieved an intersubjective and consensual understanding of texts (Drisko & Maschi, 2015; Schreier, 2012), rather than using quantitative interrater coefficients to assure validity and reliability emphasized in qualitative content analysis. The purpose of the second phase was to confirm whether themes addressed by service providers emerged in service users or not. Although the authors understand the richness of service users’ data in the focus groups, we limited its analysis deductively so as to focus our research on the experiences and perspectives of service providers. Drawing from research indicating that qualitative content analysis can be flexible based on the purpose of research (Elo & Kyngäs 2008), we find that the current methodological approach is appropriate.
In the third phase, followed the suggestions of Lincoln and Guba (1985) in which trustworthiness was ensured by using “credibility, transferability, conformability, and dependability,” as suggested by Lincoln and Guba (1985). Credibility (internal validity) was established by involving data triangulation using data sources from both service providers and services users. Investigator triangulation of having three researchers experienced in data analysis processes further heightens its credibility. In addition, focus groups were facilitated to help ensure honesty in participants by creating a safe and comfortable atmosphere. For instance, we did not collect participants’ detailed demographic information in the small group out of consideration of participants’ comfort. Understanding that transferability (external validity) is limited in the qualitative study, authors make “transferability judgment possible” (Lincoln and Guba, 1985, p. 316) by providing study findings that could apply to other contexts or practice and future research. Conformability was ensured by having the authors corroborate research findings by dividing the transcripts into the code units to categorize the content to represent data accuracy. Finally, since overlapping methods such as using focus group and interviews were not administered, dependability was ensured by having an external audit to examine the process of data collection/ analysis and to confirm the accuracy of the findings.
Findings
Representatives (N = 43) from two HPOG funded agencies were recruited to participate in one-time focus group interviews. The race and ethnicity for service providers was 50% Black, 31.3% White, and 18.8% Hispanic. Among 27 service users, 59.3% were Black and 29.6% were White. Participants ranged in age from 25 years to 55 years; the service providers aged 25 to 39 yielded at 43.8%, while service providers aged 40 to 55 yielded 56.3%. The majority of service users ranged in age from 25 to 39 years (74.1%), while 25.9% of service users yielded at age 40 to 55 years. More than two thirds of the participants were female, yielding at 75% for service providers and 88.9% for service users. All service providers held a bachelor’s degree, with a majority also having obtained their masters. Demographics of participants are summarized in Table 1.
Demographic Information Among Service Providers and Service Users.
Results from two focus groups with staff, instructors, academic advisor, and administrators at two agencies yielded four key categories: (a) the characteristics of the HPOG program related to students’ success; (b) the qualities of service providers’ relationships with students; (c) functions of peer relationships; and (d) components of increasing PSS. The overarching theme that emerged from the categories was that a nontraditional, student-centered, holistic staff approach opens the pathway from uncovering perceived employment barriers to discovering employment hope (Table 2).
Overarching Theme: Nontraditional, Student-Centered, Holistic Staff Approaches Which Lead to the Pathway From Uncovering Perceived Employment Barriers to Discovering Employment Hope.
Note. HPOG = Health Profession Opportunity Grant.
Characteristics of HPOG Programs Related to Students’ Success
Service providers were impressed with the flexible use of HPOG funding to meet service users’ financial needs, including offering free transportation. This allowed providers to deliver services effectively and increase the rate of program completion and employment placement.
They also pointed out the structural flexibility in the HPOG programs to administer health education and training as distinct and definite features of the HPOG program, as stated, “They have multiple training opportunities. [If] 1 they were slumping in one area, we moved them into some other area” (Focus Group 2, #2). The tutoring program and cohort system among peers were also identified as essential features in the HPOG programs.
Service providers described an inspirational agency culture that has been instrumental in helping their students to be successful in the programs. Their interdepartmental collaboration in support of clients was noted as a critical characteristic. The internal cooperation among staff was essential to providing cohesive and consistent care to the students. Ongoing communication between class instructors, case managers, and job developers was recognized as creating a synergistic community for students. As one staff member stated, We’ve created a type of learning community as well, because we have a relationship with advisors. I mean we have our staff, but then we also have a relationship with the instructors. Instructors are contacting either myself or the specialist directly saying, “I haven’t seen this student, do you know if they dropped?” (Focus Group 1, #2)
The agency’s relationships with other community agencies allowed staff to connect students to additional external resources and to help keep students focused on the rigorous academic demands. Staff stated that the relationships that their agency maintained in the community helped to strengthen their ability to assist apprentices.
Our agency has relationships that help us be able to support our students and extended community things that we are not able to provide as an organization. Those relationships help us to be successful and help us help our students. (Focus Group 1, #3)
Participants in the training program echoed the positive characteristics identified by service providers with regard to structural and financial flexibility in the HPOG programs. Participants pointed out that the financial support of exam fees, graduation fees, medical supplies, uniforms, bus card, and even child care had a tremendous impact on learning. They also touted the flexible program such as trade classes and tutoring as contributing to successful learning. Interdepartment collaboration and support for easy access to community resources, however, were not addressed in focus groups with service users.
Qualities of Service Providers’ Relationships with Service Users
Service providers stated that they offered ongoing case management services that provided extra support with respect. By closely monitoring and tracking student progress and by maintaining an open-door policy encouraging students to drop in helped providers be approachable and accessible. According to one provider participant, We come being that person that shows that we are approachable, and you can come to talk to us; this is our job, that we are not above you way up here, like, we’re coming out to your level. And I think that just really helps with establishing that rapport and that relationship with the students. (Focus Group 2, #7)
Some commented that beginning by setting attainable goals provided students with clear expectations for mutual responsibility. One provider stated, And again it gives that structure that I think a lot of them really respond well. Because they see what the endpoint is and then there’s like baby steps to get there. Again, I don’t think a lot of them have been through a process like that where they actually have a goal in mind. (Focus Group 1, #3)
Several participants commented on the importance of building accountability in the relationship with students. Participants de-scribed that constant monitoring of students’ progress and “intrusive” involvement in students’ life on a personal level as ways of building accountability. Select comments from providers stated, It is that intrusive model where they’re actually holding the students accountable, and making them check in, and forcing them to touch base, and I really think that’s made a big difference [in] accountability made. (Focus Group 2, #3)
Most importantly, instructors commented that their involvement with students went above and beyond educational support. They stated that students were provided with the emotional care management services needed to be successful in the program. As one provider claimed, They are getting some life skills, some encour-agement, and some support services so when they come into the classroom, they are not a stranger to someone saying to them to read chapter two. So I can talk to them about some life decisions and choices they are making that may not be good choices, and we can make better choices. (Focus Group 1, #3)
Students concurred with service providers in regard to relationships. They consistently addressed the authenticity of care from instructors and case managers and emphasized feeling deeper connections with staff and instructors, and stated that they received extra care and support to keep them on track in the HPOG programs. Unlike the more sterile terms like “non-traditional” or “intrusive” used by service providers, students spoke of a positive connection. For instance, the term “stimulus calls” from the service providers was translated by students as “on-going monitoring process.” Finally, the open-door policy was validated to foster an approachable, comfortable, and supportive relationship with service providers.
Functions of Peer Relationships
Service providers pinpointed peer relationships as an essential function that positively contributed to students’ success in the HPOG programs. The closeness between students was described as playing a vital role in creating a supportive and productive learning community. As one provider mentioned, “I think many of them, it’s that first sense of a community that they’re part of and that they’re proud of” (Focus Group 2, #3). Peer relationships in the HPOG programs were described as a means to sustain students’ academic motivation. A “buddy system or cohort system” were stated as holding accountability and inspiration among peers to continue their success in learning. As a provider described, “They really need to be brought together in it, and cohort made the team and fielded as a team” (Focus Group 1, #2).
The positive influence that peers exerted was evident in responses of service users. Peer support was described as a “huge” support system to help students amass the grit to complete the program. Accountability between peers was noted to increase self-esteem and motivation in learning. Personal connections with peers helped students overcome challenges because they were treated respectfully. As it turned out, the closeness of peers instilled motivation and hope. When students were asked to provide statements from peers that stuck with them, one said, “I’m truly your friend.” Other expressions were “I’m not gonna let you give up on your dream, because I’m a dream supporter” and “I am gonna make sure I pour back into you.” The experience of successes and failures of peers were stated to affect students’ motivation for learning.
Components of PSS Process
Service providers identified building rapport and emotional connections in the relationship as a prerequisite to increasing PSS. Service providers accentuated the importance of belief-based talks and behavior when discussing components of increasing PSS. In particular, instructors mentioned that they tended to keep the position of imposing firm statements of their beliefs on students’ success because they believed HPOG students came with a lack of discipline in learning, with little certainty of academic achievement. An instructor mentioned, I can engage their motivation to learn. What I try to do [with] those students is to motivate them. . . . Even if you didn’t expect to experience change, you are gonna experience change because you are in my classroom. So we are gonna change for the better, if nothing else at least you understand there is a responsibility in life. (Focus Group 1, #3)
Staff described the importance of modeling behaviors to motivate students and help them believe in themselves. “We want the success of people, and we also need to show that success, so people have confidence in us in what we do” (Focus Group 1, #2).
The group also pointed out that constant encouragement helped students increase the level of hope in a career pathway.
I said, you are such a great role model for your children, even as hard as it is, and sometimes you have to miss events, they see you work so hard, and they are working right alongside you. And that is an inspiration for them. (Focus Group 2, #4)
They also identified direct advice or feedback as another component to instill hope in students. Although students at first showed difficulty with accepting constructive feedback and direct pushes from instructors, instructors were confident that changes in students gradually happened, resulting in increased hope.
“Do you just want to come here sleep every day?”. . . and she thought about that [and] ran away with no answers for me. But after she had a conversation with me, she had no answer, [but] I think it sparks something in her. (Focus Group 1, #3)
Service providers used the words of “push,” “tough love,” and “imposing” to describe methods that they applied to encourage student motivation in learning. The latent meaning of “push” appeared to be somewhat extra supportive and nongiving up attitudes with a deeper understanding of students’ struggles.
Continuously promote that and instill that … encourage, uplift lovingly, and with tough love. I am making them extremely uncomfortable because I am pushing them out of the net. I am saying you must fly [like] a little bird. (Focus Group 1, #4)
Focus groups from service users commented on a similar experience in this category. They felt that staff and instructors conveyed confidence in students even when they were uncertain about their own abilities. Furthermore, the extra push in an ongoing committed relationship with the instructors helped them overcome the barriers during arduous days. Service users claimed receiving assertive and compassionate advice from service providers helped them to reflect and uncover their inner barriers. For instance, one student revealed, “ I thought that being poor is my barrier before being accepted to the HPOG programs. Now, I know that my real barrier was my ‘poor’ mentality. Being poor is not a fun thing, but it is just my situation.”
The process of PSS in the HPOG programs, from uncovering barriers to discovering hope, is twofold: It must first build a foundation through developing a unified working relationship with emotional connections between service providers and students, as well as provide a directive and assertive approach (Figure 1).
Psychological self-sufficiency (PSS) process (Category 4).
Discussion
The narrative presented in this article describes a heightened understanding of service providers’ experiences and perspectives about components attributed to students’ successful progress toward a health care career in the HPOG programs. The unique characteristics of HPOG programs and quality of service providers’ relationships with students have underscored students’ success in the program. The participants distinguished constructive characteristics, such as flexibility of grant use, interdepartmental collaboration, community relationship, flexible program structure, and learning assisted programs as key to student success. Five qualities of the service provider–student relationship are recognized: a student-centered approach, an approachable/accessible/accountable relationship, consistent monitoring system, setting up clear expectations for mutual responsibility, and combined roles of emotional support and academic support. Both service providers and students recognize that peer relationships were paramount to gaining emotional support, increasing academic motivation, and holding learning accountability.
The current findings contribute to understanding the results of quantitative findings for the HPOG program participants. For instance, HPOG students of the Focus Group 1 agency showed a high rate of PSS survey completion: 328 (86%) students completed the first PSS survey, 265 (70%) completed the second PSS survey, and 149 (39%) completed the third PSS survey. About 66.3% reported increased “employment hope,” and 55.8% reported decreased “perceived employment barriers” (HHS, 2015). While the findings quantified changes in employment hope and perceived employment barriers, the focus group findings identified “relationship” as an integral component for PSS progress.
Notably, positive relationships between service providers and students influence PSS. Coinciding with the previous study (P. Y. P. Hong, Choi, & Key, 2018; P. Y. P. Hong, Stokar, & Choi, 2016), emotionally connected relationships between service providers and service users scaffolds to the PSS process of uncovering barriers and building employment hope. Whereas developing intimate relationships with service providers emerges as a crucial component for creating a gateway to the PSS process, service providers’ optimistic outlook on students’ success is equally influential for PSS. Along with consistent engagement, service providers’ sincere advice, assertiveness, and personal involvement in students’ lives emerge as essential components in helping students move forward in achieving their career goals. While social work acknowledges the importance of relationship aspects in service delivery, the terms of “push,” “tough love,” and “imposing” suggest service providers’ active or over involvement in health career pathway programs requires additional investigation. Although the latent meaning of these terms in this study appears to be positive, connoting closeness and intimacy based on students’ explanation, service providers’ active or over involvement could raise a concern of boundary crossing in social work practice. To illustrate, the discovery of service providers’ assertiveness and direct advice to support students’ learning suggests an alternative meaning of working alliance with clients. This approach suggests service providers aspire to go beyond the scope of the professional boundary, which could be controversial when considering clients’ self-determination in social work practice. As opposed to social work ethical values, informal elements within the worker and client relationships with additional care and support are identified to help service users move forward in achieving their career goals. Therefore, further research with in-depth interviews regarding the characteristics of professional relationships with this population is necessary to better understand the implementation of nontraditional approaches of service providers.
Our findings in regard to the complex nature of professional relationships among the HPOG service providers offer practice implications in working with students in vulnerable positions. Regardless of their roles as instructors, academic advisors, or case managers, service providers in the HPOG programs tend to oscillate their roles from a therapist to coach/consultant depending on the phase of their relationship. At the beginning of the relationship, service providers take on a therapist role by conveying empathy to build rapport and understand students’ barriers. Once strong, trusted relationships are built, their role begins to shift into a resolute and reassuring coach to instill hope and motivation in clients toward learning. This method has shown measurable advantages to the PSS process among students. It suggests that gradually building an empathic working relationship and then scaffolding to proactive empowerment is immensely effective in service delivery. The results of this study also align with the recent discovery of Polyvagal theory, which stresses that turning on students’ “social engagement systems” and developing deeper social connections can maximize learning (Porges, 2011). Such significant findings in a working relationship may be confusing and dissenting among social workers because it goes against the traditional social work boundary. This study suggests that social workers should invest in fostering a productive working relationship to explore effective ways of empowering low-income individuals. The findings further guide considerations for developing a relationship-based case management model in workforce development. One possible strategy is to educate social workers to apply a PSS process which creates an opportunity for individuals to practice uncovering barriers and discovering hope.
Limitations
In common with all qualitative studies, our study cannot be generalized due to the small sample size. However, the strength of our sample lies in strong data triangulation with the recruitment of all representatives of service providers, as well as current students and graduates in two representative sites of the HPOG program. One potential limitation of this particular aspect is that discussions between service providers and administrators may become influenced by power hierarchy. Finally, although our methodological approach is appropriate to the current study for the authors’ intent to examine students’ data within the matrix developed by service providers, the authors ought to consider full inductive analysis for remaining student data to holistically explore their perspectives and experiences in a future study.
Conclusion
This study sheds light on the characteristics of the program structure and the aspects of service providers’ relationships with service users that help them succeed in an employment program. In particular, identification of complex components of service providers’ hope-activating approach is notably integral for effective service delivery. Relationship aspects of service delivery can lead to PSS and, by extension, to the more active involvement of service providers’ roles in students’ career pathway programs. The findings significantly contribute to our understanding of a critical function of service providers’ relationships relating to students’ success in the HPOG programs. It supports the need for an authentic relationship-based service in workforce development. Considering the findings, commonly accepted student-centered approaches in service delivery may need some adaptation of service providers’ different roles to reach a better outcome. The findings warrant further investigation of its application to practice delivery of case management and replication of this study.
Footnotes
Appendix
Disposition editor: Sondra J. Fogel
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the University Partnership Research Grants Program (Grants#90PH0018 and #90HG1003) from the Office of Planning, Research and Evaluation of the Administration for Children and Families, U.S. Department of Health and Human Services.
