Social Workers' Orientations Toward Community Mental Health Concepts John C. Baird, Ph.D., A.C.S.W.*
A B S T R A C T : Relations between ideological priorities in social work and community mental health were examined by a Likert-type questionnaire containing statements representing Caplan"s Conceptual Models in Community Mental Health. Seventy social workers were sampled, with equal subsamples representing the five largestfields of practice in social work. This sample appeared to be highly representative of the national social work population by fields of personal service. By analyses of variance and correlation, significant differences were found between levels of approval for respective models by the total sample, but no significant differences were found by fields of practice, or any other professional or demographic attribute. This indicates a consensual integrity in the social work profession"s community mental health orientation, and strong mutuality between social work and community mental health value orientations.
Although the social work profession has drawn heavily from psychiatric concepts of mental health and has also been strongly oriented toward community organization for m a n y years, and although there are more social workers than psychiatrists or psychologists in community mental health programs--and conversely, one of the largest fields of practice for social workers is in community mental health---explicit use of community mental health concepts has only recently begun to appear in the professional curricula or literature of social work. Social work has long avowed a dual orientation to both personal and community needs and services, yet this profession has continually verged on coming apart at the seams of conflicting micro versus macro ideological commitments, apparently oblivious of the role that community mental health concepts such as social epidemiology might fill in systematically linking personal with social phenomena. Questions therefore arise as to how much kinship really exists between the value-knowledge-practice cultures of social work and community mental health, respectively. Do they really share the same basic concepts but express them in different vocabularies? Are there implicit commonalities between social work and community mental health that can be explicated? When the present writer began in 1968 to ponder questions like these and to search for ways of analyzing relationships between social work and community mental health, little research literature on that subject could be found. Baker and Schulberg (1967) had recently constructed their Community Mental Health Ideology (CMHI) Scale and used it for comparing the *Dr. Baird, a social worker, is Community Mental Health Centers Consultant in the Ohio Division of Mental Health, Department of Mental Health and Mental Retardation, Columbus, Ohio 43221. Community Mental Health Journal, Vol. 12(3), 1976
275
276
Community Mental Health Journal
orientations of psychologists, psychiatrists, and occupational therapists; but that instrument did not appear to be entirely suitable for application to social work, for reasons that will be presented later in this paper. Then Gerald Caplan presented his Conceptual Models in Community Mental Health (1968). Caplan's models appeared to provide a suitable framework for studying the relations between social work and community mental health in terms of Social Workers" Orientations Toward Community Mental Health Concepts (Baird, 1973). The methods, findings, and implications of that research are summarized here. BACKGROUND Previous studies have shown that each profession tends to develop its own characteristic set of concepts, value priorities, and practices which represent that profession's distinctive culture and ideology (McLeod & Meyer, 1967). Such distinctive ideologies also tend to prevail in multidisciplinary fields of practice, especially in those fields in which multiprofessional teams have become institutionalized. Where various disciplines share in a common service delivery system, as in community mental health, the patterns of relations between the professional ideologies can be examined in terms of their respective levels of adherence to certain conceptual models. According to Baker and Schulberg, their CMHI Scale "discriminates between professional groups known to be highly oriented to this ideology and random samples of mental health professionals" (1967, p. 216). After comparing the orientations of psychologists, psychiatrists, and occupational therapists, the authors noted that "Data for nurses, social workers, and other mental health specialty populations are still needed" (p. 225). Subsequently, Langston (1970) applied the CMHI Scale to all the service-providing disciplines, and also to the secretaries, in two community mental health centers. In this sample, the group of nine social workers not only had higher adherence scores than any other discipline, but also had the lowest variability in their scores. The other discipline groups, in descending order of their adherence, were 7 psychologists, 20 occupational therapists and recreational therapists, 22 nurses, 7 secretaries, 13 psychiatrists, and a group of 42 aides, orderlies, and "LVN's". The remarkably low adherence of the psychiatrists was attributed to the fact that all of them were affiliated with the centers on a part-time basis, their major activity being in private practice. Social workers likewise scored higher than clinical psychologists and lawyers on the CMHI Scale in a study by Mangum and Mitchell (1973) comparing attitudes of faculty and graduate students in those disciplines. Although this scale lends itself conveniently to such cross-disciplinary comparisons, it appears to be somewhat limited in its applicability to less clinically oriented community mental health disciplines such as social work due to the language used in the scale. For example, such a statement as
John C. Baird
277
" O u r t i m e - t e s t e d p a t t e r n of d i a g n o s i n g a n d treating individual patients is still the o p t i m a l w a y for us to function p r o f e s s i o n a l l y " (p. 219, I t e m 2), e v e n t h o u g h scored negatively, could h a r d l y be characteristic of the w a y m a n y social w o r k e r s wOuld talk a b o u t their practice. Likewise, o n e w o u l d not be likely to find m a n y c o n t e m p o r a r y social w o r k e r s affirming that " O u r p r o g r a m e m p h a s i s s h o u l d be shifted f r o m the clinical m o d e l , directed at specific patients, to the public health m o d e l , focusing o n p o p u l a t i o n s " (Item 12). This q u e s t i o n a b l e c o n g r u e n c e b e t w e e n the p h r a s i n g of s t a t e m e n t s in the C M H I Scale a n d the characteristic l a n g u a g e u s e d b y s o m e of the c o m m u nity m e n t a l h e a l t h disciplines s t u d i e d t h u s p r e s e n t s s o m e difficulty in interpreting h o w m u c h the differences in i d e o l o g y ratings w e r e d u e to semantic rather t h a n to c o n c e p t u a l differences. The particular findings of the s u b s e q u e n t s u r v e y s b y L a n g s t o n a n d b y M a n g u m a n d Mitchell are also limited in their significance b y the t y p e s a n d smallness of the s a m p l e s utilized. N e v e r t h e l e s s , the basic m e t h o d o l o g y u s e d b y Baker a n d S c h u l b e r g appears to be well suited for s u r v e y i n g c o m m u n i t y m e n t a l health orientations a m o n g social w o r k e r s if the c o n c e p t s are p h r a s e d in l a n g u a g e that social w o r k e r s in general, as well as t h o s e practicing in m e n t a l health p r o g r a m s , are likely to u s e a n d if the s a m p l i n g d e s i g n p e r m i t s generalization of the findings to the national p r o f e s s i o n a l p o p u l a t i o n . PRESENT STUDY Method
A "conceptual models in community mental health" frame of reference was utilized, drawing directly from Caplan's formulation by that same title (1968) and using his specific set of models. Caplan's work was closely linked with that of Baker and Schulberg insofar as Caplan has been the Director of the Laboratory of Community Psychiatry, at the Harvard Medical School, where both Baker and Schulberg were on the laboratory staff. Caplan's formulations appeared to be especially relevant for comparing social workers' orientations to community mental health concepts because in his extensive writings Caplan has often given particular attention to the role of social work in the field of community mental health (1955, 1959). Caplan had organized his Conceptual Models in Community Mental Health into two general categories: 1. Etiologicalmodels: nutritional; developmental adjustment or crisis; community organization
and development; socialization or effective role performance 2. Practice models: public health models (epidemiology; planning and logistics; catchment
areas; populations at risk; prevention); medical practice or doctor-patient; ecological systems; shared professional domains For the present research design, these rather loosely formulated models were paraphrased so that they could provide more systematic and analytically symmetrical bases for operational scaling. Although Caplan's classificatory scheme appears to indicate that each of his models is either "etiological" or "practice" oriented, one finds in his other writing and teaching that most, if not all, of them have included both aspects. To illustrate, his "crisis" model is at least as well known for its interventive aspect as its etiological aspect; the same is obviously true of
278
Community Mental Health Journal
the concept of "community organization"; the "nutritional" model represents a concept that is essentially the same as the familiar social work concept of meeting human needs (Towle, 1952); and the "socialization" model is prominently associated with social-learning interventions such as behavior modification. Conversely, each of Caplan's "practice" models is based on certain etiological premises. Therefore each of Caplan's eight major models was restated as a cognitive-normative model that articulated both etiological and practice aspects. A second aspect, which tended to appear in most of Caplan's model formulations, but not consistently, and yet which can be considered a hallmark of the community mental health approach, is a mutual and reciprocal relevance to both personal and social phenomena (Group, 1968). Therefore all of Caplan's models were paraphrased so as to articulate this dual-reciprocal focus on both personal and social concerns. A third dimension for rephrasing these models was to translate them from the vocabulary and Harvard dialect of community mental health (Baker & Schulberg, 1967) to language generally used by social workers. Ffnally, as a further shift of orientation in the direction of relevance to the wider area of human service programs and disciplines, the paraphrasing used language and references that were applicable to the general field of personal service. This extension of the community mental health semantic frame to the broader human service frame seems justified by the view of community mental health as "a nucleus without boundaries," (Ridenour, 1961), or the more popular notion that mental health is everybody's business. This attempt to translate Caplan's models into more generic professional language was particularly intended to construct an empirical research instrument that could surmount some of the semantic limitation found in the CMHI Scale, and to make this set of scales more relevant for cross-professional comparisons in subsequent studies. All of these four criteria were thus used for paraphrasing Caplan's Conceptual Models in Community Mental Health into equivalent "normative models for human service intervention." Then, from a total of 150 trial statements, 5 statements for each of these normative models were selected on the basis of statement-to-model matching by a panel of community mental health experts, and on the basis of further evaluation after a pilot survey. The 40 statements thus selected were presented in randomized order in a Likert-type questionnaire. This was one of the instruments used in a stratified-randomized sampling plan for surveying social work practitioners with a master of sodal work (MSW) degree in the Kansas City area, with equal-n subsamples in (a) private and (b) public family service agencies, (c) community mental health centers, (d) psychiatric, and (e) medical-surgical services in general hospitals. These five program sectors represented the five largest fields of practice in the social work profession by national distribution--approximately 64% of the National Association of Social Workers membership, or 74% of the direct personal-service practitioners (Stamm, 1969). The three largest MSW-staffed agencies in each of these sectors in the Kansas City area were used for the sector subsamples, with n = 14 in each sector, or N = 70 altogether. The major dependent variable, community mental health orientation, was operationalized. as adherence scores for each of the eight conceptual models. These scores were derived from responses to the Likert-type questionnaire. Major working hypotheses postulated significant differentiation by model orientation, program affiliation, and tenure (the number of years" employment in present agency). It was chiefly hypothesized that there would be significant differences (a) between mean adherence scores for each of the models, and (b) between mean model adherence scores for each of the program sectors, and that these program-sector differences would be further differentiated by (c) length of tenure in those sectors, so that differences between profiles of model adherence in sectors would be greater for long-tenured groups than for short-tenured groups. The hypotheses that were related to sector and tenure were characterized as representing "program ideological socialization and reinforcement." Langston expressed essentially the same concept when he stated that professionals " w h o stay in a mental health center progressively adopt more of the basic ideology underlying the operation of the center" and that "Those who stay within a center for longer periods of time were more committed to the concept at the outset" (Langston, 1970, p. 391).
Findings Adherence scores for c o m m u n i t y mental health orientation were first derived from approval/disapproval responses to the sets of
John C. Baird
279
five statements per m o d e l (5SM). Relations b e t w e e n the distributions of these m o d e l scores a n d the major control variables (program sector or tenure or both), as well as various m i n o r control variables, w e r e e x a m i n e d b y analyses of variance, p r o d u c t - m o m e n t correlation (r), a n d other statistical tests9 T h r e e - w a y analyses of variance for " m o d e l s , sectors, a n d t e n u r e " did s h o w the expected significant variance for models (p < .001) for the total sample, b u t did not s h o w significant variance for m o d e l orientations as differentiated b y program sector or b y tenure, or both, b e y o n d a few borderline effects; a n d the same lack of consistent differentiation was f o u n d in the correlation analyses 9 The s t a t e m e n t - m o d e l correlations for these 5SM sets were f o u n d to be relatively w e a k (in view of r e d u n d a n c i e s in these calculations, w h i c h h a d an i n h e r e n t t e n d e n c y to elevate r scores) 9 These correlation scores for 5SM's are s h o w n in Table 1. This finding suggested the possibility that some of the statements might have r e p r e s e n t e d their respective models so poorly that the expected differentiations did not a p p e a r significant in the statistical tests. In order to p u r s u e that possibility further, the original sets of 5SM's were modified b y excluding from each set the two statements with the lowest model correlations, leaving the " t h r e e best statements per m o d e l " (3SM's). These same analyses of s t a t e m e n t - m o d e l correlation were r u n again o n these 3SM's. The s t a t e m e n t - m o d e l correlations w e r e f o u n d to be appreciably higher for all model sets, as can be seen in Table 1; so increased confidence could be placed in the interactional findings from the analyses of variance 9 Therefore all the same analyses of variance a n d correlation as before were r u n with 3SM orientation scores 9 The findings w e r e essentially the same as before, b u t were e v e n m o r e definitive since some earlier borderline effects were clearly nonsignificant in this context. The major findings for analysis of variance are s h o w n in Table 2. The correlations s h o w e d no conTABLE 1 Comparison of 3SM and 5SM Correlations Min.
3SM Max.
Crisis
.67
.75
Socialization
.55
Nutritional
.61
Public Health
- 5SM Gain in
Mln.
5SM Max.
.71
9 54
.66
.61
9 10
.82
.70
.36
.66
.49
.21
.76
.66
9
.67
.54
.12
.56
.71
.65
.38
.59
.49
9
Medical
.59
.70
.64
.47
958
.53
.11
S h a r e d Domains
954
.70
.63
9 32
.54
.44
9
Co~nunity D e v e l o p m e n t
.54
.72
.62
.47
.62
.55
.07
Ecological
954
.69
.61
.40
.63
.49
.12
.54
.82
.65
9 32
.67
.52
.13
Model
All ModeLs
Systems
3SM
16
19
280
Community Mental Health Journal
TABLE 2 Analysis of Variance: 3SM' s Source
df
MS
Sectors (A)
4
2.38
Tenure (B)
1
20.06
Models (C)
7
103.55
AxB
4
8.15
0.85
AxC
28
3.73
1.08
7
4.05
1.17
28
3.82
i.ii
BxC AxB
xC
F 0.25 2.09 29.95 ***
*** p ~ . O 0 1
cantly differentiated, (p
A B S T R A C T : Relations between ideological priorities in social work and community mental health were examined by a Likert-type questionnaire containing statements representing Caplan"s Conceptual Models in Community Mental Health. Seventy social workers were sampled, with equal subsamples representing the five largestfields of practice in social work. This sample appeared to be highly representative of the national social work population by fields of personal service. By analyses of variance and correlation, significant differences were found between levels of approval for respective models by the total sample, but no significant differences were found by fields of practice, or any other professional or demographic attribute. This indicates a consensual integrity in the social work profession"s community mental health orientation, and strong mutuality between social work and community mental health value orientations.
Although the social work profession has drawn heavily from psychiatric concepts of mental health and has also been strongly oriented toward community organization for m a n y years, and although there are more social workers than psychiatrists or psychologists in community mental health programs--and conversely, one of the largest fields of practice for social workers is in community mental health---explicit use of community mental health concepts has only recently begun to appear in the professional curricula or literature of social work. Social work has long avowed a dual orientation to both personal and community needs and services, yet this profession has continually verged on coming apart at the seams of conflicting micro versus macro ideological commitments, apparently oblivious of the role that community mental health concepts such as social epidemiology might fill in systematically linking personal with social phenomena. Questions therefore arise as to how much kinship really exists between the value-knowledge-practice cultures of social work and community mental health, respectively. Do they really share the same basic concepts but express them in different vocabularies? Are there implicit commonalities between social work and community mental health that can be explicated? When the present writer began in 1968 to ponder questions like these and to search for ways of analyzing relationships between social work and community mental health, little research literature on that subject could be found. Baker and Schulberg (1967) had recently constructed their Community Mental Health Ideology (CMHI) Scale and used it for comparing the *Dr. Baird, a social worker, is Community Mental Health Centers Consultant in the Ohio Division of Mental Health, Department of Mental Health and Mental Retardation, Columbus, Ohio 43221. Community Mental Health Journal, Vol. 12(3), 1976
275
276
Community Mental Health Journal
orientations of psychologists, psychiatrists, and occupational therapists; but that instrument did not appear to be entirely suitable for application to social work, for reasons that will be presented later in this paper. Then Gerald Caplan presented his Conceptual Models in Community Mental Health (1968). Caplan's models appeared to provide a suitable framework for studying the relations between social work and community mental health in terms of Social Workers" Orientations Toward Community Mental Health Concepts (Baird, 1973). The methods, findings, and implications of that research are summarized here. BACKGROUND Previous studies have shown that each profession tends to develop its own characteristic set of concepts, value priorities, and practices which represent that profession's distinctive culture and ideology (McLeod & Meyer, 1967). Such distinctive ideologies also tend to prevail in multidisciplinary fields of practice, especially in those fields in which multiprofessional teams have become institutionalized. Where various disciplines share in a common service delivery system, as in community mental health, the patterns of relations between the professional ideologies can be examined in terms of their respective levels of adherence to certain conceptual models. According to Baker and Schulberg, their CMHI Scale "discriminates between professional groups known to be highly oriented to this ideology and random samples of mental health professionals" (1967, p. 216). After comparing the orientations of psychologists, psychiatrists, and occupational therapists, the authors noted that "Data for nurses, social workers, and other mental health specialty populations are still needed" (p. 225). Subsequently, Langston (1970) applied the CMHI Scale to all the service-providing disciplines, and also to the secretaries, in two community mental health centers. In this sample, the group of nine social workers not only had higher adherence scores than any other discipline, but also had the lowest variability in their scores. The other discipline groups, in descending order of their adherence, were 7 psychologists, 20 occupational therapists and recreational therapists, 22 nurses, 7 secretaries, 13 psychiatrists, and a group of 42 aides, orderlies, and "LVN's". The remarkably low adherence of the psychiatrists was attributed to the fact that all of them were affiliated with the centers on a part-time basis, their major activity being in private practice. Social workers likewise scored higher than clinical psychologists and lawyers on the CMHI Scale in a study by Mangum and Mitchell (1973) comparing attitudes of faculty and graduate students in those disciplines. Although this scale lends itself conveniently to such cross-disciplinary comparisons, it appears to be somewhat limited in its applicability to less clinically oriented community mental health disciplines such as social work due to the language used in the scale. For example, such a statement as
John C. Baird
277
" O u r t i m e - t e s t e d p a t t e r n of d i a g n o s i n g a n d treating individual patients is still the o p t i m a l w a y for us to function p r o f e s s i o n a l l y " (p. 219, I t e m 2), e v e n t h o u g h scored negatively, could h a r d l y be characteristic of the w a y m a n y social w o r k e r s wOuld talk a b o u t their practice. Likewise, o n e w o u l d not be likely to find m a n y c o n t e m p o r a r y social w o r k e r s affirming that " O u r p r o g r a m e m p h a s i s s h o u l d be shifted f r o m the clinical m o d e l , directed at specific patients, to the public health m o d e l , focusing o n p o p u l a t i o n s " (Item 12). This q u e s t i o n a b l e c o n g r u e n c e b e t w e e n the p h r a s i n g of s t a t e m e n t s in the C M H I Scale a n d the characteristic l a n g u a g e u s e d b y s o m e of the c o m m u nity m e n t a l h e a l t h disciplines s t u d i e d t h u s p r e s e n t s s o m e difficulty in interpreting h o w m u c h the differences in i d e o l o g y ratings w e r e d u e to semantic rather t h a n to c o n c e p t u a l differences. The particular findings of the s u b s e q u e n t s u r v e y s b y L a n g s t o n a n d b y M a n g u m a n d Mitchell are also limited in their significance b y the t y p e s a n d smallness of the s a m p l e s utilized. N e v e r t h e l e s s , the basic m e t h o d o l o g y u s e d b y Baker a n d S c h u l b e r g appears to be well suited for s u r v e y i n g c o m m u n i t y m e n t a l health orientations a m o n g social w o r k e r s if the c o n c e p t s are p h r a s e d in l a n g u a g e that social w o r k e r s in general, as well as t h o s e practicing in m e n t a l health p r o g r a m s , are likely to u s e a n d if the s a m p l i n g d e s i g n p e r m i t s generalization of the findings to the national p r o f e s s i o n a l p o p u l a t i o n . PRESENT STUDY Method
A "conceptual models in community mental health" frame of reference was utilized, drawing directly from Caplan's formulation by that same title (1968) and using his specific set of models. Caplan's work was closely linked with that of Baker and Schulberg insofar as Caplan has been the Director of the Laboratory of Community Psychiatry, at the Harvard Medical School, where both Baker and Schulberg were on the laboratory staff. Caplan's formulations appeared to be especially relevant for comparing social workers' orientations to community mental health concepts because in his extensive writings Caplan has often given particular attention to the role of social work in the field of community mental health (1955, 1959). Caplan had organized his Conceptual Models in Community Mental Health into two general categories: 1. Etiologicalmodels: nutritional; developmental adjustment or crisis; community organization
and development; socialization or effective role performance 2. Practice models: public health models (epidemiology; planning and logistics; catchment
areas; populations at risk; prevention); medical practice or doctor-patient; ecological systems; shared professional domains For the present research design, these rather loosely formulated models were paraphrased so that they could provide more systematic and analytically symmetrical bases for operational scaling. Although Caplan's classificatory scheme appears to indicate that each of his models is either "etiological" or "practice" oriented, one finds in his other writing and teaching that most, if not all, of them have included both aspects. To illustrate, his "crisis" model is at least as well known for its interventive aspect as its etiological aspect; the same is obviously true of
278
Community Mental Health Journal
the concept of "community organization"; the "nutritional" model represents a concept that is essentially the same as the familiar social work concept of meeting human needs (Towle, 1952); and the "socialization" model is prominently associated with social-learning interventions such as behavior modification. Conversely, each of Caplan's "practice" models is based on certain etiological premises. Therefore each of Caplan's eight major models was restated as a cognitive-normative model that articulated both etiological and practice aspects. A second aspect, which tended to appear in most of Caplan's model formulations, but not consistently, and yet which can be considered a hallmark of the community mental health approach, is a mutual and reciprocal relevance to both personal and social phenomena (Group, 1968). Therefore all of Caplan's models were paraphrased so as to articulate this dual-reciprocal focus on both personal and social concerns. A third dimension for rephrasing these models was to translate them from the vocabulary and Harvard dialect of community mental health (Baker & Schulberg, 1967) to language generally used by social workers. Ffnally, as a further shift of orientation in the direction of relevance to the wider area of human service programs and disciplines, the paraphrasing used language and references that were applicable to the general field of personal service. This extension of the community mental health semantic frame to the broader human service frame seems justified by the view of community mental health as "a nucleus without boundaries," (Ridenour, 1961), or the more popular notion that mental health is everybody's business. This attempt to translate Caplan's models into more generic professional language was particularly intended to construct an empirical research instrument that could surmount some of the semantic limitation found in the CMHI Scale, and to make this set of scales more relevant for cross-professional comparisons in subsequent studies. All of these four criteria were thus used for paraphrasing Caplan's Conceptual Models in Community Mental Health into equivalent "normative models for human service intervention." Then, from a total of 150 trial statements, 5 statements for each of these normative models were selected on the basis of statement-to-model matching by a panel of community mental health experts, and on the basis of further evaluation after a pilot survey. The 40 statements thus selected were presented in randomized order in a Likert-type questionnaire. This was one of the instruments used in a stratified-randomized sampling plan for surveying social work practitioners with a master of sodal work (MSW) degree in the Kansas City area, with equal-n subsamples in (a) private and (b) public family service agencies, (c) community mental health centers, (d) psychiatric, and (e) medical-surgical services in general hospitals. These five program sectors represented the five largest fields of practice in the social work profession by national distribution--approximately 64% of the National Association of Social Workers membership, or 74% of the direct personal-service practitioners (Stamm, 1969). The three largest MSW-staffed agencies in each of these sectors in the Kansas City area were used for the sector subsamples, with n = 14 in each sector, or N = 70 altogether. The major dependent variable, community mental health orientation, was operationalized. as adherence scores for each of the eight conceptual models. These scores were derived from responses to the Likert-type questionnaire. Major working hypotheses postulated significant differentiation by model orientation, program affiliation, and tenure (the number of years" employment in present agency). It was chiefly hypothesized that there would be significant differences (a) between mean adherence scores for each of the models, and (b) between mean model adherence scores for each of the program sectors, and that these program-sector differences would be further differentiated by (c) length of tenure in those sectors, so that differences between profiles of model adherence in sectors would be greater for long-tenured groups than for short-tenured groups. The hypotheses that were related to sector and tenure were characterized as representing "program ideological socialization and reinforcement." Langston expressed essentially the same concept when he stated that professionals " w h o stay in a mental health center progressively adopt more of the basic ideology underlying the operation of the center" and that "Those who stay within a center for longer periods of time were more committed to the concept at the outset" (Langston, 1970, p. 391).
Findings Adherence scores for c o m m u n i t y mental health orientation were first derived from approval/disapproval responses to the sets of
John C. Baird
279
five statements per m o d e l (5SM). Relations b e t w e e n the distributions of these m o d e l scores a n d the major control variables (program sector or tenure or both), as well as various m i n o r control variables, w e r e e x a m i n e d b y analyses of variance, p r o d u c t - m o m e n t correlation (r), a n d other statistical tests9 T h r e e - w a y analyses of variance for " m o d e l s , sectors, a n d t e n u r e " did s h o w the expected significant variance for models (p < .001) for the total sample, b u t did not s h o w significant variance for m o d e l orientations as differentiated b y program sector or b y tenure, or both, b e y o n d a few borderline effects; a n d the same lack of consistent differentiation was f o u n d in the correlation analyses 9 The s t a t e m e n t - m o d e l correlations for these 5SM sets were f o u n d to be relatively w e a k (in view of r e d u n d a n c i e s in these calculations, w h i c h h a d an i n h e r e n t t e n d e n c y to elevate r scores) 9 These correlation scores for 5SM's are s h o w n in Table 1. This finding suggested the possibility that some of the statements might have r e p r e s e n t e d their respective models so poorly that the expected differentiations did not a p p e a r significant in the statistical tests. In order to p u r s u e that possibility further, the original sets of 5SM's were modified b y excluding from each set the two statements with the lowest model correlations, leaving the " t h r e e best statements per m o d e l " (3SM's). These same analyses of s t a t e m e n t - m o d e l correlation were r u n again o n these 3SM's. The s t a t e m e n t - m o d e l correlations w e r e f o u n d to be appreciably higher for all model sets, as can be seen in Table 1; so increased confidence could be placed in the interactional findings from the analyses of variance 9 Therefore all the same analyses of variance a n d correlation as before were r u n with 3SM orientation scores 9 The findings w e r e essentially the same as before, b u t were e v e n m o r e definitive since some earlier borderline effects were clearly nonsignificant in this context. The major findings for analysis of variance are s h o w n in Table 2. The correlations s h o w e d no conTABLE 1 Comparison of 3SM and 5SM Correlations Min.
3SM Max.
Crisis
.67
.75
Socialization
.55
Nutritional
.61
Public Health
- 5SM Gain in
Mln.
5SM Max.
.71
9 54
.66
.61
9 10
.82
.70
.36
.66
.49
.21
.76
.66
9
.67
.54
.12
.56
.71
.65
.38
.59
.49
9
Medical
.59
.70
.64
.47
958
.53
.11
S h a r e d Domains
954
.70
.63
9 32
.54
.44
9
Co~nunity D e v e l o p m e n t
.54
.72
.62
.47
.62
.55
.07
Ecological
954
.69
.61
.40
.63
.49
.12
.54
.82
.65
9 32
.67
.52
.13
Model
All ModeLs
Systems
3SM
16
19
280
Community Mental Health Journal
TABLE 2 Analysis of Variance: 3SM' s Source
df
MS
Sectors (A)
4
2.38
Tenure (B)
1
20.06
Models (C)
7
103.55
AxB
4
8.15
0.85
AxC
28
3.73
1.08
7
4.05
1.17
28
3.82
i.ii
BxC AxB
xC
F 0.25 2.09 29.95 ***
*** p ~ . O 0 1
cantly differentiated, (p
