Jerry Floersch

Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States

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Publications (41)27.27 Total impact

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    ABSTRACT: Psychiatric treatment is critical for people living with mental illness as it enables resumption of normal roles and engagement in meaningful opportunities, and it increases the chance of positive long-term outcomes. There is an urgent need to assess college student experience of psychiatric treatment because as many as 45% of college students may meet the criteria for a mental illness diagnosis. All college students are at some risk for negative mental health outcomes because of home-to-college stressors, but these are often intensified for those students living with a mental illness. The aim of this article is to qualitatively explore the psychiatric treatment and recovery experiences of college students diagnosed with mental health disorders, with a particular focus on the impact of treatment on the academic and social aspects of college. Seventeen undergraduate college students who had a psychiatric illness and were taking prescribed psychiatric medication were enrolled in this study. A semistructured interview queried college students about their perceptions of having psychiatric diagnoses and taking psychiatric medications. Authors conducted thematic analysis by using the constant comparative method for coding data and sorting in vivo codes by a shared theme. Respondents reported positive attitudes toward medication and services, endorsing themes of positive family influence, improved functioning, acceptance toward medication and service usage, willingness to disclose, and independent management of treatment. College students were empowered by their treatment because of its positive effects on success and integration into the college setting. Environmental factors that influence college students' feeling of empowerment are discussed.
    American Journal of Psychiatric Rehabilitation 01/2013; 16(3).
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    ABSTRACT: This is an exploratory study that examines how leadership potential may initially develop in adolescent children through specific parenting practices. It investigates whether adolescent children raised in an authoritative parenting environment can be linked to transformational leadership. Additionally, this study looks at the healthy parent–child interaction that promotes emotional autonomy and mastery orientation. These important psychological dispositions may form the basis for transformational leadership thinking and behavior, especially in young nascent leaders.
    Leadership 11/2012; 8(4):345-375. · 1.16 Impact Factor
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    Jeffrey Longhofer, Jerry Floersch
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    ABSTRACT: In this essay, the authors consider the challenge made by two keynote speakers at recent social work research conferences, one in the United States and the other in Europe. Both spoke of a knowledge crisis in social work. Both John Brekke (Society for Social Work and Research) and Peter Sommerfeld (First Annual European Conference for Social Work Research) proposed some version of realism as a solution to the crisis. The authors will deepen the argument for realism, however, by discussing how a critical realist perspective allows us to rethink positivist and conventionalist assumptions about the fact/value relation. Using a critical realist philosophy of social science, the authors discuss how social work has taken up positivism and myriad forms of conventionalism and also identify how practical knowledge gradually loses its place and thus contribute to social work’s ongoing knowledge crisis. The authors then offer a way of thinking about practice. The authors will consider forms of practice knowledge and propose that social work has four kinds that unfold in essentially open systems: discursive, visual, embodied, and liquid systems, and that each of these have both tacit and explicit dimensions. These forms of practice, moreover, are inevitably situated in theory-to-practice gaps (the authors call them phenomenological practice gaps), which are the source of social work’s knowledge crisis. The authors conclude with a discussion of the role of reflexivity in a science of social work.
    Research on Social Work Practice 09/2012; 22(5):499-519. · 1.53 Impact Factor
  • Jeffry Longhofer, Jerry Floersch
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    ABSTRACT: Background and Purpose: In recent years recovery' has become the single most important conceptual development in mental health service delivery. And while recovery is not a technique, method, or model of practice (i.e., motivational interviewing, cognitive-behavioral therapy, or assertive community treatment), it does purport to describe and prescribe desired and valued outcomes for clients, parents, providers, researchers, and policymakers. In research and scholarship, memoirs and personal accounts, recovery makes reference to the roles of formal and informal relationships in producing and sustaining recovery from serious mental illnesses. The aim of this study was to identify the practical knowledge' deployed in problem solving interactions among mental health providers (principally case managers) and clients. Methods: Single and comparative case study methods were used to study three clients (one with major depression and two with schizophrenia) and three case managers over 24 months. Participant observation of case manager and client-initiated interactions were audio recorded or notated and a three-stage analytic strategy (thematic, grounded theory, and narrative) was conducted using two coders who independently coded problem-solving events for type of relational activity. Coders could not agree on 33 events (i.e., the thematic relational code); these were discarded and the remaining 628 events were used in a grounded theory and narrative analysis. Results: Four categories of practical and relational knowledge were identified: doing for, doing with, standing by for support, and letting go. A narrative matrix of provider and client interactions identified the practical and relational actions (e.g., doing for and doing with) associated with specific life domains (i.e., cognitive, emotional, and behavioral). These findings demonstrated that the activities of case management were not only practical. They were also value driven. For example, when case managers respected client dignity and independence, they acted with values that guided them in making judgments about both the type and use of the relational activities (e.g., doing for and doing with activities) within specific time and spatial dimensions. Conclusions and Implications: Foucault and Bourdieu inspired an enormous and diverse literature on practice and its relationship to theory. In this paper we argue that this scholarship tends to elide how knowledge works in the ethical dimension, that is, in the inevitable and necessary tension between fact and value. Doing for and doing with, for example, emerge from practical knowledge and in the particulars of caring relationships, and their effects cannot be explained or prescribed by technique. And these practitioner reflections on value require our taking seriously values' as knowable and actionable. Indeed, these data show how practical knowledge in provider/client relationships produce particular valued' effects and how relational aspects of treatment are often overlooked because the fact/value separation in social work research consigns these to the subjective (i.e., value) and emotional (i.e., interference), thus unknowable dimensions of practice.
    Society for Social Work and Research Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy; 01/2012
  • Eileen P. Anderson-Fye, Jerry Floersch
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    ABSTRACT: Research has established that a large minority of college students today are taking psychiatric medications and that college mental health services are overwhelmed by this relatively recent trend. Little is known about the subjective experience of these college students in regard to their medications and utilizations of services as they transition from home to a peer-based environment during a key developmental moment in the transition to adulthood. In this article we argue that theory and methods from psychological anthropology are ripe to guide data collection in this area. We provide data from a longitudinal mixed-methods pilot study with residential college students to argue that policy and practice regarding college mental health and psychiatric medication can benefit substantially from insights gained through psychological anthropology. In particular, college administrators, counseling and health centers, and their professional organizations can benefit from research examining student experience and meaning making in particular institutional and community settings.
    Ethos 12/2011; 39(4):501-521. · 0.95 Impact Factor
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    ABSTRACT: Objective Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care.
    Children and Youth Services Review 11/2011; 33(11):2261-2266. · 1.27 Impact Factor
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    ABSTRACT: The extant literature describes stigma in two forms, public stigma and self-stigma. Public stigma pertains to negative social behaviors, reactions, attitudes, and beliefs directed toward people with mental illness and among persons with mental illness. Self-stigma concerns the internalized effects of public stigma. Although both types of stigma have negative impacts on people with mental illness, they produce different effects. In particular, self-stigma can negatively affect self-esteem, social relationships, willingness to engage in life opportunities, and adherence to psychiatric services. Few adult stigma models represent self-stigma, and no models exist that examine self-stigma among adolescents with a mental illness. Because of developmental differences, adolescent self-stigma may be distinct from that of adults. This study aimed to develop a self-stigma model to elucidate youths' responses to mental illness labels and how psychiatric services affect self-image and self-efficacy. The qualitative study included a sample of 27 adolescents between the ages of 12 and 17 who took psychiatric medication for a mental illness diagnosis. A semistructured interview, the Teen Subjective Experience Medication Interview, was used to query adolescents about their perceptions of having a psychiatric diagnosis and of taking psychiatric medication. The analytic strategy identified a sequence of narrative plot components that illustrated a self-stigma process among adolescents. The findings revealed a self-stigma model comprising three narrative components: stereotype, differentiate, and protect. The adolescent model was similar to yet distinct from the adult model, and developmental differences may contribute to the variation. The need for future research to validate an adolescent self-stigma model is discussed.
    Psychiatric services (Washington, D.C.) 08/2011; 62(8):893-9. · 2.81 Impact Factor
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    Jeffrey Longhofer, Jerry Floersch, Nate Okpych
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    ABSTRACT: Foster care children are prescribed psychotropic medications at rates significantly higher than same-aged peers. Concerns about the safety of psychoactive chemicals on developing bodies and potential misuses with foster care populations have led to varied and complex responses by the media, lawmakers, and researchers. First, we look at how foster youth are prescribed psychoactive substances, including polypharmacy (sometimes called concomitant prescription), and at the mounting and major responses by federal and state governments. Second, we consider a recent parameter published by the American Academy of Child and Adolescent Psychiatry. Third, we consider how foster care settings, what we call open systems, complicate parameter implementation, creating potential gaps among researcher, prescriber, foster caregivers, and youth medication explanatory models of treatment experience. And finally, to address gaps among researcher, prescriber, and patient explanatory models, we propose the use of arbitrage, a conceptual framework and process for the integration of competing and sometimes incommensurable explanatory models, knowledge and practice claims.
    Children and Youth Services Review 01/2011; 33(2):395-404. · 1.27 Impact Factor
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    ABSTRACT: Stigma greatly impacts African Americans' underutilization of mental health treatment. Stigmatizing attitudes are attributed to racial mistrust, familial, religious and cultural beliefs. However, most research on influences of these attitudes has been conducted with adults. Origins among adolescents may be unique because they have different competing influences relative to development. Identifying these influences is crucial to promoting utilization of psychiatric services as well as positive mental health outcomes among youth. The present article applies qualitative methods to explore the origin of stigmatizing attitudes among African American adolescents with psychiatric disorders. Adolescents reported similar origins of stigmatizing attitudes toward mental illness as adults, and also identified peer perceptions and media messages as influences. The findings promote the need to develop family psychoeducation programs that account for familial, racial, cultural, community and religious influences.
    Social Work in Mental Health 01/2011;
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    ABSTRACT: Background/Significance While it has been recognized that there are patient-level and system-level factors that contribute to healthcare disparities, much of the effort to date has been to focus on the composition of the healthcare workforce, the cultural competence of providers, and the role of community participation and mobilization in promoting health, little attention has been paid to the communication between healthcare providers and members of medically and socially disenfranchised communities. Objective/Purpose The purpose of this project was to identify themes in communications with healthcare providers that individuals from medically and socially disenfranchised groups perceive as preventing them from getting what they need to manage their health. Methods A participative inquiry approach used focus groups from the local community from medically and socially disenfranchised groups (African-American, Hispanic, lesbian/gay/bisexual/transgender [LGBT]), and Russian immigrant communities) to identify common themes among their experiences with healthcare providers. Participants were recruited using flyers, internet posts and ads in all local buses. The sessions were digitally recorded and transcribed. Data were analyzed using Atlas.ti by assigning in-vivo codes to the words of respondents by three researchers, independently. The coding was merged and reconciled. The in-vivo codes were grouped under more abstract (axial) codes by the patterns or themes that emerged from comparing shared characteristics and meanings. The themes were then validated in meetings with community groups. Results Three major themes emerged consistently, in all four communities and across all focus groups. Themes are wait, won't, and want. Examples of wait included waiting for an appointment, the provider, and test results. Won't included won't take a medication that makes me sick and won't go to a provider or hospital that doesn't respect me or ignores what I have to say. Want included a providers who knows them and their situation, takes their time (not rushed), who listen, enter into a human relationship, and the right medication (one that works for them). At the system level, want includes simple, understandable and affordable healthcare/insurance for all. Conclusion/Discussion Participants identified that waiting is a major barrier that interferes with or prevents getting what they need to manage their health. Further, participants report foregoing health care (won't) instead of returning to providers or hospitals whom they perceive treat them with other than a reciprocal human relationship. Participants want providers to listen to their stories, especially with regards to participants knowing their own bodies and histories.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
  • Stacey L. Barker, Jerry E. Floersch
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    ABSTRACT: Over the past 2 decades the topic of spirituality and its relationship to the social work profession has taken its place as a significant and important part of the agenda for social work research, education, and practice. In this article we discuss the results of a qualitative study that addresses how a group of social work practitioners defined spirituality and the implications of these findings specifically for social work education. Based on findings from a thematic analysis of interviews with 20 social workers, we explore the usefulness of the term spirituality in social work education and the importance of student engagement in a self-awareness process related to spirituality. A template to initiate discussion of these issues for use in the classroom is proposed.
    Journal of social work education 09/2010; 46(3):357-370. · 0.77 Impact Factor
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    Jeffrey Longhofer, Jerry Floersch
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    ABSTRACT: This paper situates medication adherence among adolescents in current cultural and political-economic debates about compliance/adherence and the formation of biomedical subjectivities. Building on prior work of the authors, this paper explores the role of desire in adherence to show how subjectivities are shaped by concordant, instrumental, or conditional forms of desire. Data is used to show how parents and adolescents compare the medicated self before and after, resulting in the formation of desire. It is argued that adherence is an outcome of desire: no desire, no adherence, or varying types of desire. Moreover, adherence is not a steady state. It is produced moment to moment as adolescents confront the desires of others. The study uses interview data to construct a case study of concordant desire, which is a form most likely to produce adherence. With concordant desire the medicated come to expect a future life on medication and a life where symptoms are stripped of their social and psychological meaning and significance.
    Anthropology & Medicine 08/2010; 17(2):159-72.
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    ABSTRACT: Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery.
    Journal of Social Work Practice in the Addictions 07/2010; 10(3):257-282.
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    ABSTRACT: This study investigated the experience of stigma among adolescents taking psychiatric medication for the treatment of a diagnosed mental illness. Although medications are intended to improve functioning and reduce mental disorder symptoms, little research has examined the potential stigma associated with taking them. This study recruited forty adolescents, ages 12–17, who met DSM-IV criteria for a mental health disorder and who were taking a psychiatric medication at the time of the study. Data were collected using a semi-structured interview instrument and were thematically analyzed using Link, Cullen, Struening, Shrout, and Dohrenwend's (1989) modified model of labeling theory. Results indicate that many adolescents did experience stigma. In particular, 90% of the sample endorsed at least one of Link et al.'s (1989) constructs of secrecy, shame, and limiting social interaction; four endorsed no stigma themes. Additional themes emerged indicating that the perceptions of adolescents' family members and school environments can accentuate their experience of stigma or serve as a protective barrier against it. The thematic findings of secrecy and shame were used to construct hypothetical models for how adolescents limited their social interaction.
    Children and Youth Services Review 04/2010; · 1.27 Impact Factor
  • Victoria R. Winbush, Jerry Floersch
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    ABSTRACT: Background and Purpose: The belief of a female parent/guardian that a youth needs mental health services is the most significant factor associated with service use (Horwitz, et al., 1992). Far fewer youth who might benefit from treatment actually receive it (Costello et al., 1993), and this is exacerbated by socio-economic and race/ethnicity factors (Turpin, et al., 1980). Thus, a better understanding of how parents facilitate their youths' treatment can help reduce unmet need and the resulting disparity in mental health treatment for children and adolescents. In addition, research on adolescent psychopathology and on the effectiveness of psychopharmacology is complemented by studies aimed at clarifying parents' role in the help-seeking process. Thus, this qualitative study investigated how parents enacted their parental responsibilities in addressing their adolescents' mental distress. Methods: A non-random, exploratory secondary analysis was undertaken to examine the subjective experience of parents of mentally distressed youth (ages 12-17). The study utilized transcripts of forty-three parents who had participated in an NIMH study designed to examine parents' experiences with adolescents' emotional illness and treatment. Respondents who resided in a mid-west urban center were predominately female (95%) and reflected diversity in terms of race/ethnicity, age, socio-economic status, education, and in the adolescents' primary diagnoses. A thematic analysis was conducted wherein Atlas.ti software was used to in vivo code respondents' descriptions of their assessment, initiation, and maintenance of their youths' treatment process. Using the constant comparative method, the themes were grouped under higher level constructs, which then represented parents' role in facilitating treatment. Results: The following ten strategies of how parents reported enacting their responsibilities toward their youths' emotional distress were found: 1) Seeking out information; 2) Acknowledging own & family members' illness/treatment; 3) Seeking family and social support; 4) Dealing with conflict; 5) Seeking and accepting professional help; 6) Communicating; 7) Navigating the unknown and second guessing; 8) Advocating; 9) Monitoring; and, 10) Gaining understanding. The findings also suggested that the unique social context of each parent/youth dyad influenced which subset of activities was deployed by a given parent. For example, a parent who had not successfully dealt with internal conflict associated with guilt made minimal use of strategies related to monitoring and seeking information. Conclusions and Implications: Each of the ten strategies can be represented on a continuum. For instance, the activity of seeking family and social support contains reaching out to others at one end of the continuum and avoiding others at the other end. Clinicians can use this list of strategies as an informal assessment tool. Doing so, can help clinicians gain a better understanding of how a given parent's actions or inactions, may be contributing to a help-seeking process whose overall impact is either more proactive in nature (i.e., facilitating resolution of the youth's problems) or more reactive in nature (i.e., impeding resolution of the youth's problems). Moreover, if mental health providers and systems incorporate an understanding of how social context affects parental initiation and maintenance of services, such efforts could contribute to reducing service use disparities.
    Society for Social Work and Research 14th Annual Conference: Social Work Research: A WORLD OF POSSIBILITIES; 01/2010
  • L. Townsend, J. Floersch, R. L. Findling
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    ABSTRACT: Adolescents are routinely treated with psychiatric medications; however, little is known about their attitudes toward pharmacological intervention. The authors used a concurrent triangulation, mixed methods design to assess whether the Drug Attitude Inventory (DAI), developed for adults, is suitable for measuring adolescent attitudes toward psychiatric medications. Factor analytic techniques and qualitative data were used to investigate whether the instrument provides comprehensive measurement of medication-related constructs in adolescents. Findings suggest that the DAI contributes to knowledge of youth attitudes toward psychotropic treatment; however, limitations were uncovered by the mixed methods approach. This study enhances the measurement and mixed methods literature by showing how qualitative and quantitative techniques served as parallel data reduction strategies for examining an instrument’s utility with a new population.
    Journal of Mixed Methods Research 01/2010; 4(1):32-55. · 1.91 Impact Factor
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    ABSTRACT: In this article, we integrate thematic, grounded theory and narrative analytic techniques. We apply methods from each to the same qualitative data to illustrate how they provide different interpretive scopes on medication meaning making. Findings from each are concatenated to produce an integrated conceptual framework for understanding adolescent experience of psychiatric medication. We conclude that thematic, grounded theory, and narrative methods, when integrated, produce a multidimensional understanding of medication experience.
    Qualitative Social Work 01/2010; 9(2).
  • Michelle R Munson, Jerry E Floersch, Lisa Townsend
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    ABSTRACT: This study explored the illness perceptions, attitudes towards mental health services and adherence behaviors among a group of adolescents in treatment for mood disorders in an urban city in the United States. Seventy adolescents completed a battery of questionnaires assessing demographics (e.g., gender, family income), perceptions of illness (e.g., consequences, treatment control) and overall attitudes towards mental health services. Adolescents and their parents also reported on the youth's adherence to both psychotropic medication and mental health appointments. Simultaneous logistic regression analyses revealed that attitudes and family income made a significant and unique contribution in explaining adolescents' adherence behaviors. Interventions that help adolescents become aware of their attitudes toward mental health services and provide information on dimensions of mood disorders, such as the chronic nature of depression and the effectiveness of treatment, may impact adherence behavior. Also, among a group of families with access to services, yearly family income remained a significant barrier to attending appointments all of the time. Policy implications are discussed.
    Administration and Policy in Mental Health and Mental Health Services Research 11/2009; 37(5):408-16. · 3.44 Impact Factor
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    Michelle R Munson, Jerry E Floersch, Lisa Townsend
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    ABSTRACT: The present study describes how adolescents perceive their mood disorders (MD; e.g., acute vs. chronic) and their attitudes toward mental health services. The study also explores the relationships between demographics, clinical characteristics, perceptions of illness and attitudes. Finally, we examine the psychometric properties of the Illness Perception Questionnaire-Revised (Moss-Morris et al. in Psychology & Health 17(1):1-16, 2002). Seventy adolescents were recruited from the greater Cleveland area. Structured interviews were conducted utilizing standardized instruments. Results show that adolescents with MD have fairly positive attitudes, with Caucasian youth reporting more positive attitudes than their nonwhite ounterparts. Illness perceptions were related to psychological openness and indifference to stigma. Implications are discussed.
    Child and Adolescent Social Work Journal 10/2009; 26(5):447-466.
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    Lisa Townsend, Jerry Floersch, Robert L Findling
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    ABSTRACT: Despite the effectiveness of psychotropic treatment for alleviating symptoms of psychiatric disorders, youth adherence to psychotropic medication regimens is low. Adolescent adherence rates range from 10-80% (Swanson, 2003; Cromer & Tarnowski, 1989; Lloyd et al., 1998; Brown, Borden, and Clingerman, 1985; Sleator, 1985) depending on the population and medication studied. Youth with serious mental illness face increased potential for substance abuse, legal problems, suicide attempts, and completed suicide (Birmaher & Axelson, 2006). Nonadherence may increase the potential for negative outcomes. The Drug Attitude Inventory (DAI) was created to measure attitudes toward neuroleptics and to predict adherence in adults (Hogan, Awad, & Eastwood, 1983). No studies have been identified that have used this instrument in adolescent psychiatric populations. The present study was undertaken to evaluate the utility of the DAI for measuring medication attitudes and predicting adherence in adolescents diagnosed with mental health disorders. Structural equation modeling was used to compare the factor structure of the DAI in adults with its factor structure in adolescents. The relationship between adolescent DAI scores and adherence was examined also. The adult factor structure demonstrated only "fair" fit to the adolescent data (RMSEA = .061). Results indicated a low, but significant positive correlation (r = .205, p < .05) between DAI scores and adherence. Lack of optimal model fit suggests that DAI items may require alteration to reflect adolescent experiences with psychiatric medication more accurately. Differences between adolescents and adults in developmental stage, symptom chronicity, diagnosis, and medication class may explain why the adult model demonstrated only "fair fit" to the adolescent data and why the correlation between DAI scores and adherence was low. The DAI may be improved for use with adolescents by creating items reflecting autonomy concerns, diagnostic characteristics, treatment length, and side effect profiles relevant to adolescent experiences.
    Journal of Child Psychology and Psychiatry 07/2009; 50(12):1523-31. · 5.42 Impact Factor

Publication Stats

127 Citations
27.27 Total Impact Points

Institutions

  • 2010–2013
    • Rutgers, The State University of New Jersey
      • School of Social Work
      New Brunswick, New Jersey, United States
  • 2004–2010
    • Case Western Reserve University
      • Mandel School of Applied Social Sciences
      Cleveland, OH, United States
  • 1992–1997
    • University of Missouri - Kansas City
      Kansas City, Missouri, United States
  • 1994–1995
    • University of Chicago
      Chicago, Illinois, United States