Proliferation in the use of the terminology around behavioral mental health suggests, on one hand, an emerging field of service that integrates psychiatric, substance abuse, and related services. On the other hand, this...Proliferation in the use of the terminology around behavioral mental health suggests, on one hand, an emerging field of service that integrates psychiatric, substance abuse, and related services. On the other hand, this development also raises questions about the coherence of this approach. This review explores the history, definitional issues, current trends, and available data on the impact of this field. It considers a variety of critiques of behavioral mental health, such as possibility that the field attempts to integrate fundamentally incompatible domains, that the term "behavioral mental health" is thus an oxymoron, and that it represents a co-optation by the insurance industry of traditional ideals of mental health and of behavioral medicine or as code for the implementation of a medical model that emphasizes short-term, behavioral, and psychopharmacological treatments at the expense of a truly biopsychosocial orientation. Other concerns include the focus on individual change and the effectiveness of behavioral health as a strategy for destigmatizing mental health. Recommendations for addressing the various barriers to realizing the ideals of behavioral mental health include revamping the role of managed care in oversight of treatment decisions, broadening the implementation of evidence-based treatment, and the development of treatment models that build on traditional social work practice models.
Social work practitioners and the agencies that employ them have long been concerned with how best to evaluate whether the interventions that they adopt are being provided appropriately or with desired outcomes. The real...Social work practitioners and the agencies that employ them have long been concerned with how best to evaluate whether the interventions that they adopt are being provided appropriately or with desired outcomes. The realities of practice in everyday service provision settings, however, make it difficult to use well-controlled research designs for evaluation purposes in such settings-especially designs involving the use of control groups. The purpose of this article is to provide practitioners in those settings with a new, feasible way to evaluate practice and yield approximate empirical findings that can inform practice decisions despite the absence of a control group. The key feature of this new approach involves the use of within-group effect size benchmarks.
This article describes the qualitative responses from a national sample of licensed clinical social workers (LCSWs) on their views regarding integrating clients' religion and spirituality (RS) in practice. Two open-ended...This article describes the qualitative responses from a national sample of licensed clinical social workers (LCSWs) on their views regarding integrating clients' religion and spirituality (RS) in practice. Two open-ended questions were asked to assess what helps or assists LCSWs in assessing and integrating clients' RS in practice and what hinders or prevents LCSWs from considering this area of clients' lives. A total of 329 responded to either item, with 319 responses to the first item and 279 responses to the second. The authors used open-coding procedures, developed a codebook to analyze the data, and reached consensus on each response. Overarching themes that emerged from LCSWs' responses to what helps them consider this area included personal religiosity, education, and having an RS-sensitive practice. Regarding what hinders RS integration, LCSWs reported that nothing hinders such integration; that it was not relevant; or listed various barriers, including a lack of training, client discouraging the discussion, or experiencing fear or perceiving RS as a taboo topic. The article concludes with a discussion of the implications for social work education and practice.
This article addresses the development of attitudes toward the other and otherness in light of the classical psychoanalytical approach of Freud. Through this approach, the authors attempt to surmount the criticism that w...This article addresses the development of attitudes toward the other and otherness in light of the classical psychoanalytical approach of Freud. Through this approach, the authors attempt to surmount the criticism that was raised in the literature in connection with the difficulty faced by students and professionals in the field of social work in achieving cultural competence. Based on this approach the authors suggest that cultural competence can develop provided two conditions exist: (1) interpersonal contact between lecturer and student, and (2) using the bond to help the student connect with the inner stranger within himself or herself, or as Freud put it, connecting with the "unconscious parts of the mind." With the help of two examples presented, the authors demonstrate how every meeting with strangeness is first and foremost a meeting with a concrete stranger-in the first case the meeting of Jewish students with an Arab student, and in the second case the meeting of a secular student with an ultra-Orthodox boy. Implications for social work practice and education are discussed.
Seclusion and restraint are commonly used by residential staff to control unsafe behaviors of youths with disabilities and complex trauma histories. This pilot study examined the effect of a nonrestraining cushion as a c...Seclusion and restraint are commonly used by residential staff to control unsafe behaviors of youths with disabilities and complex trauma histories. This pilot study examined the effect of a nonrestraining cushion as a calming device and wellness tool in a setting that prohibits supportive physical contact, to see to what extent the cushion might help these youths to better regulate their emotional distress and unwanted behaviors. Volunteers used the cushion for 15 minutes over 24 sessions. Nine students completed the study and reported reduction in anxiety and agitation, and a soothing feeling with residual effects to their daily routines. This pilot study suggests that the use of a nonrestraining, deep-pressure cushion may simulate a secure holding effect for young people with emotional dysregulation. The cushion is a safe and healing wellness tool that empowers youths and provides programs with an alternative to seclusion and restraint.
Social work has a history of forensic practice, but social work as an integral component of the holistic model of public defense is new and is creating a demand for better definition of roles and services. The intent of...Social work has a history of forensic practice, but social work as an integral component of the holistic model of public defense is new and is creating a demand for better definition of roles and services. The intent of this article is to contribute to and encourage dialogue surrounding social work practice within the holistic public defense model. A brief overview of the indigent criminal defense system and its emerging models of defense practice is provided. Models of practice established by the Knox County Public Defender's Community Law Office are offered. Challenges, implications, and future directions are discussed.
This study suggests Discovery Dating, a healthy relationships curriculum, as one way of preventing teenage pregnancy, domestic violence, and sexual assault. This study seeks to determine what theory of change best aligns...This study suggests Discovery Dating, a healthy relationships curriculum, as one way of preventing teenage pregnancy, domestic violence, and sexual assault. This study seeks to determine what theory of change best aligns with Discovery Dating, by assessing the curriculum's impact on adolescent resilience, self-efficacy, and personal agency, which are suggested as protective factors against teenage pregnancy, domestic violence, and sexual assault. Authors describe the implementation of the Discovery Dating program in a western U.S. tribal middle school during the 2011-2012 school year. The resilience, self-efficacy, and personal agency outcomes of seventh grade students who received the Discovery Dating curriculum were investigated through pre- and posttest analysis and compared with the outcomes of an eighth grade comparison group that did not receive the Discovery Dating curriculum. Findings suggest that Discovery Dating affects Native American middle school students' sense of personal agency.
Some adolescents manage to be resilient, whereas others develop posttraumatic stress disorder (PTSD) symptoms after experiencing trauma, but the mechanisms underlying these differences are unclear. Public secondary schoo...Some adolescents manage to be resilient, whereas others develop posttraumatic stress disorder (PTSD) symptoms after experiencing trauma, but the mechanisms underlying these differences are unclear. Public secondary school students (N = 98) referred for counseling completed questionnaires assessing exposure to stressful events, family communication, and PTSD. Seventy percent of the sample reported PTSD symptoms in the clinical range. Open family communication was negatively associated with female gender, problem family communication (PFC), and PTSD symptom severity. PFC was positively associated with female gender, number of stressful events, and PTSD symptom severity. Family storytelling style had a negative association with age, PFC, and avoidance symptoms. In the full regression model only the number of life events and PFC appeared to have an independent effect on PTSD symptom severity. Results indicate that exposure to stressful life events and poor family communication are associated with increased risk for PTSD symptoms. Findings may be useful in family-focused approaches to treating adolescents with trauma histories and highlighting the importance of PTSD screening in school-based counseling.
Sexuality is not an invisible dimension within social work. Social workers are constantly engaged with aspects of sexuality across virtually all practice domains. Indeed, some of the most fundamental and frequent concern...Sexuality is not an invisible dimension within social work. Social workers are constantly engaged with aspects of sexuality across virtually all practice domains. Indeed, some of the most fundamental and frequent concerns of social workers involve sexual abuse, sexual violence, and HIV and other sexually transmitted infections. However, conversations about healthy sexuality, positive sexuality, or sexual well-being that are well ensconced in many disciplines are all but absent from current social work literature, education, and practice. In this academic silence, social work is missing a significant opportunity to contribute to the larger conversation around healthy sexuality in a way that illuminates a more holistic perspective and that acknowledges desire and sexual satisfaction across the spectrum, including among marginalized and oppressed groups. In this article, authors make the case for shifting away from a pervasive focus on sexuality as solely risk based to one of balance, incorporating the normative nature and importance of sexuality, intimacy, pleasure, and desire within social work curricula, practice, and dialogue in general. They encourage social workers to recognize sexuality as a critical site of intersectionality and argue for the integration of a multidimensional approach to sexuality within social work education, practice, and research.
Reproductive rights are at risk in many parts of the United States. To inspire social workers to act, this article begins by defining and describing the concepts of reproductive rights and reproductive justice. Next, it...Reproductive rights are at risk in many parts of the United States. To inspire social workers to act, this article begins by defining and describing the concepts of reproductive rights and reproductive justice. Next, it summarizes threats to reproductive rights in five areas: preventing pregnancy, terminating pregnancy, pregnancy loss, personhood measures, and drug use during pregnancy. Applying John Kingdon's policy streams framework, the article urges more social workers to embrace the current policy window and advocate for pregnant women and others whose reproductive rights are in jeopardy. The article also provides suggestions for ways that social work practitioners, educators, and researchers can act to promote reproductive justice for all.
Women who experience intimate partner violence (IPV) are often portrayed as helpless victims. Yet many women who experience IPV implement strategies to help them survive the abuse. This qualitative study sought to explor...Women who experience intimate partner violence (IPV) are often portrayed as helpless victims. Yet many women who experience IPV implement strategies to help them survive the abuse. This qualitative study sought to explore the survivor strategies used by low-income black women who experience IPV. Authors used a semistructured interview guide to survey 26 survivors who reported being in an IPV relationship in the past two years. Thematic analysis revealed three types of survivor strategies used by low-income black women: (1) internal (use of religion and becoming self-reliant), (2) interpersonal (leave the abuser or fight back), and (3) external (reliance on informal, formal, or both kinds of sources of support). This article informs social work practitioners of the strategies used by low-income black women in surviving IPV so that practitioners can develop interventions that support these strategies.
The school-to-prison pipeline (STPP) refers to a path from the education system to the juvenile or adult criminal justice system. Over the past two decades, this path has grown significantly, and scholars attribute a myr...The school-to-prison pipeline (STPP) refers to a path from the education system to the juvenile or adult criminal justice system. Over the past two decades, this path has grown significantly, and scholars attribute a myriad of contributing factors to this increase. Each factor has its own impact and consequences, which are covered in detail based on an extensive literature review and macro practice through Race Matters for Juvenile Justice. Prior to the STPP concept, education had largely been considered a protective factor for children and a route to success as opposed to a risk factor or track toward juvenile justice involvement. Staying in school and getting good grades were regarded as strategies that even at-risk students could use to overcome poverty, prejudice, and powerlessness. But since the 1990s, the approach to discipline in U.S. public schools has changed, and the effects of this change are only now becoming evident. This article explains the correlates of the STPP and its disparate outcomes, most notably for students of color; those with disabilities; and lesbian, gay, bisexual, transgender, queer, and questioning students. The article concludes with implications for social workers in various settings and specific strategies for reducing the impact of the STPP.
For over a century the social work profession has had a dual purpose, to promote both human well-being and social justice, but we have not found research that explores how social workers understand and work toward both p...For over a century the social work profession has had a dual purpose, to promote both human well-being and social justice, but we have not found research that explores how social workers understand and work toward both purposes across multiple practice roles and settings. Authors of this article conducted qualitative research to examine how 18 social workers in various roles and settings understand and implement both purposes in their practice. Instead of a dual purpose, participants described a unifying purpose: a "just sense of well-being" that transcends role and setting. Valuing the dignity and worth of all human beings frames and fuels their work toward a just sense of well-being through three interactive themes: challenging injustice on every level; constructing justice through relationship and resource organizing; and constructing justice through the creation of accepting environments where professionals, clients, and community members can reflect and question, and change mind-sets and actions. Participants provided an array of possibilities for action with clients, professionals, and public leaders within organizations and communities. The implication here is that social workers are charged to reinvigorate purpose and values back into practice with value-based assessment thinking that frames possibilities for action across methods and settings.
Evidence-based practice (EBP) is a widely recognized concept in contemporary social work practice. However, recent studies have shown that social workers do not understand EBP correctly. Standardized administrative appro...Evidence-based practice (EBP) is a widely recognized concept in contemporary social work practice. However, recent studies have shown that social workers do not understand EBP correctly. Standardized administrative approaches to implementing EBP have led to confusion about its core practice decision-making process. This collaborative process is the heart of EBP in direct social work practice. This article explores the EBP process and addresses a vital but often underemphasized step of EBP: active collaboration with the client in decision making. Active collaboration with the client is shown to be important in that it (a) is consistent with social work's professional values and ethics, (b) is consistent with patient-centered health care in the Patient Protection and Affordable Care Act and contemporary health care approaches, (c) is consistent with culturally competent practice, and (d) has empirical support for its beneficial impact. Correctly and fully understanding EBP in direct practice is important to improving social work practice and improving client outcomes.
Sexually transmitted disease transmission, dating violence, trafficking, and unplanned pregnancy disproportionately afflict disadvantaged African American adolescents, and social services to effectively remedy this crisi...Sexually transmitted disease transmission, dating violence, trafficking, and unplanned pregnancy disproportionately afflict disadvantaged African American adolescents, and social services to effectively remedy this crisis need improvement. Moreover, disadvantaged African American adolescents have been significantly underrepresented in mental health, social services, and best practices research, so existing evidence-based practice models are insufficiently inclusive of these adolescents' perspectives. As a remedy, this study describes a formative evaluation of a youth-led, participatory action-based summer and after-school program, Love Your Love Life. Over eight successive semesters, 155 African American adolescents authored instructional materials including a guide to dating, a documentary, a workbook, a PowerPoint presentation, social media messages, and skits, and then led seminars for their peers. The highly engaged adolescents contributed valuable information about their strengths, challenges, and preferences, and suggested improvements to make sexual and romantic health curricula more relevant for their peers.
Self-help and peer-provided services for mental health and addictions have grown rapidly in recent years. Many individuals who seek professional social work services are also involved in peer-provided recovery activities...Self-help and peer-provided services for mental health and addictions have grown rapidly in recent years. Many individuals who seek professional social work services are also involved in peer-provided recovery activities. Although many social workers have positive relationships with peer-provided organizations in their communities, there is a need for social workers to increase their understanding of the goals and principles of peer-provided services, so that collaborative relationships can be established. This article provides an overview of several kinds of self-help and peer-provided services, detailing the ways in which these services can be helpful and outlining how social workers can work more closely in partnership with peer providers.
Frontline and managerial child welfare practice occurs within the context of a "partnership" among public agencies that have statutory mandate for child protection and related services and private agencies that provide a...Frontline and managerial child welfare practice occurs within the context of a "partnership" among public agencies that have statutory mandate for child protection and related services and private agencies that provide an array of services to children and families through contractual or informal means. Empirical literature has begun to develop around key questions within this interorganizational system, including how public and private child welfare agency relationships and contracting procedures should be structured to promote effective service delivery; how performance measurement and management systems can be developed to promote child safety, permanency, and well-being; and how managers can help promote the delivery of effective and culturally appropriate services. Yet the impact of these organizational and institutional child welfare trends on practitioners has not been clarified. This article synthesizes the literature on these questions to draw implications for practice for the frontline staff, both public and private, driving service delivery.
Bulimia nervosa is an often debilitating eating disorder with a biopsychosocial set of risk factors. Those presenting are at an increased mortality rate and often have physical health complications as well as harmful cog...Bulimia nervosa is an often debilitating eating disorder with a biopsychosocial set of risk factors. Those presenting are at an increased mortality rate and often have physical health complications as well as harmful cognitions related to self-esteem and overall self-concept. This article examines treatment, policy, and social work ethics as they relate to bulimia nervosa. A comprehensive cognitive-behavioral approach including psychoeducation, self-monitoring, exposure therapy, interpersonal therapy, body image therapy, energy balance training, and relapse prevention is recommended as evidence-based practice for treating bulimia nervosa. Authors identify health care policy and analyze it as a common barrier to treatment access. They also review ethical principles of competency and social justice as they relate to social work practitioners working with those diagnosed with bulimia nervosa.
Grandparent-headed families have multifaceted needs and complicated family contexts. These nontraditional families frequently have strained relationships with their grandchildren's school systems, but there are scarce mo...Grandparent-headed families have multifaceted needs and complicated family contexts. These nontraditional families frequently have strained relationships with their grandchildren's school systems, but there are scarce models providing effective strategies for working with them. The author used multidisciplinary theoretical literature and research outcomes to propose a model for working with grandparent-headed families in schools. First, unique needs, risk factors, and school barriers these grandparent-headed families experience are put forward. In addition, school professionals' needs for practice guidelines for their work with grandparent-headed families are described. A model for working with grandparent-headed families is proposed, built on four theories: symbolic interactionism, attachment theory, role theory, and the strengths-based approach. Implications for teaching, practice, and programming for grandparent-headed families in schools are presented.