Elizabeth C. Pomeroy and Polly Y. Browning
Eating disorders involve maladaptive eating patterns accompanied by a wide range of physical complications likely to require extensive treatment. In addition, “eating disorders” frequently occur with other mental disorders, such as depression, substance abuse, and anxiety disorders. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery” (NIMH, 2011). As of 2013, lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are 0.9%, 1.5%, and 3.5% among females, and 0.3%, 0.5%, and 2.0% among males respectively (Hudson, Hiripi, Pope, & Kessler, 2007). Early diagnosis is imperative; the National Institute of Mental Health estimates that the mortality rate for anorexia is 0.56% per year, one of the highest mortality rates of any mental illness, including depression (NIMH, 2006). More recent research (Crow et al., 2009) indicates mortality rates as high as 4.0% for anorexia nervosa, 3.9% for bulimia nervosa and 5.2% for eating disorders not otherwise specified. Current research and treatment options are discussed.
Eye movement desensitization and reprocessing (EMDR) is one of the two most empirically supported treatments for adult populations with noncombat, single-episode posttraumatic stress disorder (PTSD), with the other being exposure therapy. This entry describes the unconventional origin, theoretical underpinnings, and treatment protocol of EMDR, including its distinctive use of bilateral stimulation (that is, dual-attention stimulation). Also discussed are possible contraindications, unresolved issues, and the need for more research regarding the effectiveness of EMDR with other populations with PTSD, such as children and individuals with combat PTSD and complex trauma.
Sheila H. Akabas
Employee assistance programs (EAPs), or membership assistance programs when sponsored by unions, are designed to improve worker productivity and motivation by responding to problems that workers experience which interfere with job performance and satisfaction. Now a ubiquitous characteristic of American workplaces, the programs are largely staffed by social workers. This entry discusses their historic development, extent, scope, structure, how they are perceived and utilized by different racial and gender populations, and the dilemmas and challenges facing EAPs as they try to define their role, function, and best practices amid emerging trends in the world of work.
Ruth J. Parsons and Jean East
The concept of empowerment has deep roots in social work practice. Building upon the work of empowerment theorists of the 1980s and 1990s and applied broadly in the 2000s [Itzhaky and York (2000), Social Work Research, 24, 225–234; Travis and Deepak (2011), Journal of Ethnic and Cultural Diversity in Social Work, 20, 203–222], the concept of empowerment has evolved from a philosophical level to practice frameworks and methods. Substantial research confirms empowerment outcomes as personal, interpersonal, and sociopolitical. Practice interventions contain both personal and structural dimensions and are accomplished through multilevel interventions. Based on transformation ideology, empowerment is a counter to perceived and objective powerlessness. Social work relationships provide an opportunity for experiencing power and collaboration. Empowerment interventions are often useful with vulnerable populations, such as women and members of stigmatized groups.
Tonya Edmond and Karen Lawrence
Since its inception in 1987, eye movement desensitization and reprocessing (EMDR) therapy has been the subject of lively debate and controversy, rigorous research both nationally and internationally, and is now used by licensed practitioners across six continents as an effective treatment of trauma symptoms and posttraumatic stress disorder (PTSD). The aim of this entry is to provide social work practitioners and researchers with a description of the treatment approach for adults and children, EMDR’s development and theoretical basis, a review of controversial issues, and an overview of the evidence of effectiveness of EMDR across trauma types and populations.
Sadye L. M. Logan
Families in almost all societies are viewed as the basic unit for coordinating personal reproduction and the redistribution of goals within the larger societal context of production and exchange. They are vulnerable to the rapidly changing economics of the environments in which they live. Universals regarding families worldwide include a delay in marriage, an increase in divorce rates, a decrease in household size and fertility rates, and nontraditional living arrangements. The most studied aspect of families continues to be family diversity, with greater emphasis on an interdisciplinary framework. There is also a movement toward more effective ways of treating families. Placing families in an historical context, this entry discusses evidence-based family interventions, the latest research on families, family diversity, and implications for social work practice and education.
Mikal N. Rasheed and Janice Matthews Rasheed
This entry traces the historical, conceptual, and theoretical development of social work practice with families, beginning with the Charity Organization Society and the Settlement House movement. From the 1920s through the 1950s, social work practice was heavily influenced by psychoanalytic theory. However, emerging theoretical frameworks, including systems and ecological theory from the 1960s and the 1970s, shifted the focus of intervention back to the family. The 1970s saw the development of a proliferation of models for family therapy. The emergence of postmodern, constructivist, narrative and feminist thought has had a more recent influence on social work practice with families. Although these theories and models of family therapy have profoundly influenced direct practice with families, there is a renewed interest in what is described as family-centered social work practice. The theoretical foundation of family-centered practice emphasizes a strengths perspective and an empowerment model of social work practice. This approach represents a broad range of interventions that build linkages between the family and key environmental support systems of diverse, multi-stressed, and at-risk families. During the 2000s, attention has shifted to evidence-based practice (EBP). The focus on EBP has been to provide a source of information for clinicians and families to consider when selecting an appropriate intervention for the presenting problem.
Elizabeth M. Tracy and Trista D. Piccola
The history and development of family preservation as a home-based service in social work practice is traced, current research is reviewed, and future practice trends and challenges are outlined in this entry. Family preservation services are described in terms of a philosophy of practice as well as a specified service model.
Katharine Briar-Lawson and Toni Naccarato
Over the decades, family services have been one of the overarching features of social work practice, education, and research. Efficacy studies help to reinforce the focus on serving individuals in the contexts of their families and to address intergenerational family systems. Families provide the bulk of services to their members but require tailored resources, effective services, and supports. The growing diversity in families compels more cross-cultural competence, responsive policies, and evidence-based practices. Family service practitioners must increasingly address the social exclusion of many families while integrating economic and employment supports with counseling, skill training, and other interventions.
Cynthia Franklin and Laura M. Hopson
Family intervention has become an important tool for social work practitioners. This entry provides a brief history of family intervention and important influences as well as a synopsis of current research. Although these interventions require more research to better understand the populations for whom they are most effective, the evidence supports their usefulness in addressing such issues as aggression, substance use, and depression, among others.
Cheryl A. Hyde
Feminist social work practice is based on principles derived from the political and social analyses of the women's movement. As a practice approach, feminism emphasizes gendered analyses and solutions, democratized structures and processes, diversity and inclusivity, linking personal situations with political solutions, and transformation at all levels of intervention. Feminist practice is in concert with a multisystemic approach; it complements and extends strength-based social work. It requires of the practitioner, regardless of method, to be relational and open to other ways of knowing and understanding.
Reeta Wolfsohn and Dorlee Michaeli
Financial well-being is an individual responsibility in twenty-first century America, even though research reveals a serious inability for many Americans to attain it. Social workers have the education and training to help people modify behavior and a history of working with low-income and minority families, as well as the skills to engage and empower clients, making them the best professionals to help Americans take control of their money and their lives. This article explains how incorporating financial-literacy skills and models of financial behavioral change into the social work curriculum would benefit both social workers and their clients. It describes the financial social work model and an understanding of its relevance to the social work profession.
Michelle Alvarez, Kimberly Zammitt, Laura Strunk, and Kevin Filter
A functional behavioral assessment (FBA) is a set of procedures that are used to assess and identify environmental conditions that predict and maintain behavior FBA is a means to determine the purpose of a person’s behavior and the ways in which the behavior is reinforced in the person’s environment. Underlying the functional assessment of behavior is the assumption that the way one behaves is functionally related to aspects of the environment. This relation is reliable, predictable, and observable, and can thus be assessed by an outside observer. The FBA entails the use of a series of methods to determine the variables that contextualize a behavior of interest. Contextual variables can include any aspect of the individual’s environment and are usually separated temporally between those factors that occur before a behavior and those which occur after. The latter are termed consequences and the former are typically referred to as antecedents. Usually, the behaviors under study, especially in applied settings, are called target behaviors. Temporally, these factors are conceptualized in an ABC framework: antecedent, behavior, and consequence. The behavior of interest is the target of a subsequent intervention; the intervention is informed by the FBA and utilizes the understanding of the behavior’s purpose. Antecedents are altered such that target behaviors are no longer prompted or motivated by environmental conditions, new socially acceptable behaviors are taught that can access the desired reinforcer and replace the target behavior, and reinforcers are altered to decrease access when the target behavior occurs and increase access when the replacement behavior occurs. FBAs are frequently used in schools to address problem behaviors. Problem behaviors occur with students in the school setting for many different reasons. Research has determined that the use of FBAs is useful in identifying environmental factors that predict and maintain problem behaviors. The use of FBAs in the school setting has proven to increase positive student outcomes. This article demonstrates how FBAs can be used effectively in different settings.
James I. Martin
This entry explains who gay men are, how gay identity constructions have evolved since their inception, and how they continue to evolve. It also describes the health and mental health problems that gay men may present to social work practitioners. In addition, it identifies several social policies that are relevant to gay men. The entry argues that a systemic perspective that takes into account the social, political, and cultural influences on gay men is necessary for understanding the problems that such men commonly experience.
Robert L. Miller Jr.
This chapter explores salient concepts of social work practice with gay men. These concepts are described within a life cycle context. The illuminated concepts have been identified based on the biopsychosocial and spiritual developments in the social work literature related to this population since the printing of the 19th edition of the Encyclopedia of Social Work.
Clayton T. Shorkey and Michael Uebel
The entry defines Gestalt therapy, including brief history, major influences, contributors, and current status of Gestalt therapy in terms of memberships and journals. Key concepts are outlined, and the effectiveness and potential for Gestalt therapy's status as an evidence-based practice is framed in relation to recent overviews of empirical research and to what is needed in the future for further research. While the current literature in social work does not reflect a strong emphasis on Gestalt, we emphasize some of the philosophical and ethical compatibilities between these approaches.
Craig Winston LeCroy and Jenny McCullough Cosgrove
Research has shown groups are an efficient and effective modality for interventions with school-aged children. Psychoeducational and psychotherapeutic groups are frequently used to guide children in areas such as skills training, emotional regulation, violence prevention, and grief. There are key developmental questions to consider when working with children that take into consideration factors such as cognitive development and emotional maturity. Overall, groups can be an efficient and effective intervention in the school setting for use by school social workers.
This entry provides an overview of the state of health care in the United States. Service delivery problems such as access and affordability issues are examined, and health care disparities and the populations affected are identified. A discussion of two primary government-sponsored health care programs—Title XVIII (Medicare) and Title XIX (Medicaid), and the Patient Protection and Affordable Health Care Act—are reviewed along with various health care programs and major existing service delivery systems. Ethical conflicts in providing health care, and new directions and challenges are discussed, along with future roles for social workers.
Lois F. Cowles
Social work in health care emerged with immigration and urbanization associated with industrialization, and the resultant shift from physician visits to the patient's home and workplace to hospital-centered care. This change is alleged to have resulted in a loss of the doctor's perspective of the psychosocial influences on physical health. Originally, some nurses were assigned the function of addressing this loss. But eventually, the function became recognized as that of a social worker. From its beginnings in the general hospital setting in the late 1800s, social work in health care, that is, medical social work, has expanded into multiple settings of health care, and the role of the social worker from being a nurse to requiring a Master's Degree in Social Work (MSW) from a university. However, the broad function of social work in health care remains much the same, that is, “to remove the obstacles in the patient's surroundings or in his mental attitude that interfere with successful treatment, thus freeing him to aid in his own recovery” (Cannon, 1923. p 15). Health care social workers are trained to work across the range of “methods,” that is, work with individuals, small groups, and communities (social work “methods” are called “casework”, “group work” and “community organization”). They work to assist the patient, using a broad range of interventions, including, when indicated, speaking on behalf of the client (advocacy), helping clients to assert themselves, to modify undesirable behaviors, to link with needed resources, to face their challenges, to cope with crises, to develop improved understanding of their health-related thought processes and habits, to build needed self confidence to do what is required to help themselves deal with their health problem, to gain insight and support from others who are in a similar situation, to gain strength from humor, or from a supportive environment, and through spiritual experience, and from practicing tasks that are needed to deal with their health-related problems or from joining forces with others in the community to modify it in the interest of improved health status for all, or to gradually restore a sense of stability and normalcy after a traumatic experience. Most important of all, perhaps, is the “helping relationship” between client and social worker, which needs to be one of total understanding and acceptance of the client as a person. A sizable portion of the U.S. population lacks financial access to health care, where health care is regarded as a privilege rather than a right, as it is seen in all other industrial nations (except South Africa). Current trends in the U.S. health care system reflect efforts to control rising health care costs without dealing with the “real problems,” which are: (1) the lack of a single-payer health care system and: (2) the lack of focus on “public health.”
Health social work is a subspecialization of social work concerned with a person's adjustment to changes in one's health and the impact this has on that person's social network. Social workers in every setting must be ready to assist individuals and families adjusting to illness and coping with medical crises. This entry provides a brief overview and history of health social work and describes the settings and roles where this work is practiced. Significant challenges and opportunities in clinical care, research, education, and policy are discussed. Standards and guidelines for quality practice are then noted.