Claudia J. Dewane
Clinical social work is a derivative profession, drawing its knowledge and practice base from several theoretical schools. The four primary theoretical schools contributing to social-work philosophy are psychodynamic, humanist, cognitive–behavioral, and postmodern. Acceptance and commitment therapy (ACT), although considered one of the third-wave behavioral approaches, draws from all four theoretical schools of clinical intervention. This entry gives an overview of ACT development, its essential features, empirical base, tenets and techniques, and relevance to the social-work profession.
David L. Hussey
This chapter summarizes literature and research related to advances in direct practice work with adolescents. Social workers are on the forefront of developing and utilizing a variety of evidence-based practices to address complex client and community needs.
Patricia Brownell and Joanne Marlatt Otto
Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.
Sharon E. Moore
African Americans number about 35 million or 12% of the U.S. population. Their life expectancy is lower than that of White Americans, and despite the educational gains made since mid-1980s, the unemployment gap between African Americans and Whites has increased. Similarly, although the number of African Americans working in white-collar occupations has increased, the disparity in wage earnings between African American and White workers continues. Regardless of social class African Americans are made to be cognizant of their race at all times. Today they are still at risk for social issues such as substance abuse, teen pregnancy, incarceration, poverty, high rates of female headed households, infant mortality that is twice as high as Whites, residential segregation, racism, and discrimination. As daunting as these problems are, the strengths of the African American community have allowed it to thrive even amid arduous circumstances.
Colita Nichols Fairfax
Afrocentric social work is a concept and praxis approach applicable in environmental and global settings where people of African descent are located. Using concept analysis as a methodology, this article explores Afrocentric social work theory and its applicability in the social sciences. Concept analysis is an examination of a thought or theory with the intent to create a more concise operational definition. Afrocentric social work not only is applicable to racial and social justice issues, it also is applicable to intellectual and philosophical discourses of social work, which has largely ignored Afrocentric social work as a viable theory and philosophical canon. The Walker and Avant method of concept analysis is employed in this article to provide a systemic discourse to define the attributes of Afrocentric social work, as well as its structural elements that scholars and practitioners utilize as a theory and praxis application.
Lenard W. Kaye
Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.
Nancy Morrow-Howell and Leslie Hasche
Despite high levels of functioning among older adults, chronic health conditions lead to impairment and the need for help. Family members provide most of the assistance; yet formal services such as in-home personal and homemaker services, congregate and home-delivered meals, adult day services, employment and educational services, transportation, nursing homes, assisted and supportive living facilities, legal and financial services, and case management are available. Even with the growing number and type of services, unequal access and uneven quality persist. In these settings, social workers develop and administer programs, provide clinical care, offer case management and discharge planning, and contribute to policy development.
Sarah (Hicks) Kastelic
Alaska Natives represent less than 1% of the U.S. population but reside in more than 229 Native villages and account for 40% of federally recognized tribes. Most Alaska Native communities shared common Euro-American contact experiences: exposure to western religions, education, and disease. Historical trauma contributes to many of the social welfare problems Natives experience today: low educational attainment, unemployment, inadequate health care, substance abuse, and violence. Service delivery mechanisms, lack of cultural appropriateness, and isolation compound these pressing issues. Locally delivered social welfare services that take into account traditional Native worldviews, values, languages, and intergenerational relationships are effective in addressing many of these issues.
Maryann Amodeo and Luz Marilis López
This entry focuses on practice interventions for working with families and individuals including behavioral marital therapy, transitional family therapy, and the developmental model of recovery, as well as motivational interviewing, cognitive-behavioral therapy, relapse prevention training, and harm reduction therapy. A commonality in these intervention frameworks is their view of the therapeutic work in stages—from active drinking and drug use, to deciding on change, to movement toward change and recovery. We also identify skills that equip social work practitioners to make a special contribution to alcohol and other drug (AOD) interventions and highlight factors to consider in choosing interventions.
There are a range of practice interventions for clients with AOD problems based on well-controlled research.
Flavio F. Marsiglia, David Becerra, and Jaime M. Booth
Prevention is a proactive science-based process that aims to strengthen existing protective factors and to diminish or eliminate other factors that put individuals, families, and communities at risk for substance abuse. Prevention is important because alcohol and drug abuse are a leading cause of morbidity, mortality, and health expenditures in the United States. Alcohol and other drug abuse is also associated with infectious diseases, chronic diseases, emergency room visits, newborn health problems, family violence, and auto fatalities. The comorbidity of drug and alcohol abuse with mental health disorders and HIV adds urgency to the development, evaluation, and implementation of comprehensive and effective prevention interventions. The social work profession plays a key role in substance abuse prevention, as it not only targets the use and abuse of alcohol and other drugs but also aims at reducing the related negative health and psychosocial outcomes and economic burden they produce on individuals and society at large.
This entry describes the diversity among Asian American populations, setting the context to understand the need for different practice interventions. It explains the role of cultural values in the underpinnings of the selection of theoretical frameworks that guide chosen practice interventions. Indigenous and biculturalizations of interventions (Fong, Boyd, & Browne, 1997) are discussed as they relate to general and specific problems relevant to this population. Challenges and dilemmas are raised as ethical decisions are made among practitioners, who serve the Asian American native born, immigrant, and refugee populations.
Catheleen Jordan and Cynthia Franklin
Assessment is an ongoing process of data collection aimed at identifying client strengths and problems. Early assessment models were based on psychoanalytic theory; however, current assessment is based on brief, evidence-based practice models. Both quantitative and qualitative methods may be used to create an integrative skills approach that links assessment to intervention. Specifically, assessment guides treatment planning, as well as informs intervention selection and monitoring.
Steven P. Segal
Social workers are increasingly working in authoritative settings—that is, settings where they have the power to mandate conformity by the client to the normative and often legal requirements of the organization. Such settings may be residential, such as jails, prisons, and rehabilitation facilities, or community-based organizations that are part of the criminal justice system, the mental health system, the health system, and the child welfare system. The exercise of power derived from the authority vested in the setting’s objectives may and often does alter the total life situation of an individual, such as when a client is compelled to move to supervised care without the client’s consent. Under an outpatient civil commitment order or mental health court supervision, the patient may be told where to live and with whom to associate as well as be required to participate in interactive treatment and to take medication. In authoritative settings, social workers are working with “involuntary” clients—clients who understand, whether or not it is explicitly stated, that the social worker possesses the power to effect unwanted change in their life circumstance. Since the early 1990s, the field has been developing new ideas and skills that are equally useful in working with voluntary and involuntary clients. In the process, social worker authority is now viewed less as a way to gain client compliance and, instead, is understood more as an opportunity to build partnerships with clients that lead to changes that are enduring and more meaningful to clients.
Sandy Magaña and Lauren Bishop-Fitzpatrick
Autism spectrum disorder is a heritable, developmental disability that is characterized by challenges with social communication and the presence of restrictive and/or repetitive patterns of behavior. Autism spectrum disorder affects development and quality of life from very early development through old age. Social workers play a number of different roles in supporting and advocating for individuals on the autism spectrum and their families. It is important that social workers understand the etiology, diagnosis and treatment of autism spectrum disorder, how it manifests throughout the lifespan, and challenges faced by families affected by ASD.
Edward J. Mullen, Jennifer L. Bellamy, and Sarah E. Bledsoe
This entry describes best practices as these are used in social work. The term best practices originated in the organizational management literature in the context of performance measurement and quality improvement where best practices are defined as the preferred technique or approach for achieving a valued outcome. Identification of best practices requires measurement, benchmarking, and identification of processes that result in better outcomes. The identification of best practices requires that organizations put in place quality data collection systems, quality improvement processes, and methods for analyzing and benchmarking pooled provider data. Through this process, organizational learning and organizational performance can be improved.
Larry W. Foster
Bioethics and biomedical ethics are defined. Common bioethical concepts, exemplary moral values, fundamental ethical principles, general ethical theories, and approaches to moral reasoning are reviewed. The scope of topics and issues, the nature of practice situations in bioethics, and social work roles on organizational bodies that monitor and respond to bioethical issues are summarized, as are trends in bioethics. Practice contexts, from beginning to end of life, are highlighted with biopsychosocial facts, ethical questions and issues, and implications for social work—a profession uniquely positioned in giving bioethics a social context.
The historical development of the borderline concept is traced up through the development of the diagnosis of borderline personality disorder (BPD). Treatments for BPD during the 1970s and 1980s are discussed, including the object relations theories of Margaret Mahler and James Masterson, as well as trauma theory described by Judith Herman. Three evidence-based treatments (EBTs) that have emerged from the 1990s to the present time are described, as well as findings from brain imaging techniques and how new EBTs and neuroimaging have changed the view of this disorder.
June Simmons, Sandy Atkins, Janice Lynch Schuster, and Melissa Jones
Transitions in care occur when a patient moves from an institutional setting, such as a hospital or nursing home, to home or community, often with the hope or expectation of improving health status. At the very least, patients, clinicians, and caregivers aim to achieve stability and avoid complications that would precipitate a return to the emergency department (ED) or hospital. For some groups of vulnerable people, especially the very old and frail, such transitions often require specific, targeted coaching and supports that enable them to make the change successfully. Too often, as research indicates, these transitions are poorly executed and trigger a cycle of hospital readmissions and worsening health, even death. In recognizing these perils, organizations have begun to see that by improving the care transition process, they can improve health outcomes and reduce costs while ensuring safety, consistency, and continuity. While some of this improvement relies on medical care, coaching, social services and supports are often also essential. Lack of timely medical follow-up, transportation, inadequate nutrition, medication issues, low health literacy, and poverty present barriers to optimal health outcomes. By addressing social and environmental determinants of health and chronic disease self-management, social workers who make home visits or other proven timely interventions to assess and coach patients and their caregivers are demonstrating real results. This article describes care transitions interventions, research into barriers and opportunities, and specific programs aimed at improvement.
A generic set of case management functions are performed in most practice settings. To improve outcomes within a complex service delivery system, case managers need to collaboratively work with clients and care providers. By incorporating the paradigm of evidence-based practice, case managers can improve decision making through integrating their practice expertise with the best available evidence, and by considering the characteristics, circumstances, values, preferences, and expectations of clients, as well as their involvement in the decision making.
Chaos theory and complexity theory, collectively known as nonlinear dynamics or dynamical systems theory, provide a mathematical framework for thinking about change over time. Chaos theory seeks an understanding of simple systems that may change in a sudden, unexpected, or irregular way. Complexity theory focuses on complex systems involving numerous interacting parts, which often give rise to unexpected order. The framework that encompasses both theories is one of nonlinear interactions between variables that give rise to outcomes that are not easily predictable. This entry provides a nonmathematical introduction, discussion of current research, and references for further reading.