The Republic of Moldova is a small post-Soviet country that has been “transitioning” from a socialist to capitalist economy since the 1990s. Once a prosperous region of the Soviet Union, it is now among the poorest countries in Europe, facing many social problems that call for a strong social work profession. However, social work is new to the country and the profession is challenged by low societal status, meager resources, and lack of cohesion. Social work in Moldova is struggling to meet these challenges with the help from the West and the emergence of an indigenous model of professionalization. Child welfare, elder care, mental health, as well as the history of social work in Moldova, current state of social work education with its obstacles to and opportunities for progress will be discussed.
Vadim Moldovan, Eugeniu Rotari, Vadim Tarna, and Alina Zagorodniuc
Hee Yun Lee, William Hasenbein, and Priscilla Gibson
As the older adult population continues to grow at a rapid rate, with an estimated 2.1 billion older adults in 2050, social welfare researchers are determined to fill the shortage of gerontological social workers and structural lag to best serve the baby boomers who are expected to need different services than previous generations. Mental illness impacts over 20% of older adults in the world and the United States. The major mental health issues in older adults include depression, anxiety, loneliness, and social isolation. Depression is considered one of the most common mental health issues among this population; however, the prevalence could be underestimated due to older adults linking relevant symptoms to other causes, such as old age, instead of as possible depression. Like depression, anxiety symptoms are often mistaken as results of aging. It is also difficult for providers to diagnose anxiety in this population due to anxiety frequently being coupled with other illnesses and the psychological stress that comes with old age. Because the presence of loneliness or social isolation can manifest depression and anxiety symptoms in older adults, it is also difficult to separate these two issues. With the anticipated increase of the older adult population within the next few years, measurement tools have been created to assess depression and anxiety specifically for older adults. In addition to adapting assessment tools, interventions tailored to older adults are essential to ensure treatment coherence, even though medications are the go-to treatment option.
Tara M. Powell, Shannondora Billiot, and Leia Y. Saltzman
Natural and man-made disasters have become much more frequent since the start of the 21st century. Disasters have numerous deleterious impacts. They disrupt individuals, families, and communities, causing displacement, food insecurity, injury, loss of livelihoods, conflict, and epidemics. The physical and mental health impact of a disaster can have extensive short- and long-term consequences. Immediately after a traumatic event, individuals may experience an array of reactions such as anxiety, depression, acute stress symptoms, shock, dissociation, allergies, injuries, or breathing problems. Given the economic and human impact of disasters, social workers are often quick to respond. Historically, the social work profession has provided services on the individual level, but initiatives have expanded to address community preparedness, response, and recovery. This article will explore the complexities of disaster response and recovery. Health and mental health impacts will be examined. Resilience and posttraumatic growth will then be discussed, exploring how individuals overcome adversity and trauma. Individual and community level preparedness mitigation, response, and recovery will explore how the field of social work has evolved as disasters have increased. Followed by an exploration of how social work has evolved to develop individual and community level preparedness, mitigation, response, and recovery activities as disasters have increased. Finally, the article will examine special populations, including those with disabilities, children, indigenous people, older adults, and social service workers in all phases of disasters. As disasters grow more frequent it is vital for social work professionals to improve their efforts. We will conclude the chapter by examining the coordinated efforts the social work profession is involved in to help communities recover and even thrive after a traumatic event.
Cecilia Ayón, Tanya Nieri, and Maria Gurrola
Latinx immigrants represent a large segment of the immigrant population in the United States. While immigrants tend to be healthier than native-born people, they experience a number of health disparities. Latinx immigrants experience many barriers to accessing health care, including immigration policy barriers related to undocumented or recent permanent resident status, lack of culturally and linguistically responsive services, challenges during the access verification process, discrimination by providers, and external resource constraints (e.g., cost). Many are uninsured or underinsured and experience limited access to care. Existing models to understand health are examined. A social determinants of health framework is used to understand immigrants’ health outcomes. Within this framework immigration is a social determinant of health. Substantial empirical evidence illustrates how the immigration policy context impacts on immigrants’ health through exposure to enforcement activity, threat of detainment and deportation, and actual deportation. Enforcement activity is racialized to effect all Latinxs regardless of status. Other domains including economic insecurity, education, and community and social support are other sources that may disadvantage immigrants and impact on their health. The search for economic opportunity is a primary motivation for Latinxs to migrate to the United States, yet many face economic challenges and live in poverty. Education has significant impact on immigrants across the development spectrum as they experience disparities in access. Social ties are critical to the wellbeing of Latinx, evidence suggests disparities in access to support by status. Immigrants contend with a number of challenges as they integrate into society. Social determinants of health, through multiple domains, affect immigrants’ health.
Clare S. Gaskins, Melissa A. Bitalvo, and Michele R. Cohen
There is growing evidence that obsessive-compulsive disorder (OCD) is much more common in children and adolescents than originally believed. While some youth with mild to moderate OCD may be able to navigate their school day with minimal interference, for others the disorder can cause significant impairment in the ability to concentrate on school work, complete homework, and make and maintain peer relationships. School social workers and staff can play a pivotal role in shaping learning environments that support students with OCD. This article provides an overview of clinical characteristics of OCD, its assessment and treatment, how children with the disorder may present in the school setting, and ways in which school staff can assist students with OCD.
Traumatic events have permeated our lives throughout history and across the globe, inflicting profound losses on individuals, families, and communities during warfare, armed conflict, natural disasters, and relational violence. Although many survivors of these events harness their resilience and cope without long-term negative mental health effects, others experience a range of physical and mental health conditions, including trauma- and stress-related disorders. With an emphasis placed on adult trauma survivors, the conditions of posttraumatic stress disorder, acute stress disorder, adjustment disorders, complex trauma, and other stress-related conditions have been explored within a social context. Starting with a historical context, the following topics were addressed. The typologies of trauma were introduced including the definitions of Type I trauma—a single discrete event including natural catastrophes; Type II trauma—chronic and repetitive traumatic physical, sexual, and/or emotional abuse; and Type IIII—severe and multiple abusive events with multiple perpetrators. Historical and intergenerational trauma reflect a collective of complex traumatic events throughout generations that resonate in subsequent generations in terms of ungrieved losses and survivor guilt, among other psychosocial issues. Cultural and racial trauma include chronic verbal and/or physical assaults that involve racialized bigotry. Combat trauma involves a combination of deployment stressors that have affected servicemembers in distinct ways with “signature injuries” associated with different wartime conflicts. The next section addresses the current typology of the Diagnostic and Statistical Manual of Mental Disorders—V, noting the changes in diagnostic criteria, in particular related to the diagnosis of posttraumatic stress disorder (PTSD). Mental health responses to trauma vary a great deal based on a balance of risk and protective factors, often revealing noteworthy resilience and the absence of negative aftereffects. The neurobiological effects of trauma are addressed along with mental health conditions or disorders (e.g., acute stress response, PTSD, complex trauma, and anxiety disorders). Specific phase-oriented and multimodality treatment interventions are reviewed that focus specifically on the mental health conditions presented. These approaches are research-informed, culturally responsive, and theoretically grounded Finally, the responses experienced by clinicians who work with traumatized clients are outlined along with recommendations for ways to minimize the effects of secondary, or vicarious, traumatization. Clinical vignettes based on case composites have been utilized to illustrate central points.
M. Aryana Bryan, Valerie Hruschak, Cory Dennis, Daniel Rosen, and Gerald Cochran
Opioid-related deaths by overdoses quadrupled in the United States from the years 1999 to 2015. This rise in mortality predominately occurred in the wake of historic changes in pain management practices and aggressive marketing of opioid medications such as oxycontin. Prescription opioid misuse and subsequent addiction spilled over to heroin and fentanyl for many. This drug epidemic differed from others in its impact among non-Hispanic whites, leading to drastic changes in how the United States views addiction and chooses to respond. This article offers an overview of opioid use disorder (OUD), its treatment and its relationship with pain. It also discusses special populations affected and provides insight into future directions for research and social work practice surrounding opioid management in the United States. Because of the profession’s emphasis on the person and social environment as well as its focus on vulnerable and oppressed populations, social work plays a critical role in addressing the crisis.
Selena T. Rodgers
Domestic violence is a public health problem shown to inflict severe mental and physical injury on millions of individuals and has considerable social costs. Absent from the literature is an examination of womanism ideologies, which provide a greater understanding of the full praxis that black women who experience domestic violence engage. Drawing from initial conceptualizations of womanism and later contributions of Africana womanism, this article brings into focus pervasive acts of violence perpetrated against black women, their racial loyalty to protect black men, and the limitations of existing domestic violence models and interventions. This entry addresses how these three interconnected areas are treated within the conceptual framework of womanism. An overview of violence against black women reveals the historical and contemporary forms of knowledge and praxis that have sought to overcome the social problem of intimate partner abuse, including the social construction of controlling images and the Power and Control Wheel (The Duluth Model). This entry also examines the prevalence of violence perpetrated against black women and compounding factors. In addition, this author considers the Violence Against Women Act and its consequences on laws and policies that affect the race, gender, and class experiences of black women coping with domestic violence. Also analyzed is the quintessential role of demographics, the culture of domestic violence, and international debates about womanism, including how black women intellectuals are prioritizing race-empowerment perspectives and a reference point to articulate healthy black relationships are prioritized. The article also reviews social work practice with black women victims/survivors of domestic violence and their families.
Sandy Magaña and Lauren Bishop
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.
The attachment phenomenon is increasingly the focus of many social work interventions. Biologically described, differentiated types of attachment relationships result from qualities of repetitive interpersonal brain-to-brain encounters with caregivers that affect variations in emotional/affective arousal regulation; this research takes place within the field of interpersonal neurobiology. The particular focus of this entry is implicit and explicit manifestations of certain structures and functions of the brain and nervous system critical to the bio-regulation of emotions. In-born emotional circuitry is sculpted by postnatal caregiving, resulting in a pattern of emotion regulation that leads to certain attachment types. Although there is no attachment circuit per se, emotional circuits in the low brain can work together with other parts of the brain to create various types of attachment. Neurobiological influences act on the development of attachment styles during childhood that may persist into adulthood are briefly reviewed. Attachment research and often subtle biological arousal considerations are also mentioned. Over the years since John Bowlby first began to contribute his work on attachment, research has highlighted, more and more, the various biological aspects. These include the profound biological significance of the circular relationship between separation, responses to separation, and resulting attachment templates. The roles in the attaching process of neuroception, mirror neurons, transfer of affect, and long-term potentiation are described. Selected treatment theories, primarily from the social work literature, are examined for their implicit focus on aspects of the neurobiology of attachment relationships.