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.
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.
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.
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.
Cognitive therapy is a perspective on social work intervention with individuals, families, and groups that focuses on conscious thought processes as the primary determinants of most emotions and behaviors. It has great appeal to social work practitioners because of its utility in working with many types of clients and problem situations, and its evidence-based support in the literature. Cognitive therapies include sets of strategies focused on education, a restructuring of thought processes, improved coping skills, and increased problem-solving skills for clients.
James W. Drisko
This entry examines the common factors approach in social work and in related professions. The term “common factors” refers to a set of features that are shared across different specific models of psychotherapy and social services, but may not always be conceptualized as being curative influences. The common factors approach broadens the conceptual base of potentially curative variables for practice and research. The history of common factors, the research designs and statistical methods that have led to the approach’s elaboration, the approach’s empirical base, and its fit with social work’s person-in-environment perspective are each explored. The intersection of the common factors approach with the evidence-based practice movement is examined. The role of common factors in the psychotherapy integration movement is also discussed. The implications of the common factors approach for research, policy, and practice in social work are identified.
Margo A. Jackson
Despite the significant life and work experiences that a growing number of older adults have to contribute to the workforce, pervasive ageism operates in overt and covert ways to discriminate against older workers in hiring and workplace practices. This article provides a current overview of definitions, prevalence, types, and effects of ageism in the U.S. workplace. For social workers counseling older adult victims of workplace ageism, this article discusses theories, foundational knowledge, and ongoing self-awareness and training needed for bias awareness. Counseling strategies and resources are highlighted, including coping and resilience strategies to counteract ageist stereotypes and discrimination, facilitate job-seeking support, and advocate for older workers by promoting awareness and serving as a resource for employers to reduce workplace ageism.
Direct social work practice is the application of social work theory and/or methods to the resolution and prevention of psychosocial problems experienced by individuals, families, and groups. In this article, direct practice is discussed in the context of social work values, empowerment, diversity, and multiculturalism, as well as with attention to client strengths, spirituality, and risk and resilience influences. The challenges of practice evaluation are also considered.
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.
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.
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.”
Shaun M. Eack
Mental health research is the study of the causes and correlates of mental health and illness, approaches to improve mental well-being, and the delivery of effective mental health services to those in need. Social workers have been leading researchers in each of these areas of inquiry, and this article provides an overview of the broad field of mental health research, with particular emphasis on the contributions of social work. A biopsychosocial review of research on the correlates of mental health and illness is provided, followed by a synthesis of studies examining pharmacological and psychosocial approaches to improving mental health. Research on mental health services is then presented, with a focus on studies seeking to improve access to quality care and reduce service disparities. Key directions for future mental health research include identifying specific causal predictors of mental illness, improving existing treatments, and disseminating advances to the community.
Jennifer L. Magnabosco
Throughout history, measuring outcomes has been a goal and priority in the human services. This entry chronicles the history of outcomes measurement in the human services in the United States and discusses present-day outcome measurement activities as well as trends and some of the key areas for outcomes measurement in several human service domains.
Social work is distinguishable from other disciplines by its emphasis on producing change that affects clients and their environment. This emphasis has influenced the nature of social work practice research, which calls for attention to the development, design, and implementation of change strategies through the use of the science of intervention research. This paper provides a definition of intervention research, highlights its culturally congruent elements, and addresses its implications for social work evidence-based practice and practice guidelines.
Enola Proctor and J. Curtis McMillen
Assessing and improving the quality of social services is one of the most pressing concerns for social work practice and research. Practice in nearly every setting is affected by stakeholder expectations that agencies monitor and improve quality. This entry addresses the meaning of the phrase “quality of care” with respect to social work services, considers this topic in relation to quality improvement, quality assurance, and evaluation of services, and points to the research that is needed in order to assess and improve quality.
Steven L. McMurtry, Susan J. Rose, and Lisa K. Berger
Accurate measurement is essential for effective social work practice, but doing it well can be difficult. One solution is to use rapid assessment instruments (RAIs), which are brief scales that typically require less than 15 minutes to complete. Some are administered by practitioners, but most are self-administered on paper or electronically. RAIs are available for screening, initial assessment, monitoring of service progress, and outcome evaluation. Some require author permission, others are sold commercially, and many more are free and in the public domain. Selection of an RAI should be based first on its psychometric strength, including content, concurrent, and known-groups validity, as well as on types of reliability such as internal consistency, but practical criteria such as readability are also important. And when used in practice settings, RAIs should be part of a well-rounded measurement plan that also includes behavioral observations, client logs, unobtrusive measures, and other approaches.
This entry reviews the uses of scales and instruments in social work practice, including scales and instruments for diagnosis and evidencing treatment necessity, as methods for monitoring client progress, and as outcomes measures of clinical significance. A resource list for locating scales and instruments is provided.
Joel Fischer and John G. Orme
Single-system designs (SSDs) are a family of user-friendly empirical procedures that can be used to help professionals to monitor and evaluate the effectiveness of the services they provide to clients and to guide practice. SSDs can be used to evaluate interventions based on any theory or approach. Repeated measurement of the target(s) of intervention is an intrinsic and key element of SSDs. Dozens of SSDs exist, and each has its own strengths and limitations. The most basic and most widely used design is the A-B design. Data from SSDs are analyzed visually, using simple, descriptive or inferential statistics, or using criteria for practical or clinical significance.
Tomi Gomory and Daniel Dunleavy
Social work is perhaps most distinctive for its clear and outspoken commitment toward improving the well-being of society’s vulnerable and disadvantaged groups, while still emphasizing the importance of respecting and defending personal rights and freedoms. Though there is a fundamental necessity for coercion, or its threat, for eliciting civil social behavior in a well-functioning society, it is professionally and ethically imperative that social workers make explicit our rationales for, justifications of, and the evidence used to support or reject coercive practices in our work. Social work’s engagement with coercion inevitably entails the ethical and social policy arguments for and against its use, as shown in a review of the empirical evidence regarding its impact on the professions’ clients, exemplified by three domains: (1) child welfare, (2) mental health, and (3) addictions. Recommendations for future improvements involve balancing the potential for harm against the benefits of coercive actions.
Supervision of students and practitioners has been important to social work since its earliest evolution as a recognized profession. Central to the process is the idea of one professional with more knowledge, skill, and experience guiding the practice and development of another with less. The four content areas of supervision usually include direct practice, professional impact, job management, and continued learning. There are a number of supervision models, and most emphasize a positive supervisor–supervisee working relationship, a parallel process, and the importance of cultural competency. The emergence of Evidence-Based Practices and Trauma-Informed Practices has also influenced supervision. The contemporary context of social work supervision offers both opportunities and challenges to clinical supervision.