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.
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Acceptance and Commitment Therapy
Claudia J. Dewane
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Addictions: Gambling
Lia Nower and Kyle Caler
Gambling disorder is a significant public health concern. The recent and continued proliferation of land-based and interactive gambling opportunities has increased both accessibility and acceptability of gambling in the United States and abroad, resulting in greater and more varied participation. However, there is currently no designated federal funding for prevention, intervention, treatment, or research, and states are left to adopt varying standards on an ad hoc basis. Social workers receive little or no training in screening or treating problem gamblers, though research suggests that a significant proportion of those with mental health and other addictive disorders also gamble excessively. Raising awareness about the nature and scope of gambling disorder and its devastating implications for families and children is a first-step toward integrating gambling into prevention, assessment and treatment education in social work. This, in turn, will increase the chances of early identification and intervention across settings and insure that social workers can lend a knowledgeable and credible voice to addressing this hidden addiction.
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Addictions: Tobacco
Mansoo Yu and Rachel Fischer
Tobacco use is a major public-health concern in the United States. Intervention and prevention strategies for tobacco use are an urgent public-health priority because tobacco use is the single most preventable cause of death. To help social workers better understand tobacco use problems, this entry presents an overview, including definitions of terms, the scope and impact of tobacco use problems in terms of different segments of the population (that is, age, gender, race or ethnicity, geographic location, and education level or socioeconomic status), etiology of tobacco use (for example, biological or genetic; psychiatric; psychosocial; or environmental or sociocultural factors), policy history, tobacco prevention, clinical issues (such as cessation desire, treatment and success, or screening tools for tobacco use disorder and tobacco withdrawal), and practice interventions for tobacco use problems. Based on the information, the roles of social workers will be addressed.
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Adolescent Brain Development
Jessica M. Black
Although it was once widely held that development through toddlerhood was the only significant time of tremendous brain growth, findings from neuroscience have identified adolescence as a second significant period of brain-based changes. Profound modification of brain structure, function, and connectivity, paired with heightened sensitivity to environment, places adolescence both as a heightened period of risk and importantly as a time of tremendous opportunity. These findings are of key relevance for social-work policy and practice, for they speak to the ways in which the adolescent brain both is vulnerable to adverse conditions and remains responsive to positive environmental input such as interventions that support recovery and resilience.
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Adult Day Care
Namkee G. Choi
Adult day care centers provide important health, social, and support services for functionally and cognitively impaired adults and their caregivers. The adult day care services are underutilized, however, because of the shortage of centers, caregivers' lack of awareness of and resistance to using services, and the mismatch between the needs of potential consumers and their informal caregivers and the services provided by the centers. To foster and support the expansion of adult day care centers, lessons learned from national demonstration programs need to be disseminated, and social workers need to be trained to provide essential services at the centers.
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Adult Protective Services
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.
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Adults: Group Care
Robin Bonifas
This article presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings and describes their scope of services, funding, and clientele. The section “Issues in Residential Long-Term Care” addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. The article ends with a section on the role of the social worker in residential long-term care.
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Aging: Services
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.
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Alcohol and Drug Prevention Among Youth and Young Adults
Peter J. Delany, Jane Sanville, and Joseph J. Shields
Substance use and comorbid mental health disorders are widespread in the United States. Recent data suggests that previous declines in substance use among adolescents ages 12–17 years and young adults ages 18–25 observed between 2002 and 2014 may be abating. In fact, research suggests that alcohol, tobacco, and marijuana use may be increasing in response to the social distancing and isolation related to COVID-19 restrictions. Drug use contributes to overdoses, poor health status, loss of income, family violence, accidents, auto fatalities, removal of children from a home, and impaired mental, emotional, and behavioral development in children. Substance misuse, substance use disorders, and related comorbid mental health and social problems are not inevitable. Substance use prevention services focus on strengthening protective factors and reducing risk factors that put individuals, families, and communities at risk for substance abuse and related health and social consequences. The social work profession performs an important role in advancing and implementing substance abuse prevention, not only in preventing the use and misuse of alcohol and other drugs and related negative health, mental health and economic outcomes, but also in working to improve the overall health of communities through intervention programs and policies.
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Alcohol and Drug Problems: Practice Interventions
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.
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Alzheimer’s Disease and Other Dementias
Carole B. Cox
Dementia is not a disease, but a group of symptoms so severe that they inhibit normal functioning. Alzheimer’s disease is the most common type of dementia in older persons, impacting not only the person with the illness but also the entire family. Obtaining an accurate diagnosis is essential to assure appropriate and timely care and to exclude reversible causes of dementia. Social workers can play key roles throughout the course of the illness as educators, therapists, supporters, and advocates for improved policies and services.
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Assessment
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.
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Autism and Suicide
Oren Shtayermman
This article reviews the changes in the autism spectrum disorder (ASD) diagnosis in the Diagnostic Statistical Manual (DSM)-5. It reviews the risk factors associated with suicide in the general population and the link between these risk factors and individuals on the autism spectrum. When discussing autism and suicide (as a spectrum), the complexities that the two present influence parents, researchers, and practitioners. As an added dimension of convolution, there are only a small number of published studies in the area of autism and suicide, and many have marked the importance of awareness and connection between autism and suicide. The article presents the most recent and available research on ASDs and suicide. Methodological challenges related to these studies will be discussed as well as the implications for research, practice, and education.
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Autism Spectrum Disorder
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.
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Behavioral Theory
Beth Angell
Behavioral theory seeks to explain human behavior by analyzing the antecedents and consequences present in the individual's environment and the learned associations he or she has acquired through previous experience. This entry describes the various traditions within the behavioral perspective (classical conditioning, operant conditioning, cognitively mediated behavioral theory, and functional contextualism) and the clinical applications that are derived from them. Common criticisms are discussed in light of the ongoing evolution of behavioral theory and the fit of its tenets with the field of social work.
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Bereavement Practice
Mary Sormanti
Bereavement, which is the circumstance of having experienced the death of a significant other, is associated with significant emotional, cognitive, spiritual, physical, and social disruption. Given its ubiquitous nature, nearly everyone is affected by bereavement at some point, and opportunities for social work intervention with the bereaved are many and varied. This entry provides a brief summary of our extant knowledge about bereavement including its theoretical underpinnings, psychosocial sequelae, and empirical evidence of related interventions.
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Best Practices for Supporting Transgender Youth in Schools
Patrick Mulkern, August Wei, and Maggi Price
Transgender youth are those whose genders do not align with their sex assigned at birth. Transgender youth are increasingly visible and frequently encounter discrimination and a lack of understanding from others, especially at school. As a result, they experience profound mental health challenges, with one in five transgender youth attempting suicide. However, such youth who are adequately supported do not experience serious mental health difficulties. Accordingly, promoting school support for transgender youth is critical. While school staff know how to help youth generally, many want more guidance on how to help transgender youth. However, few resources provide clear and actionable best practices for school staff to help transgender youth.
Best practices for supporting transgender youth in schools include verbal, behavioral, and visual skills that all school staff can use. Research shows that when these practices are used, transgender youth experience fewer mental health challenges, feel more connected to their school community, and do better academically.
There are at least 20 best practices for supporting transgender youth in schools supported by empirical and practice-based literature; they span four categories: (a) language to use and avoid, (b) coming out at school, (c) creating a supportive school environment, and (d) preventing and intervening in bullying. Examples include sharing pronouns, advocating for, and sharing the location of gender-inclusive facilities, and intervening in gender-based bullying. School staff—including school social workers—can and should use this set of easy-to-implement, research-informed best practices to improve transgender youths’ mental health.
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Bioethics
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.
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Borderline Personality Disorder
Gloria Hegge
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.
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Bullying in Youth
Jonathan Singer and Karen Slovak
Bullying is the most common form of violence in schools and has been shown to disrupt the emotional and social development of both the targets and the perpetrators of bullying (Raskauskas & Stoltz, 2007). Bullying can be physical, verbal, relational, and direct or indirect. There are well-established age and sex trends (Olweus, 1993; Smith, Madsen, & Moody, 1999). There has been considerable research on bullying-prevention programs and scholarship on best-practice guidelines for school social workers (Dupper, 2013). An emerging concern is with the use of electronic and Internet devices in bullying, referred to as “cyberbullying.” In this article we define bullying and cyberbullying; discuss risk factors associated with being a bully, a victim, and a bully-victim; describe prevention and intervention programs; and discuss emerging trends in both bullying and cyberbullying.
