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Article

Child and Adolescent Mental-Health Disorders  

Susan Frauenholtz and Amy Mendenhall

Mental-health disorders are widely prevalent in children and adolescents, and social workers are the primary service providers for children and families experiencing these disorders. This entry provides an overview of some of the most commonly seen disorders in children and adolescents: attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, separation anxiety disorder, and specific learning disorders. The prevalence, course, diagnostic criteria, assessment guidelines, and treatment interventions are reviewed for each disorder. In addition, the key role of social workers in the identification and intervention of these disorders, as well as ways social workers can support the children and families experiencing these disorders, is discussed.

Article

Children: Health Care  

Barbara L. Jones and Casey Walsh

Despite rapid medical advances, children in this country still face significant barriers to adequate health care, including unequal access to insurance and health care. There is great need and opportunity in our nation at this time to advocate for the advancement and prioritization of pediatric health care. Children remain vulnerable to the challenges of poverty, violence, firearms, mental health, and health care access. Social workers play an important role in assisting children and families who face health care crises by providing supportive services, advocacy, culturally grounded assessment, trauma informed care, and evidence-based interventions to improve healthcare outcomes and quality of life. The Patient Protection and Affordable Care Act (ACA), signed into law in 2010, has increased access to pediatric health and behavioral health services. While the future of this law is uncertain at the time of this writing, social work is and will continue to be an important discipline to assist children and families in the areas of health promotion and adaptation to illness and injury.

Article

Children’s Health  

Shirley Gatenio Gabel

The history of social work is deeply rooted in helping vulnerable populations improve their well-being, and children have been at the forefront of these efforts since the inception of the profession. Health is long understood to be critical to children’s well-being. Social workers who are skilled in integrating different systems can play pivotal roles in engineering new and improving existing health-care infrastructures and can act as advocates for fusing health-service systems with other social infrastructures to optimize outcomes for children. This entry reviews trends in children’s health throughout the world, particularly in the United States. It describes the dramatic improvements in reducing infant mortality, child mortality and morbidity from many infectious diseases as well as accidental and environmental causes, and the unequal progress in realizing children’s health. The challenges that lie ahead that pose risks to children’s health are discussed, including the health inequities created among and within countries by social, economic, and political factors. An argument for a comprehensive, integrated, evidence-based, and cross-disciplinary approach to improve children’s future health is presented.

Article

Chronic Illness  

Patricia A. Fennell and Sara Rieder Bennett

There is a paradigm shift occurring in medicine, from models focused on treating acute illnesses to those concerned with managing chronic conditions. This shift coincides with the higher prevalence of chronic illnesses resulting from factors such as lower mortality from formerly fatal illnesses and an aging population. The chronically ill do not fare well in an acute care model, and as a result, it has become imperative to develop new models effective for these chronic conditions. These new care models will require comprehensive, coordinated case management, an activity in which social workers can play a significant role.

Article

Client Violence  

Christina E. Newhill

Client violence and workplace safety are relevant issues for all social workers across practice settings. This entry addresses why and how social workers may be targets for a client's violent behavior, and what we know about who is at risk of encountering violence. Understanding violence from a biopsychosocial perspective, identifying risk markers associated with violent behavior, and an introduction to guidelines for conducting a risk assessment will be discussed. The entry concludes by identifying and describing some general strategies for the prevention of client violence.

Article

Clinical Social Work  

Darlene Grant

The soldiers from the wars in Iraq and Afghanistan, as well as large numbers of nonwounded soldiers, experience post-traumatic stress disorder. Further, the families, groups, and communities from which all U.S. service men and women come, during and after these and other wars, have experienced their own war-related trauma. Stories on the nightly news reveal soldier reaction to combat stress, including intrusive memories, racing thoughts, nightmares, troubled sleep, irritability, anxiety, fear, isolation, depression anger, poor concentration, hyper- or hypovigilance, exaggerated responses, and increased alcohol and other drug abuse. The stories of family, friends, and community are filled with war stress symptoms of their own. Charged with keeping their families together, bills paid, jobs afloat, children safe and growing, families may experience a drop in income, loneliness and isolation, long deployments, multiple last minute combat redeployment and duty extensions, anger, frustration, depression, increased alcohol and other drug abuse, loss of trust, fear, increase in domestic violence, and school disruption. Not all of the change for family is negative as some spouses and children who are left behind find they have new skills and new independence with which to negotiate their world. The returning soldier's response to this newfound independence and skill may require the services of the clinical social worker.

Article

Cognitive Behavioral Therapy  

Addie Weaver, Joseph Himle, Gail Steketee, and Jordana Muroff

This entry offers an overview of cognitive behavioral therapy (CBT). Cognitive behavioral therapy is introduced and its development as a psychosocial therapeutic approach is described. This entry outlines the central techniques and intervention strategies utilized in CBT and presents common disorder-specific applications of the treatment. The empirical evidence supporting CBT is summarized and reviewed. Finally, the impact of CBT on clinical social work practice and education is discussed, with attention to the treatment’s alignment with the profession’s values and mission.

Article

Cognitive Therapy  

Joseph Walsh

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.

Article

Collaborative Care  

Ellen Fink-Samnick

The past two decades have witnessed a surge in the growth of initiatives and funding to weave physical and behavioral health care, particularly with identification of the high costs incurred by their comorbidity. In response, a robust body of evidence now demonstrates the effectiveness of what is referred to as collaborative care. A wide range of models transverse the developmental lifespan, diagnostic categories, plus practice settings (e.g., primary care, specialty medical care, community-based health centers, clinics, and schools). This article will discuss the foundational elements of collaborative care, including the broad sweep of associated definitions and related concepts. Contemporary models will be reviewed along with identified contextual topics for practice. Special focus will be placed on the diverse implications collaborative care poses for the health and behavioral health workforce, especially social workers.

Article

Community Healing and Reconciliation  

Joshua Kirven and George Jacinto

Community healing and reconciliation have been a focus of many nations in response to civil war, genocide, and other conflicts. There also has been an increase in the number of high-profile murders of young African Americans at the hands of law enforcement in the United States. In 2020 this problem was even more real and growing with the killings of George Floyd, Breonna Taylor, Rayshard Brooks, and Ahmaud Arbery. These tragic incidents have led to public outcry, civil unrest, and police protests for social change moving from a threshold of peaceful assemblies to violent confrontations across the United States causing the world to take notice and posit the question, “do Black lives really matter?” To answer this question a critical overview of gun violence, a reflective aftermath of the killings of two African American youths in Sanford, Florida and Cleveland, Ohio, and the community’s voice and reaction and the community’s resiliency towards healing and reconciliation are examined. Community model initiatives are introduced of the two cities affected in bridging police-community relations through acknowledging and addressing historical injustices with police and systematic racism and how they attempted to bring positive change, healing and reconciliation.

Article

Community Violence  

Muhammad M. Haj-Yahia, Neil B. Guterman, and Maria João Lobo Antunes

Community violence is a widespread concern that is receiving increasing attention by social workers. We consider here the problem of community violence and the present understanding of its rates, risk factors, protective factors, consequences, and some orientations for prevention and intervention. Growing evidence identifies a multifaceted and multisystemic ecological perspective of risk and protective factors linked with community violence exposure and its effects. Current research points to potentially helpful ameliorative and preventive strategies for social workers to consider at the micro and macro levels; however, the main focus of this article is on the macro-level factors and processes.

Article

Comorbidity  

Diana M. DiNitto

This entry defines comorbidity and similar terms used in various fields of practice. It addresses the prevalence of comorbidity, suggests explanations for comorbidity, and discusses integrated treatment for comorbid conditions and the importance of the concept of comorbidity in social work practice.

Article

Confidentiality and Privileged Communication  

Carolyn I. Polowy, Sherri Morgan, W. Dwight Bailey, and Carol Gorenberg

Confidentiality of client communications is one of the ethical foundations of the social work profession and has become a legal obligation in most states. Many problems arise in the application of the principles of confidentiality and privilege to the professional services provided by social workers. This entry discusses the concepts of client confidentiality and privileged communications and outlines some of the applicable exceptions. While the general concept of confidentiality applies in many interactions between social workers and clients, the application of confidentiality and privilege laws are particularly key to the practice of clinical social workers in various practice settings.

Article

Counseling Older Adult Victims of Ageism in the Workplace  

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.

Article

Crisis Interventions  

Albert R. Roberts

Crisis intervention has been used to help millions of at-risk and vulnerable social work clients throughout the world. Acute crisis-inducing situations range from the sudden loss of a loved one to a Stage IV cancer diagnosis to a school shooting spree. This entry includes definitions and descriptions of crisis theory and crisis intervention protocols. It traces the historical background on the development of crisis intervention programs. The next two sections discuss social work roles and techniques with persons in crisis, and evidence-based crisis intervention protocols based on the latest meta-analysis.

Article

Cultural Competency in Mental-Health Services  

Jun Sung Hong and Wynne Sandra Korr

Since the 1980s, cultural competency has increasingly been recognized as a salient factor in the helping process, which requires social-work professionals to effectively integrate cultural knowledge and sensitivity with skills. This entry chronicles the history of mental-health services and the development of cultural competency in social-work practice, followed by a discussion of mental-health services utilization and barriers to services among racial/ethnic minorities. Directions for enhancing cultural competency in mental-health services are also highlighted.

Article

Deinstitutionalization  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as transinstitutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, while it has expanded admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase/model programs illustrating what can be done, yet it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. Deinstitutionalization policy has motivated political, economic, legal, and social change in the care and control of six populations—older adults, children, people with mental illness, people with developmental disabilities, people under correctional system supervision, and, more recently, individuals without a home. A truer implementation of deinstitutionalization’s initial aspirations requires reconsideration of these changes.

Article

Deinstitutionalization in Macro Practice  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Article

Diagnostic and Statistical Manual of Mental Disorders  

Janet B. W. Williams and Michael First

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association is referred to as DSM-5 ™ . DSM-5’s early predecessor, DSM-III, differed considerably from the first two editions. Its innovative incorporation of specified diagnostic criteria had a major impact on the field of mental health. In DSM-5, these criteria have been further updated to reflect the important gains in our understanding of mental disorders.

Article

Digital Technology  

Gina Griffin

As technological advances continue to develop, delivering macro human service through social work innovations becomes a new priority for the discipline. Digital technologies offer potential applications using tablets, smartphones, cloud computing, artificial intelligence, and wearable technology to enable whole new possibilities for human services. As a result, policymakers and community organizers alike can access the existing information much faster, and potentially connect with hard-to-reach communities to make meaningful decisions. Incorporating the latest digital trends from business and industry settings to macro social work practice are highlighted. By utilizing digital technology, human service organizations can become more proactive and citizen-centered, potentially transforming personal and economic capacity.