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Article

Impaired Social Workers/Professionals  

Frederic G. Reamer

The possibility of practitioner impairment exists in every profession. Stress related to employment, illness or death of family members, marital or relationship problems, financial problems, midlife crises, personal physical or mental illness, legal problems, substance abuse, and professional education can lead to impairment. This article provides an overview of the nature and extent of impairment in social work, practitioners’ coping strategies, responses to impairment, and rehabilitation options and protocols. Particular attention is paid to the problem of sexual misconduct in social workers’ relationships with clients. The author reviews relevant ethical standards and presents a model assessment and action plan for social workers who encounter an impaired colleague.

Article

Interpersonal Neurobiology and Attachment  

Arlene Montgomery

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.

Article

Interpersonal Psychotherapy  

Sarah E. Bledsoe, Brianna M. Lombardi, Brittney Chesworth, and Samuel Lawrence

This article discusses interpersonal psychotherapy (IPT), a psychotherapeutic intervention developed by Gerald Klerman, Myrna Weissman, and colleagues in the 1970s as an outpatient treatment for major depression in adults. Based on the theories of Harry Stack Sullivan and Adolph Meyer, IPT is a manualized, time-limited intervention that addresses the underlying interpersonal antecedents and correlates of psychiatric illness. The goal of IPT as originally developed is to reduce depressive symptoms and improve interpersonal relationships. IPT has been widely tested in adults and adolescents and is an empirically supported treatment for major depression. IPT has been adapted for a variety of psychiatric illnesses and problems of living including perinatal depression, anxiety, and trauma-related disorders. Current evidence detailed below supports the use of IPT across cultures, illnesses, and populations.

Article

Interventions for Adolescent Depression  

Jacqueline Corcoran

Rates of depression increase during adolescence and may put youth at risk for suicidality, future episodes, and impaired functioning in multiple life domains. Increased vulnerability for depression during this stage may occur because it is when the cognitive capacity for personal reflection, abstract reasoning, and formal operational thought develop; depressive styles for attributing events may hence form, along with hopelessness about the future. However, other biological and social influences may also interact with the increased cognitive vulnerability. Latino ethnicity and female gender appear to exert particular influence. Treatment for adolescent depression includes medication (mainly Prozac and Zoloft), cognitive-behavioral therapy, interpersonal therapy, and family therapy. Medication and psychosocial treatment is also combined, particularly for treatment-resistant depression.

Article

Interventions for Physically and Sexually Abused Children  

Kathleen Coulborn Faller

Social workers play a vital role in helping physically and sexually abused children. In order to play this role, they need knowledge about the nature of the problem: (1) legal definitions of physical and sexual abuse, (2) its incidence and prevalence, and (3) its signs and symptoms. Social workers have three major roles to play: (1) identifying and reporting child abuse to agencies mandated to intervene; (2) investigating and assessing children and families involved in child abuse; and (3) providing evidence-based interventions, both case management and treatment, to physically and sexually abused children.

Article

Interventions for Students with Autism and Asperger’s Syndrome  

Michelle S. Ballan, Molly Burke Freyer, and Lauren Powledge

Evidence-based interventions for students with autism spectrum disorder (ASD) are explored, and trends and changes in the diagnosis of ASD in the United States are examined. Evidence-based interventions in various settings and modalities are discussed, with detailed descriptions of several effective evidence-based interventions including joint attention training, video modeling, story-based interventions, and activity schedules. The integral role of social workers in the lives of children with ASD in multiple settings, particularly the classroom, is emphasized. Social work must be vigilant to keep pace with the ever-changing field of autism, with its frequent improvements in understanding, diagnosis, and treatment.

Article

Latinx Immigrant Health and Mental Health  

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.

Article

Life Span: Older Adulthood/Seniors (From Ages 60 to 75)  

Nancy P. Kropf

Although the terms older adult and senior citizen are commonly defined as individuals 60 years and above, later adulthood contains various life-course phases and developmental periods. The young-old, defined as individuals in the age range of 60–75 years, often experience various health, social, and economic transitions. Both the individual and family systems must negotiate some of the changes that accompany the journey into later life. Therefore, this first decade of older adulthood is one that can simultaneously be enjoyable, exciting, demanding, and stressful for aging persons and their families.

Article

Major Depressive Disorder and Bipolar Mood Disorders  

Karen Kyeunghae Lee

Depression and bipolar mood disorders are mental disorders that are characterized by mood disturbance combined with decreased functioning of the affected individuals. This entry focuses on major depressive disorder and bipolar I and II disorders among adults in the United States. Bipolar disorder has unique clinical features and intervention options, and so it is discussed in a separate section after depression. Diagnosis, prevalence, comorbidity, risk factors, course, assessment, treatment, service utilization, and international perspectives are reviewed for each disorder. The implications for social work are briefly addressed at the end of this entry.

Article

Managed Care  

Vikki L. Vandiver

Since the mid-1980s, managed care has been one approach used to address the economic crisis in the American health-care system. This entry overviews managed care from the perspective of policy, procedure, practice, and system. Specifically, emphasis is given to understanding the emergence and history of managed care, multiple definitions, how it works, and examples of managed care plans, key legislation, existing research, its future, and implications for social-work practitioners.

Article

Medicaid and Medicare  

Victoria M. Rizzo, Sojeong Lee, and Rebekah Kukowski

In 1965, Titles XVIII and XIX of the Social Security Act were passed, creating Medicare and Medicaid and laying the foundation for U.S. healthcare policy. Originally, Medicare was created to meet the specific medical needs of adults aged 65 and older. In 2022, individuals with end-stage renal disease, amyotrophic lateral sclerosis (ALS), and other disabilities may also receive Medicare, regardless of age. Medicaid was established to provide a basic level of medical care to specific categories of people who are poor, including pregnant women, children, and the aged. As of 2010 as part of the Affordable Care Act (ACA), states are provided with the opportunity to expand Medicaid to close the coverage gap for public health insurance. This entry provides explanations of Medicaid and Medicare and associated social healthcare programs in the United States. An overview of significant programming developments and trends, future directions, challenges, and controversies as of 2021 are also provided.

Article

Men: Health and Mental Health Care  

Darrell P. Wheeler

Article

Mental Health: Adolescents  

Craig Winston LeCroy

Health care practitioners frequently ignore mental health problems in teens. Adolescents’ daily functioning may be hampered as they mature and are exposed to more dangerous settings. The common behavioral and mental health issues that teenagers face is critical to understanding how to best offer prevention and intervention services. Teenage mental health treatment often focuses on developing functional abilities and identifying models of care that can lessen dysfunctional symptomatology. The latest approaches to treating and preventing teenage mental health issues are presented. The mental health field has placed increased focus on implementing evidence-based treatments. In addition to treatment models, numerous additional elements must be taken into account while developing or implementing treatment.

Article

Mental Health: Overview  

Catherine G. Greeno

Mental illnesses are very common; more than one-quarter of people will develop a mental illness during their lifetime. Mental illnesses are associated with substantial disability in work, relationships, and physical health, and have been clearly established as one of the leading causes of disability in the developing, as well as the industrialized world. Mental disorders are common in every service sector important to social workers, and affect outcomes in every service sector. Mental disorders are strongly associated with poverty worldwide, and are common and often unrecognized in the general health sector, child welfare, and criminal justice settings, among others. Basic information about mental health is thus important to all social workers. Information about classification systems and major categories of mental illnesses, including depression, anxiety, psychotic disorders, and substance abuse disorders, is presented. The service system for mental disorders is badly underdeveloped, and most people who need treatment do not receive it. There is an increasing body of evidence demonstrating effective treatments, and policy is moving toward requiring that treatments offered be evidence based. This is a period of a great explosion of knowledge about mental health, and we can expect considerable advances in the coming years.

Article

Mental Health: Practice Interventions  

Phyllis Solomon

This entry focuses on services for adults with severe mental illness, specifically the five psychosocial interventions considered evidence-based practices. The emergence of psychiatric rehabilitation, the only professional discipline designed to serve a specified population, is described. The primary historical practice approaches, which are the foundation for psychiatric rehabilitation, are discussed. Each of the five evidence-based practices is then described with the empirical supporting evidence. The emphasis on this population and interventions were selected as social workers are the major providers for this population and frequent implementers and developers of these interventions.

Article

Mental Health and Older Adults  

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.

Article

Mental Health Courts  

Matthew Epperson, Julian Thompson, and Kelli E. Canada

This article discusses the emergence, structure, and purpose of the mental health court. It details the therapeutic aspects of the mental health court and its function as a specialized-treatment court serving persons with serious mental illnesses in the criminal justice system. Guiding themes, such as the criminalization of mental illness, therapeutic jurisprudence, and drug-treatment courts are described. It also identifies key legislation that contributed to the funding and proliferation of mental health courts. The effectiveness of mental health court, along with current criticisms regarding its impact on participants’ mental health and recidivism outcomes, are also covered. Last, social work values and the various roles of social workers in the mental health court are highlighted to demonstrate the relevance of mental health court to contemporary social work practice and intervention.

Article

Mental Health Disparities  

Rhonda Wells-Wilbon, Rhea Porter, Taylor Geyton, and Anthony Estreet

Millions of Americans are affected by a mental illness or disorder each year. Given the prevalence, it is unfortunate that significant disparities exist within mental health care. Some of the most common reasons mental health disparities exist include stigma, previous negative experiences, limited mental health literacy, lack of culturally aware providers and services, language access, and lack of financial resources. Additionally, members of racial and ethnic, gender, and sexual orientation minority groups, who already encounter higher levels of bias, experience poorer mental health outcomes due to disparities than their counterparts. Grounded in the values and ethics of the profession, it is no surprise that social workers play a vital role in reducing mental health disparities.

Article

Mental Health Parity  

Wayne Lindstrom

Continuing a history of inequity, private insurers have placed restrictions and limitations on coverage for mental health conditions making access to treatment services increasingly more challenging. A state-by-state advocacy movement has led to the enactment of various state laws to require mental health parity. With the Clinton Administration’s attempt at health care reform, mental health parity became part of the health reform debate and led to the passage of the Mental Health Parity Act of 1996. The inadequacies of this law were partially corrected in the Mental Health Parity and Addiction Equity Act of 2008, which included mandated coverage for substance use conditions. The Obama Administration in 2011 included these provisions in the Patient Protection and Affordable Care Act, which does not require compliance monitoring nor does it provide a definition for “mental health,” which leaves insurers to define it and hence determine what coverage will actually be available.

Article

Mental Health Policy Overview  

Christine M. Rine

Mental health practice is inextricably linked to how this concept has been understood in a historical context from which policies and systems of care develop. How mental health is perceived has shaped policy, as much as policy has influenced how mental health has been defined and subsequently treated. Early frameworks evolved, furthering the multidisciplinary nature of policies and services highlighting social and environmental contributions. Holistic approaches that appreciate social determinants are a comparatively new way to understand and advance mental health policy that underlies access to insurance, programs, and services based on qualifications and eligibility. A chronological and historical overview highlights interconnectedness and provides context to the development of mental health policies, initiatives, and systems of care. Content specific to roles of the social work profession should be included.