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.
Alcohol and Drug Problems: Practice Interventions
Maryann Amodeo and Luz Marilis López
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.
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.
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.
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.
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.
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.
Disability: Psychiatric Disabilities
W. Patrick Sullivan
The psychosocial catastrophe that accompanies serious mental illness negatively impacts individual performance and success in all key life domains. A person-in-environment perspective, and with a traditional and inherent interest in consumer and community strengths, is well positioned to address psychiatric disabilities. This entry describes a select set of habilitation and rehabilitation services that are ideally designed to address the challenges faced by persons with mental illness. In addition, it is argued that emphasis on a recovery model serves as an important framework for developing effective interventions.
Health Care: Practice Interventions
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.”
Home Visits and Family Engagement
Barbara Wasik and Donna Bryant
The importance of engaging families in home visiting was recognized more than a century ago as M. E. Richmond provided guidelines for involving families in the visiting process. She stressed individualizing services and helping families develop skills that would serve them after the home visiting services ended. During the 20th century, early organized efforts in home visiting in the United States built on methods used in other countries, especially European countries. Although interest fluctuated in the United States during the past century, since 2010 interest has increased due primarily to the passage of the Patient Protection and Affordable Care Act that provided for home visiting services to respond to the needs of children and families in order to improve health and development outcomes for vulnerable children and their families. Engaging families is essential for a productive home visiting experience requiring thoughtful program activities as well as knowledge and skills on the part of the visitor. Program responsibilities begin with the need to make good employment decisions regarding home visitors and then to provide effective training, supervision, and ongoing professional development. Providing professional training in helping skills such as observation, listening, and ways of asking questions to gain or clarify information is essential to ensure visitors can engage families. Using principles for effective home visiting—including establishing a collaborative relationship with the family; individualizing services; being responsive to family culture, language, and values; and prompting problem-solving skills—can enhance the ability of the visitor to engage the family. Programs can provide opportunities for visitors to enhance their skills in developing relationships with and engaging families. Engaging families is a reciprocal process. Some families will have a positive orientation toward working with visitors to accomplish their own goals and objectives; others may be less willing to engage. Although the program and visitors have the main responsibility for engagement, they will face challenges with some families and may need to seek creative solutions to actively engage. Just as home visitors need to engage parents in order to facilitate new knowledge and skills, parents need to engage their children to foster development. Recent research identified a set of parent–child interactions that visitors can incorporate to foster parent engagement with young children. These challenges are shared across home visit programs, as well as across cultures and countries, regardless of the professional training of the visitors or the goals and procedures of the programs.
Interventions for Adolescent Depression
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.
Mental Health Research
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.
Post-Disaster Trauma and Recovery
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.
Quality of Care
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.
Rapid Assessment Instruments
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.
Social Work and Coercion
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.