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.
Adult Day Care
Namkee G. Choi
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.
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.
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.
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.
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.
Grief and Loss
Sara Sanders, Matthew Tvedte, and Mercedes Espinal-Lujan
This article summarizes the history of grief theory and provides an overview of major theoretical frameworks for understanding grief and grief work. Specific types of losses are defined and described, including the newer concept of community grief and loss. Interventions for individuals, groups, and communities are outlined, followed by a discussion of the role of social workers in addressing grief and loss.
Health Care Social Work
Health social work is a subspecialization of social work concerned with a person's adjustment to changes in one's health and the impact this has on that person's social network. Social workers in every setting must be ready to assist individuals and families adjusting to illness and coping with medical crises. This entry provides a brief overview and history of health social work and describes the settings and roles where this work is practiced. Significant challenges and opportunities in clinical care, research, education, and policy are discussed. Standards and guidelines for quality practice are then noted.
Homelessness and Macro Interventions
Eva M. Moya, Amy Joyce-Ponder, Jacquelin I. Cordero, Silvia M. Chávez-Baray, and Margie Rodriguez LeSage
The emergence of social work and macro practice is often associated with the eradication of poverty and prevention of homelessness through the efforts of 19th century settlement houses. Structural violence and social determinants of homelessness are often grounded in unequal social, political, and economic conditions. Health and mental health were affected by the lack of stable housing, causing and increasing the complexity of health and human service needs and services. Furthermore, due to inequities, some populations are inadvertently more likely to face chronic homelessness, which can be mitigated through the role community-engagement and macro practice interventions.
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.
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.
Jessica M. Black
Scientific findings from social sciences, neurobiology, endocrinology, and immunology highlight the adaptive benefits of positive emotion and activity to both mental and physical health. Positive activity, such as engagement with music and exercise, can also contribute to favorable health outcomes. This article reviews scientific evidence of the adaptive benefits of positive emotion and activity throughout the life course, with examples drawn from the fetal environment through late adulthood. Specifically, the text weaves together theory and empirical findings from an interdisciplinary literature to describe how positive emotion and activity help to build important cognitive, social, and physical resources throughout the life course.
Practitioners who were presumed to be competent may develop difficulties that interfere with job performance. Such professionals are considered impaired and may suffer from compassion fatigue, substance abuse, mental disorders, and other forms of distress associated with daily living. Practicing while impaired is unethical and can potentially be harmful to clients. Colleague Assistance Programs from professional associations or diversion systems and legal sanctions imposed by state regulatory boards are forms of intervention strategies that are employed. Self-care strategies and consciousness-raising among professionals are the best forms of prevention.
Public Health Social Work
Sarah Gehlert, Julie A. Cederbaum, and Betty J. Ruth
Public health social work is a substantive area within the discipline of social work that applies social work and public health theories, frameworks, research, and collaborative practices to address contemporary health issues through a transdisciplinary lens. It is epidemiologically informed and characterized by prevention, health promotion, and other integrative practices. With its strong focus on health impact and population health, public health social work is central to the profession’s viability and success for tackling pervasive 21st-century challenges, such as health inequity, behavioral health integration, chronic disease, health reform implementation, and global health.
Racism and Accountable Policing for Black Adults in the United States
Robert O. Motley Jr. and Christopher Baidoo
Racism is a public health concern for Black adults in the United States given its prevalence and association with adverse health outcomes for this population. The frequency of high-profile cases involving police use of gratuitous violence against Black adults has raised concerns regarding racially discriminatory law enforcement practices. In this article, racism is defined and a discussion is offered on its impact on the health and well-being of Black adults in the United States; the intersection of racism and policing; contemporary racialized policing practices; emerging evidence on prevalence rates for exposure (direct and indirect) to perceived racism-based police violence and associated mental and behavioral health outcomes; and police accountability through executive, legislative, legal, and other remedies.
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.
Social Work in Moldova
Vadim Moldovan, Eugeniu Rotari, Vadim Tarna, and Alina Zagorodniuc
The Republic of Moldova is a small post-Soviet country that has been “transitioning” from a socialist to capitalist economy since the 1990s. Once a prosperous region of the Soviet Union, it is now among the poorest countries in Europe, facing many social problems that call for a strong social work profession. However, social work is new to the country and the profession is challenged by low societal status, meager resources, and lack of cohesion. Social work in Moldova is struggling to meet these challenges with the help from the West and the emergence of an indigenous model of professionalization. Child welfare, elder care, mental health, as well as the history of social work in Moldova, current state of social work education with its obstacles to and opportunities for progress will be discussed.
Suicide and Public Policy
Janelle Stanley and Sarah Strole
The historical context of suicidal behavior and public policies addressing suicide arose simultaneously within the United States, and both reflect a culture of discrimination and economic disenfranchisement. Systems of oppression including anti-Black racism, restrictive immigration policy, displacement of American Indigenous communities, religious moralism, and the capitalist economic structure perpetuate high-risk categories of suicidality. Suicidal behavior, protective factors, and risk factors, including firearms, are examined in the context of twentieth and early twenty first century public policy. Recommendations for public policy will be discussed with consideration for policies that impact communities disproportionately and social work ethics, such as right to die laws and inconsistent standards of care.
Trauma-Secondary, Vicarious, Compassion Fatigue
Ruth Gottfried and Brian E. Bride
Over the past three decades, along with the development of the field of traumatology, it has become increasingly clear that the after-effects of trauma exposure extend beyond those experienced by survivors or perpetrators, to include their caregivers. The nomenclature in the field of indirect trauma includes three central terms to describe this experience: vicarious traumatization (VT), secondary traumatic stress (STS), and compassion fatigue (CF). The current encyclopedia entry comprises a comprehensive description of these constructs, with emphasis on the discipline of social work. As VT is based on the theory of constructivist self-development, this theory is addressed as well. Likewise reviewed are relevant theoretical frameworks for both STS and CF, diverse conceptualizations of CF, prevalence rates, risk factors, and microlevel, mezzolevel, and macrolevel recommendations for addressing secondary, vicarious, and CF trauma.