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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David L. Hussey
This chapter summarizes literature and research related to advances in direct practice work with adolescents. Social workers are on the forefront of developing and utilizing a variety of evidence-based practices to address complex client and community needs.
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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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Colita Nichols Fairfax
Afrocentric social work is a concept and praxis approach applicable in environmental and global settings where people of African descent are located. Using concept analysis as a methodology, this article explores Afrocentric social work theory and its applicability in the social sciences. Concept analysis is an examination of a thought or theory with the intent to create a more concise operational definition. Afrocentric social work not only is applicable to racial and social justice issues, it also is applicable to intellectual and philosophical discourses of social work, which has largely ignored Afrocentric social work as a viable theory and philosophical canon. The Walker and Avant method of concept analysis is employed in this article to provide a systemic discourse to define the attributes of Afrocentric social work, as well as its structural elements that scholars and practitioners utilize as a theory and praxis application.
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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.
Article
Sarah (Hicks) Kastelic
Alaska Natives represent less than 1% of the U.S. population but reside in more than 229 Native villages and account for 40% of federally recognized tribes. Most Alaska Native communities shared common Euro-American contact experiences: exposure to western religions, education, and disease. Historical trauma contributes to many of the social welfare problems Natives experience today: low educational attainment, unemployment, inadequate health care, substance abuse, and violence. Service delivery mechanisms, lack of cultural appropriateness, and isolation compound these pressing issues. Locally delivered social welfare services that take into account traditional Native worldviews, values, languages, and intergenerational relationships are effective in addressing many of these issues.
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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.
Article
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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M. Jenise Comer and Joyce A. Bell
The Association of Social Work Boards (ASWB) is a not-for-profit 501(c)3 organization dedicated to the regulation of social work practice. The Association was created to protect clients and client systems from harm caused by incompetent, unethical, or unlicensed social work practice. The primary and most important responsibility of ASWB is to develop and maintain a national exam that is valid, reliable, and legally defensible. The Association contracts with a test vendor to administer the exam in an identical, secure environment to social work candidates for licensure in the United States, Canada, the U.S. Virgin Island, Guam, the Northern Mariana Islands, and the District of Columbia. Accomplishing the task of providing a reliable and valid exam involves a complex process of recruiting and training. The volunteers and staff are competent to complete the arduous task of constructing and reviewing different forms of the exam for each level of licensure. The test vendor and a consulting psychometrician provide supervision and analysis of test data to confirm the test performs at or above industry standards for a high stakes exam, which determines entry to practice based on a passing score.
ASWB staff members also engage in several activities that support state and provincial boards to advance regulation and safe practice. The purpose, mission, and history of ASWB will be presented in detail, along with focused attention on the exam and additional services provided to the regulatory community. Future issues will identify the Board of Director’s 2019 Strategic plan. Opportunities, challenges, and threats to professional regulation include attention to international social work practice regulation, license mobility, and deregulation.
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Steven P. Segal
Social workers are increasingly working in authoritative settings—that is, settings where they have the power to mandate conformity by the client to the normative and often legal requirements of the organization. Such settings may be residential, such as jails, prisons, and rehabilitation facilities, or community-based organizations that are part of the criminal justice system, the mental health system, the health system, and the child welfare system. The exercise of power derived from the authority vested in the setting’s objectives may and often does alter the total life situation of an individual, such as when a client is compelled to move to supervised care without the client’s consent. Under an outpatient civil commitment order or mental health court supervision, the patient may be told where to live and with whom to associate as well as be required to participate in interactive treatment and to take medication. In authoritative settings, social workers are working with “involuntary” clients—clients who understand, whether or not it is explicitly stated, that the social worker possesses the power to effect unwanted change in their life circumstance. Since the early 1990s, the field has been developing new ideas and skills that are equally useful in working with voluntary and involuntary clients. In the process, social worker authority is now viewed less as a way to gain client compliance and, instead, is understood more as an opportunity to build partnerships with clients that lead to changes that are enduring and more meaningful to clients.
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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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Edward J. Mullen, Jennifer L. Bellamy, and Sarah E. Bledsoe
This entry describes best practices as these are used in social work. The term best practices originated in the organizational management literature in the context of performance measurement and quality improvement where best practices are defined as the preferred technique or approach for achieving a valued outcome. Identification of best practices requires measurement, benchmarking, and identification of processes that result in better outcomes. The identification of best practices requires that organizations put in place quality data collection systems, quality improvement processes, and methods for analyzing and benchmarking pooled provider data. Through this process, organizational learning and organizational performance can be improved.
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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.
Article
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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June Simmons, Sandy Atkins, Janice Lynch Schuster, and Melissa Jones
Transitions in care occur when a patient moves from an institutional setting, such as a hospital or nursing home, to home or community, often with the hope or expectation of improving health status. At the very least, patients, clinicians, and caregivers aim to achieve stability and avoid complications that would precipitate a return to the emergency department (ED) or hospital. For some groups of vulnerable people, especially the very old and frail, such transitions often require specific, targeted coaching and supports that enable them to make the change successfully. Too often, as research indicates, these transitions are poorly executed and trigger a cycle of hospital readmissions and worsening health, even death. In recognizing these perils, organizations have begun to see that by improving the care transition process, they can improve health outcomes and reduce costs while ensuring safety, consistency, and continuity. While some of this improvement relies on medical care, coaching, social services and supports are often also essential. Lack of timely medical follow-up, transportation, inadequate nutrition, medication issues, low health literacy, and poverty present barriers to optimal health outcomes. By addressing social and environmental determinants of health and chronic disease self-management, social workers who make home visits or other proven timely interventions to assess and coach patients and their caregivers are demonstrating real results. This article describes care transitions interventions, research into barriers and opportunities, and specific programs aimed at improvement.
Article
Maria Roberts-DeGennaro
A generic set of case management functions are performed in most practice settings. To improve outcomes within a complex service delivery system, case managers need to collaboratively work with clients and care providers. By incorporating the paradigm of evidence-based practice, case managers can improve decision making through integrating their practice expertise with the best available evidence, and by considering the characteristics, circumstances, values, preferences, and expectations of clients, as well as their involvement in the decision making.
Article
Anthony N. Maluccio
Social work has a long tradition of direct practice with children in a range of settings, such as child welfare, child guidance, hospitals, schools, and neighborhood centers. This entry focuses on general principles and strategies for direct social work practice with preadolescents and, to a lesser extent, their families, within an eclectic conceptual framework.
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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.
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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.
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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.
