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Article

Diane Rae Davis

Harm reduction is a helping strategy that attempts to alleviate the social, legal, and medical consequences associated with unmanaged addiction, and in so doing, limit the harms, such as infectious disease (HIV, hepatitis), violence, criminal activity, and early death, without necessarily attempting to “cure” the addiction. While abstinence may be an ideal outcome from a harm reduction standpoint, abstinence is viewed as only one of several means of improving a person's life. Harm reduction strategies are well known in the U.S. through methadone maintenance and syringe-exchange programs, and are increasingly relied on in the treatment of co-existing disorders.

Article

Sleep  

Jessica M. Black

Sleep is required for healthy and adaptive neurobehavioral and psychosocial functioning throughout the life course. Sleep is restorative, facilitates memory consolidation, improves immune function, and regulates emotional responses. Sleep deprivation, whether due to sleep disorders or other life conditions and transitions, is a significant risk factor for negative developmental outcomes at all stages in the life course. This article adheres to the biopsychosocial model to review current research describing the benefits of adequate sleep and ways in which insufficient sleep, as determined by developmental needs throughout the life course, can undercut healthy development. Particular attention is paid to social issues of relevance to social workers, with a closing discussion of policy and implications for future work within the field.

Article

Elizabeth C. Pomeroy, Danielle Parrish, Angela M. Nonaka, and Kathleen H. Anderson

This article reviews existing knowledge on the assessment of children with fetal alcohol spectrum disorders (FASD) and available screening, prevention, and intervention services. The wide range of preventable conditions associated with FASD throughout the life cycle is described, along with associated high-risk maternal behaviors. In addition, cultural and social determinants are discussed, in an effort to inform social work practice. The differentiation of FASD and protective factors that have been identified as reducing negative outcomes for children and their families affected by prenatal alcohol exposure are also explained. Finally, multidisciplinary and culturally appropriate prevention services are emphasized as well as early diagnosis and strength-based intervention strategies.

Article

Elizabeth C. Pomeroy and Polly Y. Browning

Eating disorders involve maladaptive eating patterns accompanied by a wide range of physical complications likely to require extensive treatment. In addition, “eating disorders” frequently occur with other mental disorders, such as depression, substance abuse, and anxiety disorders. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery” (NIMH, 2011). As of 2013, lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are 0.9%, 1.5%, and 3.5% among females, and 0.3%, 0.5%, and 2.0% among males respectively (Hudson, Hiripi, Pope, & Kessler, 2007). Early diagnosis is imperative; the National Institute of Mental Health estimates that the mortality rate for anorexia is 0.56% per year, one of the highest mortality rates of any mental illness, including depression (NIMH, 2006). More recent research (Crow et al., 2009) indicates mortality rates as high as 4.0% for anorexia nervosa, 3.9% for bulimia nervosa and 5.2% for eating disorders not otherwise specified. Current research and treatment options are discussed.

Article

Mansoo Yu and Rachel Fischer

Tobacco use is a major public-health concern in the United States. Intervention and prevention strategies for tobacco use are an urgent public-health priority because tobacco use is the single most preventable cause of death. To help social workers better understand tobacco use problems, this entry presents an overview, including definitions of terms, the scope and impact of tobacco use problems in terms of different segments of the population (that is, age, gender, race or ethnicity, geographic location, and education level or socioeconomic status), etiology of tobacco use (for example, biological or genetic; psychiatric; psychosocial; or environmental or sociocultural factors), policy history, tobacco prevention, clinical issues (such as cessation desire, treatment and success, or screening tools for tobacco use disorder and tobacco withdrawal), and practice interventions for tobacco use problems. Based on the information, the roles of social workers will be addressed.

Article

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

Allen Rubin

Eye movement desensitization and reprocessing (EMDR) is one of the two most empirically supported treatments for adult populations with noncombat, single-episode posttraumatic stress disorder (PTSD), with the other being exposure therapy. This entry describes the unconventional origin, theoretical underpinnings, and treatment protocol of EMDR, including its distinctive use of bilateral stimulation (that is, dual-attention stimulation). Also discussed are possible contraindications, unresolved issues, and the need for more research regarding the effectiveness of EMDR with other populations with PTSD, such as children and individuals with combat PTSD and complex trauma.

Article

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

Charles Wilson, Donna M. Pence, and Lisa Conradi

The concepts of trauma and trauma-informed care have evolved greatly over the past 30 years. Following the Vietnam War, professional understanding of post-traumatic stress disorder (PTSD) increased. The greater understanding of trauma and its effects on war veterans has extended to informing our comprehension of trauma in the civilian world and with children and families who have experienced abuse, neglect, and other traumatic events. This elevated insight has led to the development of evidence-based models of trauma treatment along with changes in organizational policies and practices designed to facilitate resilience and recovery. This paper highlights the concept of trauma-informed care by providing an overview of trauma and its effects, then providing a comprehensive description of our understanding of trauma-informed care across child- and family-serving systems.

Article

M. Aryana Bryan, Valerie Hruschak, Cory Dennis, Daniel Rosen, and Gerald Cochran

Opioid-related deaths by overdoses quadrupled in the United States from the years 1999 to 2015. This rise in mortality predominately occurred in the wake of historic changes in pain management practices and aggressive marketing of opioid medications such as oxycontin. Prescription opioid misuse and subsequent addiction spilled over to heroin and fentanyl for many. This drug epidemic differed from others in its impact among non-Hispanic whites, leading to drastic changes in how the United States views addiction and chooses to respond. This article offers an overview of opioid use disorder (OUD), its treatment and its relationship with pain. It also discusses special populations affected and provides insight into future directions for research and social work practice surrounding opioid management in the United States. Because of the profession’s emphasis on the person and social environment as well as its focus on vulnerable and oppressed populations, social work plays a critical role in addressing the crisis.

Article

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.