The passage of the Affordable Care Act (ACA) has injected new life into primary health care by establishing the primary care medical home (PCMH) as a cornerstone of health-care reform legislation. In addition to the PCMH, the ACA has a number of primary-care components that can open opportunities for social workers. Concerns remain for payment reform in the implementation of the PCMH. The implementation of the ACA is still a work in progress, with anticipated modifications and changes as issues arise.
Rebecca S. Ashery
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.
Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.
Addie Weaver, Joseph Himle, Gail Steketee, and Jordana Muroff
This entry offers an overview of cognitive behavioral therapy (CBT). Cognitive behavioral therapy is introduced and its development as a psychosocial therapeutic approach is described. This entry outlines the central techniques and intervention strategies utilized in CBT and presents common disorder-specific applications of the treatment. The empirical evidence supporting CBT is summarized and reviewed. Finally, the impact of CBT on clinical social work practice and education is discussed, with attention to the treatment’s alignment with the profession’s values and mission.
Wendy Auslander and Elizabeth Budd
The purpose of this article is to provide an overview of: diabetes and its significance, the differences in types of diabetes, and landmark clinical trials that have resulted in changes in philosophy and treatment of diabetes. Second, a review of the various types of evidence-based and promising behavioral interventions in the literature that have targeted children and adults are presented. Social workers and other helping professionals are uniquely positioned to work collaboratively to improve psychosocial functioning, disease management, and prevent or delay complications through behavioral interventions for children and adults with diabetes.
Concepcion Barrio, Mercedes Hernandez, Paula Helu Fernandez, and Judith A. DeBonis
Social workers in health and mental health and across public and private health sectors are expected to be knowledgeable of comprehensive approaches to effectively serve individuals dealing with psychotic disorders, including family members involved in their care. Effective services require expertise in assessment, diagnostics, treatment planning, and coordination of community support services. This article provides a knowledge base for social work practitioners working with clients challenged by the experience and consequences of serious mental illness, such as schizophrenia spectrum and other psychotic disorders. We begin by reviewing the public health significance of these disorders, clinical phenomenology and its historical context, and symptoms and classification. We then discuss the family and cultural context, evidence-based treatments, and several social and clinical issues that social work practitioners should be aware of when working with this client population.
Tonya Edmond and Karen Lawrence
Since its inception in 1987, eye movement desensitization and reprocessing (EMDR) therapy has been the subject of lively debate and controversy, rigorous research both nationally and internationally, and is now used by licensed practitioners across six continents as an effective treatment of trauma symptoms and posttraumatic stress disorder (PTSD). The aim of this entry is to provide social work practitioners and researchers with a description of the treatment approach for adults and children, EMDR’s development and theoretical basis, a review of controversial issues, and an overview of the evidence of effectiveness of EMDR across trauma types and populations.
Yin-Ling Irene Wong and Claudia J. Vogelsang
Homelessness is a major social problem in the United States. The article starts with an overview of homelessness in American history, followed by the definition of contemporary homelessness, its prevalence, and the composition and diverse characteristics of the homeless population. Contrasting perspectives on what causes homelessness are discussed, while the multidimensionality of the homeless experience is explored. The unique experiences of three subpopulations, including homeless persons who are involved in criminal justice, emerging youth leaving foster care, and older homeless persons are further featured. Public and community responses to homelessness are examined, highlighting evidence-based and emerging practices that aim at reducing and preventing homelessness. A discussion of international homelessness follows, as homelessness is recognized as a global issue affecting people living in poverty in both the developed and developing world. The article concludes with discussion of the implications for social work.
Dorinda N. Noble
Children are interesting, resilient people, whose lives are often perilous. Social workers deal extensively with children and families, and with policies that affect children, to help children and families overcome family disruption, poverty, and homelessness. Social workers also provide mental health care while working to ensure that children get medical care. Schools are areas of practice for social workers dealing with children. The issues of ethical practice and social justice for children are complex.