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Abstract: Abstract In both graduate classrooms and field placements, social work student interns are increasingly taught empirically-supported, behaviorally-focused models as the primary way to engage in ethical practice. They are less prepared, however, to handle the personal impact of powerful psychodynamic processes active in therapeutic settings. In adolescent group treatment environments, the combination of novice therapists with dual-diagnosed, involuntary/mandated teens sets the stage for both behavioral and transference/countertransference issues to arise. Although supervision at the field setting is expected to ameliorate emergent issues, the behavioral and group-level focus of field supervisors may not be enough to identify and overcome deeper psychodynamic challenges. Student interns, as they provide professional treatment to their clients, may therefore have to self-navigate emotionally charged inter- and intra-personal conflicts and attempt to metabolize their own reactions to trauma and dysfunction. This paper presents a detailed post-treatment review of a student intern’s struggle to metabolize individual countertransference dynamics in a group setting in the service of a client, and provides supervisory insights on his approach to highlight the challenges and possibilities in such an environment. PubDate: 2023-03-25
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Abstract: Abstract Evidence-based practice (EBP) is one of social work’s most prominent attempts to close the research-practice gap. However, EBP’s reception in social work has remained tepid. For over 20 years, supporters have defended EBP against skeptics’ recurring concerns—a seemingly endless cycle of identical arguments against and counterarguments for EBP. This article argues that a core barrier to the adoption of EBP is the ontological, epistemological, and methodological tensions used to justify EBP’s lack of ethical fit with the profession. Existing counterarguments for EBP have failed to address these tensions, instead responding by correcting surface-level misconceptions about the philosophy of science itself. However, such corrections do not satisfactorily demonstrate EBP’s reliance upon not just empirical evidence, but also experiential and situated ways of knowing that skeptics believe EBP excludes. This article will meaningfully engage with skeptics’ concerns and offer a philosophical dissection of EBP, exploring its multiple sources of evidence and elaborating on how they link to post-positivist, social constructivist, and critical paradigms. Following the tenets of philosophical pragmatism, this argument constitutes a paradigmatic re-conceptualization of EBP toward epistemological plurality. This article is a call to move beyond either-or ideological debates, and re-focus on EBP’s still-untapped potential to address research and practice needs. PubDate: 2023-03-10
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Abstract: Abstract Depressive disorders are related to social withdrawal and a loss of social contacts. Moreover, a lack of social integration and social support are risk factors for relapse and rehospitalization. Despite the crucial role of social networks for mental health and social support, knowledge about the structure of social networks or how they promote social support in terms of coping with depressive disorders is scarce. The present study aims to analyze social support in people with depressive disorders using ego-centered social network analysis for formal description. Ninety-seven former psychiatric inpatients participated in the study. Network size and density, a small number of conflicts in the relationships of ego to alters, and the multiplexity of social support dimensions were associated with perceived social support—measured via Social Support Questionnaire (F-Soz-U-K-14). Considering relational ratios which correlated with perceived social support, five types of social support networks were differentiated by means of cluster analysis: (1) no social support, (2) professionally supported birth family, (3) the more the merrier, (4) concentrated support, (5) overchallenged nuclear family. More than each relational characteristic on its own, their co-occurring patterns as network types provide the very structures of social support. This underpins the crucial role of structural approaches and networking skills in social work practice. German Clinical Trials Register (DRKS): DRKS00011561. Trial registration date: 10. March 2017. PubDate: 2023-03-01
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Abstract: Abstract Our study reports on a scoping review examining the role of diagnosis within social work practice in Canada and the United States (US). Adopting the process laid out by Arksey and O’Malley, the search captured 189 academic and grey literature drawn from six health and social sciences databases and published from January 1980 to April 2020. The majority of literature were based in the US, and studies covered a variety of practice settings including hospitals, community clinics, medical health clinics, and private practice. Various versions of the DSM was mentioned in over half of the publications that made mention of the use of a diagnostic tool. Four themes emerged from the analysis: professional positioning, clinical activities and diagnosis, contextual factors, and education and training. The focus on holistic care through intersecting identities and social determinants of health in social work provides a balance to the biomedical model adopted by the DSM. Further inclusion of social work perspectives in the development of the DSM may help raise awareness and inclusion of ecological factors in diagnosis. In addition, the lack of uniformity in the inclusion of diagnosis in social work curriculum has been noted as an opportunity to offer higher quality instruction and supervision to students to better utilize diagnostic tools. We suggest that expanding the scope of practice for social work to include diagnosis can help increase the capacity of the healthcare system to identify and address mental health concerns. PubDate: 2023-03-01
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Abstract: Abstract The rapid spread of COVID-19 led to, among other things, confusion in news coverage and public health safety. In academe, university leaders were pressured to quickly construct new plans for holding university classes while integrating the safety protocols required by government officials. Though this sudden shift may have been necessary, it also disrupted the biopsychosocial needs, developmental norms, and milestones of emerging adults on college campuses. Current research on emerging adults’ biopsychosocial needs during COVID-19 is scant, and research efforts may have been diverted due to the suddenness of campus shutdowns. Social work clinicians nonetheless need a theoretical framework that primarily focuses on emerging adults’ needs during and post pandemic. Therapeutic settings create platforms for emerging adults to share their stories and for clinicians to understand their clients’ lived experiences during a pandemic such as COVID-19. An awareness of how the experience of shared trauma can affect the therapeutic relationship is crucial to the wellbeing of both client and clinician. This composite case study illustrates a treatment intervention constructed from resilience theory that included narrating what unfolded, learning emotional regulation, building sources of support, and making meaning of the experience. The framework in this paper suggests that resilience theory can be an effective therapeutic approach for emerging adults during and after the COVID-19 pandemic and recommends further attention to the role of social workers in higher education. PubDate: 2023-03-01
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Abstract: Abstract This paper proposes that a core dynamic, created by both members of a couple dyad, underlies many of the conflicts and tensions that motivate couples for therapy. Childhood relational traumas are often a significant factor in creating the core dynamic as each member of the dyad brings their internal worlds and lived experience to their relationship. As the core dynamic is identified and connected to both the current tensions and past relational experiences, including affective responses and the meanings attributed to interactions, a significant process in couples therapy is underway. Relational psychoanalytic theory, with its attention to subjectivity, intersubjectivity, enactments and dissociative processes, provides an ideal construct for conceptualizing and working with this core dynamic in therapy. This paper uses case material to illustrate how childhood relational trauma can influence the creation of a couple’s underlying core dynamic and the therapeutic value of working through this core dynamic as part of couples therapy. PubDate: 2023-03-01
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Abstract: Abstract Persons living in individualistic cultures with low levels of differentiation of self are prone to experiencing internal distress. The specific pathway by which this relationship occurs, however, has been minimally studied. We hypothesized that two psychological constructs which are related to differentiation of self—vulnerable narcissism and maladaptive perfectionism—would partially explain its negative outcomes. A serial mediation model supported the explanatory roles of vulnerable narcissism and maladaptive perfectionism in the relationship between differentiation of self and internal distress. This study draws attention to the contributing roles of vulnerable narcissism and maladaptive perfectionism for clinical social workers seeking to understand and alleviate the psychological distress commonly experienced by persons with low self-differentiation. PubDate: 2023-03-01
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Abstract: Abstract This paper chronicles the process through which five clients in therapeutic sessions work through their experiences with leaving the LDS (Mormon) church, including the associated friction with immediate and extended family and the consequences these experiences have on participants’ sense of identity. Using grounded theory to analyze client notes, we discovered three broad “central categories” across all five research participants. These categories include first, the process of leaving the LDS religion and church and associated faith crises (of various degrees), second, the experience of tension between the need for authenticity and family expectations concerning religion and faith, and sometimes sexuality, and the resulting feeling of “leading two lives,” and third, the consequences of the faith crisis and friction with family members on clients’ sense of identity, and their work towards the achievement of identity at the same time. PubDate: 2023-03-01
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Abstract: Abstract It is clear from the international social work literature that social workers experience high levels of stress and burnout due to the cognitive, emotional and physical demands of the profession. There are however no integrative theories, developed by social workers, on how this stress, burnout and its impact on the emotional and psychological well-being of social workers can be ameliorated and then improved. This article makes an original contribution to this literature by proposing the use of the clinically modified Buddhist psychological model, as a beneficial lens for understanding how to improve reflective practice in social work along with the feelings of stress, burnout, anxiety, low mood and well-being deficits that can result from social work practice. This paper will outline the rationale for the development of the clinically modified Buddhist psychological model, before outlining the theory itself and how it might support stress coping processes and reflective social work practice. This paper has significance for all social workers, social work students and social work educators, as it provides a theory which could help to inform improved reflective social work practice and self-care. PubDate: 2023-03-01
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Abstract: Abstract While pregnancy presents a strong motivation to seek and comply with treatment for opioid use disorder (OUD), many women relapse within the first year of childbirth. Addressing relapse risk, we examined the perinatal experiences of mothers with OUD through 6 months postpartum. We recruited mothers (N = 42) with a history of OUD into the Newborn Attachment and Wellness study, all of whom met with a child welfare worker immediately after giving birth. In qualitative interviews, mothers described their social, physical, emotional, and psychological perinatal experiences. Seven themes categorically informed relapse risk (i.e., related to childhood bond, mother-infant attachment, birth support, child protective services, breastfeeding, mental health, and recovery planning). In conclusion, we noted a critical window in which clinical social workers and other health/behavioral health providers have the opportunity to capitalize on mothers' desire not to “ever want to touch it again." We outline specific avenues for directed support in the perinatal and postpartum period associated with reduced risk for relapse, and we make recommendations to enhance risk assessment practices. PubDate: 2023-03-01
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Abstract: Abstract Children who have been removed from their homes as a result of maltreatment and abuse and have been placed in foster care or are in the process of adoption often continue to meet their birth parents by court decision. This contact is often held under supervision. Supervised contact is intended to provide children the opportunity to maintain the parent-child relationship in a safe and neutral setting. Findings have shown that in some cases supervised contact can be harmful, undermining the children’s sense of security and placement stability. It has been suggested that agencies have limited practice skills to help build constructive relationships through contact visits, and may thereby be failing to offer sufficient support for supervised contact. While the literature highlights various aspects that need to be implemented to improve visits, there is a lack of a trauma-informed approach, whereby professionals supervising visits can address the traumatic experiences that led to the circumstances of supervised visitation and respond to the difficult emotions of all those involved. This paper provides practice guidelines for professionals accompanying supervised visits using principles of Child-Parent Psychotherapy, a trauma-informed dyadic intervention model for young children. Case vignettes illustrate how professionals supervising contact might address the child’s trauma history and help birth parents and foster/adoptive parents respond to the child’s attachment needs following trauma, and how professionals can support birth parents and foster/adoptive parents, thereby promoting safety and improving child-parent interactions. Recommendations are offered for attaining the best clinical practices in supervised contact, using seven practical guidelines. PubDate: 2023-02-21
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Abstract: Abstract While the evidence on the adverse impact of the COVID-19 pandemic on the well-being of frontline social workers is emerging, the research on the impact of the pandemic on their performance is scarce. The presented study explores how the relationship between work environment predictors and perceived stress explains the job performance of child welfare social workers during the pandemic using survey responses of 878 child welfare social workers. The findings revealed the mechanism through which environment predictors and perceived stress interacted in explaining job performance during a time of large-scale crisis. We found that C.W. social workers who experienced greater COVID-19-related service restrictions reported poorer job performance, that perceived stress disrupted workers’ supervision and autonomy, and that supervision and job autonomy protected C.W. social workers from the adverse effects of perceived stress and workload on their job performance. Conclusions included the importance of autonomy and supervision in mitigating job-related stressors and the need to adapt and enhance child welfare supervision during times of national crisis. PubDate: 2023-01-20
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Abstract: Abstract From fear of contracting the virus, isolation from physical distancing, to navigating lifework balance, the COVID-19 pandemic is expected to leave long-lasting psychosocial impacts on many. Shared trauma refers to similar psychological reactions to an extraordinary community event when experienced by both the clinicians and clients. We examined the experiences mong mental health clinicians in Canada and the United States (n = 196) in this online survey study during the second phase of the pandemic (Spring 2021). In addition to using traditional survey items (e.g., demographics, scales, and short answers), we also used video-recorded Simulated Clients (SC; i.e., professional actors) as a novel method to elicit the participants’ assessment of the SCs and the psychosocial impacts of the COVID-19 pandemic. Using shared trauma as a theoretical framework, we analyzed both quantitative and qualitative data. Quantitative results suggested that although these mental health clinicians certainly reported experiencing psychosocial impacts of the pandemic themselves, these shared experiences with client and general populations did not greatly impact how they understood the SCs. Qualitative results helped further contextualize the clinicians’ own personal and professional lives. Implications for clinical practice and further research related to shared trauma are discussed. PubDate: 2022-12-15 DOI: 10.1007/s10615-022-00860-0
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Abstract: Abstract Homicide survivors struggle, often long-term, with a crisis of meaning that can complicate grief and undermine healing. This manuscript provides a magnification of Stage 3 of the Theory of Post-Homicide Spiritual Change (Theory of PHSC), a three-stage grounded theory of healing after homicide among 30 homicide survivors, developed by Johnson and Zitzmann (A grounded theory of the process of spiritual change among homicide survivors. OMEGA-Journal of Death and Dying, 81(1), 37–65. https://doi.org/10.1177/0030222818755285). Stage 1 of the Theory of PHSC occurs in the early aftermath of a murder and is characterized by a state of shock and disintegration of survivors’ belief systems. In Stage 2, survivors undergo an indefinite and stagnating process of grappling with a crisis of meaning. Some survivors eventually shift into the third stage of healing that is a focus of this manuscript. Abandoning their unanswered questions, they shift into a mode of making meaning focused on creating significance through intentional action. By providing a magnification of Stage 3 of the Theory of PHSC, this manuscript yield in-depth insights that can be used to help social work practitioners and other helping professionals harness the healing potential of meaning-making grounded in action and support survivors in regaining a sense of renewal and forward momentum in their lives. PubDate: 2022-12-08 DOI: 10.1007/s10615-022-00856-w
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Abstract: Abstract Public outrage over police-involved deaths of people in mental health crisis has prompted governments to expand access to crisis services that partner police with social workers. Mobile Crisis Intervention Teams (MCIT) offer assessment and support for people in distress while averting escalation. Little attention has been given to the requisite competencies for social workers on MCITs. This narrative review, informed by crisis theory and the author’s experience as an MCIT social worker, provides a roadmap of knowledge and skills to familiarize practitioners, educators, and students with this growing intervention model. Social workers on MCITs should have the capacity to engage complex clients, de-escalate tension, assess for risk, plan for safety, provide brief addiction counselling, diffuse interpersonal conflict, link clients with community resources, advocate for change, challenge systemic racism, build constructive relationships, and document services with awareness of relevant legislation. The role of social workers on MCITs is multifaceted and requires attention to balancing client well-being, client safety, and community safety. The practice insights discussed in this article are relevant to preventing harm and loss of life while facilitating engagement between clients and mental health services. PubDate: 2022-12-01 DOI: 10.1007/s10615-021-00823-x
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Abstract: Abstract Use of self is a core concept in the development of authentic social work and human services practice. For students with a history of adversity, learning how to integrate past adverse experiences into their use of self can be difficult. Adversity may have motivated many to enter the helping professions, but students may not always be sure how and when their adverse experiences can be integrated into their use of self. A qualitative survey of students from three different universities in South East Queensland, Australia, found that recognizing experiences of adversity and their impact could be an essential component in learning use of self. Further data was collected via interviews with 20 students at the primary researcher’s university. A grounded theory approach enabled qualitative data to be analyzed from 199 surveys and all interviews to explore how student experiences of adversity contributed to their understanding and development of use of self. By acknowledging past adversity, students described how they used a relational rather than a traditional dichotomous model of use of self in learning to be a practitioner. The outcomes of this study highlight the importance of formally acknowledging students’ own lived experiences of adversity and the importance of understanding use of self from a relational perspective for this cohort. PubDate: 2022-12-01 DOI: 10.1007/s10615-020-00766-9
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Abstract: Abstract The work of Alfred Adler’s Individual Psychology arguably applies to contemporary social work practice and education. The tenets of Individual Psychology are reviewed in the context of a historical sketch of Adler's work as a medical doctor, psychoanalyst, and colleague of Freud. His eventual divergence from psychoanalysis to begin his own psychological and education movement which focused on social reform is emphasized. Individual Psychology is examined in detail including original case examples demonstrating his influence on and compatibility with contemporary social work theories. Empirical evidence is provided supporting present-day application of his theory. Adler serves as a much-needed example of a professional who successfully and simultaneously advanced both the micro and macro world of mental health. Adler's contribution deserves to be explicitly included in social work curricula. PubDate: 2022-12-01 DOI: 10.1007/s10615-021-00793-0
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Abstract: Abstract Disaster exposure is a strong predictor of survivor mental health following large-scale disasters. However, there is continued debate regarding how disaster exposure should be measured and quantified, as well as whether specific types of disaster exposure are more likely to influence certain mental health outcomes like psychological distress or post-traumatic stress disorder (PTSD). In this article, we propose the Disaster Exposure Matrix to explain how specific types and levels of disaster exposure are associated with particular mental health outcomes. We use data from the Sandy Child and Family Health study—an observational cohort study of 1000 randomly selected New Jersey residents who were living in the nine counties most-affected by Hurricane Sandy (2012)—to examine how direct and indirect disaster exposure at both the individual and community levels influence the likelihood of experiencing psychological distress and probable PTSD in the two years after Hurricane Sandy. Weighted logistic regression models demonstrate that particular measures of individual-level direct and indirect exposure uniquely influence probable PTSD and psychological distress, respectively. Community-level indirect exposure is significantly associated with psychological distress but not with probable PTSD. Findings highlight the importance of specificity when measuring the effects of disaster exposure on mental health, including separating exposures that occur at the individual and community level, as well as distinguishing those that are experienced directly from the event from those that are indirect and experienced after the meteorological or geophysical event has passed. PubDate: 2022-12-01 DOI: 10.1007/s10615-021-00814-y
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Abstract: Abstract Sexual minority men are at a higher risk for body dissatisfaction (BD). Previous studies have found that experience of sexual minority stress heightens BD. The protective effects of satisfying relationships with one’s romantic partners and parents are underexplored in this population. This study examined the individual effects of sexual minority stress, romantic relationships, and child-parent relationship and explored the moderating effect of relationship satisfaction. Data came from a sample (n = 405) of gay (86.8%) and bisexual (13.2%) men (mean age = 28.54, SD = 5.6) in Taiwan who responded to an Internet-based survey containing questions about BD, sexual minority stress, satisfaction with romantic partnership, and the quality of relationship with parents. Multiple regression analysis shows that those with a higher level of BD reported a greater level of sexual minority stress and poorer relationship satisfaction with a romantic partner and parents. Meanwhile, relationship satisfaction could not buffer the adverse effect of sexual minority stress on BD. This study suggests that sexual minority men’s BD is modestly associated with sexual minority stress while satisfying relationships with a romantic partner and parents protect against BD. These findings highlight that social workers need to address the interpersonal-level factors when working with sexual minority men to promote a healthy body image. PubDate: 2022-11-11 DOI: 10.1007/s10615-022-00855-x
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Abstract: Abstract The current study aims to explore whether the protective factors identified in the research literature for Black sexual minority adolescents in urban neighborhoods are similar to those of their heterosexual peers. Participants for the study consisted of 638 Black adolescents, aged 12 to 22 years, who resided in four neighborhoods in Chicago’s Southside. Findings indicated that for sexual minority adolescents, government assistance was negatively correlated with perceived school safety while having caring teachers was positively associated with perceived school safety. For heterosexual adolescents, caring parents, a lower level of peer victimization, caring teachers, and bonding to school were positively associated with perceived school safety. However, perceived connectedness to the neighborhood was negatively related to perceived school safety. Except for caring teachers, protective factors were not significantly associated with perceived school safety among sexual minority adolescents as they were for heterosexual adolescents. Overall, findings from the study demonstrate that although identifying protective factors is critical; for Black sexual minority youth, it is especially important to consider macrosystem-level factors that would impede feeling safe in school, such as the presence of racism and homophobia in the school environment. PubDate: 2022-10-25 DOI: 10.1007/s10615-022-00854-y