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  Subjects -> SOCIAL SERVICES AND WELFARE (Total: 224 journals)
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Clinical Social Work Journal
Journal Prestige (SJR): 0.498
Citation Impact (citeScore): 1
Number of Followers: 26  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1573-3343 - ISSN (Online) 0091-1674
Published by Springer-Verlag Homepage  [2469 journals]
  • The Clinically Modified Buddhist Psychological Model for Social Work
           Practice and Self-care

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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: 2022-06-24
       
  • Social Work Responses to Domestic Violence During the COVID-19 Pandemic:
           Experiences and Perspectives of Professionals at Women’s Shelters in
           Sweden

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      Abstract: Abstract This study explores how social work professionals at women’s shelters in Sweden experience, understand, and are responding to domestic violence under the impact of the COVID-19 pandemic. A qualitative longitudinal research design was employed, and multiple semi-structured interviews were conducted with 14 professionals at women’s shelters over a period of one year. The results are presented in three overall themes; (a) professional challenges due to increased needs, (b) professionals’ adjustments to new circumstances, and (c) professionals’ attributions regarding client barriers to help seeking. The results show diverse and changing experiences among the professionals as the pandemic progressed. Clients and professionals have shared the same collective trauma associated with the pandemic, which has affected the professionals’ understanding of and response to domestic violence. The professionals understand both clients and themselves as being more vulnerable and susceptible to risk under these new circumstances. Social work adjustments focused on maintaining contact, reducing risk and prioritizing safety, which had both positive and negative consequences for both clients and professionals. The study concludes that the professionals coped with the uncertainty they experienced during the pandemic by relying on both their previous knowledge and work experience of domestic violence and their experience of sharing trauma with clients.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-022-00833-3
       
  • Long-Term Effects of a Cult Childhood on Attachment, Intimacy, and Close
           Relationships: Results of an In-Depth Interview Study

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      Abstract: Abstract Cults are religious organizations requiring total commitment and submission from their members. They form a highly controlling environment with rigid structures to suppress individuality. Being born and raised within a cultic community has a significant impact on the life course of those affected. Especially after exit or exclusion, second generation ex-members commonly have to face different challenges. This study aimed to investigate these cultic childhood experiences and their long-term effects on the individual development and the further lives of those affected. Former cult members (n = 16) who were born and raised in cultic groups participated in an in-depth qualitative interview study. The findings indicate that growing up in a family belonging to a cult is often associated with serious restrictions, burdens and even traumatization. Later in life, this may lead to the development of self-esteem problems, mental disorders, and difficulties in intimate relationships. Individual life experiences should be taken into account when providing help for those who have grown up in a cult and managed to get out of it. Based on the study results, recommendations for psycho-social practice are presented in this paper.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-020-00773-w
       
  • The Mental Health Impacts of Successive Disasters: Examining the Roles of
           Individual and Community Resilience Following a Tornado and COVID-19

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      Abstract: Abstract Prior research has found that exposure to natural hazards and infectious disease are associated with adverse mental health outcomes. Less studied are the ways that individual-level and community-level resilience can protect against problematic mental health outcomes following exposure to successive disaster events. In the current study, we examine the role of individual and community resilience on mental health outcomes among 412 adults in Nashville, Tennessee exposed to an EF-3 tornado followed by the COVID-19 pandemic. Results found the cumulative impact of exposure to the tornado and COVID-19 was related to higher levels of PTS and depression symptoms. Individual resilience had a protective, inverse relationship with PTS and depression symptoms and mediated the relationship between community resilience and adverse mental health outcomes. Findings support the development of a multi-system disaster resilience framework that links individual resilience capacities to broader community resilience capacities to activate and sustain healthy adaptation following exposure to successive disasters.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00830-y
       
  • Traumatic Stress and Homelessness: A Review of the Literature for
           Practitioners

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      Abstract: Abstract A growing body of evidence connects traumatic stress and homelessness, which illustrates the importance of trauma and-resiliency-informed care (TIC) to appropriately serve persons experiencing homelessness (PEH). This paper reviews the literature on traumatic stress, including the biology of trauma as well as psychosocial, environmental, and systemic factors. These areas of knowledge constitute necessary elements when designing systems of care for PEH in order to provide effective services, avoid re-traumatization, and create healing environments to foster resilience. The authors identify trauma-specific evidence-based therapies, and comprehensive programmatic approaches that stem from established trauma-informed core values. Practical applications of the reviewed literature are utilized to demonstrate how organizations can adopt a trauma and resiliency-informed approach, based on both the reviewed literature as well as the authors’ collective clinical experience. A key takeaway is an emerging consensus that service providers must consider trauma when designing and offering services to persons with a history of homelessness. The authors offer recommendations for future pathways to create outcome measurement tools for social service providers based on the theory of self-efficacy and using concrete, quantifiable variables.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00824-w
       
  • Co-constructing a Conceptual Understanding of System Enactment

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      Abstract: Abstract System enactments are co-created phenomena characterized by confounding and emotionally charged multi-person interactions that emerge through the convergence of patients’ complex psychopathology, staff vulnerabilities, and the organizational dynamics of the clinical system in which all are embedded. There is ample literature about the psychoanalytic construct of enactment in the therapeutic dyad. Though systems-based clinicians often experience system enactments which transcend the dyad and occur within the projective field of the system, there is no comparable literature that discusses this phenomenon. This paper describes a qualitative study that investigated how psychodynamic clinicians understood the phenomenology and impact of system enactments on clinicians, treatment processes and organizational climate. Major themes were identified through qualitative analysis of the data. The following four key findings were distilled from the resulting themes of the study’s two research questions: (1) Clinicians conceptualize system enactments from a classical perspective; (2) System enactments have an experiential impact on clinicians in the domains of affect, cognition, behavior, and physiological arousal, which may be related to secondary traumatic stress responses; (3) Clinicians demonstrate a collapse of mentalizing associated with ruptures in the patient’s treatment, conflict in the working relationships between staff, and problematic organizational dynamics; and (4) Interconnected and reciprocal interactions among all levels of the system including patient subsystem, individual staff subsystem, intra-staff subsystem and organizational subsystem, are shaped by the impact of system enactments. A conceptual understanding of system enactmentis outlined, and implications for clinical social work education and practice, organizational policy-making and research are addressed.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00829-5
       
  • CTiBS and Clinical Social Work: Telebehavioral Health Competencies for
           LCSWs in the Age of COVID-19

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      Abstract: Abstract Licensed Clinical Social Workers (LCSWs) have been integrating technology into psychotherapy practice for at least two decades, but the COVID-19 pandemic dramatically shifted the primary method of service delivery for diagnostic assessment and therapy to telebehavioral health. By developing telebehavioral health competencies, the 250,000 + LCSWs in the US can ensure and enhance the quality of care both during and after the COVID public health emergency (PHE). This article applies an evidence- and consensus-based, interprofessional telebehavioral health (TBH) competency framework to the field of social work. This framework was developed by the Coalition for Technology in Behavioral Science (CTiBS), initially published in 2017. It has seven competency domains: (1) clinical evaluation and care; (2) virtual environment and telepresence; (3) technology; (4) legal and regulatory issues; (5) evidence-based and ethical practice (comprised of Standards and Guidelines and Social Media); (6) mobile health and apps; and (7) telepractice development. The framework outlines three competency levels (novice, proficient, and authority) covering 49 specific objectives and 146 measurable competencies or practices. The TBH competencies support existing in-person clinical practices and are intended for trainees and practitioners who are implementing TBH in practice. This competency framework can also be used to integrate clinical social work professional development, research, and training. Additionally, considerations for other behavioral health professions regarding licensure, certification, and policy may apply to clinical social work. Future research is needed on implementation and evaluation of the competencies.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00827-7
       
  • Interventions with Survivors of Interpersonal Trauma: Addressing the Role
           of Shame

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      Abstract: Abstract This practice article considers the empirical research on the relationship between shame and trauma resulting from interpersonal violence. It explores the evidence suggesting that shame rather than fear is a better predictor for the development of PTSD and presents the argument that shame, along with fear, should be acknowledged and addressed in the course of intervention with trauma survivors. The article defines shame in its relation to other self-conscious emotions, discusses the mechanism underlying the formation of shame, gathers evidence for the actions of shame in the maintenance of PTSD/C-PTSD and barriers to healing, and examines research supporting practice principles for working with shame. It provides guidance for identifying the unique ‘web of shame’ that may present in trauma survivors, an understanding of how shame effects behavior and emotional responses and suggests therapeutic strategies for working with shame. A case example is presented along with practice principles for working with shame in social work interventions with survivors of interpersonal violence.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00832-w
       
  • Adapting Trauma-Focused Cognitive Behavioral Therapy to Treat Complex
           Trauma in Police Officers

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      Abstract: Abstract Police officers are at risk of being exposed to multiple traumas throughout their careers. Compared to the general population, police officers are also at elevated risk for the development of post-traumatic stress disorder (PTSD), increased suicidal ideation, and increased substance use. Cognitive-behavioral interventions have proven empirical validity for the prevention and treatment of PTSD and complex trauma. However, the efficacy of these interventions in police officers has not been studied. This paper will provide the practitioner with an overview of the factors that contribute to the complexity of trauma exposure in police officers, describe trauma-focused cognitive behavioral therapy as an evidence-based treatment for this population, and illustrate how this treatment can be adapted to better fit the needs of police officers. Implications of these adaptations and suggestions for future areas of intervention research with law enforcement are also described.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-020-00770-z
       
  • A Review of Trauma Specific Treatments (TSTs) for Post-Traumatic Stress
           Disorder (PTSD)

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      Abstract: Abstract Trauma is a significant public health concern that has widespread and adverse effects on people. There is a high prevalence of trauma and PTSD in general populations, and that prevalence greatly increases among the clinical populations that social workers serve. To address the hidden epidemic of trauma, there are various trauma-specific treatments for PTSD. Scholars have highlighted a critical use of research evidence as a starting consideration in clinical decision-making and named the necessity to map out effective interventions according to population and types of trauma, including both conventional and non-conventional treatments. A rapid systematic review was conducted to fill this gap and found thirty-four empirically supported studies, including nineteen conventional and seven non-conventional treatment approaches for PTSD. The included conventional therapies are cognitive behavioral therapy (CBT), sleep-specific CBT, trauma-focused CBT, internet CBT, virtual reality exposure therapy, prolonged exposure, narrative exposure therapy, cognitive processing therapy, eye movement desensitization and reprocessing (EMDR), hypnotherapy, emotion focused therapy, skills training in affect and interpersonal regulations (STAIR), interpersonal psychotherapy (IPT), dialectical behavioral therapy (DBT), seeking safety, trauma incident reduction, accelerated resolution therapy (ART), metacognitive therapy, and imaginary rehearsal therapy. The non-conventional approaches included are yoga, physical activities, emotion freedom technique, acupuncture, mantram repetition program, mind–body therapy, and music therapy. We further explored the therapy content, population, type of trauma, outcomes, and strengths/limitations under each treatment to guide clinicians to select the best practice for idiosyncratic clients. Lastly, we discussed limitations of the current review, clinical considerations in selecting empirically supported treatment for PTSD and future research implications to guide clinical social workers.
      PubDate: 2022-06-01
      DOI: 10.1007/s10615-021-00816-w
       
  • Therapeutic Change in Couples Therapy: The Core Dynamic

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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: 2022-05-26
      DOI: 10.1007/s10615-022-00848-w
       
  • Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk
           Implications

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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: 2022-05-19
      DOI: 10.1007/s10615-022-00847-x
       
  • Critical Clinical Social Work Practice: Pathways to Healing from the
           Molecular to the Macro

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      Abstract: Abstract Interdisciplinary study in neurobiology, liberation psychology, and social work highlight the ways in which the brain is related to various cognitive, personality, and behavioral characteristics within a cultural context by blurring lines between dimensions, such as nature and nurture, person and environment, and micro and macro. This paper considers study findings that generate potential clinical social work strategies that are particularly relevant for communities of color experiencing ethno-racial trauma. The purpose of this paper is to support clinical practitioners’ efforts to use holistic approaches and practices by incorporating the “bio” component of the biopsychosocial paradigm as it relates to racism. There are at least three pathways by which racism may produce neurobiological consequences that affect the biopsychosocial functioning of populations of color: (a) socio-structural/environmental, (b) stress and/or trauma, and (c) epigenetics. The Flint, Michigan water crisis—wherein the local government allowed lead to contaminate the city’s drinking water causing negative health (brain and body) consequences for Flint residents, a predominantly Black and Brown community—presents an example of the intersecting pathways and autopoietic nature of racism that infects relationships, institutions and systems; causes dehumanizing affects; and produces ill effects as evidenced by racial health inequities. The issues, such as racial health inequities, that social workers struggle to resolve tend to be complex and multi-dimensional. Therefore, comprehensive practice is needed to support healthy biopsychosocial functioning. As such, this paper offers Critical Clinical Social Work Practice (CCSWP) informed by the Critical Transformative Potential Development (CTPD) framework. CTPD centers a trauma-informed and healing-centered approach to CCSWP by transforming consciousness into action to change self, relationships, and environment; ideally, working cyclically from the molecular to the macro. Given the field’s enduring commitment to social justice, the biopsychosocial model, and the person-in-environment perspective, social work is in a unique position to critically consider how brain health (bio) is affected by trauma (psycho) stemming from racism (social). These multi-level (molecular to macro) considerations empower clinical social workers to innovate integrated strategies that can overcome complex challenges perpetuating racial health inequities.
      PubDate: 2022-05-13
      DOI: 10.1007/s10615-022-00843-1
       
  • The Structural Clinical model: Disrupting oppression in clinical social
           work through an integrative practice approach

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      Abstract: Abstract It is critical that clinical social workers become actively aware of the endemic processes and manifestations of racism, social inequities, structures and dynamics of white supremacy within and across organizational, supervisory and clinical relationships. The Structural-Clinical Model (SCM) is presented, providing a multi-layered and theoretically rich pathway for clinical social workers to examine the intricate, and multifaceted interconnections expressing racialized oppressive forces across macro, meso and micro systems that impact the totality of clinical practice. SCM integrates critical race theory, liberation psychology, and relational theories bridging long standing theoretical and conceptual divides. The SCM aims to de-pathologize clients, recognizing instead the pathology of white supremacy, racism, and other oppressive structural forces affecting organizations, relationships and people’s lives, particularly those most racially, ethnically and historically marginalized within our society. The SCM is introduced with a structural assessment framework designed to explore how structural social inequalities produced by white supremacy impact social work organizations, the clinical supervisory relationship and the supervisor-therapist-client relationship. A multilevel case example is provided to demonstrate how structural power dynamics that influence service delivery can be identified through critical dialogue using the SCM in the clinical supervisory relationship and between the clinical social worker and client.
      PubDate: 2022-05-05
      DOI: 10.1007/s10615-022-00841-3
       
  • The 15 Year Relay

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      PubDate: 2022-04-27
      DOI: 10.1007/s10615-022-00846-y
       
  • “There is Just a Different Energy”: Changes in the Therapeutic
           Relationship with the Telehealth Transition

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      Abstract: Abstract The therapeutic relationship (TR), including its therapeutic frame, is the foundation of the therapeutic endeavor. In response to the COVID-19 pandemic and the rapid transition to videoconferencing for therapeutic encounters, we employed a cross-sectional exploratory survey with 1490 respondents to understand how practitioners adapted to the changes. In this secondary analysis focused on the TR, we analyze the clinicians’ (N = 448) spontaneous narratives about facets of the TR. Temporally, we focused on how these adaptations occurred during the initial part of the pandemic before vaccination was available and while the TR was still adapting to teletherapy videoconferencing under the duress of pandemic crises. We find three broad themes: (1) It is a “much more remote relationship”; (2) The "connection…remains surprisingly strong"; and (3) It is “energetically taxing.” Each reflects clinicians’ views of the TR as altered, but surprisingly resilient. Although grateful for the safety of virtual therapeutic encounters, clinicians mourned the loss of an embodied encounter, experienced depletion of energy beyond Zoom fatigue, and nonetheless recognized their clients’ and their own abilities to adapt.
      PubDate: 2022-04-25
      DOI: 10.1007/s10615-022-00844-0
       
  • Qualitatively Exploring Mental Health Attitude Changes among Emerging
           

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      Abstract: Abstract Emerging adult military members and veterans (MMV) are experiencing many transitions (e.g., adulthood, military). The sum of these changes can cause stress, anxiety, and mental health challenges. Stigma of mental health and treatment exists, and military populations are often not seeking or engaging in appropriate care. Recent research emphasizes the need to uncover mental health attitudes and self-stigma barriers regarding help seeking. We evaluated the impact of a single motivational-interviewing enhanced interview with 26 MMV, all who reported high risk substance use. In 75-minute interviews with the primary focus of discussing their experiences regarding mental health, substance use, and identity development, the interviewer incorporated motivational interviewing strategies (e.g., affirmations, complex reflections). Participants shared their developmental experiences, stressors transitioning, and barriers and stigma around mental health treatment. Participants completed a survey which included a variety of standardized measures and open-ended questions two weeks before and after the interview. Qualitative follow-up data via open ended questions shows the session was well received by participants as they could share their stories, think critically about their military experiences, and brainstorm solutions for mental health care. We conclude that using individual, confidential interviews to discuss sensitive topics for data collection with MMV is an area to continue developing. Conducting qualitative research with motivational interviewing strategies has the potential to be twofold: advance scholarship and inform practitioners, but also serve as a therapeutic platform for some participants.
      PubDate: 2022-04-22
      DOI: 10.1007/s10615-022-00837-z
       
  • Examining Racial Differences in Internalizing and Externalizing Diagnoses
           for Children Exposed to Adverse Childhood Experiences

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      Abstract: Abstract A substantial evidence base has established both that adverse childhood experiences (ACEs) deleteriously impact youth mental health outcomes and that racial biases in diagnosing youth are common among mental health professionals. However, the literature to date has hardly examined the relationship between ACEs and diagnostic disparities based on race. This study examines how racial disparities and ACEs contribute to childhood diagnoses of internalizing and externalizing disorders. Using data from the 2017 National Survey of Children’s Health, racial disparities in internalizing (i.e., depression, anxiety) and externalizing (i.e., behavioral/conduct problems) mental health diagnoses were analyzed using logistic regression. ACE score was a significant predictor of all three diagnoses and presented a dose–response relationship. Race was also found to be a significant predictor of diagnoses, as Black children were less likely to be diagnosed with anxiety or depression and more likely to be diagnosed with behavioral problems. Moreover, when examining racial disparities in mental health diagnoses by ACE score, the present study found that the severity of these disparities increased at higher ACE scores. Our study demonstrates that while ACEs are harmful for all children, providers’ identification of internalizing and externalizing disorders appears to occur differentially based on the race of the child they diagnose. These findings yield important insights about potential bias among healthcare providers, educators, and clinical social workers and warrant further research, training for professionals, and culturally responsive interventions. As such, we call on clinical social workers to lead the effort to address racial disparities within mental health services.
      PubDate: 2022-04-20
      DOI: 10.1007/s10615-022-00842-2
       
  • Building Resilience: Helping Emerging Adults Cope During the Novel
           Coronavirus Pandemic

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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: 2022-04-19
      DOI: 10.1007/s10615-022-00845-z
       
  • The Use of Neuroscience in Interventions for Intimate Partner Violence
           (IPV): A Scoping Review

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      Abstract: Abstract This paper presents a scoping review of empirical studies on the incorporation of neuroscience into interventions for survivors of intimate partner violence. Using Arksey and O’Malley’s framework for scoping reviews, 13 articles were collected for this review. The results showed an overall paucity of research incorporating neuroscience into intimate partner violence interventions. The majority of the studies were conducted in North America, split between various fields of medicine, nursing, psychology, and social work, and were all published between 2013 and 2020, showing the timeliness of this topic. A majority of the studies used quantitative design, with fewer using qualitative or mixed methods design. While some articles described fully integrating neuroscience into study design, most articles highlighted its significance and called for a further examination of the role of neuroscience in this field. This paper offers suggestions for the inclusion of neuroscience into social work practice with those impacted by intimate partner violence.
      PubDate: 2022-03-29
      DOI: 10.1007/s10615-022-00840-4
       
 
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