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Abstract: Social work regulatory rules and practices should balance the social values of promoting consumer safety and workforce equity. As the two values often compete, the balancing act should be guided by empirical evidence about the effects of regulations on consumers and the workforce. Unfortunately, however, empirical studies investigating the relationships between various regulatory rules and practices and consumer safety and workforce equity are rare in the existing literature. This paper identifies critical gaps in the current knowledge base and proposes a series of future research agendas that call for empirical evidence, including detailed data on jurisdictional regulatory rules and practices, the measures of consumer safety, and licensed social workers’ demographic, employment, and practice characteristics. The paper concludes by calling out to all social work stakeholders about the need for empirical evidence on the effects of social work regulatory rules and practices. PubDate: 2023-12-04
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Abstract: Adverse childhood experiences (ACEs) are relatively common among the general population and have been shown to be associated with eating disorders and body dysmorphic disorder. It remains relatively unknown whether ACEs are associated with muscle dysmorphia. The aim of this study was to investigate the association between ACEs and muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults. A community sample of 912 adolescents and young adults ages 16–30 years across Canada participated in this study. Participants completed a 15-item measure of ACEs (categorized to 0, 1, 2, 3, 4, and 5 or more) and the Muscle Dysmorphic Disorder Inventory. Multiple linear regression analyses were utilized to determine the association between the number of ACEs experienced and muscle dysmorphia symptomatology. Participants who experienced five or more ACEs, compared to those who had experienced no ACEs, had more symptoms of muscle dysmorphia, as well as more symptoms related to Appearance Intolerance and Functional Impairment. There was no association between ACEs and Drive for Size symptoms. Participants who experienced five or more ACEs (16.1%), compared to 10.6% who experienced no ACEs, were at clinical risk for muscle dysmorphia (p = .018). Experiencing ACEs, particularly five or more, was significantly associated with muscle dysmorphia symptomatology, expanding prior research on eating disorders and body dysmorphic disorder. Social workers should consider screening for symptoms of muscle dysmorphia among adolescents and young adults who experience ACEs. PubDate: 2023-12-01
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Abstract: Excited delirium is a term that has been used in policing and emergency medicine to describe a condition characterized by bizarre, agitated, and aggressive behaviours. In the article ‘Knowledge and skills for social workers on mobile crisis intervention teams,’ I used this term in reference to people in crisis who may present with engagement barriers and aggressive behaviours. Evidence has emerged that law enforcement organizations are using it to justify the excessive use of force by officers and deaths of people during police interactions. The American Psychiatric Association and American Medical Association have released statements emphasizing that excited delirium is not an official diagnosis and denouncing its use as a justification for the use of force against people with mental health concerns. Social workers should be aware of this controversy and avoid the use of this term in crisis intervention practice and documentation. I regret the inclusion of this language in my article and recognize that excited delirium is not a valid diagnosis, nor should it be considered a legitimate rationalization for the use of force by law enforcement officers. PubDate: 2023-12-01
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Abstract: Social work students experience high levels of stress, which makes them vulnerable to stress-related disorders such as depression. Attachment security has been associated with better stress regulation. Another factor that is closely associated with attachment is mentalization, i.e., the ability to reflect about one's own and others’ mental states, which may also influence the way people cope with stress. The main aim of the study was to investigate the impact of attachment and mentalization on stress, depression, and anxiety in social work students. 460 social work students completed the short version of the "Experiences in Close Relationships-Revised questionnaire” (ECR-RD8), “Relationship Questionnaire” (RQ-2), “Certainty About Mental States Questionnaire” (CAMSQ), “Perceived Stress Scale” (PSS-10) as well as the “Patient Health Questionnaire” (PHQ-9) and the “Generalized Anxiety Disorder Scale” (GAD-7) in a cross-sectional research design. The majority of the current social work students (71.1%) were assigned to an insecure attachment style and reported noticeably high levels of stress, depression, and anxiety. Insecurely attached students showed even higher levels of stress, depression, and anxiety compared to securely attached students. Moreover, the results indicate that securely attached students have better mentalizing skills and that mentalizing skills (partially) mediated the effect of attachment security on perceived stress, depression, and anxiety. Due to the importance of mentalization for stress regulation, mental health, and the quality of relationships, programs promoting mentalization in social work students should be implemented in social work education programs. PubDate: 2023-12-01
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Abstract: Solution-focused brief therapy (SFBT) is an empirically-supported psychotherapeutic intervention in treating mental health issues in the general population. When being delivered to adolescents and young adults (AYAs) diagnosed with cancer, specific techniques and skills of SFBT need to be tailored to meet the unique bio-psycho-social challenges of the AYA cancer population. Using a patient-centered approach, our team interviewed 14 AYAs with cancer who received SFBT for cancer (SFBT-C) to inform the tailoring and refinement of the existing SFBT intervention specifically for the AYA cancer population. Themes emerged within three broad categories that informed the tailoring and refinement of SFBT for AYAs with cancer, i.e., general experiences, strengths, and weaknesses of SFBT-C. AYAs with cancer found SFBT-C overall positively different from other approaches. Strengths include SFBT-C’s collaborative nature, using positive emotion as an important change mechanism, and a good balance between being relevant to cancer and not focusing too much on their cancer. Areas of improvement include assignment flexibility and different strategies to address resistance. The findings of this paper significantly inform the delivery of SFBT-C to AYAs with cancer using patient-centered feedback and input. PubDate: 2023-12-01
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Abstract: Clinical care following a severe brain injury often requires a host of physical and psychological rehabilitation interventions. However, a brain injury affects the entire family. Therefore, a family-level approach to neurorehabilitation services should be favoured over an individual one. Social workers are often well positioned to assess and address family-level processes. By exploring key family-level theories, models, and approaches to brain injury intervention, this article provides clinical social workers with practical guidance. Illustrated through a descriptive case example, it serves as a user-friendly resource for application in real-world settings. The skills and tools discussed will likely be familiar even to those without practice experience in neurorehabilitation. The value of emphasizing clinical process skills related to common factors in therapy rather than content expertise related to brain injuries is discussed. References for comprehensive brain injury family interventions and reliable sources of information for clinicians and families are provided throughout the article. PubDate: 2023-11-27
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Abstract: Couples therapy is challenging in many ways because there are two people who are in distress, each wanting more from their partner, to be understood, and to be responded to emotionally. A common denominator in a variety of approaches to treating couples is verbal communication. This relies on what is available cognitively to the couple. However, sources of tension and disconnection are often outside of their awareness, limiting the effectiveness of the treatment. Somatic-based approaches have strategies that both enable clients to access emotional experience that is held in their implicit memory and is outside of awareness; and regulate nervous system response, which is necessary to fully avail oneself of the growth process of therapy. These somatic-based approaches have been designed for individual therapy. I have adapted some of these somatic interventions to the couple dyad and have found this to be a crucial addition to couple’s therapy. Key components are providing and maintaining structure in session, tracking the body for signs of nervous system activation, employing strategies for nervous system regulation and implementing directed interventions. This somatic-based approach enables couples to communicate more effectively, respond to each other emotionally, solve problems between them and sets the conditions for memory reconsolidation to take place. PubDate: 2023-11-22
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Abstract: This article explores the concept of parallel process, the flow of unconscious client material from supervisee to supervisor and the reverse of this flow, which may lead to impasses within the supervisory triad. It also discusses the concept of modeling, or observational learning, which deviates from key constructs of parallel process, yet at times has been conflated with parallel process in social work scholarship, pedagogy, and practice. In highlighting the differences between the two concepts, we seek to show the scope of their respective explanatory power and to heighten awareness and help supervisors make conscious choices in supervision that align with a clear understanding of their theoretical underpinnings. We examine newer directions for parallel process that include its connections to neurobiology, trauma, and diversity, intersectionality, and cultural humility, and we provide two case vignettes to elucidate the phenomenon. Finally, we offer an integrative discussion of implications for supervision. PubDate: 2023-11-15
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Abstract: In an effort to provide engaging, strengths-based support to underserved BIPOC youth, I developed the Storiez trauma narrative intervention. Storiez is a nine-step process to support youth in reflecting on their experiences, creatively processing their narratives, integrating memories, and developing a future vision. Storiez is grounded in social work principles and rooted in trauma theory, narrative therapy, and the creative arts. Storiez demonstrates an amalgamation of lessons learned during my clinical encounters with urban youth, exploration of the trauma literature, participation in trauma trainings, and my own personal use of storytelling and the arts to process complex trauma. What began as an experimental, creative process with clients evolved into a formalized tool for urban youth across treatment settings. PubDate: 2023-11-04
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Abstract: Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP’s that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. PubDate: 2023-11-01
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Abstract: Family engagement, or meaningful family participation and involvement, has been linked to improved child welfare outcomes. Yet, to date, interventions to increase family engagement have been understudied. This study presents information from a pilot of the Texas Permanency Outcomes Project (TXPOP) Practice Model, an innovative model developed to increase family engagement and improve permanency outcomes for children in foster care in Texas. A total of n = 60 practitioners and caregivers completed the practice model training and completed a pre-survey (before any training) and post-survey (six-months after completing the last training). The survey included the scales related to family engagement, demographic information, and open-ended questions to expand on their experiences with the training. In parallel, all participants completed a feedback form with an open-ended question about overall experiences with the training within one week of the training. We examined attitudes toward family engagement and family engagement practices using two scales developed uniquely for the project. We compared pre-post scores on the family engagement measures and used thematic analysis to qualitative code open-ended responses related to family engagement. Four main themes emerged related to engaging families: empowering families, sharing power, providing explanations for children, and building a trusting relationship. Key takeaways for clinical social workers and child welfare agencies are explored. PubDate: 2023-10-31
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Abstract: Latino families in new destination states within the United States face significant burdens that adversely impact the suicide risk among their adolescents. Many of these adolescents’ lives depend on the clinical social work services they receive. Little is known regarding how clinicians providing services in new destination states conceptualize Latino adolescent suicidality and what strategies they use to intervene. This qualitative study explored clinicians’ experiences and understanding of suicidal behaviors among Latino adolescents and the strategies used to intervene in a new destination state. We situate the study within the unique history of Latino populations in new destination states in the United States and how that history intersects with clinical service accessibility and delivery. Ten clinicians working in mental health were interviewed. The data were examined using thematic analysis. Three themes were identified: (1) there is a lot, (2) trying to go above and beyond, and (3) hurdles. Overall, the results highlight clinicians’ need and desire for more support. Based on the findings, we offer recommendations for addressing service delivery challenges to increase the accessibility and quality of suicide prevention services for Latino families. We also provide clinicians with suggestions for suicide prevention intervention strategies that may be received well among Latino clients. PubDate: 2023-10-27
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Abstract: Latinx older adults have a high risk for depression; however, the impact of discrimination on mental health among Latinx older adults is relatively unknown. Critical consciousness (CC) and intersectionality theory can play a role in understanding the socio-political context that affects the social relationships and well-being among Latinx older adults. Using a Critical Educational Gerontology (C.E.G.) approach, this article presents a conceptual framework that can be utilized to enhance social relationships and well-being among Latinx older adult populations. The development of the conceptual framework presented in this article is based on literature about community-dwelling Latinx older adults who attend senior centers in New England. Previous research suggests that less acculturated and linguistically-isolated populations have lower rates of perceived discrimination. However, a growing body of research suggests that although one may not perceive certain acts as discriminatory, the effects of unfair and prejudicial treatment on one’s sense of self and well-being may have long-term, determinantal health and mental health consequences. Given the importance of mental health to healthy aging, it is imperative to develop interventions and resources that strengthen social relationships to address the detrimental impact of discrimination on mental health. Senior centers may be ideal for developing and delivering such interventions to community-dwelling Latinx older adult populations. PubDate: 2023-10-26
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Abstract: Social work’s ethical mandate to engage in social justice, coupled with its fraught history of complicity in oppressive policies, makes critical the disruption of bias and racism within social work practice. As influencers and guides in clinical learning, social work supervisors have the potential to disrupt racism. There is an emerging body of literature on how to effectively engage in culturally-conscious social work supervision. However, research on anti-racism supervisory strategies in social work is limited and predominantly conceptual. This exploratory qualitative study’s aim was to identify strategies used by social work supervisors who self-identify as “anti-racist” to disrupt racism in the practice of their supervisees. The major findings of this study include a foundational element in this process: the identification of biases. Based on these findings, this article outlines strategies that social workers can use to detect bias in their staff, as well as other implications for social work practice and research. PubDate: 2023-10-24
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Abstract: This article aims to rethink the clinical and social work with forced migrants through the concept of “field” as it is described in the context of Bionian psychoanalysis. The proposed approach goes beyond the individual trauma of the refugee, to arrive at a clinic of the “traumatic field” that includes, but also overcomes, the dyadic relationship searching for the link between intra-psychic, inter-psychic and social dimensions. The work with mediation “devices”, the dream field, and the group as a social witness will be discussed as operational tools of a clinical social practice of intervention extended to relevant emerging social contexts. PubDate: 2023-10-18
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Abstract: Medical social work is gradually developing in China, and children’s hospitals greatly need medical social workers. However, different groups have different perceptions of medical social workers’ roles. The role of nascent Chinese medical social workers in children’s hospitals is unclear, which hinders the growth of this profession. Therefore, this study aimed to resolve role ambiguity by comprehensively exploring the specific roles of Chinese medical social workers in a children’s hospital. A descriptive qualitative research design was adopted. Twenty-six participants, including medical social workers (n = 8), primary caregivers of children (n = 6), and medical staff (n = 12, including 6 doctors and 6 nurses), were recruited by purposive sampling at a tertiary-level children’s hospital in China between October and November 2022. Face-to-face semi-structured interviews were conducted to collect data. Three major themes with eleven roles were extracted through Colaizzi’s 7-step method of phenomenological data analysis: (1) the role identified by all three groups: psychological supporter, resource linker, and consultant; (2) the role identified by healthcare professionals: coordinator, planner, assessor, advocate, organizer, promoter, and educator; and (3) the role identified by medical social workers themselves: manager. This qualitative study was the first to comprehensively describe the eleven roles assumed by Chinese pediatric medical social workers in the hospital and role ambiguity among different groups. The lack of medical background and practitioners, as well as lower social status, led to medical social workers’ role ambiguity problems. Recommendations to strengthen policy support, cultivate a new medical social work culture, and increase the social understanding and recognition of medical social work to resolve role ambiguity are provided. PubDate: 2023-10-11
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Abstract: Since the MSW remains the terminal degree for practice, doctoral education is optional for clinical social workers. However, practitioners may consider earning a doctoral degree to advance their careers. Doctoral education is not for everyone, and this paper provides information about getting a doctoral degree to help practitioners make an informed decision. Social work now has over 100 doctoral programs and two types of doctoral degrees: the traditional Ph.D. and the “practice doctorate” called the DSW. These expanded options raise many questions about whether to get a doctoral degree; whether to choose a Ph.D. or DSW program; what doctoral study is like; what applications usually require; and what social workers with doctoral degrees do once they graduate. Issues of diversity, equity and inclusion (DEI) in doctoral programs are also discussed as they are important to all potential students but especially those who identify as BIPOC. There are also tips on how to survive and thrive while in a doctoral program, reassuring practitioners that getting a doctoral degree is possible. Finally, new directions in doctoral education in social work are discussed, which include the option of online study and changes to integrate anti-racist thinking into the curriculum and research. PubDate: 2023-10-10
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Abstract: The evidence for the potential of mindfulness-based programmes (MBPs) to support improved stress coping and feelings of burnout in social workers is growing. MBPs which are specifically designed for social workers might help to enhance social work practice, whilst simultaneously supporting reductions in stress, burnout, and attrition in the profession. The aim of this qualitative study was to explore the experience of twelve social workers who completed the Mindfulness-based social work and self-care programme (MBSWSC). Thematic data analysis resulted in six key themes being identified: professional motivation, mindfulness practice challenges and facilitators, benefits of increased self-awareness, impact professionally, use of mindfulness practices in direct work, the importance of having a social work tailored programme. This study provides further promising evidence of the acceptability and effectiveness of MBSWSC as a social work self-care and reflective practice programme. It is becoming increasingly clear that social workers are more likely to enrol in and fully engage with MBPs, which are specifically designed to support their social work practice and stress processing skills, if they are offered by their organisation. The increased access to MBPs of this nature is likely to lead to reduced burnout, and retention issues within the social work profession. PubDate: 2023-10-07
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Abstract: Previous research on the physical and mental health of firefighters indicates higher risk of coronary disease, stroke, cancer, hearing loss, and decreased mobility, as well as suicide risk, depression, anxiety, and substance use than in the general population. In spite of this, there is minimal research available on evidence-based interventions to reduce the impact of high-stress and high-trauma work on the mental health and well-being of firefighters. In collaboration with the Salt Lake City Fire Department, we conducted a feasibility study to understand how psychological resilience training influences the mental and social health of firefighters. A pre-intervention survey (n = 186) provided baseline data on firefighters’ mental health and wellbeing. Domains measured were depression, anxiety, stress, post-traumatic stress disorder, substance use, suicide risk, willingness to attend couple’s therapy, and quality of life. Three hundred firefighters then received three 90-minute training sessions on MindShield™, a newly-developed trauma-informed, mindfulness-based intervention. Analysis of measurement instrument completion rates suggests firefighters were amenable to the process, though concerns about data privacy may have inhibited response on certain instruments. Qualitative data derived from four post-intervention focus groups (n = 33) informed recommendations for future intervention delivery: shorter training sessions, leaving the training with a tangible reminder of the MindShield™ tools, embedding firefighters more into the training presentation, and clarifying data access and privacy protocols. Both the intervention and measurement tools used were generally well-received, indicating MindShield™ is a feasible intervention to mitigate the impact of high-stress, high-trauma work on firefighters. PubDate: 2023-10-04
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Abstract: A clear definition of clinical social work [CSW] remains necessary to guide education, to inform the public, and to orient funders and regulators. Yet, from its earliest origins, clinical social work has defied simple definition. With varying definitions, we wondered how contemporary clinical practitioners viewed their work, whether they affirmed these definitions, or included other aspects of practice, knowledge, skill, and practice focus. This qualitative study explored how 40 contemporary clinical social workers across the United States define CSW, theories, and skill sets that support its practice. Thematic analysis revealed that CSW practice has a person in environment focus, systems perspective and an emphasis on social justice. Findings also affirmed the view that CSW is a value and purpose driven practice that emphasizes the treatment relationship that utilizes the person-in-environment framework in relation to understanding, assessing, and treating psychosocial problems with unique perspectives and skills while addressing social justice concerns. Implications for social work education and practice included strengthening monitoring and evaluation since this was scarcely mentioned as tasks of CSW as well as identifying theoretical frames that align with the social work code of ethics and the profession’s overall identity. PubDate: 2023-09-25
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