SOCW 2001

Baby boomers

Americans born between 1946 and 1964; make up the largest age cohort in the US population. Their aging will necessitate a vast increase in health, recreation, housing, and nutrition services for people who are older, as well as increases in entitlement programs, such as Social Security -People will continue to live longer

Social work education

-Students in accredited BSW programs complete a minimum of 400 hours of field practicum; MSW students complete a minimum of 900 hours -Field practicum organizations include child welfare agencies, schools, hospitals, mental health agencies, senior centers, homeless and battered women's shelters, and juvenile and adult probation programs, among others

Historical background of SW practice with the elderly

-1945: the Gerontological Society of America was established to promote age-related issues -1947: the National Conference of Social Workers highlighted a paper by social worker Rose McHugh on practice with people who are older; McHugh emphasized the dignity and uniqueness of older clients -1958: the Council on Social Work Education, with support from the Ford Foundation, presented the Seminar on Aging in Aspen, Colorado. This was the first time social work educators discussed how to assess the social service needs of older clients and how to build a curriculum that prepared students to work with them -1960: the National Council on Aging was established -1965 Older Americans Act (OAA) established the federal Administration on Aging (AOA) and statewide Area Agencies on Aging (AAA), both of which were designed to coordinate and fund social services for older people -Unfortunately, both the EOA and OAA were and remain seriously underfunded. -1965: the federal government recognized the health care needs of people who are older with the establishment of the Medicare and Medicaid programs -1960s also saw a dramatic increase in the number of skilled nursing facilities; many nursing homes hired social workers to provide services for residents and their families -1971 White House Aging Conference: federal Department of Housing and Urban Development (HUD) worked to provide better housing for people who are older; one HUD project included building rent-controlled apartments for older people on fixed incomes -1974: Supplemental Security Income (SSI) was added to the public assistance package provided by the federal government; SSI provides income for older people living in poverty -1980s: the American Association of Retired Persons (AARP) became more visible and lobbied to increase and maintain gains made by and for older people; a nonprofit, nonpartisan organization dedicated to helping older Americans achieve lives of independence, dignity, and purpose -2003: Medicare Modernization Act (MMA); provided prescription drug benefits for Medicare-eligible seniors by implementing a Part D benefit where members enroll with private companies to obtain prescription medications; provision in the legislation does not allow the federal government to negotiate drug prices with the drug companies, a controversial position

Healthcare Reform of 1990

-1990s: Clinton administration created a task force that proposed universal health care, under which everyone would be covered by insurance, regardless of preexisting conditions and employment status -The task force also advocated for the development of a single-payer plan, in which health care would be financed by the federal government through payroll and personal taxes and administered by state governments; economic distinctions are eliminated in a single-payer plan, and everyone receives the same quality and quantity of care, regardless of ability to pay -1993 FMLA: requires public agencies, including state, local, and federal employers, local schools, and private-sector employers with 50 or more employees, to grant family leave and temporary medical leave under certain circumstances -An FMLA eligible employee must be granted up to 12 workweeks of unpaid leave during any 12-month period for any of the following reasons: the birth and care of the employee's newborn child, placement with the employee of a child for adoption or foster care, to care for an immediate family member (spouse, child, or parent) with a serious health condition, or when the employee is unable to work because of a serious health condition; on return from FMLA, the employee must be restored to his or her original job or to a job with equivalent pay, benefits, and other terms and conditions of employment -1993 Health Insurance Portability and Accountability Act (HIPAA): increased people's ability to maintain continuous health coverage when they change jobs by guaranteeing a continuation of eligibility for equivalent coverage and limiting the use of some preexisting conditions; HIPAA did not require employers to pay for health coverage, so the cost, which is very high, is borne by the employee who changes jobs or leaves the previous job; HIPAA does not apply to workers in all places of employment, and it does not permit people to keep the same health coverage when they change jobs -2 important amendments were made to HIPAA; as a result of the first, the Newborn and Mother's Health Protection Act of 1996 (NMHPA), health insurance plans may not automatically restrict benefits for a hospital stay in connection with childbirth to less than 48 hours following vaginal delivery or 96 hours following a C-section unless a doctor determines that the mother or newborn is ready for discharge; the second amendment, the Women's Health Care and Cancer Rights Act of 1998 (WHCRA), provides protections to patients who choose to have breast reconstruction in connection with a mastectomy; WHCRA does not require plans to pay for a mastectomy, but health plans that cover mastectomies are subject to WHCRA protections

Defining poverty

-2 ways of viewing poverty: absolute and relative -Absolute poverty: uses a dollar value that is firmly set; anyone who earns less than that amount is officially categorized as poor -Relative poverty: uses comparisons to determine who is poor and who is not; example: the median value of a home in 2013 was $160K; using a relative standard, any family that owns a house worth less than $160,000 is below the midpoint and therefore could; be considered relatively poor; a relative scale begins with agreement about the level of economic resources the average person should have and then uses that standard to determine who has enough and who does not -Official definition of poverty is in absolute style to determine eligibility for social welfare programs by the SSA originally; poverty threshold is the term for poverty line; today, poverty threshold set by the DHS of Census Bureau -Poorest populations in America (14%) show trend of poverty in children with single mothers, which is evidence of juvenilization and feminization of poverty -Juvenilization of poverty: tendency for children to be disproportionately represented in the ranks of those who are poor; even when poverty rates have been high, the poverty rates for children have been higher -Feminization of poverty: poverty is more likely to happen to women than to men; wage gap between men and women and childbearing costs mean women are more likely to reach poverty threshold

Healthcare Reform in the Obama Administration

-2010 Affordable Care Act (ACA): designed to lower healthcare costs over time by providing insurance for millions more people, making preventive care free, and changing how hospitals treat patients so that more people will be treated before they need expensive emergency room care

Historical background of the mental health system

-5 major movements in mental health since the early 1800s: the moral treatment movement, the mental hygiene movement, the community mental health movement, the legal advocacy movement, and the consumer movement -Early 1800s, there was no organized government effort to treat mental illness; people with mental illnesses were regarded as "lunatics," and their families took care of them; prevailing attitude was that mental illness stemmed from violations of physical, mental, and moral laws -Dorothea Dix brought about many reforms at both the state and federal levels, including the founding of more than 30 public and private institutions -The early twentieth century was a time of progressive public policies; advocates of improved public health-focused attention on care and treatment in mental hospitals; recognition of the needs of people with mental illnesses led to the development of the first psychiatric units in hospitals, which moved away from punitive moral treatment to a more medical approach -WWII brought the use of psychotropic drugs, or antipsychotics -Community Mental Health Centers Act was passed in 1963; encouraged the deinstitutionalization of people with mental illness; the shift in the location of psychiatric care from inpatient facilities, particularly public mental hospitals, to the community; it was believed that previously institutionalized people could take psychotropic medications and live in the community while being supervised by community mental health professionals -1980s-90s consumer movement: People with mental disorders and their families became advocates for better care; organizations such as the National Alliance on Mental Illness was created to educate the public and reduce the stigma of mental illness. Building public understanding and awareness through consumer advocacy helped bring mental illness and its treatment into mainstream medicine and social services -Recovery movement: grew out of the consumer efforts discussed earlier and has had a transformational effect on mental health practice; although illness and disease have been the focus of the mental health system for many years, a shift began to take hold in the early 2000s and has continued to the present time; the US Department of Health and Human Services issued a statement encouraging public mental health agencies to utilize a recovery approach; since that time, recovery has been rapidly becoming a primary approach to mental health care in agencies around the country -The recovery model stresses that people with mental health issues can and do recover, and can be engaged in productive ways in their communities; however, recovery in mental health does not necessarily mean that people recover completely from their illness as it does when talking about physical health; the model states that consumers should direct their own recovery, determining what goals they want to achieve; this means that there are many paths to recovery, and the process may be different for each consumer; this person-centered focus follows the social work diversity perspective, acknowledging and embracing differences based on experience, culture, race, ethnicity, gender, sexual orientation, and class as well as the many other ways that we differ from one another -The recovery model is holistic, focusing on all aspects of a person's life; part of the recovery process can involve helping consumers find housing, work, a strong support system, education, engagement in the community, and a religious or spiritual connection, in addition to mental health services; the model also focuses on encouraging consumer strengths and avoiding labeling consumers.

Social factors of mental illness

-A client's problems must be seen in the context of the social environment (i.e., family, peers, colleagues, friends) and the larger physical and cultural surroundings -Example, a few mental disorders, including depression, panic disorder, and eating disorders, disproportionately affect women; they are more likely to experience depression and anxiety than men; it may be the result of biochemical differences or environmental stressors or both -Other disorders affect more men than women; men are more likely to develop substance abuse and antisocial personality disorders -There is a reciprocal relationship between a child's biological state and the environment; physiological changes may result from exposure to trauma (e.g., abuse, neglect, violence, or separation from a parent) and may interfere with the child's development of the ability to deal with an adverse environment; biological vulnerability sometimes occurs first, making some children more susceptible to problems when their environment is not nurturing -Social factors that increase biological risk include inadequate prenatal care, which can lead to prenatal damage from low birth weight; exposure to alcohol, tobacco, or illegal drugs, which can trigger or exacerbate mental disorders; exposure to toxic chemicals; and dangerous living conditions -Social work's emphasis on the person-in-environment concept is particularly appropriate for understanding the reciprocity between biological and social factors in promoting mental health

Biological and psychological factors of mental illness

-Successfully diagnosing and treating mental disorders requires a biopsychosocial perspective that focuses on interactions between a person's social environment, medical history, past experiences (e.g., trauma, family, peers, school, larger sociocultural environment), psychological variables, and genetic factors

The current mental health system

-A de facto mental health service system because it is simply a loosely coordinated set of public (government-funded or operated) and private services; the US Surgeon General refers to four segments within the de facto system: specialty mental health services, general medical/primary care services, human services, and voluntary support network services -Specialty mental health services are those provided by mental health specialists, including social workers, psychologists, psychiatrists, and counselors -General/medical primary care service providers include doctors and nurses in hospitals and primary care physicians in clinics; for many people who enter the de facto mental health system, the first point of contact is through medical doctors or hospitals; primary care physicians have been the focus of educational efforts by mental health professionals to assist them in recognizing early symptoms of mental disorders, particularly clinical depression -The human service sector consists of social services, school-based services, counseling, vocational rehabilitation, prison-based services, and religious-based social services; this sector is by far the largest provider of children's mental health services -The voluntary support network sector consists of self-help groups such as Alcoholics Anonymous (AA) and similar 12-step programs; Recovery Inc., a support group for people with mental disorders; and other support groups sponsored by voluntary organizations like the National Alliance on Mental Illness and Mental Health America -The goal of managed care is to reduce costs by emphasizing cheaper, brief treatments or group treatment approaches, by making sure applicants for service meet criteria, and by reviewing the medical necessity of all treatment; incentives, in which professionals receive bonuses for providing less care, and risk-sharing contracts, in which providers agree to treat a specified number of consumers for a specified cost, are features of managed behavioral health care service delivery; limiting the number of annual outpatient visits and limits on inpatient care are also common features of the managed care system -Deinstitutionalization was prompted by the need to reduce the costs of psychiatric care, by attention to the rights of people who were involuntarily hospitalized, and by advances in evidence-based psychosocial and psychotropic drug treatment -The fragmented delivery system is further complicated by the criminalization of mental health problems coupled with ineffective follow-up care after discharge from hospitals and inpatient psychiatric facilities -To address the shortage of inpatient beds discussed earlier, and the gaps in community treatment, 45 states and the District of Columbia have developed assisted outpatient treatment; AOT, also known as outpatient commitment (OPC), allows someone with a serious mental illness and a history of medical noncompliance to be released into the community with a court-ordered treatment plan

Change agent

-A social worker or other helping professional or a group of helpers whose purpose is to facilitate improvement

Health

-A state of complete physical, mental, and social wellbeing and not merely the absence of illness -Medical model: US health system follows this; the sickness is located in the patient, and the physician or licensed expert has the authority to heal or cure it; it is a deficit model in that doctors' questions are designed to elicit disabilities, distress, dysfunction, and dependency; strengths, successes, and effective coping strategies are not solicited or taken into account; every clinical intervention is an attempt to cure a disease or sickness; there is little connection between the patient and the patient's environment (ex: community context, social life, workplace); the role of patients in their own healing is diminished; they are rewarded for being passive; patients learn to place complete trust in the authority of the doctor; they wait for illnesses to go away or be cured by the doctor, and they get angry if the doctor does not cure; the doctor's main goal is to eliminate symptoms and complaints or cure the sickness; this view of health care is contrary to the social work values of emphasizing strengths and empowerment -Wellness model: places the authority and responsibility for health on each individual; promotes a healthy lifestyle in the areas of physical, social, mental, and environmental wellbeing, and works to create strong and healthy communities with safe and clean physical environments; the wellness model emphasizes prevention; the preventive aspects of the wellness model empower the patient and make him or her the doctor's partner in a comprehensive and well-coordinated plan to enhance the quality of life; the growing use of the wellness model is accompanied by increased reliance on alternative medical methods (acupuncture and homeopathy); emphasis on wellness and prevention may eradicate the artificial barriers between mental and physical health; there will be as much focus on psychological disorders resulting from lifestyle, environment, substance abuse, and stress as on the treatment of physical diseases

Roles of social workers in healthcare

-Acute care settings include hospitals and other inpatient environments; generally involves a two- or three-day stay in a hospital; SWs can be found in almost every hospital unit, including intensive care, kidney dialysis, oncology, newborn nurseries, neonatal intensive care, pediatrics, and geriatrics -Psychological assessment -Discharge planning -Ambulatory care includes outpatient services, education, counseling, and community outreach -Long-term care (LTC) is medical care within a residential setting provided to individuals who are unable to care for themselves but don't need the intensive services provided in a hospital; LTC can be provided through home healthcare or in outside facilities such as nursing homes; levels of care range from complete care to limited services such as the provision of meals and help with dressing or bathing; long-term care settings include nursing homes, rehabilitative facilities, assisted living residences, hospice care facilities, and patients' homes; social work services in long-term care settings focus on both chronic physical conditions and emotional wellbeing -Nursing homes are residential healthcare facilities that provide medical care like that that is provided in a hospital, although not as intensive; they often serve as a stepping-stone for people, particularly older people, between the hospital and a return home or a move to a less medically oriented setting -Assisted living facilities are designed to emulate retirement living; promote social activities, congregate dining, and recreational opportunities; often have living rooms, TV rooms, and private dining areas that residents can reserve; differ from retirement communities in that they offer a continuum of medical care and assistance with daily living tasks; often there is medical personnel on staff; residents can receive assistance with bathing, dressing, and upkeep of their small individual rooms or apartments; assisted living facilities are much less restrictive than nursing homes, but more structured and medically equipped than people's own homes; they are expensive, and the costs are not covered by health insurance -Hospice provides services for people with terminal illnesses who are expected to die within 6 months; services are offered in the person's home or in inpatient hospice facilities; the hospice movement calls on specialized skills in counseling related to grief and dying; hospice SWs typically work in interdisciplinary teams to help dying patients and their family members and friends prepare for natural death -A developmental disability is a severe, chronic disability that is attributable to a mental/physical impairment that manifests itself before 22 and is likely to continue indefinitely; disability results in substantial limitations in 3+ areas of major life activity, such as self-care, learning, mobility, economic self-sufficiency, and capacity for independent living; intellectual disability, autism, cerebral palsy, epilepsy, and Down syndrome are common developmental disabilities -SWs serve as case managers, coordinating services to ensure that clients' needs are met; advocate for clients' rights within the maze of programs and services, and also for the development and implementation of well-funded, client-centered programs that meet the needs of diverse client groups; SWs investigate claims of abuse and neglect by caregivers, educate parents and other providers about available resources, and work in programs that train and employ people with developmental disabilities; SWs are also involved in preventing developmental disabilities through efforts to reduce poverty and improve prenatal care

Treatment of mental illnesses

-Although the recovery model can be implemented in a variety of ways, a report from the Substance Abuse and Mental Health Services Administration outlined the following 12 principles for recovery-oriented systems: 1. There are many pathways to recovery. 2. Recovery is self-directed and empowering. 3. Recovery involves a personal recognition of the need for change and transformation. 4. Recovery is holistic. 5. Recovery has cultural dimensions. 6. Recovery exists on a continuum of improved health and wellness. 7. Recovery emerges from hope and gratitude. 8. Recovery involves a process of healing and self-redefinition. 9. Recovery involves addressing discrimination and transcending shame and stigma. 10. Recovery is supported by peers and allies. 11. Recovery involves (re)joining and (re)building a life in the community. 12. Recovery is a reality. -Assertive community treatment (ACT) is an integrated, intensive, community-based treatment approach for people with serious mental illnesses; a multidisciplinary team composed of cross-trained psychiatry, social work, nursing, vocational rehabilitation, and substance abuse staff, as well as a peer specialist, provides services 24 hours a day to help consumers succeed in the community -Psychiatric (or psychosocial) rehabilitation teaches skills needed to function as normally as possible in the community. Consumers learn how to reduce the effect of their ongoing symptoms of mental illness and promote wellness and recovery -Cognitive-behavioral psychotherapy is based on the premise that faulty thinking results in unwanted behavior; the consumer is taught to change his or her reaction to faulty thoughts when they occur

Explanations of social injustice

-Biological determinism: the notion that success is predetermined by innate intelligence; is incompatible with the social work values that people are shaped by their environment and are capable of change -The socialization process: when children see stereotypical representations of members of various groups on television and in the movies, they begin to accept these stereotypes as reality -Psychological perspectives: in racism/prejudice, people are afraid of what they do not know and do not understand, translating to differential treatment; by scapegoating, putting the blame on others who are already on the margins, there is no need to examine social conditions or other reasons that may contribute to individual and community problems; projection -Sociological perspectives: scarce resources and self-interest can also help explain discrimination and oppression; because there are limited resources, there will be intergroup competition for these resources, which can create hostility; people begin to believe that the only way they can get ahead is at someone else's expense; economic insecurity fuels bias against oppressed groups; in a tight job market, people who are unemployed or underemployed may blame members of other groups for taking their jobs. -Functionalist perspective: discrimination and oppression serve a variety of purposes in society; even though they have a negative effect on oppressed people, prejudice/discrimination can build cohesiveness and solidarity among groups; politically, the people in power can benefit from oppression because they can blame problems on various oppressed groups, which is a form of systematic or institutionalized scapegoating, and it keeps the focus of people's anger off of those in power; similarly, when oppressed groups are fighting each other, people are less likely to join together to fight those in power; oppressed people are often an inexpensive source of labor; example, women traditionally make less money than men, so employers pay them less

Who are social workers

-CSWE accredited BSW and MSW programs -Upon graduation from an accredited BSW/MSW program and pass the exam associated with it (BSW, MSW or MSW with field practice); for clinical licensure, you must complete at least 2 years of post-MSW experience under LCSW supervision -Engage in micro practice/direct services to individuals, families, and small groups; macro practice by conducting research into social problems and their solutions, engaging in policy analysis, etc. -We must help individuals/families function better and at the same time work to change societal conditions that limit individual/amily functioning; example, Jane, who has recently lost her job, can benefit from job training and help with interviewing skills so that she can more easily get a new job; she and others like her can also be helped by social advocacy efforts to develop new jobs in low-income areas and by legislative efforts to provide health coverage for the unemployed and working poor -2 types of doctorate-level degrees: DSW (doctor of social work; original social work doctoral degree) degree or PhD (doctor of philosophy; has grown more common over years) degree, depending on the school attended; recent attempts made to make DSW more of an advanced clinical practice degree and the PhD more of a research-focused degree; social workers holding doctoral degrees usually work as social work educators, researchers, administrators, or policy analysts -NASW supports/advocates for social work professionals; the average NASW member holds a master's degree in social work, has practiced social work for 16 years, and earns on average $45,000 annually

Advocacy

-Calls for knowledge of the public policy process; identifying/building on a community's assets can be a positive way to address poverty; example: SWs can get to know people living in a neighborhood and meet the community's informal leaders, who meet with public officials about the community's needs

Generalist social work practice

-Can include a wide array of approaches with different theories and emphases; allows SWs to choose from a variety of skills and techniques to find the best intervention to fit the person in his or her environment -General practice levels: individuals and families, groups, and communities

Roles of social workers in the child welfare system

-Case management includes assessing a child's problems and needs and determining what steps are necessary to provide services for the child and family; may include contacts with other service providers Case managers may need to advocate for a child to obtain services despite barriers in the process Case management is involved when SW tries to find low-income housing for a family, works with a foster family to provide counseling services for a child placed in the home, and works in a hospital to help a family find aftercare services for a child -Direct practice involves face-to-face contact with children and family members to form a therapeutic relationship and work through issues

Generalist social work practice with individuals and families

-Case management or family interventions -Case managers coordinate a program of services and refer clients to appropriate places where they can receive these services, follow up with the client, ensuring both continuity and coordination of the services that are provided; can develop a good rapport with, and a deeper knowledge of, the client and his or her concerns; can serve as an advocate for the client while providing linkages with other service providers -Case management is person-in-environment perspective; strategies include outreach and engagement, assessment of strengths and needs, planning for service or treatment, linkages to resources and referrals, service delivery monitoring, and evaluation of outcomes -Engagement and assessment using empathy and getting to know client; assessment; intervention; -Intervention services can take place through information and referral (I&R), the creation of network linkages, and the provision of direct services -Monitoring and evaluation

Major social welfare programs

-Cash assistance -In-kind benefits such as housing vouchers or food stamps -Entitlements (as cash assistance or as in-kind benefits); once a person is eligible to receive a benefit, there is no time limit to the receipt of that benefit; ex: Social Security -Public assistance programs: designed to alleviate poverty; means-tested programs, meaning that people must be poor to qualify for benefits; ANF, Medicaid, SNAP, and public housing -Social insurance programs: prevention of poverty; Social Security, Medicare, unemployment insurance (cash assistance), and workers' compensation (cash assistance) OR a private health maintenance organization (HMO) may provide health care services for individuals who elect to use its services and for people who are referred from government programs to use its services

BASIC APA CITATION FORMATTING

-Citing from a reference entry: "AUTHORS (YEAR) noted that..." (narrative); "...noted (AUTHOR YEAR)" is parenthetical -USE AUTHOR NAME AND PUBLICATION YEAR -Use APA 7th Edition; page titled References at the top, listed alphabetically by last name, and formatted double space with hanging indentation -Author name, and first initial. (YEAR.) Title. Publication information -If no year, use "n.d." -For title, capitalize only the first word, the first word after a colon, and proper nouns; italicize titles from sources published by own entity such as a DVDs, webpages, or books -Direct quotations include the author(s), year and page/paragraph of the quote; ---Narrative: Malone (2012) reported that "women who exercised regularly during pregnancy have children who score...5 points higher on intelligence tests" (p.297). -----Parenthetical: Exercising during pregnancy is important, as "pregnant women who exercised regularly during their second and third trimesters were 45% less likely to have gestational diabetes that those who did not exercise" (Harner, 2013, para. 4). -Paraphrases include the author(s) and the year of publication of source paraphrased. -----Narrative citations: According to Jones (2012), regular consumption of carrots reduces the need for cataract surgery in adults who are 65 and older. -----Parenthetical citations: Regular consumption of carrots reduces the need for cataract surgery in adults who are older (Jones, 2012). -PAGE NUMBERS EXPLAINED: -----Direct quotations: include page and paragraph number; if there is a page number, use; if not, use para number -----Paraphrase: generally do not include page and para number; include page and para number only if you want to point readers to a specific location of the information -----"yada yada yada (yada year)" (p. 169). -Narrative citations: the author name appears in the sentence itself, rather than within parentheses -Citing: -----Parenthetical: Paraphrase of an idea goes here (Author, Year). -----Narrative: Author (Year) reported that "quotation here" (p. xx). -USE & INSTEAD OF "AND" IN PARENTHETICAL CITATIONS; USE "AND" INSTEAD OF & IN NARRATIVE CITATIONS -Parenthetical quotations with page number: (Smith & Jones, 2013, p. 45) -Narrative quotation: Smith and Jones (2013) said "x..." (p. 45).

Overcoming social injustice

-Civil rights: the rights to which people are entitled because they are members of society; these rights afford people legal protection from discrimination and oppression; throughout American history, oppressed groups have been denied equal access to political, social, and economic institutions; for exam-ple, for many years, only white men could vote; employers could legally refuse to hire a person because he or she had a disability, was Latino, or was Jewish, among other reasons. African Americans were forced to sit in the back of buses, attend separate schools, and use colored only drinking fountains -Protection from discrimination: 14th Amendment: no state may "deny to any person within its jurisdiction the equal protection of the law." Even after slavery was outlawed and the South defeated in the Civil War, it was clear that African Americans, particularly those in the southern states, would not be afforded civil rights and protection from discrimination without intervention by the federal government -15th amendment: gave all men, regard-less of race or color, the right to vote -19th amendment: which guarantees women the vote -Civil Rights Act of 1964: outlawed discrimination or segregation in public accommodations and employment on the basis of race, color, sex, religion, or national origin as well as unfair or differential treatment of people of color in voter registration; gave the federal government the right to enforce antidis-crimination laws and punish people who broke them, and it gave individuals the right to sue those who discriminated; the Act of 1968 added protection against discrimination in housing -Age Discrimination In Employment Act protects employees who are 40 years old or above from being treated differently at work on the basis of their age. The law, which applies to companies with 15 or more employees, is designed to eliminate the practice of terminating older employees based on stereotypes that older people are slower, harder to train, more out of touch with technology, and less adaptable to change than their younger counterparts. -Americans With Disabilities Act of 1990 outlaws discrimination against people with dis-abilities in public accommodations, employment, transportation, and public services; requires "reasonable accommodation" for people with disabilities in workplaces and public facilities -Employment Non-Discrimination Act prohibits employers from using sexual orientation as the basis for employment decisions such as hiring, firing, promotion, and compensation -Defense of Marriage Act: defined marriage as between one man and one woman, and it allowed states not to recognize as a marriage a union of a same-sex couple that may be considered a marriage in another state. In June 2013, the Supreme Court ruled that Section 3 of DOMA, which defined marriage between one man and one woman, was unconstitutional. In June 2015, the Supreme Court ruled that the constitution guarantees a right to same-sex marriage. This decision made marriage equality a reality across the United States -Matthew Shepard and James Byrd, Jr., Hate Crimes Prevention Act: empowers the Department of Justice to investigate and prosecute bias-motivated violence, to aid state and local jurisdictions with investigations and prosecutions of bias-motivated crimes, and to provide grants to cover the extra expenses often required for investigation and prosecution of hate crimes. The HCPA also requires the Federal Bureau of Investigation to include among the categories of statistics on hate crimes that it records those crimes committed based on gender and gender identity -Affirmative action programs aim to increase the number of women and POC in jobs/schools. The idea is that groups that have more re-sources should provide something to groups that have fewer resources. Many people think that affirmative action means preferential treatment and quotas. The original purpose of affirmative action programs was not, however, to set quotas. Instead, the policies were designed to require institutions to develop plans enabling them to go beyond business as usual and search for qualified people in places where they did not ordinarily con-duct their searches or their business. . . . The idea of affirmative action is not to force people into positions for which they are unqualified but to encourage institutions to develop realistic criteria for the enterprise at hand and then to find a reasonable diverse mix of people qualified to be engaged in it. -Refugees differ from immigrants in that they move due to coercion or danger in their lives

Social welfare system

-Collection of programs, resources, and services available to help people; social welfare addresses the wellbeing of people in society, and in order to enhance people's wellbeing, services are often developed through public federal/state laws/policies -Two approaches of the social welfare services: institutional and residual -Instutitional welfare services are meant to prevent problems; proactive and provide benefits or services to people before problems arise; Social Security, the national program that most people pay into during their working years, is available to people when they age, it guarantees a monthly payment to help keep people out of poverty; even if people are wealthy and do not need Social Security benefits, if they paid in while working, they receive monthly payments; everyone who paid in during his or her working years is entitled to, or guaranteed, benefits; the preventive aspect of this program is that it provides a minimum income to keep people in retirement from falling below the poverty line -Another institutional resource is a tax benefit, such as the exemption for children on federal income tax forms; a specified amount is deducted (subtracted from a person's taxable income) for each dependent child; provides all parents with a small break in taxes, not because there is immediate need, but because lawmakers recognize that raising children is costly -Residual services make up most US welfare services and come into play only after there is an identifiable problem; designed to address only the identified problem; for example, if a single-parent family is too poor to pay for even basic needs, certain programs can provide monthly cash assistance or credit to purchase food or help pay rent; available only when all other resources are lacking and when there is a documented need; this is a reactive approach to helping people (Reactive means that the response comes after the problem or need is identified)

History of US Social Welfare

-Colonial period 1690-1800: English; Elizabethan Poor Laws; in response to settlers experiencing illness and deprivation and death; poor were deemed worthy/unworthy to receive aid; worthy included widows, orphans, the elderly, and people with physical disabilities; unworthy included single mothers with kids out of wedlock and able-bodied single adults; aid for the poor first came from families, and only when the family absolutely could not provide economic support, did public authorities step in; legal residence establishment required; aid was temporary and only for emergencies; values we have in common: we also wait for need to arise, and provide aid on a case-by-case basis; resulted in our residual approach to social welfare services -Pre-civil war period 1801-1860: Residential institutions; purpose of rehabilitation; common value is the concept of residential institution/hospitalization -Civil War and postwar period 1861-1874: during the Reconstruction period after the war, the federal government tried to aid displaced families/make reparations for losses; the Freedman's Bureau became the first federal social service program to provide temporary assistance to newly freed slaves, help reunite families, provide medical care and food rations, and make property available; first organized federal effort to ensure social justice -Progressive era 1875-1925: economic and social transformations; major changes in social welfare and the birth of the profession of social work due to industrialization; Charity Organization Societies and the Settlement Movement -Great Depression and New Deal 1926-1940: Roosevelt's New Deal ideas that federal economic relief could be used as a stopgap measure to alleviate unemployment and economic slowdown and that major public investment was required to address poverty; immediate relief efforts coupled with the creation of long-term programs, all supported by the federal government; goal was to provide financial relief and short-term employment, then investing public funds to promote long-term employment; immediate efforts included the distribution of funds through the Federal Emergency Relief Administration and job placement through the Civil Works Administration; Social Security Act of 1935 provided long-term protections through a federal program of social insurance and public assistance and was the first comprehensive federal effort to ensure economic security and address poverty.; social insurance is what we refer to today as Social Security; Works Progress Administration; federal policies included the Securities and Exchange Commission and the FDIC -WWII and postwar economy 1941-1959: GI Bills funded education, training, employment services, and home and business loans to help returning soldiers adapt to civilian life -Social Reform years 1960-1975: War on Poverty was a series of policies and programs under the Economic Opportunity Act; demonstrated a renewed emphasis on social justice and the fair distribution of resources and opportunities; included job training, employment incentives, and community action; Medicaid and Medicare; Civil Rights Act and Voting Rights Act -Retrenchment period 1976-2000: Reagan; devolution, or the return of control of social services from the federal to the local level; the result was a diminished role for the federal government in antipoverty programs and increased variation among programsWelfare reform legislation passed in 1996 replaced the public assistance program called Aid to Families with Dependent Children; the result of welfare reform in the 1990s was to limit the total number of years that a family can receive public assistance, place more stringent work requirements on parents, and devolve program control and design to states; represent a strong retrenchment from federal responsibility for social welfare -New Millenium 2000-present: 9/11 caused shift away from devolution; federal response included aid to individuals, cities, and even the airline industry; due to Great Recession, the Troubled Assets Relief Program (TARP) was created to support companies and banks that were in critical financial condition; 2010 Patient Protection and Affordable Care Act was signed into law and was first successful attempt at creating health care coverage for all those who were uninsured

Historical background of diversity

-Colonization of the First Nations was sup-ported by the federal and state governments, which passed laws that allowed, encouraged, or mandated forcing the Indigenous Peoples from their homes to provide land for white settlers; nations were uprooted and moved to desolate lands, where they were often forced to live among other nations without any recognition of the vast cultural differences among them. Oppression, discrimination, and prejudice based on race also involved massacres by whites and decimation of native cultures. Children were forced to attend boarding schools where they had to forsake their cultures, including their religions, spiritual traditions, and languages, and learn to behave according to the dominant European American culture; forced relocation and enslavement -Expansion into Mexico -Immigration -Refugee status -Undocumented or unauthorized immigrants

Causes of poverty

-Culture of poverty: belief that people learn to be poor from growing up in impoverished areas, but fails to explain how some people who grow up poor become economically self-sufficient -Functionality of poverty: theory that poverty plays an important role in the economic structure and that there is little incentive to rid the nation of it; maintaining a pool of people who are poor means that workers are always available for less desirable and lower-paying but necessary jobs; maintains that poverty keeps wages from increasing too much too fast; most views are also laden with values about worthiness and deservedness -William Ryan coined the term "victim blaming"; argues that this is how Americans accept a society that rewards some people with good jobs, safe homes, and two-parent families while others do not receive benefits; if poverty is the fault of each poor person, then others do not need to examine the way income is earned or consider whether all people have the opportunity to acquire wealth

Roles of social workers in gerontology

-Current practice interventions; long term care; groupwork: support groups; therapy groups; social, recreational, and educational groups; service and advocacy groups; and family caregiving groups

Individualistic theories of criminal behavior

-Deterrence theory: Beccaria, father of criminology; people who don't associate certain, swift, and severe punishment with criminal activity will choose crime; we all have a free will and are responsible for our actions; criminals willfully choose crime; swift and severe punishment must be exacted, even for minor crimes -Biological determinism: Lombroso; criminals are genetic misfits or throwbacks to a more primitive, violent time. They may have an extremely low IQ or a biochemical imbalance; rehabilitation not possible -Psychological determinism: First popularized in the 1920s; defects of the mind are the cause of all misbehavior, including crime; internal forces, beyond the offender's control, determine destiny; criminal offenders should be housed in secure mental health facilities—some for life, others for whatever length of time necessary for them to be rehabilitated through therapy; criminals either have a mental illness or they are psychopaths; in other words, in Freudian terms, their superego/conscience failed to develop -Social disorganization/the subcultural hypothesis/cultural transmission: the roots of these theories come from Émile Durkheim; criminals emerge from poverty-stricken, deviant, and delinquent subcultures that have rejected the values of mainstream society; criminal values and actions are passed from one generation to the next; eliminate poverty; prisons and prison personnel must model a positive and supportive environment for prisoners; offer legitimate educational opportunities and job skills to offenders so that when they return to the outside world, they will have the means to access mainstream society's reward system; if the conditions of the geographic area are changed, people will have no reason to turn to crime; otherwise, people living in poverty must either accept their fate and work hard to gain little, or reject a classist society's values and resort to crime

Working with at risk students

-Developmental disabilities include mental/cognitive impairments appearing before 22yo -A learning disability is defined as a significant difference between the child's overall intelligence and their ability to read, write, or do mathematical calculations; ost children with learning disabilities are intelligent, but get frustrated with school because they can't master some academic skills as quickly as other children -ADHD: when a child repeatedly displays distractibility, hyperactivity, and impulsivity for more than six months -

Child development theories

-Ecological approach: SWs must identify the systems that affect the child's life (includes families, schools, peer groups, neighborhoods); the larger systems affecting a child may include public policies, the surrounding community, and changes in the federal system that result in resources or barriers for children; SW must consider the interaction between the child and these systems; hence the application of person-in-environment, or the ecological framework to identify all areas for intervention, not just those at the individual level -Human development theory: Prenatal stage: fetal development to birth; preventive health during pregnancy is important Infancy: birth to 3yrs; development of attachment in relationships is shown through recognition/interaction with caregivers/parents; skills of coordination, locomotor and sensorimotor skills, speech improvements; problems may occur if child doesn't have a healthy attachment to caregiver Preschool years: 3-5yrs; height and weight growth, more complex language, longer sentences, increased questioning and desire for understanding, forming of peer relations; problems can involve lack of social reactions, refusal to imitate others, refusal to eat, refusing to talk, etc. Middle childhood: 6-12yrs; includes elementary school yrs; cognitive improvements in memory, language, conceptual thinking, deductive reasoning, problem solving; problems may include psychosomatic complaints, anxiety/mood disorders, and educational or behavioral issues Adolescence: 13-18yrs; junior and high school yrs; growth spurts, hormone changes, reproductive system maturation, cognitive ability improvement in mastering complex processes, abstract thinking; seeking acceptance from peers; moral development -Cognitive development theory: Piaget; cognitive processes start out basic and concrete in infancy and become more abstract and complicated with moral development -Social learning theory: Bandura's idea that behavior is learned through socialization; the theory derives a variety of behavioral methods like modeling and positive reinforcement, for bringing about learned behaviors; parent training programs and residential/ group-home settings for children utilize social learning theory -Psychosocial theory: Erikson; children progress through clear stages of development; human development is presented as a series of psychosocial crises; ideally, people prepare themselves for the next stage of development by resolving each crisis; failing to resolve a crisis can lead to problems in later stages -These theories serve as the context for determining which intervention strategies are appropriate in a given situation

Ecological framework for practice and cultural competency

-Ecological framework for practice provides a strong foundation for social workers to integrate cultural sensitivity and multiculturalism. By understanding that all people are in constant interaction with all aspects of their environments, the social worker can recognize cultural and experiential differences. Such awareness helps the worker develop "an attitude of respect for the client's experiences and lifestyle, an appreciation of the client's right of self-determination, knowledge about the client's group's life, skill in helping and knowledge of human behavior" -Empowerment practice and ethno-conscious practice include strategies for effecting social change in addition to providing culturally competent social services. Both approaches should be grounded in a strengths perspective. Social work practitioners must identify the positive elements of each person's culture and build on those strengths

Theoretical frameworks for generalist social work practice

-Ecological systems framework: SWs need to understand their clients in the context of the social systems and people they interact with --Example: Client with AIDS; in addition to individual intervention, SW must understand every system he interacts with and the impact of that system on him -Strengths and Diversity perspectives: strengths outlines 3 principles that every individual, group, family, and community has strengths, trauma and abuse, illness, and struggle may be injurious, but they may also be sources of challenge and opportunity, and every environment is full of resources --Diversity perspective: SWs must know about the ways that people differ based on race, ethnic background, gender, ability, sexual orientation, religion, gender identity, class, and age; understanding and actively confronting our personal biases and developing a sense of cultural humility

Jobs and poverty

-Economic wellbeing doesn't always increase when more people are employed; one reason for this is because many people are underemployed or working poor, meaning their jobs do not pay enough to meet basic living expenses -In 2017, the national minimum wage was $7.25 per hour. If someone worked 40 hours a week for 52 weeks a year at minimum wage, her or his total annual income would be $15,080 before taxes or Social Security withholding, which is $20 above the poverty threshold for a single person -Income distribution is highly unequal; the top 1 percent of households hold more than 40 percent of all wealth. For all households, the top 10 percent hold 75 percent of all wealth, and the bot-tom 90 percent hold the rest, 25 percent of all wealth -Race a big factor in inequal income distribution; direct link between poverty and race, due to discrimination/prejudice

Values and ethics

-Educational Policy and Accreditation Standards outlines -Service; primary goal is to help people in need and address social problems -Social justice; challenging social injustice -Dignity and worth of a person; inherent -Importance of human relationships -Integrity -Competence -Human rights -Scientific inquiry -Ethical responsibilities: recognize and manage personal values in a way that allows professional values to guide practice (if you're homophobic and can't be unbiased towards a gay client, refer them to someone else); respect and promote the right of clients to self-determination (a client's right to self-determination should only be limited by actions or potential actions that may cause imminent harm to the client or others); respect a client's right to privacy and confidentiality; avoid conflicts of interest or dual relationships with clients; use appropriate supervision and consultation with colleagues when you are in doubt about the appropriate course of action to take or when you have questions about whether a particular action or behavior is ethical

Psychosocial interventions

-Fear accompanies poverty; fear of living in a dangerous neighborhood, fear of what will happen next -People in poverty typically feel out of control, that none of the things they have tried have helped change their economic conditions; poverty leads to negative mental health and contributes to depression and low self-worth; particularly harmful for children and affects their physical and mental development -Individual-level work should involve solution-focused interventions that emphasize what can be done rather than analyze problems; the goal is to help clients identify actions they've used in the past that have been helpful and to develop new ways to deal with problems; by focusing on prior successes, people feel better about themselves and begin to feel empowered to make changes -SWs can also increase employability by finding resources to support employment, like childcare/transportation/affordable clothing; it may mean helping other people complete high school or college or get work training -Group-level interventions include encouraging people to participate in mutual aid, self-help groups, or community activities; involvement in groups helps people feel connected and decreases their feelings of isolation as they struggle to make ends meet; groups can help people stop blaming themselves and instead begin to see the larger context of poverty in US society -Another intervention is to focus on people's natural helping networks—family, friends, or religious groups -Since the mid-1970s long-term economic growth hasn't improved economic wellbeing of full-time workers; contrary to expectations, the poverty of full-time workers was higher at the end of the 20th century than it was during the recession that preceded the economic boom of the 1990s; from the end of World War II-1970s, incomes of all families grew at a similar rate, but since the 1980s, income growth has been proportionately much greater for those at the highest levels, at rates four times that of lower earners; therefore, individual intervention without structural change is not sufficient in dealing with poverty; community-level interventions that stress advocacy and political change enhance personal interventions and can achieve social change.

Community practice

-Focused on creating change in the social environment; methods include organizing, planning, development, and change -Models of community practice include neighborhood and community organizing, functional organizing with people of special interest or concern, community social and economic development, social planning, program development and community liaisons, political and social action, coalition building

Sociological aspects of aging

-Gerontological SWs need to understand social roles and expectations; example, marital roles, grandparenthood, and sexual behavior, and how they change as people age -Activity theory and disengagement theory examines role changes among the elderly -Activity theory states that the more active a person is, the more satisfied he or she will be during the "golden years" -Disengagement theory says that to withdraw and become more introspective as one grows older is normal and healthy -Both behaviors can be found in people as they age

Human development within the social context

-Gerontological SWs use the ecological approach to examine the context of a client's life -4 major relevant categories are biological and physiological aspects of aging, cognitive processes and emotional/psychological development, sociological aspects of aging, and legal, political, and economic aspects of aging

Social worker roles in fighting social injustice

-Helping clients find and meet with others in similar circumstances so that they can work together to solve problems -Ensuring that clients know agency policies, including grievance policies, so that they can advocate for their rights -Teaching clients when threats or disruptions might be effective in getting their needs met -Supporting clients' decisions about what is right for their lives

Sociological theories of criminal behavior

-Hold individuals accountable but also suggest that society and prison environments need to change -Structural problems such as poverty, inequality, constrained residential patterns, and institutionalized racism, rather than personal, psychological, or biological problems, are viewed as the root causes of criminal behavior -Broken window theory: Wilson and Kelly; the level of crime committed in an urban area is correlated with the number of broken windows; the theory suggests that neighborhoods in which police tolerate misdemeanors are most likely to have high rates of felony-level crimes; according to the broken window theory, changing the context will eliminate or radically reduce the criminal behavior; suggests that focusing on little things in the environment is more effective than trying to directly fix the problems of institutionalized racism and poverty

Child welfare

-Includes activities, programs, interventions, or policies that are intended to improve the overall wellbeing of children -Maltreatment is the physical or mental injury, sexual abuse, or exploitation, negligent treatment, or maltreatment of a child by a person who is responsible for the child's welfare, under circumstances which indicate that the child's health or welfare is harmed or threatened thereby, as determined in accordance with [federal] regulations -SWs must notify CPS -CPS is responsible for the investigation of allegations of abuse/neglect, protection of children at risk of abuse or neglect, service delivery, and placement of maltreated children; SWs serve as CPS intake workers, caseworkers, supervisors, and administrators -Foster care is a major social welfare program to care for children outside of their families; the idea is for a child to be placed in a foster home while the family receives services to overcome problems; the ultimate goal is for the child to return home This goal is implemented through permanency planning; to provide stability for children in foster care, SWs follow federal guidelines; first choice should be to return a child home; if that fails, the second choice is adoption; if a child is not adopted, foster care becomes the long-term solution -Family preservation services: "activities designed to help families alleviate crises that might lead to out-of-home placement, maintain the safety of children in their homes, support families preparing to reunify/adopt, and assist families in obtaining services and other supports necessary to address multiple needs in a culturally sensitive manner" Purpose of family preservation is to provide support so crises can be averted; or if crises do occur, families are helped to cope and stay together Often these supportive services include parenting education classes, individual or family counseling, alcohol and drug services, in-home visits, and referrals to needed community services -Juvenile justice handles delinquency, juvenile detention, probation programs, juvenile court proceedings, and case management Local and state governments use the system for issues related to children like crime, violence, running away; it is also the legal forum where decisions about removing children from their homes in cases of abuse or neglect are made Because of its involvement in abuse and neglect cases, the juvenile justice system is considered to be part of the child welfare system

Implications of diversity in social work practice

-Keep in mind the influence of history on oppressed groups such as black people or Indigenous Peoples

Cost of poverty

-Lack of affordable housing, mental illness -Homelessness; Stewart B. McKinney Homelessness Act: designed to provide resources and services to address the problem of homelessness -Poverty is related to inadequate health, substandard housing, low educational achievement, drug use, and dangerous living situations -The consequences of living in poverty are shorter life spans, inferior education, poor health, hunger, and lack of opportunity

Historical background of child welfare system

-Late 1800s and early 1900s; poor living conditions in orphan asylums; concern as to whether children can be socialized/integrated into society when raised in institutions; new theories of intervention were developed One solution, called "placing out", arranged for children to live with substitute families, or foster care -1912 creation of US Children's Bureau; responsible for monitoring the condition/treatment of children nationwide -1921 creation of Child Welfare League of America; privately-owned; concerned wellbeing of children; concept of assistance to mothers was introduced; development of juvenile court system -1940s-50s saw reduction in institutional and foster care; family preservation and keeping family together was new focus Friendly visits by Charity Organizations were replaced by counseling and assessment Wraparound services is a strength-based response to child welfare; the child and the family develop a set of goals, a team of people who are relevant to the child's wellbeing work collaboratively to develop and implement a care plan to meet goals -Family group decision making adopted by many states supporting the idea that families can contribute to decision making in child welfare

In-kind benefits

-Medicare -Medicaid -Veterans Health Services -SNAP -Public housing units in federally built complexes administered by local authorities; eligible poor families/elderly persons pay minimal rent -Section 8 housing involves government vouchers given to low-income families to supplement their rent; privately owned apartments are officially designated by local housing authorities as Section 8 residences and are available to voucher recipients -WIC provides nutrition and health assistance to low-income pregnant and new mothers, infants, and children up to the age of five years -School Breakfast and Lunch Program

Healthcare Reform of 1960

-Medicare was added to the Old Age, Survivors, and Disability Insurance program to complete the social insurance coverage of retirees -Medicare provides health insurance coverage to people who are eligible for Social Security and for some in certain categories of medical need; Part A of Medicare covers inpatient hospital costs, post-hospital nursing facility services, home health services, and hospice care; it is funded by payroll taxes and contributions by employees; part B, Supplementary Medical Insurance, is a voluntary program subsidized by the federal government; people who choose to participate pay monthly premiums, an annual deductible, and copayments for services; Part B covers physician services, outpatient services, and diagnostic tests. -Medicare was expanded in 2003 through the Medicare Prescription Drug, Improvement, and Modernization Act, which created Part D, a new prescription drug benefit; recipients can opt to enroll in subsidized prescription drug coverage and pay monthly premiums, an annual deductible, and copayments -Long-term nursing care often not covered by Medicaid -Health Maintenance Organization Act of 1973 helped start the managed care movement

Models of intergroup relations

-Melting pot: with exposure to the mass media and a common educational system, newcomers to the US would eventually lose their cultural uniqueness and become Americans; all Americans would share beliefs, customs, values, and a language; in spite of close contact between groups and a common public educational experience, the expected melting of cultures has not occurred -The melting pot ideal rests on the belief in a unique American culture distinct from other cultures - in reality, all groups were supposed to aspire to an Anglo-European culture; in other words, the historically dominant white, Anglo-Saxon Protestants would be able to retain their culture, but all other groups were to give up theirs and adopt the dominant culture -Cultural pluralism: people retain their unique cultural characteristics while they mix socially and economically with other groups; they can live and work together, yet each group is valued for its unique contribution to society; people can be proud of their cultural heritage, retain their own language, and continue to observe their traditions; they draw on their cultural heritage to create strong communities and increase self-awareness and self-respect -Separatism: groups live in the same country but do things as separately as possible; each group develops its own social and economic institutions; means further excluding members of oppressed groups from mainstream systems and institutions -Separatism by dominant groups is often fueled by prejudice and discrimination; on the other hand, members of non-dominant groups have at times made decisions to live as separately as possible from dominant culture; their desire to separate is usually a response to being left out of mainstream society, of not feeling safe, and of seeing little chance of social and economic success if they remain within the dominant culture

Historical background of the US healthcare system

-Mid-1800s: first organized efforts at developing a health care system through the public health movement -Early 1900s: advances in knowledge about the contagion of bacterial diseases support the attempts of public health advocates to institute reforms that could positively affect people's health; health and medical organizations and services began to develop; social work began to participate in the movement -Social workers such as Jane Addams and Florence Kelley pressed employers to improve working conditions and provide health care coverage -1933: economic upheaval caused by the Great Depression; patients could not afford medical care, which prompted doctors and hospitals to develop health insurance companies, including Blue Shield -1950s: health insurance was primarily provided as part of employment -1960 Healthcare Reform

Cultural competency

-Multiculturalism is regarded as the ideology that society should recognize and include equally all different cultures -Cultural competence is the worker's ability to understand individuals, families, and communities of different cultures and to use that understanding as a basis for intervention and practice; one must understand the effect of culture on the person in environment—what an individual's culture means to him or her in all his or her systems; includes awareness of the effect of oppression and discrimination on people's lives. To be culturally competent, social workers must understand the his-tory and current realities of people from various cultural backgrounds

Social Work's Mandate for Social Justice

-NASW Code of Ethics addresses commitment to social justice; social justice is one of the 6 core values -"Social workers promote social justice and social change with and on be-half of clients. "Clients" is used inclusively to refer to individuals, families, groups, organizations, and communities. Social workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice" -"Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers' social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people" -Council on Social Work Education's Educational Policy and Accreditation Standards shape/monitor social work curriculum programs; "purpose of the social work profession is to promote human and community well-being. Guided by a person-in-environment framework, a global perspective, respect for human diversity, and knowledge based on scientific inquiry, the purpose of social work is actualized through its quest for social and economic justice, the prevention of conditions that limit human rights, the elimination of poverty, and the enhancement of the quality of life for all persons, locally and globally"; it is not enough to work on the individual level

Hate crimes

-Occur when people are victimized because of their race, ethnicity, religion, sexual orientation, ability, or gender or gender identity -Surge of hate crimes and groups as of 2016; particular rise in anti-Muslim hate groups

Cash assistance programs

-Old Age Survivors Disability Insurance/Social Security provides benefits when a covered worker retires or becomes disabled, and it also covers the worker's surviving spouse or children who are under 18 -Unemployment insurance -SNAP: uniform eligibility set by fed gov -Worker's compensation -TANF: entire family is eligible to receive benefits for no more than 24 consecutive months and a lifetime total of five years; all adult participants must spend 20 hours per week in a job or job-related activity; devolution of services (The movement of programs from the federal level to the state level); funded through an annual federal block grant, a set amount of money; for the poorest families with young children, but only for limited periods of time; resulted in declining caseload numbers -Supplemental Security Income provides cash assistance to people who are poor and are 65 or older, or blind or disabled; funded by general tax revenues; uses DHS guidelines

School social work

-Origins in private agencies/civic organizations in Boston, New York, Hartford in 1906 and 1907, which funded visiting teachers (the name given to early school social workers) to help support immigrant and "underprivileged" children in schools The Rochester, New York, Board of Education introduced the first school-financed visiting teachers in 1913; job was to increase interaction and cooperation between students' families and the schools -The identity of school social work was solidified with the founding of the American Association of School Social Workers in the 1940s; in 1955, the association became part of the larger National Association of Social Workers -1960s efforts of school social workers began to be assessed using social science research techniques; school SWs began to focus on school reform and address inequality in educational opportunities; began to tackle such issues as racism and students' rights in response to racial tensions from integration and busing -1975 Education For All Handicapped Children Act meant SWs became the case managers for children with disabilities -IEPs in the 1980s for children with disabilities and to network with other programs and services; IEP outlines the expected level of educational performance, annual goals, including short-term objectives, specific educational services provided to the child; the extent to which the child will be able to participate in regular education classes; and an evaluation process to determine how goals and objectives will be met An IEP must be prepared for every child with a disability by a representative from the school district, the student's teacher, and the parents; the plan must be revised annually

Delivery of services in intervention: Information and referral (I&R)

-Overall goal of information and referral is to enhance a client's access to service by improving awareness and knowledge of services and reducing barriers to them -Often, social services are specialized or are offered as parts of larger systems, and are thus difficult to locate; without specialized knowledge, and particularly when they are in crisis, clients are sometimes at a loss to identify needed services -These efforts are part of reducing barriers to service and fulfilling the role of information and referral

Biological and physiological aspects of aging

-People with health problems or Alzheimer's will need help establishing daily routines to monitor and control symptoms and avoid medical crises; this requires a basic knowledge of the functions of human physiology and systems -SWs must have knowledge about the physical and mental impairments that are related to chronic illness as well as normal changes that may occur in the senses (sight, hearing, touch, taste, and smell) and sleep patterns as a person ages -SWs can help by pointing out the availability of large-print books or books on audiotape to a client who has weakened eyesight, or telephone amplifiers for a client who has a hearing deficit; for older people who have difficulty sleeping and are at risk for dependency on sleeping pills, the social worker can suggest using relaxation techniques, abstaining from certain foods and drinks, taking daily walks, and avoiding afternoon naps -SWs need to be aware of the side effects of commonly used medications and of potentially harmful interactions between prescription and over-the-counter drugs -An adverse drug event (ADE), more commonly called a drug reaction, could lead to hospitalization or, in the extreme, a loss of independence for this group

Barriers to social justice

-Prejudice: attitude involving judging or disliking groups and individuals based on myths and misconceptions; example: a prejudiced person might be afraid of members of a certain group and not want them to move in next door, but he/she would not do anything to prevent members of this group from buy-ing the house -Discrimination: an action involving treating them differently, usually by denying them something, based on their membership in a group; example: POC being pulled from line more often to be searched by airport security; POC being monitored/followed by security guards more in stores than white people -Oppression: systematic and pervasive mistreatment of people based on their membership in a certain group; it can include differential treatment that is built into institutions and systems, AND instances of violence; restricts people's opportunities, life chances, beliefs in what they can be, and self-determination -The situation of a poor, young African American boy is an example of oppression. He lives in a neighborhood characterized by violence and decay. He goes to a school that has inadequate funding, where he receives a poor education and thus has less chance than a wealthier white child to go to college and get a job that pays well. He is often harassed by police solely on the basis of his skin color and is at increased risk of being injured or killed by police. This young man's mistreatment is systematic and pervasive. He is experiencing oppression; for oppression to occur, the mistreatment must be institutionalized or built into the social system in some way; does not require overt discrimination -Institutional discrimination: occurs when discrimination is built into the norms and institutions in society and is enforced by those in power; example: it's well known that public schools serving predominantly low-income children and children of color have far fewer resources than schools serving wealthier and white children and thus provide a lower standard of education -Racism: the systematic mistreatment of people based on race; is institutionalized and perpetrated by members of groups who have power or control over society and its institutions -Groups experiencing racism: African Americans, Indigenous Peoples, Latinos, and Asian Americans; racism historically shown through genocide or forced relocation -Sexism: the oppression that grows out of the belief that men are superior to women; 2 social conditions resulting from sexism include the gender gap (the difference between men's and women's earnings) and the feminization of poverty (more women than men live in poverty) -Homophobia; heterosexism is the institutionalized bias directed at gay men, lesbians, bisexuals, and people who are transgendered; examples of institutionalized antigay bias include the exclusion of lesbians and gay men from the military and the refusal of most states to let lesbians and gay men marry and openly adopt children -Classism: institutional and cultural attitudes/behaviors that stigmatize the poor and place a higher value on wealthier people; economic system creates and supports excessive inequality and does not meet the basic human needs of poorer people; classist attitudes hold that the poor are less capable and less industrious than those who have more resources and that they are responsible for their own poverty -Class refers to income, social status, and power; people perceived to be lower class are treated differently, not only because of how much money they have but also because of how they talk, what they wear, where they live, and the type and extent of education they have attained -Ableism: oppression of disabled people -Ageism: the belief in the superiority of youth over age and the systematic oppression of people because they are older; discrimination based on age can happen to people of different ages in different situations; can cause extreme economic hardship; older people are often driven out of jobs by forced retirement or find it hard to get jobs because employers do not want to hire them -Religious persecution/Anti-Semitism; also Muslims, Sikhs, and Hindus; some face harassment if they dress, celebrate, and worship in ways that are foreign to members of the mainstream population; acts of terrorism carried out by Muslim groups have spurred anti-Islamic sentiments and actions in recent years, increasing the incidence and impact of hate crimes -Cis normativity/cisgender privilege: systemic advantages people who identify with their birth gender experience -Gender identity refers to people's perception of themselves as male, female, neither, or sometimes both; sex is whether one is male/female biologically -Privilege: People who are members of mainstream or dominant groups have certain privileges built into their lives; hether they consciously take advantage of the privileges or not, they still benefit from them -Privilege examples; men have the privilege of being able to walk alone at night without fear of sexual assault. White people have the privilege of seeing themselves reflected positively in the media on an ongoing basis. Heterosexuals have the privilege of being able to marry in all 50 states and countries around the world. Able-bodied people have the privilege of easy access to public buildings, public transportation, worksites, and more. Having privilege means that, in general, members of dominant groups have an easier time economically and socially in American society

Central concepts and theories

-Primary mission: to enhance wellbeing and help meet basic human needs of all people with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty -Focus on individual wellbeing in a social context and the wellbeing of society -Person-in-environment perspective: one's environment includes the culture and beliefs that are part of people's lives, the impact they experience as a result of public policies, and the effects of prejudice and oppression that are part of the larger environment of our society -Example: If we consider Jane and her family from the person-in-environment perspective, we need to ask about relationships between Jane and her extended family, what living in their neighborhood was like before she lost her job, what activities the children have been involved in, and what those activities mean to them. Perhaps Jane and her children belong to a church, a synagogue, or a mosque that might be a place of support and resources that Jane did not think of and which her social worker can suggest she consider. Does she have social connections from her job at the grocery? Or does her former boss have connections with other businesses that might need someone, and he could recommend Jane? Are there barriers to opportunities like education so that Jane has not been able to gain skills that would prepare her for better-paying employment? -If the person lives in poverty, for example, the everyday struggle to survive might result in depression. Therefore, interventions aimed at reducing poverty would also be appropriate ways to alleviate the individual's depression

NASW Code of Ethics

-Professional standard of practice -Mission is to enhance human wellbeing; help meet basic needs of all people -Service: -Social justice: -Dignity and worth of person: -Self determination: client has right to determine the course of treatment in which they will engage; for example, if a client wants to avoid medication for depression, we must try psychotherapy if that's what's desired -Integrity: openness with client; honesty, trustworthiness -Informed consent: inform client of right to refuse services, benefits/risks, etc.; only provide services after obtaining informed consent -Competence: seeking consultation or guidance from supervisors -Importance of human relationships:

Historical influence of theories of human behavior in social work practice

-Psychodynamic theory: people's behaviors were purposeful and deter-mined and that some of those determinants were unconscious -Psychosocial treatment: Freud and Erikson; Hollis's Casework publication became the guide to psychosocial treatment; interacting genetic, biological, and sociocultural factors explain the cognitive and emotional processes, both conscious and unconscious, that motivate human behavior -Psychodynamic theory is the basis of many casework interventions, including psychosocial treatment, the problem-solving method, and task-centered casework -Problem-solving method: Perlman; method of psychosocial treatment; 2 fundamental assumptions underlie the problem-solving method: client problems do not represent weakness and failure on the part of the client, but are instead a natural part of life and the process of human growth and change, AND if clients cannot solve their problems, it is because they lack the knowledge or resources to effectively do so; the client-worker relationship is critical to the problem-solving method; the relationship is collaborative and provides the client with a source of encouragement and the safety needed to initiate creative problem solving -Task-centered social work: shortened treatment periods were more effective in problem solving than the long-term treatments associated with psychosocial interventions; Reid and Epstein; characteristics of task-centered casework are that it is short term; the focus is on client-acknowledged problems; and sessions are highly structured into specific activities; because task-centered casework is brief and focuses on the presenting problem, the emphasis is on identifying a problem rather than identifying the underlying cause, and once the problem is identified, the desired outcome or change is then identified; determining tasks to overcome obstacles and achieve the desired outcome is the goal of this approach -CBT: Pavlov and Watson; the behavioral aspects of treatment are designed to weaken the connections between habitual reactions (fear, depression, rage, or self-defeating behaviors) and troublesome situations, and also to calm the mind and body so the person can think more clearly and make better decisions; cognitive aspects teach about thinking patterns and how to change patterns that are based on distorted or irrational beliefs -Cognitive-behavioral therapies (CBT) have been the most researched of any therapy model; over many years found cognitive-behavioral therapies to be effective in treating depression, anxiety, relationship challenges, social phobias, eating disorders, and post-traumatic stress disorder (PTSD); cognitive-behavioral therapies are one of the most frequently used clinical interventions in social work practice -Crisis theory and Crisis intervention: A crisis is a situation where person's normal coping mechanisms are inadequate/not working; crisis intervention is a short-term model that is designed to assist victims/survivors to return to their pre-crisis level of functioning; focus on reactions to and consequences of such catastrophic or traumatic crises as war, rape, natural disaster, and workplace and school violence; assistance that is provided as quickly as possible, brief treatment periods with a focus on practical information and tangible support, the goal of reducing symptoms, and efforts to mobilize the client's social support networks -Mindfulness-based theories and therapies: Mindfulness is the process of bringing one's attention to what is happening internally and externally in the current moment, often through meditation; suggests that being fully aware in the present allows people to reduce regret and guilt about the past and decrease worry about the future; includes mindfulness-based cognitive therapy and mindfulness-based stress reduction -Mindfulness-based cognitive therapy: people learn about the relationship between their thoughts and their feelings and actions, and also learn the skills to be more fully present so they can become aware of their thoughts as they occur; people learn to notice and accept their thoughts and feelings without having to judge or react to them; MBCT can help people be-come less reactive and less driven by destructive patterns and habits and is used to treat depression, anxiety, and addiction, as well as other mental and physical health concerns -Mindfulness-based stress reduction: people learn to be actively focus on what is happening in the present moment; during an eight-week program, people gain mindfulness skills through meditation as well as movement activities such as yoga; as participants learn to be more present, they are able to pause before reacting to external stimuli; allows people to change their behavior and to notice negative thoughts and patterns that contribute to stress, depression, and anxiety

Global perspective in generalist practice

-SWs can draw on the knowledge and practice of other SWs across international boundaries

US drug classification system

-Schedule I: no accepted medical use; high abuse potential; heroin, marijuana? -Schedule II: restricted medical use; prescription-only; high abuse potential and can lead to physical and psychological dependence; cocaine and morphine -Schedule III: medical use; prescription-only; low risk for physiological dependence, but a high risk for psychological dependence; codeine, steroids -Schedule IV: Xanax, Valium -Schedule V: OTC medications

Critical public policies

-Social Security Act: first major legislation that included programs to aid older adults; Old Age, Survivors, and Disability Insurance (OASDI) is the social insurance program that most people refer to as Social Security; simply put, all working Americans pay taxes into the system during their working years, and they and eligible family members receive monthly benefits on retirement or in the event of long-term disability -Medicare: a universal, federally funded, compulsory health insurance program for older people; covers basic health services, but does not cover nursing home care costs over 100 days or prescription drugs -Medicare has four parts: Hospital insurance (Part A) helps pay for inpatient hospital care and certain follow-up services; medical insurance (Part B) is optional, with a monthly premium, and pays for up to 80 percent of allowable doctors' services, outpatient hospital care, and other medical services; Medicare Advantage (Part C) provides an expanded set of options for the delivery of health care, typically coordinated care plans through HMOs or PPOs; prescription drugs (Part D) provide subsidized access to prescription drug insurance; Part D is also optional, with the enrollee paying a premium -Medicaid: a jointly funded (federal and state), needs-based health insurance program for individuals and families whose incomes and assets fall be- neath a set amount; covers hospital inpatient care, doctors' services, skilled nursing facility care, home health services, pharmacy services, mental health services, and long-term and short-term nursing home costs -Social Security Income: includes cash assistance to people who are poor and elderly or poor with disabilities; in most states, SSI benefits are only 75 percent of the poverty level -Social Services Block Grant program provides federal funds for adult foster care and daycare programs, as well as for home meals and other social services primarily for SSI recipients; Older Americans Act (OAA) of 1965, which has been reauthorized several times, also funds social services like senior centers and nutrition programs -FMLA: allows women and men time off from work to care for dependent parents and newborn children; requires covered employers to grant eligible employees up to 12 weeks of unpaid leave during any 12-month period for the birth of a child, adoption of a child, or placement of a foster child; or to care for a spouse, child, or parent with a serious health condition

Social construction of differences

-Social construction takes place when the people who have power in a society define a group's characteristics and determine the group's value. Their perceptions of their own group and of other social groups are accepted by the larger society. -Americans tend to think of differences between social groups as facts of nature; in the area of "race," as with many other socially constructed differences, the United States has a long history of determining that some "races" are more desirable than others; Beliefs in physical differences between the races can result in differences in medical care. A 2015 study compared pain treatment for African American and white patients. The study found that a large number of white medical students and residents had inaccurate beliefs about pain differences between white and African American patients. Their beliefs resulted in different assessments, diagnoses, and treatments for pain -Gender is also a social construction. That is, most of the differences attributed to sex are really the result of socially defined gender roles. The culture has valued the characteristics attributed to males more than those attributed to females. For instance, auto mechanics (traditionally male) are generally paid more than child-care workers (traditionally female), although caring for children requires at least as many skills as repairing automobiles

Social justice

-Social justice refers to the level of fairness that exists in human relationships -Injustice has been described as coercively established and maintained inequalities, discrimination, and dehumanizing, development-inhibiting conditions of living (e.g., slavery, serfdom, and exploitative wage labor; unemployment, poverty, starvation, and homelessness; inadequate health care and education), imposed by dominant social groups, classes, and peoples upon dominated and exploited groups, classes, and people (Gil's definition) -Inequalities and conditions that limit people's abilities to develop are established and maintained coercively; many limitations, such as poverty, unemployment, inadequate education, are placed on people by conditions that exist outside of themselves; example: although some people choose not to work, many others are forced into unemployment by a lack of jobs, inadequate transportation, and a lack of affordable child care -True social justice: a society in which all members feel physically, emotionally, and psychologically safe; resources are distributed equitably; jobs are available for all who want them; all people have the same basic rights and opportunities; and all are able to develop to their fullest potential -By Gil's definition, the conditions that limit people's chances are imposed by dominant social groups and classes; suggests that certain groups in society have more power than other groups and that they can dictate the conditions under which others must live; people with money who are predominantly male, white, Protestant, heterosexual, able-bodied, young to middle-aged adults tend to make up the dominant groups with power

Theoretical basis for social work practice

-Social workers rely on biological, sociological, anthropological, and psychological knowledge and theories to help them understand human development; a theory is "an organized set of ideas that seek to explain a particular phenomenon;" MUST be testable -A conceptual framework combines theories, beliefs, and assumptions to help us understand how people interact in their social systems and how those systems help or block health and wellbeing; gives social workers a basis from which to view situations with clients and provides guidance for the assessment, intervention, and evaluation process -Bertalanffy's general systems theory: developed many other future theories; described the functioning of living systems; systems theory explains a person's behavior in terms of circular or mutual causality. In other words, Jane influences her environment, and Jane's environment influences her. Closely related to mutual causality is the concept of wholeness: "Every part of a system is so related to its fellow parts that a change in one part will cause a change in all of them and in the total system -The focal system interacts with and is affected by all the subsystems in the social environment of the neighborhood, including the families of Jane's neighbors, the local school, and the family service agency; the focal system is determined by the social worker's point of focus' if the social worker's macro intervention is focused on encouraging the passage of legislation that will make it easier for women like Jane to get unemployment insurance, then the unemployment insurance program is the focal system. If the social worker is developing an after-school program that could benefit Jane's children, the school is the focal system -Ecological systems framework: builds on general systems theory and integrates the person-in-environment perspective; rests on the life model, which views people and their environments as reacting to and changing in response to each other; The focus is on the interface, which is what happens between people and the environment. For example, as a result of Jane's job loss and her residence in a neighborhood with few employment opportunities, her life is out of balance, and the environment is not supportive of her needs. The ecological life model emphasizes examining the fit (or lack of fit) between Jane and her environment. The intervention goals become trying to help Jane adapt to this situation and changing the environment to be more supportive. One of the concerns about this approach is that adaptation of the individual is much more manageable, so environmental change is often ignored. However, adherence to the full eco-logical perspective includes addressing both the fit of the client to the environment and the extent of support from the environment -Strengths perspective: building on clients' strengths to create positive change; it is the opposite of frameworks that encourage social workers to approach clients from a deficit or problem base; asserts that a problem-based approach is not the most effective way to help clients change and grow. Focusing primarily on problems can reinforce the negative views that clients may have of themselves and their communities; suggests that all individuals, groups, and communities have strengths that often go unnoticed and unappreciated by the individuals, groups, and communities themselves, as well as by the outside world. The strengths perspective means recognizing the strengths that are inherent in individuals, groups, and communities, and using these strengths as building blocks for change -Community organizing: social workers first go into a neighborhood to begin bringing the residents together to work for change; social workers using the strength perspective would more likely map out the best points of the community rather than focus on rebuilding the worst -Langer and Lietz's strengths perspective factors: resilience developed from prior experience overcoming adversity; having hope that there can be positive outcomes; drawing on culture and one's cultural identity that gives a person a sense of belonging to a larger group; and using those relationships that involve collaboration, the sharing of making decisions -Empowerment perspective: a psychological state, a sense of competence, control, and entitlement—that allows one to pursue concrete activities aimed at becoming powerful; people must believe that they are capable of doing things for themselves, gaining increased control over their lives, and influencing events and situations that affect their lives -Diversity perspective: emphasizes the incredible diversity of social workers and their clients; Standards and Indicators For Cultural Competence In Social Work Practice guides social work practice with diverse populations through 10 standards ---1. Ethics and values ---2. Self awareness ---3. Cross-cultural knowledge ---4. Cross-cultural skills ---5. Service delivery ---6. Empowerment and advocacy ---7. Diverse workforce ---8. Professional education ---9. Language and communication ---10. Leadership to advance cultural competency

Generalist social work practice with groups

-Socialization groups: Bringing people together for a specific purpose; example: informal recreation such as baseball or basketball games -Support or counseling groups -Support games -Self-help groups -Social action groups

Responsibilities of school SWs

-Some districts go by the least restrictive environment for students; others use a pupil health or services team which may include teachers, school administrators, school psychs, nurses, parents, and a speech/hearing therapist; purpose of the team is to make an ongoing assessment of students' social, emotional, and physical needs as well as their strengths -School SW helps students use their strengths to meet the identified needs, and also helps them gain access to school/ community resources when appropriate -NASW says school social workers are primarily advocates, consultants, and mediators

1887 Settlement Movement

-Started with Neighborhood Guild and Jane Addams' Hull House -Based on the belief that in order to help poor people, workers had to live within the community and provide services from their dwelling or settlement; philosophy of the movement was that an individual's well-being was directly linked to external surroundings; most settlement houses were located in poor neighborhoods, and much of the workers' efforts involved helping immigrants adjust to life in US; ultimate goal was to shrink the gap between people who were poor and people of the wealthier classes -Differs from the training of Charity Organization Societies COS because instead of the focus being on individuals and families as well as on organized ways to coordinate the provision of social services and to determine individual need, training for Settlement Movement focused on individuals as active participants in their surroundings, on work with groups and communities, and with an emphasis on social reform and political action, and acknowledgment of the strengths of different immigrant groups -Differed from empowerment in COS because instead of seeing empowerment as a critical concern of personal change like COS, Settlement workers strove to empower people and communities to demand social change -Today's social work combines elements of both the Charity Organization Societies and the Settlement Movement -Social Work founding year 1898 when formal training was initiated at the New York School of Philanthropy (which is now the Columbia University School of Social Work in New York City) at the urging of Mary Richmond

Current healthcare system

-The US health care system is still primarily financed through an employment-based health insurance system -2010 ACA was a compromise bill that didn't include a public option; as a result, at least 3 major problems have to be fixed in order to make the ACA more effective and efficient: (1) affordability of insurance premiums is still a problem; (2) too few healthy people and too many sick people are signing up for insurance on the state and federal exchanges; (3) health care costs are still rising; these problems are fixable, but only if Republicans work with Democrats to create a public option that can compete with private insurance companies on the exchanges; in addition, Congress needs to increase the subsidies to individuals and/or insurance companies to make premiums more affordable, and increase the penalty on young, healthy people who are not yet signing up for insurance -2 types of plans: fee-for-service plans (insured chooses a doctor and receives services, and the insurance company pays the bill; insured often must pay part of the bill; patient can choose any doctor and can go to specialists at will) and managed care (designed to screen out unnecessary and inappropriate care and to reduce costs; managed care organizations require patients to use doctors and hospitals that are part of an approved network; if a patient goes out of the network, the services either are not covered or are reimbursed at a lower rate; companies also review and often limit what doctors can do; for example, doctors must frequently get preapproval before ordering tests, and may also be required to prescribe cheaper generic drugs -Health maintenance organization (HMO): a common managed care structure; requires a client to have a PCP who is the first contact and who provides complete care; client can visit a specialist only after getting a referral from the primary care physician; HMOs pay physicians monthly fees, and patients make copayments for office visits and prescriptions; one of the ways HMOs reduce costs is by limiting tests -Preferred provider organizations (PPOs): another form of managed care; encourage clients to use health care providers from an approved network of doctors and hospitals; fees from hospitals and doctors who are not part of the network aren't covered or are reimbursed at a lower rate; PPOs offer participants more choice than HMOs

Gerontology

-The study of the biological, psychological, and social aspects of aging -The goal of gerontological SWs is to promote and advance older clients' social, emotional, and physical well-being so that they can live more independent and satisfying lives

Social work as a profession

-To promote human and community wellbeing; guided by a person and environmental framework, a global perspective, human diversity -Purpose is quest for social and economic justice and prevention of the conditions that limit human rights, elimination of poverty, and quality of life for all persons -Social workers must help society work better for people and help people function better within society -Micro practice: Helping individuals fit better into their environments; can include TANF, food assistance, job training, educational programs -Macro practice: changing the environment so that it works better for individuals -Mezzo practice refers to work with families and small groups; sometimes used to refer to practicing in between micro and macro, and sometimes you will not see it identified, and practice with families and small groups is subsumed under micro practice -Keen understanding of societal forms and marginalized/oppressed groups

Cognitive process and emotional/psychological development

-When people retire, they must restructure their time, build relationships outside of work, and develop new identities not linked to their jobs; elders who are able to accomplish these tasks are more likely to have satisfying postretirement years -On the basis of theories of personality development, gerontological social workers can help clients navigate stressful life events such as retirement, widowhood, physical decline, residential relocation, loss, and approaching death -SWs need to know about factors that affect learning, intelligence, and memory as people age; the inability to learn or perform new tasks, impairment of intelligence, and memory loss are not necessarily synonymous with aging -Many life and environmental factors interact to affect cognitive processes

Stages of cultural understanding

1. Cultural destructiveness: The worker holds attitudes, policies, and practices that destroy cultures. 2.Cultural incapacity: The worker believes in the superiority of dominant groups, does not support nondominant groups, and engages in discriminatory behaviors. 3.Cultural blindness: The worker believes that there are no differences be-tween people, that they are all the same; this tends to reflect a belief that the dominant culture is universal. A non-ableist term for this concept is cultural evasiveness. 4.Cultural precompetence: The worker begins to respect other cultures and demonstrates this respect through one or two actions, followed by a sense that he or she has done enough. 5.Cultural competence: The worker accepts and respects differences, continuously expands cultural knowledge and resources, and actively pursues engagement with nondominant clients and coworkers. 6.Cultural proficiency: The worker esteems other cultures, engages in research and outreach to build cultural knowledge and specializes in culturally competent practice -Cultural humility stresses that each of us is a unique individual and knows him- or herself best. To effectively work with others, social workers must not only understand cultural differences and know themselves but also acknowledge that it is not possible to know all there is to know about anyone else. Effective practice requires an open mind and an awareness that the best way to learn about others is directly from them. Cultural humility also requires practitioners to examine power differentials between themselves and clients and to recognize and address structural barriers to culturally appropriate services. -Multiethnic or transracial adoption, the permanent placement of children of one ethnicity or race with parents of a different ethnicity or race, is very controversial among social work practitioners

Substance abuse

The continued use of alcohol or other drugs (legal or illegal) in spite of adverse consequences

Family

A system of individuals who are interrelated and have significant relationships

Psychogeriatrics

A combination of psychiatric and mental health care and services for older people

Addiction

A compulsion toward a specific behavior, such as the use of alcohol or other drugs, despite negative consequences, and psychological or physical dependence on the behavior or substance being abused

Ethnopsychopharmacology

A growing area of study that looks at the way ethnic and cultural influences affect a client's response to medication; there is increasing evidence that there are significant differences in response to drugs used to treat mental illness among members of different racial and ethnic groups -For example, there is some evidence that Asian Americans and Latinos with schizophrenia may require lower doses of antipsychotic medications than white Americans

Social work roles in mental healthcare system

Administrators, counselors, case managers, advocates

Drugs

Any chemical substances taken internally that alter the body's functioning

Cultural humility

Cultural humility means being aware that we see the world through our own particular lens and engaging in ongoing self-reflection and self-critique. It also means approaching people as individuals and taking the time to learn about how they are unique and what is important to them

Social work careers

Child welfare, people who are older, health care/medical social work, mental health, school social work, substance abuse, violence/victims/criminal justice, crisis/trauma/disasters, military social work, public welfare, community organization, policy practice, management/administration, rural social work, international social work

First period of life

Childhood; children are vulnerable to discrimination and oppression because they look to others to recognize their needs

2017 Republican House of Representatives American Healthcare Act

Dead on arrival; if passed by the Senate, would repeal important parts of the ACA of 2010, or "Obamacare"

Charity Organization Societies

First established in NY 1877 to discover the causes of poverty and eliminate them; focus was on the individual and reflected the belief that poverty was a character defect; by rehabilitating individuals, COS participants believed, poverty would be eliminated; friendly visiting was regarded as a better alternative than charity because it used scientific investigation to determine need and to organize the giving of relief; Mary Richmond exemplified leadership and wrote Social Diagnosis

US Healthcare System

Includes prevention, diagnosis, treatment, rehabilitation, and health maintenance services, which are provided in public, private, for-profit, and nonprofit settings that include hospitals, private clinics, public clinics, long-term care facilities (ex: nursing homes, assisted living facilities), hospices, rehabilitation facilities, and home health care agencies

Child welfare system

Includes social work services, such as child protection, foster care, and adoption

Delivery of services in intervention: Network linkages

Knowledge about the breadth of services is a critical component of providing network linkages. People may receive services from multiple social service systems. The social worker can act as the link between the systems

Culture-bound syndromes

Patterns of aberrant or problematic behavior unique to a local culture; may appear more commonly among people who are older or less acculturated

Unemployed

Physically able to work but unable to find employment

Mental Health Parity Act

Prohibits insurers from imposing lifetime and annual benefit limits on mental health services that are not imposed on physical health care

US Diversity

Race is considered an umbrella term that generally includes multiple ethnic groups that share common cultural patterns or national origins

Mental illness

Refers collectively to health conditions characterized by alterations in emotions, thinking, or behavior; these changes result in distress or problems functioning socially, with family, and/or at work

Drug misuse

Refers to the inappropriate use of medications or prescribed drugs

Mental Health Parity and Addiction Equity Act

Requires that treatment limitations (e.g., number of visits) and financial requirements (e.g., co-pays and deductibles) be the same for mental health care as they are for physical health care; the MHPAEA applies to plans sponsored by private and public sector employers with more than 50 employees

Code of Ethics on Social Justice

Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers' social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people.

CSWE on social justice education

The purpose of the social work profession is to promote human and community well-being. Guided by a person-in-environment framework, a global perspective, respect for human diversity, and knowledge based on scientific inquiry, the purpose of social work is actualized through its quest for social and economic justice, the prevention of conditions that limit human rights, the elimination of poverty, and the enhancement of the quality of life for all persons, locally and globally.

Mental health

The successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and providing the ability to adapt to change and cope with adversity