SW 220 Final Chapter 9 - 16 Learning Objectives

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Examine who commits crime

Variable related to crime include gender, age, race, and social class. Men are much more likely to commit crimes, although the arrest rate foe women is increasing. People younger than 25 are the most likely to commit crimes and commit the most violent crimes. Crime is also related to race in that African Americans have a much higher crime rate. However, the crime rate is also related to social class that involves poverty, increased police surveillance and potential racial profiling, and single-parent family structure. Asian Americans have a markedly lower crime rate that their representation in the population.

Discuss issues faced by lesbian and gay youths (including the coming out process)

Same-gender sexual orientation may place additional social pressures on youths. Social workers can help lesbian and gay people explore their sexual identities and come out to others. Coming out involves both coming out to oneself and also to others including other people with the same sexual orientation, family and friends, and the world in general. Careful thought should be given to whom to trust and how to come out.

Describe school social work and school social work roles

School social workers strive to improve the overall functioning of students, teachers, school systems, and communities. Their roles include consultant, counselor, facilitator, educator, advocate, broker, case manager, community intervention collaborator, and policy initiator and developer.

Propose ways to enhance multiculturalism and reduce racism in schools

Social workers can fight racism and encourage multiculturalism by leading open discussion, infusing such content in curricula, focusing on the appreciation of difference, providing school staff with multicultural training, and involving parents in efforts to promote multiculturalism.

Describe social work roles (in health care provision)

Social workers have been involved in preventative, primary, tertiary, restorative, and continuing care in health-care practice. Settings include hospitals, medical clinics, and diagnostic and treatment centers; public health departments and other health care contexts; Veteran's Affairs hospitals; and managed care settings.

Describe substitute placements for children

Substitute services assume all aspects of parental responsibilities on a temporary or permanent basis. Kinship care involves informal or formal placement with a relative or part of the child's family's supportive network. Foster family care is the provision of substitute care with a family for a planned temporary or extended period when parents or legal guardians are unable to care for a child. Permanency planning is currently an important theme is foster care. A group home provides a substitute setting and family environment for a group of children originating from different families. Residential treatment center are bigger agencies that are more structured and provide daily care, meet educational needs, and address emotional and behavioral issues. Independent living services provide out-of-home placement for youths approaching adulthood during their transition to adulthood.

Examine supportive services in child welfare (including child maltreatment and child protective services, family preservation, child day care, family life education, and respite care)

Supportive services involve the provision of external support to enhance family functioning while children remain in the home. They include basic financial assistance, mental health treatment, child protective services, intensive family preservation services, day care, family life education, and respite care. Child maltreatment is the umbrella term for physical abuse, sexual abuse, and neglect, and psychological abuse. Physical abuse involves injury and results in physical and behavioral symptoms. Sexual abuse entails sexual activity with children. Incest involves sexual intercourse between family members. Child neglect concerns failure to provide for a child's needs. Psychological abuse entails belittlement, humiliation, and causing damage to self-esteem. Almost 2 million cases of child maltreatment are reported and investigated in the United States annually. Child protective services are interventions aimed at protecting children at risk of maltreatment. The assessment of risk and protective factors is an important aspect of treatment planning. Family preservation services are concentrated services provided to families in crisis in order to strengthen the family and prevent children's out-of-home placement. Child day care is an agency or program that provides supervision and care for children while parents or guardians are at work or otherwise unavailable. Family life education involves learning experiences for the purpose of increasing people's knowledge, developing skills, or enhancing self-awareness concerning issues relevant at some point during the life span. Respite care is supervision of a child by another caregiver, allowing the parent an interval of relief from the responsibilities of child care

Explain the treatment process for substance abuse and dependence

The treatment process for substance abusers involves engagement; assessment; a multiple-system approach to individualized treatment including individual, group, and family treatment; and the importance of developing a continuing care plan.

Investigate the importance of self-determination (for people with disabilities as an ethical aspect of social work practice)

To maximize self-determination, social workers should adopt three approaches. First, they should assume a consumer-centered approach, accepting people as knowing their own needs and as being capable of making intelligent decisions about services. Second, social workers should learn about services and resources so that they may convey this information to clients. Third, they should advocate for people with disabilities whenever possible.

Recognize some trends in evidence-based (mental health) practice

Trends in evidence-based practice include comprehensive community support, family education and support, work encouragement and assistance, coordinated treatment for concurrent substance abuse issues, and educational and coping skill development groups.

Examine AIDS as an international problem (particularly in sub-Saharan Africa)

in 2014, 1.2 million people died from AIDS around the globe, and there were an estimated 2million new HIV infections. Currently, about 25 million people are HIV positive in sub-Saharan Africa, the most severely affected global region. HIV infection is especially a problem for African women. Approaches to addressing the problem include providing education about HIV/AIDS, providing safe sex programming, empowering women to gain greater control over their lives, providing funding for treatment, and developing a cure.

Identify community resources for people who abuse are are dependent on substances

Community resources for substance abusers include detoxification, outpatient treatment, inpatient treatment, therapeutic communities, halfway houses, pharmacological adjuncts, and self-help groups. Alcoholics Anonymous (AA) provides an example of self-help organization.

Review the wide range of criminal justice settings in which social workers practice

Criminal justice settings include forensic social work, adult correctional institutions, administrative planning centers, community-based corrections involving probation and parole, victim assistance programs, domestic violence services, and juvenile corrections. Some settings reflect an overlap among juvenile corrections, mental health services, and child welfare.

Discuss adoption

Adoption is the legal act of taking in a child born to other parents and formally making that child a full member of the family. Types of adoptions include blood-related, unrelated, agency, independent , international, special needs (often subsidized), and trans-racial adoptions. Social workers can help adoptive families address issues involving lack of control concerns about the adopted child, pressures on adoptive parents, and psychological and behavioral issues of the child.

Address the need to advocate for resources (for children and families)

Advocacy is a major responsibility for social workers. Ongoing advocacy is needed to increase quality, accessible day care; improve maternal and child health; prevent and address child maltreatment; and help families get out of poverty.

Discuss issues older adults commonly face (including ageism, discrimination in employment, poverty, retirement, health-care issues, abuse, living conditions and family variables, and transitional issues)

Ageism involves harboring negative images of and attitudes toward people simply because they are older. Older adults experience discrimination in employment. Almost half of the older adults living in the United States would fall below the poverty line if they were not receiving Social Security benefits. Current debate focuses on a variety of ways to save Social Security. Suggestions include changing benefit amounts, worker contribution amounts, time lines, and criteria for the recipients. Factors that increase the potential for poverty include advanced age, female gender, and being a person of color. The average age of planned retirement is 64. The older people get, the more likely they are to experience health problems. An estimated 1.5 million older adults are victims of physical or emotional abuse. Older adult abuse is "the violation of an older adult's human and civil rights by any other person or persons"; Such abuse may involve a lone incident or multiple, recurring acts. In addition to physical and emotional, types of abuse include sexual, financial, discriminatory, and institutional abuse in addition to neglect. To assess abuse, there are three aspects to it. First, the practitioner should closely observe the older adult's appearance, behavior, and living situation. Second, the worker should conduct a careful appraisal of the older adult's strengths and ability to function. Third, the practitioner should conduct interviews with the older adult to solicit specific information. There are many treatments including: educating victims about resources and options, breaking through denial and shame, safety planning [determining what actions to take if abuse takes place], building support networks, traumatic or post traumatic stress [distressing physical and emotional effects after experiencing a traumatic event], family counseling. When abuse is related to stress experience by caregivers, provision of supportive services can relieve some of the stress. Such services can help out and give caregivers a break. Services include support groups where caregivers can empathize with each other, provide a means to vent tensions, and discuss suggestions for coping and care provision. Delivering meals to the home can ease the care-giving burden. Periodic telephone contacts can check up on how things are going and provide older adults with a means to communicate their concerns. Other services include respite programs and adult day care. Many older adults prefer to live on their own or with other family members. Transitional issues as people age include coping with health problems and increasing dependence.

Emphasize the wide diversity in families and their structure

Families involve primary groups, mutual obligations, and common habitation. Family structure is "the nuclear family as well as those nontraditional alternatives to nuclear family which are adopted by persons in committed relationships and the people they consider to be 'family'". Variations in family structures include single-parent families, step-families, blended families, and inter-generational families. Lesbian, gay, and bisexual families experience a special risk of discrimination.

Describe the types of crime

Felonies are grave offenses punishable by at least a year in prison and possibly even death. Misdemeanors are less severe offenses, with punishments ranging from incarceration of less than a year to monetary fines. Categories of crime include violent, property, and offenses not fitting in these two categories. Such offenses involve white-collar, identity theft, corporate, victimless, organized, and hate crimes.

Examine contexts for social work practice with older adults (including home and community based services, discharge planning in hospital settings, and service provision in nursing homes)

Home-based services are types of assistance provided to people in their own homes, either formally or informally by informal support networks. Community-based services are those provided to meet psychological and social needs outside the home in the community. Discharge planning is the comprehensive assessment of a patient's abilities and needs, the development of a plan to facilitate that patient's transition out of the hospital and back into the community or agency setting, and implementation of that plan. Assisted living facilities provide a combination of lodging, support services and health care, as needed. It represents a less intensive care-giving alternative to nursing home placement. Nursing homes or skilled care facilities are residential centers that provide nursing care and rehabilitation for people who have severe functional limitations as a result of acute illness, surgery, or advanced dementia.

Define common terms used in the Alcohol and Other Drug Abuse (AODA) field

Language commonly used in substance abuse intervention tends to revolve around the terms alcohol, drug, and substance (often reffered to as psychoactive substance). In everyday usage the term alcohol refers to any type of fermented or distilled liquor containing alcohol such as whiskey or beer. Drug refers to a wide range of materials that alter mood or consciousness when ingested, including amphetamines, cannabis, cocaine, and hallucinogens. Substance is commonly used to refer to mind-altering drugs, including alcohol (hence the term alcohol and other substance abuse). In the context of abuse described here, the terms substance and drug are often used interchangeably. AODA stands for Alcohol and Other Drug Abuse. Several other terms used in conjunction with alcohol, drugs, and substance are tolerance, withdrawal, intoxication, alcoholism, alcoholic, dependence, and addiction. The DSM-5 defines a substance use disorder based on 11 criteria in 4 categories. These categories include impaired control, social impairment, risky use, and pharmacological issues.

Encourage critical thinking (about the reasons for teen pregnancy, what should be done about it, and the provision of sex and education

Critical thinking questions were raised concerning the reasons for teen pregnancy and how the issue could be addressed. Other questions were raised concerning conservative and liberal views on policies regarding the provision of sex education and the programmatic content that should be included.

Define developmental disabilities (and identify a range of specific disabilities clustered under its umbrella)

Developmental disabilities are severe and chronic, occur before age 22, are likely to be permanent, and result in substantial functional limitations. Developmental disabilities include intellectual disabilities, cerebral palsy, epilepsy, orthopedic problems, deafness and hardness of hearing, visual impairment, and autistic spectrum disorders. Some people have multiple disabilities.

Identify the scope of psychiatric diagnoses for mental health problems

Diagnoses for psychiatric disorders include neurocognitive disorders; schizophrenia and other psychotic disorders; depressive disorders; bipolar disorders; anxiety disorders; trauma - and other stressor - related disorders; dissociative disorders; sexual disorders; paraphilic disorders; eating disorders; disruptive, impulse control, and conduct disorders; obsessive-compulsive and related disorders; and personality disorders.

Examine the wide range of mental health settings in which social workers practice

A large percentage of social workers practice in some aspect of the mental health field. A critical concept in mental health treatment is client treatment in the least restrictive setting possible. Mental health settings that employ social workers include inpatient mental and psychiatric hospitals, residential treatment centers for children and adolescents, group homes, psychiatric units in general hospitals, outpatient treatment agencies, employee assistance programs, and community mental health centers, which provide a wide range of services.

Describe HIV and AIDS (including its essence, its treatment, empowerment for people living with AIDS, and social work roles)

AIDS is caused by a retrovirus that attacks the immune system. People gradually become less resistant and more vulnerable to opportunistic diseases. Extremely low CD4 T-cell counts result in AIDS. HIV is transmitted by the exchange of bodily fluids, especially by semen, blood, and vaginal secretions. Race and gender are variables involved in transmission. The most common test for HIV is the antibody screening test, immunoassay. Other tests include antibodies and antigen screening, rapid, foll-up diagnostic, RNA, and home screening tests. HIV/AIDS cannot be cured, but cocktail drugs (a mixture of different drugs) referred to as HAART (highly active antiretroviral therapy) have been used effectively to inhibit progression of the disease in many people. Social workers can provide support and focus on strengths for people living with HIV/AIDS. They can provide counseling, crisis intervention, linkage with support systems, family counseling, support group referral, and advocacy.

Demonstrate empowerment when working with older adults (that incorporates values and goals, and provide case examples of active aging)

An empowerment perspective for working with older adult stresses values and goals involving respect, appreciating difference, valuing choice, and promoting health. Active aging emphasizes: participation in life, health, and security. Playing music can bring great joy to people of any age. Music can decrease stress and lower blood pressure. It provides an excellent hobby for people who used to play are now retired with more time to spend doing what they want. Joyce who lives in Miami, picked up her French horn after a lull of 15 years and joined a band in in the community: one of her fellow band members is 90 years old. Gloria hasn't been able to walk for a long time without assistance of a walker, but more recently has a new skill. Cox has arthritis, but used to love to bowl. Teen volunteers taught her how to play electronically on a Wii bowling video game. She says it's not quite the same, but she swings her arm using the same motion as she when she was trying to knock down real bowling pins. However, now she can remain contentedly in her chair. She's having fun. Frances, 84, is a competitive trick water skier who also bikes 10 miles a day. She's proud of her strong and flexible knees on which she can elegantly maneuver like a dancer. She also takes pride in her appearance and prefers wearing cotton candy lipstick. She has gained national attention and has starred in television commercials and magazine ads sponsoring V8 that stress a healthy lifestyle.

Describe generalist social work practice with people who have developmental disabilities

Case management and advocacy are important when working with people who have developmental disabilities. Case management is the process of organizing, coordinating, and maintaining a network of formal and informal supports and activities designed to optimize the functioning and well-being of people with multiple needs. Advocacy is the process of affecting of affecting or initiating change either with and/or on behalf [of clients or] client groups to: [1] obtain services or resources for clients that would not otherwise be provided, [2] modify or influence policies, procedures, or practices that adversely affect [individuals, families,] groups or communities, [or] [3] promote new legislation or policies that will result in the provision of [much-needed] resources or services.

Describe child welfare and its continuum of services

Child welfare is the traditional term for the network of policies and programs designed to empower families, promote a healthy environment, protect children, and meet children's needs. Child welfare services respond to a continuum of need ranging from limited to moderate to extensive.

Explore common defense mechanisms used by people with substance abuse disorders

Common defense mechanisms employed by substance abusers include minimization, rationalization, and denial. Minimization: Assigning little importance to drug use or its consequences. The individual distorts reality and makes it smaller than it actually is. The user will minimize the amount of substance actually consumed by referring to it as being a smaller amount than it actually is. It may also include indicating that the substance consumption has a lesser impact on behavior, a situation, or life in general than it actually does. "I really don't drink that much" when in actuality they drink 3 six-packs a day. Rationalization: Involves making excuses for the problems caused by the dependence on the substance. "I didn't flunk the exam because I had a hangover; the professor made the questions much harder than she said she would". Denial: The most prevalent defense used by people who are substance dependent, involves insisting to oneself that nothing's wrong. There's no problem. Denial distorts reality so you just don't see the truth. If you don't think it's a problem, it doesn't exist; out of sight, out of mind.

Pose critical thinking questions (that address the dynamics of substance use disorders and compare treatment models)

Critical thinking questions are posed concerning the rationale for using and abusing substances. Other questions address the comparison of a traditional four-phase abstinence model of treatment with a treatment model focusing on strengths and the concept of least harm.

Engage in critical thinking (about confronting myths about older adults, financing Social Security, determining whether Social Security discriminates against women, and proposing how older adults might be empowered though macro practice

Critical thinking questions are posed concerning untrue myths about older adults, including that they are riddled with disease, are unattractive, sleep all the time, can't learn new things, and are senile. Questions raised about Social Security concern raising the retirement age, decreasing benefits, increasing the maximum amount of income that can be taxed, cutting increases in benefits, and offering benefits only to those who are less well off (establishing a means test). Questions also concern whether Social Security is fair to women and, if so, whether it should be reformed. Finally, critical thinking questions are raised about how older adults might be treated, resources provided, and services developed from residual versus institutional and conservative versus liberal perspectives.

Engage in critical thinking (about advocacy to combat child maltreatment and controversial issues in adoption)

Critical thinking questions regarding child maltreatment involve the conservative-liberal and residual-institutional orientations to addressing the issue. Questions concerning adoption include those examining trans-racial adoption. special needs adoption, openness about information, and independent adoptions.

Engage in critical thinking (about personal feelings and stereotypes and concerning disability, residual versus institutional approaches to service provision for people with disabilities, empowerment through language, deinstitutionalization, and the Americans with Disabilities Act)

Critical thinking questions were posed concerning personal biases about disability, who should be responsible for funding and providing services to people with disabilities how words can affect how people with intellectual disabilities are viewed, the pros and cons of deinstitutionalization, and the extent to which the ADA is effective.

Engage in critical thinking (about various issues related to mental health)

Critical thinking questions were posed regarding the extent to which the DSM-5's assessment and labeling system is fair and adequate. Questions were raised about the suitability of several approaches to psychotherapy, the advantages and disadvantages of electroconvulsive therapy, and the advantages, and disadvantages of managed care.

Engage in critical thinking (about heath care coverage, over-generalization regarding various racial and ethnic groups, and ways to address the HIV/AIDS problem in sub-Saharan Africa)

Critical thinking questions were posed regarding the provision of national health insurance and the adoption of a liberal or conservative perspective. Other questions were raised concerning personal cultural values and avoiding over-generalization about other cultures. Finally, questions were posed about how to address the HIV/AIDS problem in sub-Saharan Africa.

Employ critical thinking skills (about the ethical dilemma of punishment versus empowerment, and the issue of providing expensive health care for prisoners

Critical thinking questions were raised regarding conservative and liberal approaches to providing punishment versus empowerment to prisoners. Questions were also posed concerning the practice of providing prisoners with expensive health care.

Address cultural competence in mental health settings (including barriers to accessing services and improving cultural competence)

Cultural competence, defined as mastery of a particular set of knowledge, skills, policies, and programs used by the social worker that address the cultural needs of individuals, families, groups, and communities, is just as important in mental health as in other social work settings. Barriers people of color often face in receiving mental health services include lack of help seeking behavior, mistrust, stigma, cost, and clinician bias. Cultural competence can be enhanced by developing individual practitioners' skills. It can also be enhanced by culturally competent organizations that celebrate diversity and constantly strive to develop cultural competence throughout the agency.

Describe family relationships in families addressing substance abuse and dependence

Eight themes characterize the families of substance abusers that focus on the substance becoming the most important center of the family's life. First, the abuser's use of his or her substance of choice becomes the most important thing in the family's life. Because the abuser's top goal is getting enough of the substance, other family members must structure their own behavior around this. Second, family members strive to keep the family together even when conditions are deteriorating due to the abuser's behavior. The unknown is scary. At least thy know what the current conditions are, regardless of how bad. Third, family members often act as enablers for the abuser's substance use. Enabler assume increasing responsibility for maintaining family functioning and making excuses on the abuser's behalf. In essence, this role enable the dependent person to continue consuming the substance, yet assume less and less responsibility for the consequences of that behavior. Fourth, family members often feel tremendous guilt. They think that they are at fault. The addicted person keeps denying responsibility, and someone must be help accountable, so the family members often take the blame. The spouse might feel that everything would be okay if he or she could just be the right kind of husband or wife or could just do the right thing. Fifth, family members often do not know what they want. Their lives are centered around the addicted individual. They only know what the addict wants. That is the primary focus of attention. Most family members are trying to hold onto their sanity and to keep themselves, and the family, from going under. Sixth, family members feel worthless. They feel as though no one cares for how they feel or for what they want. They feel profoundly inadequate and unlovable. They feel rejected by others. They do not feel as though they have a fair chance in life, and somehow they feel as though this is fair - that it is their fault anyway. This would not be happening to them if they were better persons. This is all they deserve. This is all they can get. Seventh, family members don't trust others. They have been disappointed so many times by the dependent person's behavior that they can't afford to dream about things getting better. They avoid discussing the problem with others inside or outside the family. They don't want to rock the boat. Eighth, family members have poor communication skills. They learned a long time ago the credo of the addicted family. Don't talk, don't trust, and don't feel. These individuals do not talk to their friends or other family members. They are cut off from everyone. They feel afraid of open communication. If they talked openly, then the truth might come out and the family would be destroyed.

Explore value discrepancies between cultural values (those of Asian and Pacific Islander [API] and health care provision (in the United States))

Five concepts directly related to API cultures that affect health care provision include filial piety, collective versus individual decision making, emphasis on harmony versus conflict, nonverbal communication, and a sense of shame at asking for help. Potential conflicts between API cultures and the U.S. health care system include informed consent, advance directives, decisions about nursing home placement, disclosure of terminal illness, and end-of-life decisions. Suggestions include training health care personnel to sensitize them to API cultural values, addressing end-of-life decisions with whole families instead of just individuals, assuming a family-centered decision-making model, establishing parallel services to traditional services that better meet the needs of API culture, and encouraging social workers to advocate for improved policies and practice strategies.

Explain the concept of "gayging"

Gayging is the invisibility, lack of attention, and unfair treatment many LGBT people experience as they get older. Social workers must be sensitive to their needs and their increased risk of discrimination.

Describe the issue of "global graying"

Global graying is an international phenomenon where the proportion of older adults is increasing globally. When addressing this issue, social workers should emphasize self-determination, enhancement of the environment and political milieu on the behalf of older adults, and existing strengths of the older adult population.

Identify the types of groups school social workers run

Groups social workers run include groups for parents of students who are parents; for students whose families are experiencing divorce; for students who are addressing substance abuse issues; for students at risk of dropping out; for students addressing stress, grief, and loss issues; for socialization and peer interaction skill development; and for addressing racial and cultural issues.

Identify major types of health problems

Health problems include those related to unhealthy lifestyles, physical injuries, environmental factors, poverty, and contagious diseases.

Discuss social work roles in mental health settings

In micro practice social workers can be case managers. They can also provide counseling and crisis intervention, in addition to linking clients with need resources and providing community education about mental health. MSWs can be psychotherapists. Existential therapy: Deals with important life themes. Rather than perscibing techniques and methods, it is an attitudinal approach to the issues of living. Themes include living and dying, freedom, responsibility to self and others, finding meaning in life, and dealing with a sense of meaninglessness. Expanding self-awareness is the primary goal. Person-centered therapy: Takes a positive view of individuals, believing that they tend to move toward becoming fully functioning. The goal is for genuineness, acceptance, and empathy. Behavior therapy: Aims to change factors in the environment that influence an individual's behavior as well as the ways in which individuals respond to their environment. Cognitive therapy: Emphasizes how people think and what they believe directly affect their actions, thoughts, and emotions. The goal is to identify unproductive and negative thoughts, evaluate their thought patterns, and alleviate inaccurate prescriptions about self, others, or circumstances. In mezzo practice, social workers can run treatment groups and treat families. In macro practice, social workers can be advocates for change, function as managers and administrators who can improve policies and service provision, and develop innovative programs to meet mental health needs.

Explore empowerment strategies for diverse older adult populations (including African American grandparents who are primary caregivers for grandchildren and the culturally competent treatment of older Navajo people residing in a nursing home

In nursing homes, social workers can empower residents by developing planes based on strengths, helping residents make decisions, addressing issues of concern raised by family members, linking residents with outside services, assisting other staff in understanding residents' needs, and advocating for residents' rights. Empowerment stratifies should focus on adaptation, competence, relatedness, and autonomy. Increasing sensitivity to older adults and their issues can enhance effective work with this population. Empowerment of people facing death includes understanding the emotional stages they may undergo, encouraging the expression of feelings, focusing on spirituality, and helping the individual make decisions including those involving legal documents. Provided are eight suggestions on how to help loved ones cope with the loss. 1. Help survivors actualize the loss. Talk about the loss. What happened? Ask. 2. Help them identify and express feelings. If they are dealing with anger, be indirect (what do you miss the most/least?). Four common difficult emotions are anger, guilt, anxiety, and helplessness. 3. Help survivors in living without the deceased. The problem-solving approach works well for this. Discourage major life changes for a while. 4. Facilitate emotional withdrawal from the deceased. Encourage survivors to go on. 5. Provide time to grieve. Crucial times include 3 months and 1 year after the death, anniversaries of the death, and holidays. Help clients prepare in advance for these. 6. Educate clients about customary grieving reactions of other individuals to help normalize the experience. 7. Allow for individual differences [including cross-cultural differences]. Be sensitive to individual styles. 8. Provide for continuing support. Encourage clients to join support groups. Grandparents Who Care is an example of a program that stresses empowerment. It provided support for African American grandparents who were the primary caregivers of their grandchildren. Support groups and political advocacy were emphasized. The Chinle nursing home in the central Colorado Plateau offers another example of empowerment by providing culturally sensitive care to older adult Navajo residents. Its programming emphasized traditional values including: culturally sensitive communication; clan associations and social structure; respect for personal space, modesty, privacy, and cleanliness; traditional food; rituals concerning dying and death and other cultural rituals.

Discuss youth gangs (including membership, types, prevention, and treatment)

It is estimated that 29,400 gangs exist throughout the United States. Gangs provide members with a range of benefits including social support, respect, protection, excitement, and financial benefits. Gangs are an international phenomenon. Types of gangs include criminal, conflict, retreatist, and cult/occult. Prevention, intervention, and suppression are three means of combating gangs.

Discuss avenues of empowerment (legislative and community empowerment)

Legislation that has empowered people with disabilities includes the Americans with Disabilities Act (ADA) of 1990 that forbids discrimination and requires public accommodations in many circumstances. Another example of legislation is the Developmental Disabilities Assistance and Bill of Rights Act of 1990 that renewed grant programs and acknowledged that more resources were needed for people with disabilities. The Individuals with Disabilities Education Improvement Act of 2004 requires that a free appropriate public education be provided to all children (including children with disabilities) from ages 3 to 21 in the least restrictive environment possible. Ways social workers can work toward empowerment include advocating for federal and state legislation to make resources available to clients and working with community residents to establish resources. Legislation empowering people with visual impairment includes Rehabilitation Act of 1973, the Randolph-Sheppard Act, and the 1931 Pratt-Smooth Act. SSI can provide benefits to people who are legally blind. Social workers can advocate for services, link people with needed resources, establish self-help groups, and work with schools to empower children with visual impairment. Communities can empower people with intellectual disabilities by establishing and using The Arc chapters, providing information and referral services and help lines, providing non-institutional living facilities, offering vocational and employment programs, developing other support services, advocating for equal rights, soliciting community volunteers to help The Arc programming, providing recreational activities, and initiating various creative linkages with community life.

Identify methods of administering substances

Methods of substance administration include oral consumption, inhalation, injection, or ingestion via mucous membranes.

Examine managed care within the mental health context

Most of the same issues apply to managed care in mental health as in other health care settings. Three important concepts are capitation, gatekeeping, and utilization management. There is much pressure on physicians and clinicians to find the least expensive treatment modalities possible for any particular client to minimize cost. Often, this not in the best interests of the client. It is therefore social workers' responsibility to advocate on their client's behalf.

Describe two community programs for youths (one that empowers Latin@ youths through a community assets assessment and one that explores how an African American spiritual community empowers its youth

New Bridges targeted a group of Latin@ youths who were at risk and hired them to conduct a community assets assessment. Results included the identification of student leaders to sponsor community projects, the provision of invitations to local business leaders to come in to speak to students, and special school projects emphasizing community strengths. An ethnographic study in Utah resulted in a church-sponsored support group for African American youth and the development of a computer literacy program.

Examine teenage sexual activity, pregnancy, parenting issues, and social work roles

Of all births in the United States, 9.3% are to teenage mothers. More than half have their babies, 35% have abortions, and 14% have miscarriages. The U.S. pregnancy rate is significantly higher than that of other Western countries. Possible reasons include that society is not clearly conveying to teens that childbearing is an adult activity, they are not receiving clear messages about the normalcy of sexual behavior, and family planning information and contraception are not readily available. The importance of comprehensive sex education and the provision of straightforward information about sexuality is stressed.

Define mobility disabilities (and identify a range of specific disabilities clustered under its umbrella)

People with mobility disabilities are those whose physical differences require them to achieve physical activities in a variety of alternate ways. Acquired mobility disabilities include stroke, muscular dystrophy, rheumatoid arthritis, multiple sclerosis, myasthenia gravis, and spinal cord injury.

Examine historical perspectives concerning developmental disabilities

Prior to the late 1960s, community treatment and legislation focused on individual pathology. During the 1970s and 1980s, people assumed a more community-based approach. Important concepts included normalization, deinstitutionalization, individual program planning, and the developmental model. During the 1990s and beyond, consumer empowerment has been emphasized. Major concepts include individualization, emphasis on choice, innovation, and family support.

Review the current status of health care in the United States

The Patient Protection and Affordable Care Act of 2010 (ACA) is summarized and discussed. Its intent is to provide health care to most Americans. Pros of the ACA: 1. Allows states to cover more people on Medicaid. 2. Encourages access to preventative services without cost. 3. Permits young adults under age 26 to remain on their parent's health insurance policy. 4. Provides tax credits to help more Americans pay for insurance even if they lose or change jobs or in the event that they become ill. 5. Offers consumer protection by closer monitoring of insurance companies and their practices. 6. Ends lifetime maximums and most annual maximums imposed by insurance companies. 7. Cracks down on insurance fraud. 8. Extends health insurance coverage to people with pre-exsisting health conditions. 9. Provides a 50% discount on brand-name prescription drugs for older adults on Medicare who enter the "donut-hole" where their drugs are not covered. 10. Offers tax credits to small businesses for providing health insurance to their employees. Cons of ACA: 1. It is very expensive. 2. Is it constitutional to force people to buy medical insurance from private companies. 3. Many small businesses don't want to pay for insurance for all of their employees. Managed care is the country's major approach to improving access, controlling cost, and ensuring quality of health care. It includes a broad range of health plans that manage and make decisions about patients' care. Problems in managed care include questions regarding the efficiency and effectiveness of capitation. Ethical dilemmas include the gate-keeping role of managed care organizations, potential issues with informed consent, and possible violations of confidentiality when patients seek treatment. Problems plaguing health care provision historically in the United States include variations in service provision including race, gender, and socioeconomic status. People living in poverty, people with lower socioeconomic status, and people of color are at special risk of having poorer and unequal access to adequate health care. Escalating costs present another problem in health care provision. The U.S. health care system costs significantly more per capita than the health care system in any other industrialized nation.

Explore the incidence of crime

The crime rate has experienced a decrease over the past decade. The crime rate appears to be related to the state of the economy, decreased crack cocaine use, a larger police force, and more severe sentences for criminals.

Review the criminal justice system (and define some of the key concepts involved)

The criminal justice system is the complex, integrated system of programs, policies, laws, and agencies dedicated to preventing and controlling crime. The system's functions include adjudication (passing legal judgement), incarceration (confining by putting in prison or jail), and rehabilitation (restoring to a a state of productive, noncriminal functioning in society).

Describe domestic violence (including its cycle, dynamics, and how to address the problem)

The cycle involves buildup of tension, the explosion, and a honeymoon period. There are many reasons why women stay in abusive relationships. Treatment strategies emphasize providing support, emphasizing empowerment, and advocating for services.

Compare two treatment models for substance abusers

Two contrasting treatment models are described. One is based on the traditional abstinence approach to recovery, and the other is a strengths-based model that emphasizes a least harm approach and focuses on achieving greater control of substance consumption (which may not include total abstinence). The Four Stage Recovery Model: Stage 1: Abstinence - during this stage, which can persist for as long as two years, clients strive to maintain sobriety. A major focus is on avoidance of mind-altering substances. In essence the individual learns to get through most days without experiencing or giving in to overwhelming cravings or urges to use. Relapses are common. Stage 2: Confrontation - Lasting up to five years, this stage sees clients begin confronting and changing the personal, family, and social issues that contributed to their chemically dependent lifestyle. They learn how to conduct adult relationships, assume responsibility for their actions, and explore lifestyles that do not include drugs and the people associated with their chemically dependent past. Clients are often obsessed with their abstinence and recovery, confronting people and experiences in their past daily, often with shame and guilt about what happened. Stage 3: Growth - Usually occurring after at least five years of abstinence, this phase reflects beginning a new lifestyle not involving substance abuse. New social support networks are established, and daily life does not involve constant attention to maintaining abstinence and recovery. Stage 4: Transformation - this stage marks a true change in life orientation from the former substance-using days. The client has established social networks and personal skills to live and thrive. The mind altering substance no longer has a place in this new existence. The Strengths Perspective on Alcohol Abuse and Dependence Treatment: Harm Reduction - a treatment approach emphasizing means to reduce the harm to users caused by the addiction. It is to help people help themselves by moving from safer use, to managed use, to abstinence, if so desired. The labeling of clients (he is an alcoholic, she has an eating disorder, etc.) is avoided; clients provide the definition of the situation as they see it. Clients who wish it are given advice on how to reduce the harm in drug use such as don't drink on an empty stomach, etc. Consistent with the strengths perspective, the counselor and client collaborate to consider a broad range of solutions to the client-defined problem; resources are gathered or located to meet the individual needs of the client. Above all, clients are viewed as amenable to change.

Describe the substances involved in abuse and dependence

Types of mind-altering substances include central nervous system (CNS) stimulants, CNS depressants, and other addictive substances. Stimulants are psychoactive substances that boost the functioning of the central nervous system. Depressants are psychoactive substances that suppress, slow, or relax the central nervous system. Other substance categories include cannabinoids, dissociative anesthetics, hallucinogens, and opioids and morphine derivatives. Newer drugs most recently appearing on the substance use and abuse scene include Molly, Spice, Krokodil, and bath salts.

Discuss school violence and social workers' role in its prevention

Violence has become a major problem in schools. To assist in the prevention of school violence, social workers can conduct needs assessments, provide conflict resolution, and develop violence prevention programs.


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