Mansoo Yu and Rachel Fischer
Tobacco use is a major public-health concern in the United States. Intervention and prevention strategies for tobacco use are an urgent public-health priority because tobacco use is the single most preventable cause of death. To help social workers better understand tobacco use problems, this entry presents an overview, including definitions of terms, the scope and impact of tobacco use problems in terms of different segments of the population (that is, age, gender, race or ethnicity, geographic location, and education level or socioeconomic status), etiology of tobacco use (for example, biological or genetic; psychiatric; psychosocial; or environmental or sociocultural factors), policy history, tobacco prevention, clinical issues (such as cessation desire, treatment and success, or screening tools for tobacco use disorder and tobacco withdrawal), and practice interventions for tobacco use problems. Based on the information, the roles of social workers will be addressed.
Jessica M. Black
Although it was once widely held that development through toddlerhood was the only significant time of tremendous brain growth, findings from neuroscience have identified adolescence as a second significant period of brain-based changes. Profound modification of brain structure, function, and connectivity, paired with heightened sensitivity to environment, places adolescence both as a heightened period of risk and importantly as a time of tremendous opportunity. These findings are of key relevance for social-work policy and practice, for they speak to the ways in which the adolescent brain both is vulnerable to adverse conditions and remains responsive to positive environmental input such as interventions that support recovery and resilience.
Namkee G. Choi
Adult day care centers provide important health, social, and support services for functionally and cognitively impaired adults and their caregivers. The adult day care services are underutilized, however, because of the shortage of centers, caregivers' lack of awareness of and resistance to using services, and the mismatch between the needs of potential consumers and their informal caregivers and the services provided by the centers. To foster and support the expansion of adult day care centers, lessons learned from national demonstration programs need to be disseminated, and social workers need to be trained to provide essential services at the centers.
Maryann Amodeo and Luz Marilis López
This entry focuses on practice interventions for working with families and individuals including behavioral marital therapy, transitional family therapy, and the developmental model of recovery, as well as motivational interviewing, cognitive-behavioral therapy, relapse prevention training, and harm reduction therapy. A commonality in these intervention frameworks is their view of the therapeutic work in stages—from active drinking and drug use, to deciding on change, to movement toward change and recovery. We also identify skills that equip social work practitioners to make a special contribution to alcohol and other drug (AOD) interventions and highlight factors to consider in choosing interventions.
There are a range of practice interventions for clients with AOD problems based on well-controlled research.
Carole B. Cox
Dementia is not a disease, but a group of symptoms so severe that they inhibit normal functioning. Alzheimer's disease is the most common type of dementia in older persons impacting not only the person with the illness but the entire family. Obtaining an accurate diagnosis is essential in order to assure appropriate and timely care and to exclude reversible causes of dementia. Social workers can play key roles throughout the course of the illness as educators, therapists, supporter and advocates for improved policies and services.
Behavioral theory seeks to explain human behavior by analyzing the antecedents and consequences present in the individual's environment and the learned associations he or she has acquired through previous experience. This entry describes the various traditions within the behavioral perspective (classical conditioning, operant conditioning, cognitively mediated behavioral theory, and functional contextualism) and the clinical applications that are derived from them. Common criticisms are discussed in light of the ongoing evolution of behavioral theory and the fit of its tenets with the field of social work.
June Simmons, Sandy Atkins, Janice Lynch Schuster, and Melissa Jones
Transitions in care occur when a patient moves from an institutional setting, such as a hospital or nursing home, to home or community, often with the hope or expectation of improving health status. At the very least, patients, clinicians, and caregivers aim to achieve stability and avoid complications that would precipitate a return to the emergency department (ED) or hospital. For some groups of vulnerable people, especially the very old and frail, such transitions often require specific, targeted coaching and supports that enable them to make the change successfully. Too often, as research indicates, these transitions are poorly executed and trigger a cycle of hospital readmissions and worsening health, even death. In recognizing these perils, organizations have begun to see that by improving the care transition process, they can improve health outcomes and reduce costs while ensuring safety, consistency, and continuity. While some of this improvement relies on medical care, coaching, social services and supports are often also essential. Lack of timely medical follow-up, transportation, inadequate nutrition, medication issues, low health literacy, and poverty present barriers to optimal health outcomes. By addressing social and environmental determinants of health and chronic disease self-management, social workers who make home visits or other proven timely interventions to assess and coach patients and their caregivers are demonstrating real results. This article describes care transitions interventions, research into barriers and opportunities, and specific programs aimed at improvement.
Barbara L. Jones and Casey Walsh
Despite rapid medical advances, children in this country still face significant barriers to adequate health care, including unequal access to insurance and health care. There is great need and opportunity in our nation at this time to advocate for the advancement and prioritization of pediatric health care. Children remain vulnerable to the challenges of poverty, violence, firearms, mental health, and health care access. Social workers play an important role in assisting children and families who face health care crises by providing supportive services, advocacy, culturally grounded assessment, trauma informed care, and evidence-based interventions to improve healthcare outcomes and quality of life. The Patient Protection and Affordable Care Act (ACA), signed into law in 2010, has increased access to pediatric health and behavioral health services. While the future of this law is uncertain at the time of this writing, social work is and will continue to be an important discipline to assist children and families in the areas of health promotion and adaptation to illness and injury.
Shirley Gatenio Gabel
The history of social work is deeply rooted in helping vulnerable populations improve their well-being, and children have been at the forefront of these efforts since the inception of the profession. Health is long understood to be critical to children’s well-being. Social workers who are skilled in integrating different systems can play pivotal roles in engineering new and improving existing health-care infrastructures and can act as advocates for fusing health-service systems with other social infrastructures to optimize outcomes for children. This entry reviews trends in children’s health throughout the world, particularly in the United States. It describes the dramatic improvements in reducing infant mortality, child mortality and morbidity from many infectious diseases as well as accidental and environmental causes, and the unequal progress in realizing children’s health. The challenges that lie ahead that pose risks to children’s health are discussed, including the health inequities created among and within countries by social, economic, and political factors. An argument for a comprehensive, integrated, evidence-based, and cross-disciplinary approach to improve children’s future health is presented.
Patricia A. Fennell and Sara Rieder Bennett
There is a paradigm shift occurring in medicine, from models focused on treating acute illnesses to those concerned with managing chronic conditions. This shift coincides with the higher prevalence of chronic illnesses resulting from factors such as lower mortality from formerly fatal illnesses and an aging population. The chronically ill do not fare well in an acute care model, and as a result, it has become imperative to develop new models effective for these chronic conditions. These new care models will require comprehensive, coordinated case management, an activity in which social workers can play a significant role.