Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.
Elizabeth C. Pomeroy and Polly Y. Browning
Eating disorders involve maladaptive eating patterns accompanied by a wide range of physical complications likely to require extensive treatment. In addition, “eating disorders” frequently occur with other mental disorders, such as depression, substance abuse, and anxiety disorders. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery” (NIMH, 2011). As of 2013, lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are 0.9%, 1.5%, and 3.5% among females, and 0.3%, 0.5%, and 2.0% among males respectively (Hudson, Hiripi, Pope, & Kessler, 2007). Early diagnosis is imperative; the National Institute of Mental Health estimates that the mortality rate for anorexia is 0.56% per year, one of the highest mortality rates of any mental illness, including depression (NIMH, 2006). More recent research (Crow et al., 2009) indicates mortality rates as high as 4.0% for anorexia nervosa, 3.9% for bulimia nervosa and 5.2% for eating disorders not otherwise specified. Current research and treatment options are discussed.
Eye movement desensitization and reprocessing (EMDR) is one of the two most empirically supported treatments for adult populations with noncombat, single-episode posttraumatic stress disorder (PTSD), with the other being exposure therapy. This entry describes the unconventional origin, theoretical underpinnings, and treatment protocol of EMDR, including its distinctive use of bilateral stimulation (that is, dual-attention stimulation). Also discussed are possible contraindications, unresolved issues, and the need for more research regarding the effectiveness of EMDR with other populations with PTSD, such as children and individuals with combat PTSD and complex trauma.
Linda P. Darrell
The perspective of end-of-life care has changed over the years. People are living longer, fuller lives due to advanced medical care and technology along with an increased interest in healthier lifestyles. The focus of end-of-life care has expanded to include accidental and sudden, unexpected death, chronic illness, anticipated death from longevity, and illnesses impacting children. An expanded perspective of end-of-life care must account for the challenges and changes of service delivery within a multi-cultural 21st-century milieu. The significance of advanced medical technology and improved lifestyles is an important component of a primary multidisciplinary assessment to understand the impact of such a life-altering occurrence as end-of-life care. Equally as important is a culturally inclusive perspective to accommodate the significance of longevity due to improved lifestyles, advanced medical technology, ethnicity, spirituality, and racial awareness. This article will explore the multiple concerns surrounding end-of-life care issues from an expansive worldview.
Sandra Owens and Letha A. Chadiha
There is evidence that family caregiving in the United States has been increasing at an unprecedented rate as a result of various societal issues. This entry provides a summary of the scholarly literature regarding elder-caregiving trends, demographics, legislation, challenges, and racial and socioeconomic impacts, as well as the rewards of caregiving. Additionally, the entry provides empirical findings regarding evidence-based interventions associated with family caregiving of older adults.
Elizabeth C. Pomeroy, Danielle Parrish, Angela M. Nonaka, and Kathleen H. Anderson
This article reviews existing knowledge on the assessment of children with fetal alcohol spectrum disorders (FASD) and available screening, prevention, and intervention services. The wide range of preventable conditions associated with FASD throughout the life cycle is described, along with associated high-risk maternal behaviors. In addition, cultural and social determinants are discussed, in an effort to inform social work practice. The differentiation of FASD and protective factors that have been identified as reducing negative outcomes for children and their families affected by prenatal alcohol exposure are also explained. Finally, multidisciplinary and culturally appropriate prevention services are emphasized as well as early diagnosis and strength-based intervention strategies.
Maryah Stella Fram
This entry provides an overview of current knowledge and thinking about the nature, causes, and consequences of food insecurity as well as information about the major policies and programs aimed at alleviating food insecurity in the United States. Food insecurity is considered at the nexus of person and environment, with discussion focusing on the biological, psychological, social, and economic factors that are interwoven with people’s access to and utilization of food. The diversity of experiences of food insecurity is addressed, with attention to issues of age, gender, culture, and community context. Finally, implications for social work professionals are suggested.
Joan O. Weiss
The recent explosion of genetic knowledge that was a product of the Human Genome Project has extraordinary implications for social workers and their client population. It is imperative that social workers recognize how vital their role is in helping clients come to terms with being at risk for a genetic condition or facing the uncertainty of a genetic diagnosis in the family. Understanding the psychosocial and ethical implications of genetic testing is important for all social workers, no matter where they are practicing. Social workers must take an active part in ensuring that clients are protected against genetic discrimination and learn more about basic genetics and genetic resources.
Toba Schwaber Kerson and Jessica Euna Lee
Within its 150-year history, public health has grown from a focus on local communities to include countrywide, then international, and now global perspectives. Using the United Nations’ Millennium Goals as its primary framework, this entry provides an overview of global public health within the broadest possible context of the world and all of its peoples. Also provided are the global burden of disease as measured in disability-adjusted life years, global health statistics, current health priorities, and recommendations for action by social workers and other health professionals.
Diane Rae Davis
Harm reduction is a helping strategy that attempts to alleviate the social, legal, and medical consequences associated with unmanaged addiction, and in so doing, limit the harms, such as infectious disease (HIV, hepatitis), violence, criminal activity, and early death, without necessarily attempting to “cure” the addiction. While abstinence may be an ideal outcome from a harm reduction standpoint, abstinence is viewed as only one of several means of improving a person's life. Harm reduction strategies are well known in the U.S. through methadone maintenance and syringe-exchange programs, and are increasingly relied on in the treatment of co-existing disorders.