Barbara L. Jones
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.
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.
Christina E. Newhill
Client violence and workplace safety are relevant issues for all social workers across practice settings. This entry addresses why and how social workers may be targets for a client's violent behavior, and what we know about who is at risk of encountering violence. Understanding violence from a biopsychosocial perspective, identifying risk markers associated with violent behavior, and an introduction to guidelines for conducting a risk assessment will be discussed. The entry concludes by identifying and describing some general strategies for the prevention of client violence.
The soldiers from the wars in Iraq and Afghanistan, as well as large numbers of nonwounded soldiers, experience post-traumatic stress disorder. Further, the families, groups, and communities from which all U.S. service men and women come, during and after these and other wars, have experienced their own war-related trauma. Stories on the nightly news reveal soldier reaction to combat stress, including intrusive memories, racing thoughts, nightmares, troubled sleep, irritability, anxiety, fear, isolation, depression anger, poor concentration, hyper- or hypovigilance, exaggerated responses, and increased alcohol and other drug abuse. The stories of family, friends, and community are filled with war stress symptoms of their own. Charged with keeping their families together, bills paid, jobs afloat, children safe and growing, families may experience a drop in income, loneliness and isolation, long deployments, multiple last minute combat redeployment and duty extensions, anger, frustration, depression, increased alcohol and other drug abuse, loss of trust, fear, increase in domestic violence, and school disruption. Not all of the change for family is negative as some spouses and children who are left behind find they have new skills and new independence with which to negotiate their world. The returning soldier's response to this newfound independence and skill may require the services of the clinical social worker.
Addie Weaver, Joseph Himle, Gail Steketee, and Jordana Muroff
This entry offers an overview of cognitive behavioral therapy (CBT). Cognitive behavioral therapy is introduced and its development as a psychosocial therapeutic approach is described. This entry outlines the central techniques and intervention strategies utilized in CBT and presents common disorder-specific applications of the treatment. The empirical evidence supporting CBT is summarized and reviewed. Finally, the impact of CBT on clinical social work practice and education is discussed, with attention to the treatment’s alignment with the profession’s values and mission.
Cognitive therapy is a perspective on social work intervention with individuals, families, and groups that focuses on conscious thought processes as the primary determinants of most emotions and behaviors. It has great appeal to social work practitioners because of its utility in working with many types of clients and problem situations, and its evidence-based support in the literature. Cognitive therapies include sets of strategies focused on education, a restructuring of thought processes, improved coping skills, and increased problem-solving skills for clients.
The past two decades have witnessed a surge in the growth of initiatives and funding to weave physical and behavioral health care, particularly with identification of the high costs incurred by their comorbidity. In response, a robust body of evidence now demonstrates the effectiveness of what is referred to as collaborative care. A wide range of models transverse the developmental lifespan, diagnostic categories, plus practice settings (e.g., primary care, specialty medical care, community-based health centers, clinics, and schools). This article will discuss the foundational elements of collaborative care, including the broad sweep of associated definitions and related concepts. Contemporary models will be reviewed along with identified contextual topics for practice. Special focus will be placed on the diverse implications collaborative care poses for the health and behavioral health workforce, especially social workers.
Diana M. DiNitto
This entry defines comorbidity and similar terms used in various fields of practice. It addresses the prevalence of comorbidity, suggests explanations for comorbidity, and discusses integrated treatment for comorbid conditions and the importance of the concept of comorbidity in social work practice.
Carolyn I. Polowy, Sherri Morgan, W. Dwight Bailey, and Carol Gorenberg
Confidentiality of client communications is one of the ethical foundations of the social work profession and has become a legal obligation in most states. Many problems arise in the application of the principles of confidentiality and privilege to the professional services provided by social workers. This entry discusses the concepts of client confidentiality and privileged communications and outlines some of the applicable exceptions. While the general concept of confidentiality applies in many interactions between social workers and clients, the application of confidentiality and privilege laws are particularly key to the practice of clinical social workers in various practice settings.
Margo A. Jackson
Despite the significant life and work experiences that a growing number of older adults have to contribute to the workforce, pervasive ageism operates in overt and covert ways to discriminate against older workers in hiring and workplace practices. This article provides a current overview of definitions, prevalence, types, and effects of ageism in the U.S. workplace. For social workers counseling older adult victims of workplace ageism, this article discusses theories, foundational knowledge, and ongoing self-awareness and training needed for bias awareness. Counseling strategies and resources are highlighted, including coping and resilience strategies to counteract ageist stereotypes and discrimination, facilitate job-seeking support, and advocate for older workers by promoting awareness and serving as a resource for employers to reduce workplace ageism.