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Irwin Epstein and Stephen A. Kapp
This entry reviews agency-based research and the unique demands created by the organizational context where this activity resides. Three primary stakeholder groups are identified: administrators and program managers, supervisors, and direct service workers and clinicians. Possible uses of agency-based research by each of the respective stakeholder groups are described. Finally, the role of service consumers in agency-based research is discussed.
Nancy R. Hooyman
The rapidly growing older population is more heterogeneous by health and economic status, gender, race, sexual orientation, and family and living arrangements than any other age group. Although many adults face vulnerabilities and inequities as they age, most elders are resilient. This entry reviews this diversity, discusses concepts of productive, successful, and active aging, and suggests leadership roles for social workers in enhancing the well-being of elders and their families.
Lenard W. Kaye
Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.
Jeanette C. Takamura
Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.
Daniel S. Gardner and Caroline Rosenthal Gelman
Minority and immigrant elders constitute a greater proportion of the population than ever before and are the fastest growing segment of the older population. Within these racial and ethnic groups there is considerable variation with regard to age, gender, country of origin, language, religion, education, income, duration of U.S. residency, immigration status, living arrangements, social capital, and access to resources. The authors summarize research on older adults regarding racial and ethnic disparities, barriers to health and social service utilization, and dynamics of family caregiving. Implications are offered for social-work practice, policy, and research.
Nancy Morrow-Howell and Leslie Hasche
Despite high levels of functioning among older adults, chronic health conditions lead to impairment and the need for help. Family members provide most of the assistance; yet formal services such as in-home personal and homemaker services, congregate and home-delivered meals, adult day services, employment and educational services, transportation, nursing homes, assisted and supportive living facilities, legal and financial services, and case management are available. Even with the growing number and type of services, unequal access and uneven quality persist. In these settings, social workers develop and administer programs, provide clinical care, offer case management and discharge planning, and contribute to policy development.
Sarah (Hicks) Kastelic
Alaska Natives represent less than 1% of the U.S. population but reside in more than 229 Native villages and account for 40% of federally recognized tribes. Most Alaska Native communities shared common Euro-American contact experiences: exposure to western religions, education, and disease. Historical trauma contributes to many of the social welfare problems Natives experience today: low educational attainment, unemployment, inadequate health care, substance abuse, and violence. Service delivery mechanisms, lack of cultural appropriateness, and isolation compound these pressing issues. Locally delivered social welfare services that take into account traditional Native worldviews, values, languages, and intergenerational relationships are effective in addressing many of these issues.
Anna Celeste Burke
Historically, U.S. policy has been characterized by long-standing ambivalence evident in the changing emphasis placed on prohibition as the aim of drug policy, and in debate about the relative merits of various approaches to drug control. Often characterized as supply reduction versus demand reduction efforts, significant changes have occurred over time in these efforts, and in the emphasis placed on them. In the last quarter of the twentieth century, U.S. drug policy adopted a more prohibitionist stance, with increased reliance on a variety of law enforcement, and even military actions, to control the supply and use of drugs, even in the face of evidence for the effectiveness of prevention and treatment, and high costs associated with the burgeoning incarceration rates.
Shulamith Lala Ashenberg Straussner and Richard Isralowitz
Social workers commonly encounter individuals and families that have problems resulting from alcohol and other drug (AOD) misuse, abuse, and dependence. This entry provides an overview of AOD problems in the general population and within such subpopulations as young people, the elderly, women, ethnic and racial minorities, and the gay and lesbian community. Clinical and policy responses to these problems in the United States, the roles of social workers in this field, and directions for the future are addressed.
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.