Steven P. Segal and Leah A. Jacobs
The deinstitutionalization policy sought to prevent unnecessary admission and retention in institutions for six populations: elderly people, children, people with mental illness or developmental disabilities, criminal offenders, and, more recently, the homeless. It also sought to develop community alternatives for housing, treating, and habilitating or rehabilitating these groups. U.S. institutional populations, however, have increased since the policy’s inception by 212%. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house these groups, often referred to as transinstitutionalization. This entry considers how this shift has affected the care and control of such individuals from political, economic, legal, and social perspectives, as well as suggestions for a truer implementation of deinstitutionalization.
Janet B. W. Williams
The fourth edition of the Diagnostic and statistical manual of mental disorders Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association is referred to as DSM-IV. DSM-IV's predecessor, DSM-III, differed considerably from the first two editions. Its innovative incorporation of specified diagnostic criteria and a multiaxial system for evaluation resulted in its having a major impact on the field of mental health.
Lisa S. Patchner and Kevin L. DeWeaver
The multiplicity of disability definitions can be attributed to the heterogeneity of disability, its multifactoral nature, and its effects across the life span. Of particular concern to the social work profession are those persons with neurocognitive disabilities. Neurocognitive disabilities are ones where a problem with the brain or neural pathways causes a condition (or conditions) that impairs learning or mental/physical functioning or both. Some examples are intellectual disabilities, autism spectrum disorders, and savant syndrome. Neurocognitive disabilities are the most difficult to diagnose often times because of their invisibility. Providing services for people with neurocognitive disabilities is very difficult, and people with these disabilities are among the most vulnerable populations in today's society. This entry discusses neurocognitive disabilities and current and future trends in social work disability practice.
W. Patrick Sullivan
The psychosocial catastrophe that accompanies serious mental illness negatively impacts individual performance and success in all key life domains. A person-in-environment perspective, and with a traditional and inherent interest in consumer and community strengths, is well positioned to address psychiatric disabilities. This entry describes a select set of habilitation and rehabilitation services that are ideally designed to address the challenges faced by persons with mental illness. In addition, it is argued that emphasis on a recovery model serves as an important framework for developing effective interventions.
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.
Sheila H. Akabas
Employee assistance programs (EAPs), or membership assistance programs when sponsored by unions, are designed to improve worker productivity and motivation by responding to problems that workers experience which interfere with job performance and satisfaction. Now a ubiquitous characteristic of American workplaces, the programs are largely staffed by social workers. This entry discusses their historic development, extent, scope, structure, how they are perceived and utilized by different racial and gender populations, and the dilemmas and challenges facing EAPs as they try to define their role, function, and best practices amid emerging trends in the world of work.
Tonya Edmond and Karen Lawrence
Since its inception in 1987, eye movement desensitization and reprocessing (EMDR) therapy has been the subject of lively debate and controversy, rigorous research both nationally and internationally, and is now used by licensed practitioners across six continents as an effective treatment of trauma symptoms and posttraumatic stress disorder (PTSD). The aim of this entry is to provide social work practitioners and researchers with a description of the treatment approach for adults and children, EMDR’s development and theoretical basis, a review of controversial issues, and an overview of the evidence of effectiveness of EMDR across trauma types and populations.
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.