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.
Clayton T. Shorkey and Michael Uebel
The entry defines Gestalt therapy, including brief history, major influences, contributors, and current status of Gestalt therapy in terms of memberships and journals. Key concepts are outlined, and the effectiveness and potential for Gestalt therapy's status as an evidence-based practice is framed in relation to recent overviews of empirical research and to what is needed in the future for further research. While the current literature in social work does not reflect a strong emphasis on Gestalt, we emphasize some of the philosophical and ethical compatibilities between these approaches.
Sara Sanders, Matthew Tvedte, and Mercedes Espinal-Lujan
This article summarizes the history of grief theory and provides an overview of major theoretical frameworks for understanding grief and grief work. Specific types of losses are defined and described, including the newer concept of community grief and loss. Interventions for individuals, groups, and communities are outlined, followed by a discussion of the role of social workers in addressing grief and loss.
Health social work is a subspecialization of social work concerned with a person's adjustment to changes in one's health and the impact this has on that person's social network. Social workers in every setting must be ready to assist individuals and families adjusting to illness and coping with medical crises. This entry provides a brief overview and history of health social work and describes the settings and roles where this work is practiced. Significant challenges and opportunities in clinical care, research, education, and policy are discussed. Standards and guidelines for quality practice are then noted.
This entry provides an overview of the state of health care in the United States. Service delivery problems such as access and affordability issues are examined, and health care disparities and the populations affected are identified. A discussion of two primary government-sponsored health care programs—Title XVIII (Medicare) and Title XIX (Medicaid), and the Patient Protection and Affordable Health Care Act—are reviewed along with various health care programs and major existing service delivery systems. Ethical conflicts in providing health care, and new directions and challenges are discussed, along with future roles for social workers.
Lois F. Cowles
Social work in health care emerged with immigration and urbanization associated with industrialization, and the resultant shift from physician visits to the patient's home and workplace to hospital-centered care. This change is alleged to have resulted in a loss of the doctor's perspective of the psychosocial influences on physical health. Originally, some nurses were assigned the function of addressing this loss. But eventually, the function became recognized as that of a social worker. From its beginnings in the general hospital setting in the late 1800s, social work in health care, that is, medical social work, has expanded into multiple settings of health care, and the role of the social worker from being a nurse to requiring a Master's Degree in Social Work (MSW) from a university. However, the broad function of social work in health care remains much the same, that is, “to remove the obstacles in the patient's surroundings or in his mental attitude that interfere with successful treatment, thus freeing him to aid in his own recovery” (Cannon, 1923. p 15). Health care social workers are trained to work across the range of “methods,” that is, work with individuals, small groups, and communities (social work “methods” are called “casework”, “group work” and “community organization”). They work to assist the patient, using a broad range of interventions, including, when indicated, speaking on behalf of the client (advocacy), helping clients to assert themselves, to modify undesirable behaviors, to link with needed resources, to face their challenges, to cope with crises, to develop improved understanding of their health-related thought processes and habits, to build needed self confidence to do what is required to help themselves deal with their health problem, to gain insight and support from others who are in a similar situation, to gain strength from humor, or from a supportive environment, and through spiritual experience, and from practicing tasks that are needed to deal with their health-related problems or from joining forces with others in the community to modify it in the interest of improved health status for all, or to gradually restore a sense of stability and normalcy after a traumatic experience. Most important of all, perhaps, is the “helping relationship” between client and social worker, which needs to be one of total understanding and acceptance of the client as a person. A sizable portion of the U.S. population lacks financial access to health care, where health care is regarded as a privilege rather than a right, as it is seen in all other industrial nations (except South Africa). Current trends in the U.S. health care system reflect efforts to control rising health care costs without dealing with the “real problems,” which are: (1) the lack of a single-payer health care system and: (2) the lack of focus on “public health.”
Jessica Grogan and Frank C. Richardson
The Humanistic Psychology Movement, which began in 1962 and flourished throughout the 1960s and 1970s, exercised a strong influence over the development of social work assessment and practice. Defined by its distinctive research methodologies, based on the phenomenology of Husserl and Heidegger and in the consideration of subjective, experiential elements, humanistic psychology contributed to the modern practice of qualitative and survey-oriented research. Its health and growth orientation, antihierarchical emphases, and affirmation of the inherent strengths of human nature also greatly impacted therapeutic practice. Specific therapeutic orientations that arose from the movement include person-centered counseling, existential therapy, Gestalt counseling, transactional analysis, and the strengths perspective.
Frederic G. Reamer
The possibility of practitioner impairment exists in every profession. Stress related to employment, illness or death of family members, marital or relationship problems, financial problems, midlife crises, personal physical or mental illness, legal problems, substance abuse, and professional education can lead to impairment. This article provides an overview of the nature and extent of impairment in social work, practitioners’ coping strategies, responses to impairment, and rehabilitation options and protocols. Particular attention is paid to the problem of sexual misconduct in social workers’ relationships with clients. The author reviews relevant ethical standards and presents a model assessment and action plan for social workers who encounter an impaired colleague.
Sarah E. Bledsoe, Brianna M. Lombardi, Brittney Chesworth, and Samuel Lawrence
This article discusses interpersonal psychotherapy (IPT), a psychotherapeutic intervention developed by Gerald Klerman, Myrna Weissman, and colleagues in the 1970s as an outpatient treatment for major depression in adults. Based on the theories of Harry Stack Sullivan and Adolph Meyer, IPT is a manualized, time-limited intervention that addresses the underlying interpersonal antecedents and correlates of psychiatric illness. The goal of IPT as originally developed is to reduce depressive symptoms and improve interpersonal relationships. IPT has been widely tested in adults and adolescents and is an empirically supported treatment for major depression. IPT has been adapted for a variety of psychiatric illnesses and problems of living including perinatal depression, anxiety, and trauma-related disorders. Current evidence detailed below supports the use of IPT across cultures, illnesses, and populations.
Amanda Duffy Randall and Donna DeAngelis
Social work regulation protects the public by establishing the qualifications that a professional must possess, by establishing a means of holding professionals accountable, and by having a system for the public to make complaints against allegedly incompetent or unethical practitioners and have them investigated and adjudicated. Certification also exists in various specialty areas of social work practice, as is a function of professional organizations versus governmental regulatory agencies.