Primary prevention involves coordinated efforts to prevent predictable problems, to protect existing states of health and healthy functioning, and to promote desired goals for individuals and groups, while taking into consideration the physical and sociocultural environments that may encourage or discourage these efforts. This entry discusses the history of this basic approach to professional helping from medical, public-health, and social-science perspectives. It also reviews major theories that guide preventive thinking and action. One section sketches the substantial empirical base for evidence-based practice and how such information can be retrieved. This entry concludes with a review of practice methods for increasing individual strengths and social supports while decreasing individual limitations and social stresses, which together characterize most contemporary preventive services.
Practitioners who were presumed to be competent may develop difficulties that interfere with job performance. Such professionals are considered impaired and may suffer from compassion fatigue, substance abuse, mental disorders, and other forms of distress associated with daily living. Practicing while impaired is unethical and can potentially be harmful to clients. Colleague Assistance Programs from professional associations or diversion systems and legal sanctions imposed by state regulatory boards are forms of intervention strategies that are employed. Self-care strategies and consciousness-raising among professionals are the best forms of prevention.
Zebulon C. Taintor
Psychosocial (or psychiatric) rehabilitation is a mixture of skills and support for persons severely impaired by mental illness. The population in need is vast. Practitioners marshal support at the level needed while helping a person develop skills that will gradually reduce the need for support. Financial support is gained by offsetting treatment and other supports such as institutional care. Social workers are especially well qualified for this work on multidisciplinary treatment teams. Recovery is key to most agency mission statements.
Kia J. Bentley and Christopher P. Kogut
To advance the discussion of the interface between psychopharmacology and contemporary social work practice, we present a brief primer on the different types of medications used in psychiatry and our current understanding of how they work. We also discuss how decisions are made about psychiatric medications in the real world to treat some of the more common mental illnesses. Along the way, we will also present some of the recent research in psychopharmacology of particular interest to social workers and the clients they serve, as well as some of the future directions we can expect in the years to come. From that foundation, we review major activities of social workers in psychiatric medication, address some of the key controversies centering on issues of access, the role of drug companies, and especially medication for children. We conclude with brief reflections on what is “best practice” and notions of the future of interdisciplinary practice in health, mental health, and beyond.
Enola Proctor and J. Curtis McMillen
Assessing and improving the quality of social services is one of the most pressing concerns for social work practice and research. Practice in nearly every setting is affected by stakeholder expectations that agencies monitor and improve quality. This entry addresses the meaning of the phrase “quality of care” with respect to social work services, considers this topic in relation to quality improvement, quality assurance, and evaluation of services, and points to the research that is needed in order to assess and improve quality.
Concepcion Barrio, Mercedes Hernandez, Paula Helu Fernandez, and Judith A. DeBonis
Social workers in health and mental health and across public and private health sectors are expected to be knowledgeable of comprehensive approaches to effectively serve individuals dealing with psychotic disorders, including family members involved in their care. Effective services require expertise in assessment, diagnostics, treatment planning, and coordination of community support services. This article provides a knowledge base for social work practitioners working with clients challenged by the experience and consequences of serious mental illness, such as schizophrenia spectrum and other psychotic disorders. We begin by reviewing the public health significance of these disorders, clinical phenomenology and its historical context, and symptoms and classification. We then discuss the family and cultural context, evidence-based treatments, and several social and clinical issues that social work practitioners should be aware of when working with this client population.
Paula S. Nurius and Charles P. Hoy-Ellis
Evolving understandings of stress have literally transformed how we think about health as contextualized within complex and multilevel transactions between individuals and their environment. We present core concepts of stress through the lens of life-course and life-span perspectives, emphasizing appraisal-based and biobehavioral models of stress response systems. We describe theories of allostatic load, embodiment, epigenetics, weathering processes, and accelerated aging that operationalize mechanisms through which stress affects health and contributes to health disparities. In addition to social determinant and life-span developmental perspectives on stress and health, we emphasize the value of health-promotive factors that can serve to buffer stress effects. Social work has important roles in targeting health-erosive stress from “neurons to neighborhoods”.
Every year, more people in the world die from suicide than from homicide and wars combined. Efforts to reduce suicide have made several advances. Research has identified numerous suicide risk factors, and, though small in number, effective prevention and intervention strategies have been identified. Social workers are likely to encounter suicidal clients in their work, requiring suicide assessment and intervention skills.
Julie Cerel and Myfanwy Maple
Suicide is a more prevalent cause of death in many countries than automobile accidents, homicide, and breast cancer. Despite this, the experience of people left behind after a suicide is not well understood. This entry provides a sociohistorical overview of suicide to place suicide death in a relevant cultural context, explores the bereavement experiences of those grieving a loss to suicide, and presents the debate about similarities and differences regarding suicide bereavement in relation to other forms of traumatic death. In addition, this entry examines the role of social workers in working with people bereaved by suicide.
The term survivor has been applied to people who have endured diverse traumatic or life-threatening experiences ranging from sexual abuse to airplane crashes and wars. In the past 25 years, the term has also been applied to those diagnosed with cancer, an illness that once claimed the lives of most who were diagnosed with it, but which many now survive because of treatment advances. This entry addresses the social-work profession’s involvement with cancer survivorship as one example of survivorship. Social workers encounter cancer survivors in every practice arena, including hospitals and palliative-care programs as well as schools, correctional facilities, and mental-health clinics. They conduct research and provide education about the psychosocial impact of cancer and also provide counseling and advocacy. With their focus on strengths and resilience and their range of skills and knowledge about the biopsychosocial impact of life-threatening and traumatic experiences, social workers are uniquely positioned to assist survivors in adjustment to survivorship and in restoring well-being through micro, mezzo, and macro systems interventions.