Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

Examining Protective Factors for Dysthymia Among Individuals Attending Substance Abuse Treatment

ABSTRACT

Dysthymia affects millions of people and has been associated with impaired psychosocial and occupational functioning and poor clinical treatment outcomes. Yet few studies have examined protective factors that can be utilized to help individuals with dysthymia in clinical settings, particularly among individuals with comorbid substance use disorders. The purpose of this study was to examine the potential protective quality of adult attachment dimensions, spirituality, and meaning in life among clients with and without dysthymia in treatment for addiction. Data were obtained from 305 self-report questionnaires administered to clients attending a residential substance abuse treatment center. Approximately 25% of the sample met criteria for dysthymia. Results from logistic regression analyses indicated that purpose and meaning in life and attachment anxiety were the most important protective factors against having dysthymia. These results suggest that mental health professionals may need to integrate these protective factors into the treatment of individuals with dysthymia and substance use disorders, which may enhance treatment outcomes and maximize treatment effectiveness. Future studies should continue to explore protective factors that can assist individuals who experience these comorbid conditions and consider replicating this study using an ethnically diverse sample and other clinical settings to determine the generalizability of the findings.     

社会融合视角下聋人大学生身份认同及其影响因素研究

认同被视为个人对外在环境和自身状况的综合反映,相当程度上能够表现出个人心理层面社会融合的状态。本文以N学院在校全部聋人大学生为研究对象,通过304份问卷调查,对他们身份认同进行研究,结果表明：聋人大学生身份认同呈现四个倾向分化并处于一定困境之中;听力损失年龄在四个认同倾向上影响并不显著,性别、听力损失程度、家庭背景、家庭教育、学校受教育方式、学业成绩以及社会交往等因素对身份认同影响比较显著。政府、学校及家庭等相关人员要关注聋人大学生身份认同困境并寻找对策以促进他们融入社会。     

The Medical Center's Impact in the Network to Sustain the Aged in the Community

A process is described to show how a Social Work Department of a Medical Center ascertained the need to offer a continuum of comprehensive services to a high risk elderly population. This includes aiding and participating with the board and administration of the Medical Center to develop a varied network of services programs. A community based program model is used to show the utilization of individual and group modalities in working with this age population. Clinical material is incorporated to emphasize that aging clients are accessible for psychosocial interventions and can utilize their ego strengths through group living and group counseling. Experiences will highlight that behavioral changes can be brought about through a reintegration of social, emotional, and environmental forces.     

Contract or Con Trick? A Reply to Rojek and Collins

Correspondence should be sent to Leeds Family Service Unit, 15 Lavender Walk, Leeds 9, Yorkshire. Summary In this paper we identify some major misconceptions in a paperwhich appeared earlier in this journal. We argue that contractwork has been misunderstood and that contracts can be used effectivelyand without dishonesty. In particular, the point is made thatcontracts are a practical working concept which offers a meansof discussing and resolving clashes in perspective and of modifyingthe unequal power balance between clients and social workers.     

Abstracts of theses,July 1955: Smith College School for Social Work

Abstract

This commentary amplifies the dynamic strategies in Message in a Bottleto consider in working with clients who seek to augment psychotherapy with psychopharmacologic treatment. This commentary also addresses how to evaluate and enhance psychotherapy outcome independent of medications and reviews some of the factors which contribute to positive treatment outcome. In order for clinicians to resist the pervasive colonizing effects of the medical model, this commentary reevaluates some of the claims that medications seem to promise and reinforces data which demonstrate that psychotherapy remains a safe and effective first-line treatment.     

Period prevalence and types of psychosocial risk factors in pregnant women in an urban Swedish community

During a three-year period a total population of pregnant women attending antenatal clinics in Linköping, Sweden was screened for being at psychosocial risk. The prevalence of different psychosocial risk factors was compared with the corresponding prevalence in women referred to and accepting or declining to take part in a specialised training programme at a parent–baby clinic. In general, the present study showed that there was a constant proportion of about 4–5% of pregnant women with psychosocial risk factors. Psychiatric problems and social problems of relevance for pregnancies/parenthood were about equally frequent (i.e. 44 and 45%), while drug-addiction problems were at 11%. Only one in three women with risk factors were eventually referred to the parent–baby clinic, and every second woman referred finally took part in the programme. With the knowledge that an early intervention in families with psychosocial risk factors may alleviate some adverse or disadvantageous developments in children, it is a challenge to identify and to motivate these women to enrol in various support and training programmes. There are still too few pregnant women at risk who are ready to accept the further support that they may need, and the rationale for their reluctance must be better known.     

Inter‐agency joint protocols for safeguarding children in social care and adult mental‐health agencies: a cross‐sectional survey of practitioner experiences

Parental mental illness, substance misuse and domestic violence are common risk factors for the maltreatment and neglect of children. Safeguarding children is everyone's responsibility, including professionals working primarily with adults. In the UK, Local Safeguarding Children Boards (LSCBs) were established to ensure that all agencies work together to safeguard children. Many LSCBs developed multi‐agency joint protocols to enhance collaboration, but there is limited evidence of their effectiveness. This paper reports findings from a cross‐sectional survey of practitioner self‐reported experiences of joint protocols, which was conducted in one inner London borough, to evaluate their impact on professional practice. A self‐complete questionnaire administered to all professionals in adult mental‐health and children's social care services in the borough yielded a response from 119 practitioners. The survey found that the protocols had been widely disseminated and provided clear guidance to practitioners. Practitioners perceived that they had increased awareness of the risk factors for safeguarding children and some had used the protocols to help them gain access to services for their clients. Practitioners also perceived that they had improved inter‐agency working between children's social care and adult mental‐health services. However, respondents indicated that positive interpersonal contact with practitioners from other agencies was equally important in promoting joint working and inter‐agency collaboration.     

Three Approaches to Understanding Self-Help Groups

With the increasing importance of self-help groups, professionals need to augment their understanding of how groups work in order to help clients make effective use of them. Three conceptual frameworks-social networks, social learning and cognitive theory-explain the basic psychosocial processes of self-help groups. Practice implications indicate how clients can benefit from self-help groups and suggest how professionals might enable their clients to realize the full benefits of participation in them.     

Social workers' use of spiritual practices in palliative care

Numerous studies have examined client use of spiritual and/or religious practices to cope with illness and adversity. This study explores social workers' use of spiritual practices as reflected in their work with palliative care clients. Survey results (n = 327) indicated significant relationships of spiritual practices such as yoga, prayer and meditation to working with palliative care clients. The total number of these approaches is predicted by factors such as theoretical orientation and the social workers' own struggles with palliative care and other issues. Our study supports the need for additional investigation of spiritual issues in practice.     

Correlates of Treatment Retention Among Persons with Serious Mental Illness Receiving Integrated Care in a Community Mental Health Setting

ABSTRACT

Knowledge about methods to retain community mental health (CMH) clients in integrated primary and behavioral health care (PBHC) programs is needed to address longstanding health disparities. A preexisting data set that contained the clinical records of 446 PBHC program participants was used to examine whether baseline sociodemographic, health, and psychosocial characteristics predicted retention in care at 6 months post-enrollment. Results indicated that less than half of PBHC participants (43.7%) were retained in care, and approximately 17% of the variance in retention was explained by the inclusion of seven predictors in the model (overall health, medications, laboratory data, primary care provider, disorder type, transportation, and living arrangement). Clients with thought disorders were almost twice as likely as those with mood disorders to be retained in care, and greater frequency of prescribed medications also increased the likelihood of treatment continuation (ORs = 1.99 and 1.20, respectively). Future research should identify factors that improve retention in integrated PBHC programs overall, and among persons with mood disorders, in particular.     

Perceptions of Difference Between Aging and Disability Service Systems Consumers: Implications for Policy Initiatives to Rebalance Long-Term Care

This study explores service professionals' perceptions of how and why older adults and younger persons with disabilities are different consumers and clients within the long-term care service sector. Data are from 2004, early in the history of federal long-term care rebalancing initiatives, reflecting perceptions at that time. Findings suggest professionals working within aging, developmental disability, and physical disability service networks believe significant distinctions exist related to age of clients and nature of service required and how it is delivered. Overall need for greater professional and organizational capacity to support provision of service to both aging and disability populations is reported.     

Perceptions of difference between aging and disability service systems consumers: implications for policy initiatives to rebalance long-term care

This study explores service professionals' perceptions of how and why older adults and younger persons with disabilities are different consumers and clients within the long-term care service sector. Data are from 2004, early in the history of federal long-term care rebalancing initiatives, reflecting perceptions at that time. Findings suggest professionals working within aging, developmental disability, and physical disability service networks believe significant distinctions exist related to age of clients and nature of service required and how it is delivered. Overall need for greater professional and organizational capacity to support provision of service to both aging and disability populations is reported.     

Social Workers' Use of Spiritual Practices in Palliative Care

Abstract

Numerous studies have examined client use of spiritual and/or religious practices to cope with illness and adversity. This study explores social workers' use of spiritual practices as reflected in their work with palliative care clients. Survey results (n = 327) indicated significant relationships of spiritual practices such as yoga, prayer and meditation to working with palliative care clients. The total number of these approaches is predicted by factors such as theoretical orientation and the social workers' own struggles with palliative care and other issues. Our study supports the need for additional investigation of spiritual issues in practice.     

Improving the working environment for workers in children's welfare agencies

The working environment and workplace ecology of children's welfare agencies is important to the quality of their service provision. In the past, restructuring and professional development and training have been standard responses to changing needs and demands on children's services but have generally failed to improve the working environment. This research argues that concrete strategies can be developed from a detailed understanding of significant factors impacting on workers' satisfaction and morale. The specific stresses and rewards impacting on workers in three children's welfare services in Australia were investigated over a 12-month period to obtain preliminary information for the formulation of strategies likely to improve satisfaction and morale. The participating organizations were of different size, organizational structure, responsibilities and philosophy. Most factors identified in the study applied across the different organizations. Using a combination of journal writing, recording of critical incidents, relationship mapping and workshops, child welfare workers documented their day-to-day work experiences, outstanding events and networking activities. The narrative data were analysed using force field analysis and quasi-stationary equilibrium analysis based on a categorical framework of individual, team, organizational and political factors. Job satisfaction was strongly linked to intrinsic aspects of the work itself, that is, achieving outcomes for clients. Dissatisfaction with the job was strongly linked to organizational constraints, and strong team identification counterbalanced constraints. Largely unmentioned were political issues, professional practices and ideological and religious beliefs that undoubtedly impacted on practice. This research suggests some concrete steps to enhancing the quality of workplaces in children's welfare services.     

The Interpretation of Line of Regard by Prelingually Deaf Children

The ability of 5- to 12-year-old deaf children to utilise and interpret another person's visual line of regard (where the eyes are looking) was studied in four experiments using cartoon faces. The children had little difficulty in determining whether or not a face was looking directly at them. They had more difficulty, however, with more complex tasks requiring them to infer mental states of desire and intention from line of regard and to ignore line of regard when it was inappropriate to attend to this cue. Deaf children raised in a hearing environment appear to have more difficulty with these more complex tasks than hearing children. The results are discussed in terms of the special difficulties facing some deaf children in the development of skills involving utilisation of line of regard and the implications for the development of joint attentional behaviour, theory of mind and dyadic social interaction in deaf and hearing children.     

The Relationship between Public Long-Term Care Insurance Awareness and Preparation for Later Life in South Korea

An increased focus on individual preparation for later life paired with a shift in family support within South Korea makes it necessary to study factors that influence preparation for later life among South Korean adults. This study examined whether the awareness of public long-term care insurance (LTCI) was related to South Koreans' financial, psychosocial, and physical preparations for later life. Data from the third wave (2009) and third supplement wave (2010) of the Korean Retirement and Income Study (KReIS) yielded a sample of 2,487 middle-aged adults. Multiple regression analyses were used to compare the influence of the awareness of public LTCI on financial, psychosocial, and physical preparation by dividing the sample into negative status and positive status groups based on subjective perceptions of current economic, relationship, and health conditions. The results showed that being aware of public LTCI increased preparation for later life in financial, psychosocial, and physical domains. In addition, participants in the negative status group had higher scores for psychosocial and physical preparation than individuals who perceived themselves as being in relatively better situations. These findings suggest that the policy makers and practitioners should include education on LTCI and the risks it targets across various preparation domains as well as account for differences in perception and preparation among sub-populations of middle-aged adults in order to ensure effective social policies for the elderly population.     

And then I became a prostitute … Some aspects of prostitution and brothel prostitutes in Dakar,Senegal

In the framework of a research undertaken to study the role of clients of brothel prostitutes in the spread of HIV in Dakar, Senegal, prostitutes working in several sectors of prostitution (street, bar, hotels, etc.), provided information about their life and about how they became prostitutes through opened interviews. Information was also obtained by observation of the brothels during the fieldwork with clients. This paper describes some characteristics of prostitution in brothels and prostitutes in Dakar, Senegal. This research shows that young African women are vulnerable to HIV infection because sexual relations with men are an important means to achieve social and economic status, and for some women they are necessary for survival. These data show that Senegalese prostitutes, because of their high HIV prevalence, represent a reservoir of HIV infection and a core group for HIV transmission into Senegalese society. This suggests that in spite of information and free condoms, a number of prostitutes engage in unprotected sex. Clandestine and minor prostitutes are at major risk because they are not targeted for condom interventions. Pockets of non-utilization of condoms were found in some geographic areas (brothels) of Dakar and merit local interventions.