Beliefs,Death Anxiety,Denial, and Treatment Preferences in End-of-Life Care

Abstract

This study examined cultural and religious beliefs, death anxiety, denial, and medical treatment preferences in end-of-life care in a sample of social work students, community residents, and medical students in a mid-western city of 49,000. Results indicated that most social work students, community residents, and medical students preferred palliative as opposed to life-prolonging care during terminal illness. The three groups differed in cultural and religious beliefs and all three reported a moderate amount of death anxiety. Students reported less denial of terminality than community residents. Implications for personal and professional preparation to provide end-of-life care are discussed.     

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.     

Factors affecting the constancy of the intelligence quotients of problem children 1

Abstract

This theoretical study is based on the premise that the dynamics of metaphor, the joining of two disparate entities in a single relational field to produce a new concept, represent a prototype of change. Literature is reviewed as it applies to certain relationships between metaphor and psychotherapy. As both metaphor and psychotherapy are rooted in language, language is viewed both as it informs the self and as it is used as a tool of psychotherapy. Psychoanalytic theory of language development is presented as are theories of how language, specifically metaphor, might be integrated and influence the change process.     

The Significance of the Early Stage of Illness as a Focus for Social Work Help

Summary This paper considers the experience of illness as a series ofinterrelated phases, in which the beginning phase which is thetransition from health to illness is shown to have special significance.The common responses to this stage of illness are denial, welcomeor inertia, each of which may give some forewarning of problemsthat may be encountered later in the illness. Traditionallysocial work help has focused onto the acute or convalescentstages, but it is suggested here that the beginning phase ofillness offers a rewarding point for intervention, not onlywhen opening new cases, but also among clients who are alreadyknown and where health problems may interact with other problems.The implications of this are explored both for agency policyas well as an added dimension of diagnostic understanding ofindividual clients no matter what the agency     

The disaster relief and social work after the Wenchuan earthquake in Mainland China

ABSTRACT

This paper mainly focuses on the development of disaster social work in Mainland China and the intervention of social work in disaster relief. Before the Wenchuan earthquake and in the initial stage of post-earthquake, disaster social work was mainly based on individual psychotherapy; from the earthquake to the year of 2012 in which post-earthquake recovery and reconstruction was completed, the disaster relief began to emphasise community building and integration, while the basic framework for disaster social work was also established. Social workers begin to explore the new mode of developmental and localised disaster social work. By combining with the practical experiences from disaster social work, this paper tries to highlight the dilemmas confronting disaster relief in Mainland China and put forward some corresponding countermeasures and suggestions, which could improve the future disaster relief system in Mainland China.     

Experiencing breast cancer in the context of mental illness in New Zealand

ABSTRACT

This study aimed to explore the experiences of women with mental illness who had also experienced breast cancer diagnosis and treatment, in particular, to identify barriers and facilitators to cancer treatment. Semi-structured interviews were conducted with ten breast cancer survivors who had had contact with secondary mental health services prior to their cancer diagnosis. Thematic analysis was used to identify key themes. Participants described positive experiences of cancer treatment, expressing surprise at both how well they coped with diagnosis and treatment and how well they were treated by services. Many contrasted this with their less positive experience of mental illness and mental health services. The women interviewed were active participants in their cancer treatment and did not report feeling stigmatised because of their mental health experiences. A lack of connection between cancer and mental health services was described, but this was not regarded as necessarily a bad thing. This study begins to counter the stereotypes of the difficult patient or the person unable to understand and cooperate in their own care which are prevalent in the literature. Further work is needed to understand the reasons for disparities in cancer outcomes.     

List of tables

Abstract

This paper details a model of intermittent psychotherapy defined as a sequence of time-limited psychotherapies over an extended period of time. The model emphasizes the importance of relationship, careful assessment of short-and long-term client needs, focused work in successive stages, attention to termination while maintaining connection, and planned follow-up contact. To support the intermittent model, a new conceptualization of termination is offered, allowing for maintenance of client-clinician connection. Selection and exclusion criteria are discussed, as are necessary skills for the treating clinician. A case example illustrates application of the intermittent model. A careful review of the pertinent research literature on time-limited therapies is included.     

Caring for the Child Welfare Client: Am I Good Enough?

ABSTRACT

Given the demographics of youth served by the child welfare system, culturally responsive approaches are critical to effective social work practice and desperately needed. Like many adolescents who grow up in the child welfare system, Paul, a White adolescent male in foster care, was beset by a lack of adequate environmental resources and multiple stressors and had little hope or motivation to work on improving his situation. This article highlights the author's “use of self” as an African American male therapist who worked with Paul, using a Winnicottian and caring framework. Because child welfare workers are often overburdened by the demands of work, including large caseloads and clients with few to no resources, they find it difficult to consistently provide empathic and caring behaviors for their clients. The author highlights his therapeutic work and struggles with Paul and offers cultural insights and Winnicottian strategies when working with adolescents in the child welfare system who are ultimately in need of permanency and stability.     

The Influence of Community Upon the Development of Self: An Exploratory Study

Abstract

Ritual, a universal human mode of action that serves multiple functions in every culture, is also a powerful source of psychological healing. In recent years therapists have drawn upon the power and creativity of ritual and the rite of passage to help people bring order and definition into their lives and to master various life transitions. This paper describes how adult incest survivors, in published autobiographical accounts, have incorporated the use of ritual into their self‐healing processes. Implications for clinical work are drawn.     

Group work is … powerful! This stuff changes … lives: training on group processes for facilitators of curriculum-based groups

ABSTRACT

This article describes a four-year group work training project conducted with facilitators of curriculum-based parenting groups who had not been trained in group work or group processes. A total 14 group facilitators and 144 group members from 34 groups were involved in the training and the mixed method evaluation. Participants described how the training modified their group facilitation, helping them understand that the groups themselves as well as the curricula were informative and transformative, and that group members as well as group facilitators had roles. Further, facilitators indicated that the training resulted in fundamental change in their self-perceptions from being simply purveyors of a parenting curriculum to empathic agents of change as well.     

Abstracts of theses: Smith college School for social work 1945

Abstract

This paper examines various psychoanalytic conceptions of trauma, including ideas associated with classical psychoanalytic theory, object‐relations theory, self‐psychology and continuous construction theory. Clinical issues germane to the psychotherapy of children are then discussed and a clinical vignette presented. The vignette focuses upon the psychotherapy of a 10‐year‐old boy, with particular attention given to the narrative discourse that evolved in the course of the boy's therapy. The evolution of the child's narrative is illustrated through the use of transcribed material derived from different phases of the boy's treatment.     

Bipolar Illness,God, and Object Relations: The Treatment of M

This article explores the concomitant change in one client's object relations and his image of God that occurred in the context of psychoanalytically oriented psychotherapy. The case demonstrates the benefit of long-term psychoanalytically oriented treatment to help an individual with major mental illness to heal emotionally, mentally, and spiritually. The client, who suffers from bipolar I disorder, experienced significant developmental mastery as he moved from the paranoid/schizoid position to the depressive position (developmental stages conceptualized by theorists Melanie Klein and Douglas Fairbairn). In addition, the psychotherapy mitigated the effects of homonegativity on M's self-image and his experience of his homosexuality. Through our work, the client began to see and interact with this clinical social worker, others, and the God of his understanding, in a more realistic and healthy manner. M's participation in a 12-Step group and his adherence to its beliefs augmented changes he made through psychotherapy. Through a long-term psychoanalytically oriented psychotherapy and involvement in Al-Anon meetings, the client's belief in a punishing God shifted toward a more benevolent one—a God who had a plan for his life that was revealed through the transformation of his suffering. In summary, M's object relations changed toward a greater balance of emotions and development of more textured relationships, including his relationship toward himself and God.     

Differences in Problems Faced by Families with a Child Coping with a Serious Emotional Disorder or an Adult Member Coping with Mental Illness

Abstract

Examination of similarities and differences in the issues families face can help determine whether models for families with a child coping with serious emotional disorder (SED/behavioral disorder (BD)) warrant inclusion in, or adaptation of, interventions for families with an adult member coping with a mental disorder. Families attending psycho-education workshops identified problems faced in managing their family member's illness. Composite lists of problems generated by 175 participants were categorized and sorted, using previously established methods for determining reliability and validity. Fourteen categories were identified for children and fifteen for adults, with ten overlapping. Family members attending the child-focused workshops more often listed mood symptoms and problem behaviors. Family members attending the adult-focused workshops more often listed family issues, denial and noncompliance, and positive symptoms of psychosis. Problems identified by families with a child coping with SED/BD may be sufficiently distinct from those of families with an adult coping with mental illness to warrant separate and distinct interventions.     

Interpreting the Countertransference Erection

Abstract

This essay examines the interrelationship between internal experience of therapists and that of their clients in the conduct of psychotherapy. The position taken is that of relational theory, and clinical case material is used to illustrate the discussion.     

Restorative justice for juvenile offenders in China: Current practices and challenges

ABSTRACT

In recent decades, restorative justice has gained considerable recognition worldwide and has become a prominent option for diverting juveniles away from the traditional criminal justice system as well as delivering fair and just outcomes in the justice process. This paper provides an overview of how the criminal justice system operates for juvenile offenders in the People’s Republic of China (hereafter, China). Based on a sophisticated literature review of recent Chinese academic journal articles on restorative justice for juveniles, the paper presents an analysis of the characteristics and operational procedures of current practices. Deficits and potential future developments pertaining to Chinese restorative practices for delinquents are also discussed.     

An Overview of Men's Groups

Men's groups have existed for a variety of purposes, including consciousness-raising, support, education, counseling, and psychotherapy, for several years, but they have been described infrequently in the literature. This overview of men's groups presents a rationale for such groups in terms of changing perspectives on the masculine gender role. It also describes several applications for two specific types of men's groups, consciousness-raising and psychotherapy groups. The author discusses some of his own experiences as a leader in men's groups as well. The author states that the future of men's groups depends on an increased use of these groups and on more extensive reporting about them in the professional literature.     

Meaning making and playing in psychoanalytic therapies

Abstract

This paper explores Freud's idea of the transference as a playground, and Winnicott's assertion that psychotherapy is a subspecies of play. In the context of what those authors called “intermediate” space, a person discovers ways of interpreting or attributing meanings to inner feelings, thoughts, and being as he engages in dialogue with others. Whether with children or adults, psychoanalytic therapies have developed a specialized form of playing in the service of this necessary communication with another, as the case examples will illustrate.     

Empathic Action and Family Resilience: A Narrative Examination of the Benefits of Helping Others

ABSTRACT

Empathy is identified as a protective factor that has been helpful for children considered at high risk for poor mental health and social functioning due to experiencing stressful circumstances such as family violence, substance abuse of a parent, or poverty. Yet, little is known about its relevance to a family's ability to overcome adversity. This study examined the narratives of 20 resilient families who maintained family functioning despite experiencing a multitude of risk factors including poverty, death of a child, significant health problems, or substance abuse problems. Narrative analysis was used to identify the ways families situated empathic actions within their stories of resilience. Findings suggest families developed increased compassion for others as a result of their own experiences with loss, trauma, or stress and discussed how helping others increased their ability to cope with the challenges they faced. Future research and practice implications are outlined and support the usefulness of strengths-based concepts and interventions.