The Psychiatric Medication History

Abstract

This article presents The Psychiatric Medication History: An Interview Schedule, a 30-step semi-structured protocol designed to help practitioners understand how clients manage their psychotropic medications and interpret their effects. The critical perspective leading to the design of this interview schedule, its purposes for clients and practitioners, its divergence from traditional treatment histories, and its uses and limitations are discussed. The author contends that, in a safe space, taking a psychiatric medication history according to these suggested guidelines offers clients an opportunity to construct an independent, evidence-tested personal narrative about their medication use. To practitioners, taking such a medication history offers a person-in-en-vironment point of entry into the psychopharmacology scene.     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.     

Disability Services and College Students with Psychiatric Disabilities

Abstract

Weiner (1999) has suggested that the process of accepting a disability and its associated limitations is often protracted for students with psychiatric disabilities, thus leaving many students unable to fully participate in services or in the design of academic accommodations. This research examines the relationship between psychiatric disability identity and use of academic accommodation services for 57 undergraduates with psychiatric impairments who are experiencing problems in their academic functioning. Willingness to utilize services was related to students' identification as having a psychiatric disability. Social work interventions are needed to support students in accepting psychiatric disabilities while concurrently crafting necessary accommodations.     

Should There Be Mentoring Efforts to Help Retain and Recruit More Males Into Baccalaureate and Master's Social Work Programs?

Social work programs need to actively set mechanisms in place to attract more men into a predominately female academic major through mentoring, recruitment, and retention efforts. This article conducts a review of the literature to examine whether mentoring efforts should be directed at male social work students. It is inconsistent for the social work profession to embrace the concept of providing culturally competent practices to clients but fail to address and combat a significant gender gap in the delivery of services to male clients.     

‘Even if Martians exist,they’re far from our everyday life’: faculty perspectives regarding gay and lesbian students in social work education

Following a study on gay and lesbian students’ experiences in a Social Work Department in Greece, this qualitative study explores faculty perspectives regarding lesbian and gay students in social work education. Perceptions of gay and lesbian students’ invisibility and low level of comfort were held in common by participants, although some faculty members referred to the more inclusive and accepting climate of the Social Work Department compared to other higher education Departments and Greek society in general. Most participants reported that same-sex sexuality issues are inadequately covered in the curriculum. Displays of heterosexist behaviour by students were reported by most participants and so were conflicts among students when same-sex sexuality issues were discussed in class. The lack of official anti-discrimination policies that include sexual orientation was highlighted. In the absence of a common strategy regarding the teaching of same-sex sexuality content, faculty determined on an individual level how and to what extent to discuss such issues in the classroom. At times the faculty appeared willing but not adequately prepared to approach gay and lesbian issues. Implications for social work education are discussed.     

The Attitudes of Social Work Students and Practicing Psychiatric Social Workers Toward the Inclusion in the Community of People with Mental Illness

Abstract

This study measured and compared the attitudes of social work students and practicing psychiatric social workers to the inclusion in the community of people with mental illness. The Community Living Attitude Scale Mental Illness (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 68 Israeli BA social work students (first year: n = 35; third year: n = 33) and 28 practicing psychiatric social workers. Overall, the participants endorsed Empowerment and perceived the Similarity of persons with mental illness to themselves more than they agreed with the Exclusion attitude of segregating those persons from community life. First-year students rated Empowerment and Similarity significantly lower than did the third-year students and rated Sheltering significantly higher than did psychiatric social workers. Psychiatric social workers did not differ from third-year students and did not have stronger attitudinal commitment to the inclusion paradigm. They differed from first-year students only in the sheltering attitude; they showed lower support for sheltering people with mental illness.     

Social work education in Australia and the USA: comparative perspectives and contemporary issues

The article discusses similarities and differences in social work education and profession in Australia and the USA, reflects on contemporary issues and challenges that affect social work education and practice in both countries, and identifies mutual areas of learning and exchange. Drawing on secondary data, it comparatively analyses important variables such as the growth of social work education, curricula and curricular models, accreditation standards, code of ethics and professional licensure. The analysis shows significant similarities and differences in these variables, and brings out unaddressed issues and challenges. It argues that the profession in general has not adequately been successful in translating its value-based ideals into social work education and practice in both countries, particularly in the context of the free market economies. Experiences of both countries provide scope for mutual sharing and learning.     

Stimulant Medication Use,Misuse, and Abuse in an Undergraduate and Graduate Student Sample

In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin. Men and women reported similar use patterns. Most respondents who abused or misused stimulant medication swallowed pills; 40% used intranasally. Reasons for abusing or misusing stimulant medication included improving attention, partying, reducing hyperactivity, and improving grades. Consistent with previous studies, results suggest that abuse of stimulant medication is a concern on college campuses. The results point to various reasons for and methods of abusing and misusing stimulant medication that may direct future research, prevention, and intervention.     

Recovery Lessons Learned from Individuals with Psychiatric Disabilities

ABSTRACT

Over a long career in the public mental health system, the author has seen the progress in the service delivery that has given consumers more independence and ownership of their recovery. Until another breakthrough in brain science improves the outlook for prevention and treatment of brain disorders, the push to improve expectations with supports to manage their recovery needs to continue. The author describes Harbor City Services, Inc, a market-based social enterprise that creates jobs offering security against losing a job because of reappearing symptoms, including some jobs with the potential for growth beyond entry level. The growth of this business over 25 years shows the highs and lows of moving from public funding and charity to a self-supporting business. The author encourages the use of business strategies to improve the vocational opportunities that help sustain recovery and offers tips on employment and business.     

Students’ views on expanding contours of social work practice through spirituality

ABSTRACT

This article surveys the views of 15,067 social work students across 12 countries on social work practice and spirituality. Responses were elicited on precoded binary response categories as derived from literature. Results of the logistic regression analyses, as embedded in the original study design, showed that students from Australia, European countries, and the United States; women; postgraduate students; Christians; and those with higher self-reported spirituality scores saw mindfulness-based spiritually–sensitive interventions as the core mode of micro–level work with individuals and groups. Spirituality was seen as philosophically expanding the contours of practice by laying newer ways of assessment, intervention, and change.     

Social work students in the aftermath of Hurricanes Katrina and Rita: correlates of post-disaster substance use as a negative coping mechanism

Social work students’ post-disaster coping while in the field is an important workforce issue with ethical implications. The current study utilized secondary data collected in a previous study examining post-disaster alcohol and other drug (AOD) use among social work student volunteers (N = 416) in the wake of Hurricanes Katrina and Rita (HKR). The current sample included participants from the original study who responded to a single-item measure of AOD use as a negative coping mechanism (N = 290). The present study examined potential explanatory variables of AOD use in the aftermath of HKR, including demographic (age, gender, and race) and psychosocial characteristics (hurricane-related stressors, previous traumatic stressors, and post-traumatic stress). The multivariate logistic regression model distinguished between students who never or rarely used AOD and those who used AOD often to cope with HKR, accounting for 24% of model variance. Social work students who report post-disaster AOD use may risk experiencing additional, trauma-related vulnerabilities, should be further assessed, and provided necessary specialized supports to enable their well-being and to prevent impaired practice.     

Navigating the gendered academy: women in social work academia

ABSTRACT

Women fare less well than men across all academic disciplines: they are less likely to be promoted, they earn less, and many more professors are men. There has, however, been little analysis to date of the experience of women in social work education, a discipline that has historically had higher representation of female staff and students. This study set out to explore women in the social work academy through a case-study of social work education in Scotland. A mixed-methods approach was used, including a review of relevant literature; an online survey of women and men academics in social work education; and semi-structured interviews with female social work leaders, past and present. The study found that women in the social work academy faced the same pressures as other women in higher education; some of these pressures were also shared by men. Most significant, however, was the extent to which women in social work academia experienced twin challenges, firstly, as female academics and secondly, as female social work academics in a discipline that struggles for recognition in the academy. We conclude that this makes for a contradictory and, at times, ambiguous experience for women as they navigate the gendered academy.     

Invisible students: experiences of lesbian and gay students in social work education in Greece

This article explores through semi-structured interviews the experiences of four lesbian and two gay students from the Social Work Department in the Technological Educational Institute of Crete, Greece. The complete absence of openly out lesbian or gay students or faculty members in the Department was considered reflective of the particular social and cultural context of Greece. Participants reported that lesbian and gay issues were marginalised in the curriculum and that heteronormativity often prevailed in the classroom. Consequently, same-sex sexuality was generally invisible and, when discussed, certain faculty members and peers often appeared to be uncomfortable. Within this context, participants stressed the importance of the professors’ role regarding the climate and content in the classroom. None of the participants considered that their sexual orientation had affected negatively their academic attainment; the lesbian or gay identities sometimes had a positive effect on participants’ academic attainment level exactly because of the negative impact these identities had on their social life. Most participants felt that their studies had not prepared them adequately for gay affirmative practice. Implications for social work education are considered.     

The Social Work and Politics Initiative

Abstract

Social work is becoming a more politically oriented profession. In addition, social work education is including politics as a greater part of the curriculum. Still, much more can be done to increase the amount of political content in social work education. This paper describes a model for involving students in political social work without drastically altering current arrangements. The model consists of two parts: a class on politics and social work and field practica in state legislators' district offices. Following a discussion of the literature on education for political social work, we look closely at the Social Work and Politics Initiative. We also examine problems encountered with the program.     

Support for gay and lesbian rights among social work students in Greece

This study explores social work students’ level of support for gay and lesbian rights. Respondents were all the students (N?=?460) attending classes in a Social Work Department in Greece. While students were generally supportive of gay and lesbian rights, a significant percentage believed that social workers should support gay and lesbian rights only when lesbians and gay men do not offend or upset others and their rights do not contradict the prevalent religion and societal values. Religiosity was an important correlate of students’ level of support for gay and lesbian rights. Findings are discussed in relation with social work education.     

Learning pattern of social work students: a longitudinal study

Research on learning patterns of social work students is scare. This longitudinal study addresses this issue by employing mixed methods of quantitative and qualitative study design to understand the learning pattern of students throughout their undergraduate social work studies. Six rounds of quantitative data collected by structured questionnaires and four rounds of qualitative data collected by focus group interviews have been conducted at an interval of every 6 months to track the learning pattern and to evaluate the continuous impacts of social work education on students. Results indicate that although students’ evaluation on the curriculum was positive and with significant difference in mean scores, paired sample t-tests found no significant difference between time 1 and 6 of all outcome variables. With regard to students’ change in attitude, acquisition of knowledge and skills, results indicate a ‘U-shape’ trend and a fluctuating learning pattern with a rebound in different outcome variables toward the end of the three-year study. Qualitative data echoes the findings and reveals that students go through the confused freshman stage, to disillusioned in practicum and finally with enriching experience upon graduation. The paper discusses meanings and implications of student learning pattern to social work education.     

Seven Rules to Live by: Accommodations in Social Work Education and the Field

Students with disabilities are a growing population in higher education (National Center for Education Statistics, 2009 National Center for Education Statistics . ( 2009 ). Number and percentage distribution of students enrolled in post-secondary institutions, by level, disability status, and selected student characteristics: 2003–04 and 2007–08 . Retrieved from http://nces.ed.gov/programs/digest/d09/tables/dt09_231.asp  [Google Scholar]). Providing accommodations for students with disabilities can raise ethical and social justice questions and pose challenges for social work faculty, administrators, and field instructors. Social work educators must balance the legal mandates for nondiscrimination and reasonable accommodation against ethical obligations around protection of clients and preparation for practice. This article presents case examples in the context of legal analysis to help social work educators make difficult decisions about student academic performance.     

Social work graduate students’ understanding of strength-eliciting questions in the context of social work assessment

This exploratory study examines Estonian social work graduate students’ (n?=?46) understanding of strength-eliciting questions in the context of social work assessment, using a quasi-experimental, pre/post-test research design. Students’ responses indicate some changes in their reflections of strength-eliciting questions after the training course. In the beginning of the course, students’ responses suggested somewhat more emphasis on a deficit approach, including focus on the past, deficiencies, hardships, and problems, while the importance of solutions, resources, etc. was acknowledged to a lesser extent. Comparing the post-intervention to the baseline, less responses and questions were focused on feelings, problems, ‘why’, and closed questions. Some changes in the students’ perspectives about strength-eliciting questions after the training course can be seen according to the concept of the strengths perspective described in the literature review. These changes include more focus on understanding solutions, strengths from the present, the view of the client as the expert, and the importance of motivation and change as well as empowering and encouraging.     

Service user or service provider? How social work and human services students integrate dual identities

Students studying undergraduate social work and human services (SWHS) degrees may have used health and human service agencies, before and during their university education. Using services provides them with insights that are useful for professional practice. However, this article identifies that they experience a fear of shame and stigma revealing this during their studies. In examining interview data from 15 undergraduate SWHS students they recounted how they integrated their experience of being a service user into their professional development. It is argued that insider knowledge of services can provide them with valuable insights for practice. Students spoke about how positive experiences motivated them to study and provided models of effective practice, exemplifying its potential power to assist those in need. Negative experiences of service use can also be beneficial for learning what ‘not to do’. Although students found the experience of service use invaluable, they felt it was never acknowledged within the curriculum. Consequently, students interviewed in this study identified service users as ‘others’. They feared disclosing their own use of services due to perceived shame and stigma. Failing to provide opportunity for students to integrate their service user experience into their professional development creates a false dichotomy which does not acknowledge the intersection of these dual identities.