What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

Using Social Media to Change the Narrative Around Chronic Illness

Chronic illness is a prevalent issue for many individuals. Various theoretical approaches have been employed in the psychotherapeutic treatment of chronic illness and the effects it has on the individual with the illness. These approaches frequently overlook the strengths of the person living with the illness as well as fail to address aspects of modern life such as social media use of the client and the influence it holds for those living with a chronic illness. This paper proposes the application of narrative therapy and social media use as a narrative therapeutic technique when treating those who suffer from chronic illness. A clinical vignette is used to illustrate possible applications of therapeutic techniques in conjunction with therapist-directed social media use. Implications for clinical practice and limitations are discussed.     

Through a glass darkly: Chronic illness in the therapist

This paper is about doing psychotherapy while suffering from a chronic illness. The purpose is to describe the manner in which ongoing irreversible pain integrates itself into the life of any human being, but specifically that of the therapist. The process of weaving the experience into the life narrative and in turn the therapeutic narrative is explored.     

Business Incubation for People with Severe Mental Illness Histories: The Experience of One Model

ABSTRACT

The Enterprise People was a business incubator for people with serious mental health conditions that operated in Madison, Wisconsin, from 1998–2005. It supported entrepreneurs with learning basic business skills, start-up processes and expenses, back office supports, ongoing problem solving, and for some, with space to conduct their businesses. The original impetus was to discover whether people with SMI histories could successfully start and operate small businesses. Although this was confirmed, the experience also uncovered factors that will allow other projects of this sort to succeed, and some core infrastructural supports that need to be created. The experience demonstrates that self-employment supported by formal business incubation is a viable option in the range of mental health vocational rehabilitation models.     

Collaborative care for individuals with bipolar disorder or schizophrenia and co-occurring physical health conditions: A systematic review

While rates of chronic physical health conditions are increasing for the general population, individuals with severe mental illness are at greater risk. Co-occurring mental and physical health conditions are associated with poor health care utilization, socioeconomic, and patient-reported health status outcomes. This study used systematic review procedures to investigate the effectiveness of collaborative care models for improving the health of adults with bipolar disorder or schizophrenia and co-occurring chronic physical health conditions. Six studies met inclusion criteria, and included outcomes related to quality of life, physical health, and mental health. Collective and study-level results are reported and discussed, including implications for social work practice and research.     

Experiencing Stigma and Exclusion: The Influence of Neoliberal Perspectives,Practices, and Policies on Living with Chronic Illness and Disability

Neoliberal perspectives, policies, and practices increasingly affect chronically ill and disabled people's embodied experiences of stigma and exclusion. Neoliberalism emphasizes individual responsibility and self-sufficiency, a limited social safety net, and narrow governmental accountability. Examining pivotal experiences of chronically ill people shows how neoliberalism can frame their alternatives, interactions, and actions. This examination prompts reconsidering Goffman's concept of stigma to include how larger social policies and practices affect experiencing stigma and exclusion and, also, illuminates temporal features of receiving a diagnosis, disclosing illness, and dealing with disabilities and unpredictable bodies. The analysis derives from an ethnographic story and published and unpublished personal accounts from first-hand and library research over the course of my career.     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Debates on Immigration

No abstract available for this article.     

Negotiating Personal Experience over the Lifetime: Narrative Elasticity as an Analytic Tool

Sociology and neighboring disciplines have produced different analytic tools to examine the dialogical relationship between individuals and society (“narrative work,” “identity work,” “moral career,” “moral breakdown”). However, the question of how individuals negotiate the interpretation of personal experience over their lifetimes in a changing cultural context remains unexplored. This article introduces narrative elasticity as a feature of narrative work and as a time‐sensitive analytic tool for conducting inquiries into processes of temporal retraction and expansion of what storytellers conceive as the normal order of significance. The application of this tool to the analysis of mature and elderly Chileans' life stories shows how cultural change occurs at the individual level, considers factors that motivate and inhibit processes of reinterpretation of personal experience, and identifies different levels at which it operates.     

Living Arrangements During Childrearing Years and Later Health of African American Mothers

Using longitudinal data from the Woodlawn Project (N= 680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health outcomes include SF‐36 Physical Functioning, SF‐36 Bodily Pain, depressed mood, and anxious mood. Specific patterns of living arrangements were related to later health, controlling for age, earlier health, education, and poverty. Poverty explained many, but not all, of the relationships between living arrangements and health. Findings underscored the benefits of social support and social integration and highlighted the negative effects of marital dissolution on health.     

Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

ABSTRACT

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.     

Lived Experience and Interpretation in Narrative Theory: Experiences of Living with HIV/AIDS

Narrative analysis builds on the strengths of qualitative research by examining the construction of meaning and symbolic systems in a framework that is explicitly temporal and that links research in the humanities with that in the social sciences. Qualitative methodologies often assume reported data accurately reflects the realities of lived experience. On the other hand some research drawing on cultural studies argues that the facts of a person's life are irrelevant. This paper argues for a middle way based on narrative theory that explores the interaction of objective events and their subjective interpretation. Further, narrative analysis enables exploration of the temporal structure of people's experiences focusing on both how a person's memories of the past and anticipations of the future influence their understanding and actions in the present. These points are developed drawing on the theory and methodology of both Symbolic Interactionism and Paul Ricoeur's Hermeneutics. The experiences of people living with HIV/AIDS are used to illustrate and explicate the usefulness of narrative analysis.     

Psychosis,Psychiatry, and Escape: A Social Work Academic's Retrospective Self-Narrative

This is a self-narrative account written retrospectively by a UK-based social work academic reflecting on the direct experience of being a psychiatric inpatient. A contextualization is established for the experience of psychosis and the psychiatric response. Psychosis is justified as a rational response that challenges the otherness often adopted toward users of mental health services. The psychiatric system is found to be restrictive and disempowering, posing a barrier to recovery. Personal narrative experience is analyzed considering the strengths of psychiatric care, which are contrasted against informal support mechanisms. Informal support proves to be beneficial as opposed to coercive psychiatric hospital care.     

For better or for worse? Transformation of social network relations due to long-term illness

This paper explores whether, and if so how, long-term illness affects and changes personal social relations and how these transformations are related to diagnosis, length of the sick leave, age and gender. It is based on qualitative in-depth interviews (N?=?10) and a broader representative survey among long-term ill people (n?=?319). The results reveal that illness affects the social relationships in both positive and negative directions. On the one hand, the proximity and mobilization of support from family and friends increases during the period of illness and new relationships are included in the networks. On the other hand, the distance within some relationships increases, and some disappear or become less support-rewarding. While the need for social relationships seems, for the majority, to be essential and constant, the results show that the circle of close personal relationships is shifting and that emotional intensity and reciprocal exchange vary.     

Empowering Alliances in Pursuit of Social Justice: Social Workers Supporting Psychiatric-Survivor Movements

This article reviews historical and current examples of harmful and forced treatments as well as scientific discrimination that have been applied to people diagnosed with mental illness. It discusses anti-psychiatric social action in North America from 1970 to the present. A review of social work's foundations in social justice, empowerment, and person-in-the-environment perspectives highlights the congruencies and communal benefits for both the social work profession and psychiatric-survivor movements. Through this discussion, it is apparent that the professed values of the social work profession are actually more compatible with psychiatric-survivor movements than with any allegiances to the biomedical model of psychiatry.     

“Sometimes,I think I might say too much”: Dark Secrets and the Performance of Inflammatory Bowel Disease*

This study examines the dramaturgical embodiment of chronically ill bodies managing “fecal matters” (Weinberg and Williams 2005) in Inflammatory Bowel Disease (IBD) support groups. Data were derived from my reflections as a person with IBD, a year of participant observation, and semi‐structured interviews with support group members. I first uncover the boundaries of the private body (Cahill 2006). Secondly, I focus on the entrenchment of IBD within the stigma of fecal matters. Lastly, I explore the disparate ways that support group members harnessed language to protect their embodied selves from symbolic fecal contamination, from a “soiled self.”     

Mental health practitioners’ strategies in equine-assisted psychotherapy: implications for social work

Equine-assisted psychotherapy (EAP), in this study, which included a mental health practitioner, an equine specialist, at least one horse, and a client in therapy sessions, is emerging in social work practice, education, and research. The purpose of this paper was to explore experienced EAP mental health practitioners’ cognitive activities and strategies to inform the social work profession.

Utilizing a constructive narrative approach, eight experienced EAP mental health practitioners participated. Two semi-structured, face-to face, individual interviews were used to gain their perspectives. Qualitative software assisted thematic analysis. The findings included a main theme identified as participants’ concrete strategies used in EAP with two subthemes. The second main theme identified abstract strategies with six subthemes.

EAP provides a holistic framework as social workers incorporate horses and natural environments in practice, which is consistent with systems theory. The findings inform experienced mental health practitioners to be effective therapists and educators, as well as to instill confidence in novices. Recommendations for the application of the findings in social work practice, education, and research are explained.     

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.     

Telehealth for Patients with Chronic Pain: Exploring a Successful and an Unsuccessful Outcome

Abstract

Cognitive-behavioral therapy (CBT) is effective for treating chronic pain, but little is known about the mechanisms that might facilitate or hinder its utility when delivered by videoconference. In a single-case experimental design, we explored the outcomes of two adults with chronic pain who were provided with videoconference-based CBT. The goal was to examine the relationship between therapeutic alliance as well as presence felt and clinical outcomes. Therapeutic alliance was high overall for both participants; however, only the successful case’s alliance ratings significantly increased over treatment. Levels of presence felt in videoconferencing were also high, but were not related to therapy outcome.     

Integrative Family Therapy With Childhood Chronic Illness: An Ethics of Practice

A challenge for contemporary family therapists is negotiating differences between modern and postmodern frameworks in the practice context. Modernists espouse a systemic metaphor; use evidence‐based and interventive approaches, including strategic, structural‐ or solution‐focused techniques, and believe in the therapist's knowledge, expertise and power to influence individuals or families to change. On the other hand, postmodernists follow a social constructionist, dialogical or narrative paradigm, which identifies the main ingredient of therapy as language, conversation, understanding and the therapist's ‘not knowing’ stance in eliciting a person's expertise and story Yet many practitioners adopt a middle way between these paradigm polarities, one that is less theory‐driven and more pragmatic, flexible, integrative and practice‐based. This is consistent with evidence‐based practice and research demonstrating common factors across all therapies. The value of preserving systemic thinking in family therapy is recognised while reaching forward to a postmodern social constructionist and dialogical approach. The article describes this integrative stance in family therapy as paramodern based on an ethics of practice. This is illustrated by a detailed case study of integrative family therapy, which addresses anxiety, anger and sleeping issues associated with a chronic childhood illness called Perthe's disease.