Are Methadone Counselors Properly Equipped to Meet the Palliative Care Needs of Older Adults in Methadone Maintenance Treatment? Implications for Training

Today's methadone patients differ greatly from those of the past. Because of the rise of polydrug use and the HIV and hepatitis epidemics, treatment has become much more complex, which multiply the concerns and complexities of treatment. Patients entering methadone programs are also more commonly presenting at ages well into their 50s, 60s, and 70s; and this phenomenon of high rates continues to grow. The majority of these individuals in treatment have presented with a number of significant comorbid medical conditions that will progress and eventually lead to death. This aging cohort must be approached with a modified treatment plan that focuses on management and promoting healthy aging, while attending to their maximum delay of illness, disease, and disability. This article argues that it is necessary for counselors working with this group to adopt a palliative care philosophy. This article also makes recommendations in areas that counselors need to be knowledgeable and skilled in to provide appropriate palliative services specific to this aging population with multiple needs as they near end of life.     

Job Mobility and Early Career Wage Growth of White,African‐American,and Hispanic Women*

Objective. This article examines whether and how young women's job mobility influences racial and ethnic wage‐growth differentials during the first eight years after leaving school. Methods. We use the NLSY‐79 Work History File to simulate the influence of job mobility on the wages of skilled and unskilled workers. Results. African‐American and Hispanic women average less job mobility than white women, especially if they did not attend college. Unskilled women who experience frequent job changes during the first four postschool years reap positive wage returns, but turnover beyond the shopping period incurs wage penalties. Job mobility does not appear to boost wage growth for college‐educated women. Conclusions. Among unskilled women, race and ethnic wage disparities partly derive from group differences in the frequency of job changes, but unequal returns to job mobility drive the wage gaps for skilled women. We discuss several explanations for these disparities.     

Group Work with First Episode Schizophrenia Clients

ABSTRACT

Group work with first episode schizophrenia clients is an effective way of improving ego functioning, building adaptive coping skills, and addressing the painful feelings associated with learning of this diagnosis. First episode schizophrenia clients are typically in their late teens to late twenties, and confront the cognitive disability, the stigma and the loss of social roles and statuses at a developmentally difficult stage of emotional growth. The dynamic processes by which cohesive groups reduce isolation, build self-esteem, and provide peer support are illustrated with case material. The group work consists of integrating psychoeducation with clients' concerns in order to provide optimal adjustment to the disease. The groups described in this article are structured within a continuing care team treatment model in a medical facility, but the group work discussed may be utilized in a variety of settings.     

精神病患陪护小组工作的本土化探索

随着中国社会的急剧变迁,精神疾病已经在全国疾病总负担中占据第一位。在精神疾病治疗和服务供求关系严重失衡的情况下,中国政府倡导了以家庭为依托、以社区和医院为支持系统的精神康复模式,精神病患家属在其中起着至关重要的作用。因此,研究和探索本土化的精神病患陪护小组工作成为迫切的任务。本文通过小组成员问题描述,分析他们的需要,以情感表达理论为分析框架,设计了小组的介入策略与工作内容,透过小组评估,检验了小组效率。最后,通过小组过程反思探索了精神病患陪护小组的本土化。     

Telephone Support Groups for Caregivers of Persons with AIDS

Caregivers of persons with AIDS experience numerous stressors in their caregiver role and could benefit from support groups. However, caregiving responsibilities make it difficult for many to attend face-to-face groups. This article describes experience with a telephone support group pilot project for this population. The time-limited, semi-structured groups used conference call technology; the eight session group protocol war designed to meet caregiver needs for information about resources and coping skills. Pilot data from interviews with group members from the first two completed groups on this project indicated that participants valued the group experience highly.     

PRACTICE PRINCIPLES FOR WORKING WITH GROUPS OF MEN WHO BATTER

Based on a series of working assumptions about men who batter. this article suggests a model of group treatment to effect change in their violent behavior. The model stresses sequential phases and calls attention to thc responsibility to employ safety checks throughout the treatment process in the group.     

Free provision of services and cross-border labour recruitment

This article identifies how the use of the European Union (EU) mobility rules, as formulated by the EU's Posting Directive, has been linked to the temporary provision of services in practice. It demonstrates how this linkage, legitimised by European Court rulings, undermines the Directive's original intent to provide rights-based regulation of labour mobility in the Union. In the assessment of posting practices, striking findings of two studies co-conducted by the author in 2003 and 2010 are discussed. In the first section, the origins of the Directive are described, followed by sections that contextualise the posting rules in the framework of the fundamental economic freedoms of EU Treaties, and discuss the problems related to implementation and enforcement. Based on the Directive's definition of posting, three issues of governance and practice are raised: (a) regulation of the employment relationship, (b) application of labour conditions and (c) respect for collective agreements. A final section offers policy recommendations in order to deal with the ways in which posting governance and practices currently impede any vision of rights-based mobility in the EU. It is argued that current minimalist interpretation of the posting rules can neither guarantee equal treatment nor protect the rights of temporary migrant workers.     

Adventure therapy and its impact on the functioning of youth in a community setting

The purpose of this article is to explore the impact of one type of activity-based group work, adventure therapy (AT) group practice, on youth in a community-based mental health setting. Using data collected from Adventure Works, a nonprofit outdoor behavioral healthcare and adventure therapy counseling center, this article explores treatment outcomes to identify the effectiveness of adventure therapy group interventions. AT has been identified as an effective intervention within wilderness and residential settings, but little research exists focusing on adventure therapy in a community setting. Data collected shows positive outcomes for youth participating in adventure-based group therapy. Research and practice implications are discussed.     

Alzheimer's disease and related dementias

The number of individuals with Alzheimer's disease or a related dementia is growing at a staggering rate. Thus, it is essential that social workers in geriatric settings are knowledgeable about this disorder and the appropriate interventions to use at all stages of the disease. The purpose of this article is to examine the types of non-pharmacological, psychosocial treatments that are used to manage the behavioral manifestations and changes in the mood of individuals with Alzheimer's disease or a related dementia. While great strides have been made in pharmacological treatments of Alzheimer's disease, less attention has been given to the types of psychosocial interventions that are readily employed in community-based and long-term care settings to assist in the care of these individuals. This article provides an overview of psychosocial interventions, as well as identifies the direction for future evidence-based treatment studies, for individuals with Alzheimer's disease and related dementia.     

Transport related social exclusion in New Zealand: Evidence and challenges

Abstract

People without functional access to a car in countries where private vehicles are the predominant form of transport are at a disadvantage. Alternative modes of travel in such settings often do not meet people's mobility needs, creating barriers to participation in work, education, social activities, sport and leisure, and to accessing basic goods and services. In New Zealand, private vehicles have long been prioritised as the mode of personal transport in land transport planning policy. However, this is beginning to change with policy objectives now including improvement of access and mobility for all, and reduction of social exclusion. Despite this there is very little evidence of the experiences of those with mobility or access problems in New Zealand. This article seeks to provide qualitative data about experiences of transport related social exclusion, the efficacy of alternative modes for people's mobility needs, the impacts of these difficulties on people's lives, and the policy implications of these findings.     

Income mobility among the elderly in Sweden during the 1990s

Using a large panel dataset, this article investigates the degree of, and explanatory factors for, income mobility amongst the elderly in Sweden during the 1990s. It contributes to literature on welfare indicators for the older population as it supplements the welfare picture of the income adequacy with insights into income certainty during old age. Our methodological approach is to work with the administrative register data for Sweden, and this allows us to use a reliable record of incomes for a large sample of the elderly. Results for Sweden-born and foreign-born elderly persons are analysed separately and compared with corresponding groups of people of working age. Not surprisingly, nearly all of our results indicate that the income of the older population is more stable than that of the working age population, and upward income mobility is not as usual among the elderly as among other groups. The multivariate regression analyses identify several explanatory factors affecting those elderly who experienced income mobility. Most importantly, the death of a spouse increases the probability of downward income mobility, particularly amongst women. These and other findings of this research point to triggers of income poverty in old age that should be taken into account in policies concerned with the level and indexation of retirement income of future pensioners.     

Cancer treatments

Cancer is of particular importance to gerontology due to the changing nature of the disease. Survival rates are at all time highs as a result of technological advances in early detection and treatment of cancer. Some less aggressive or invasive forms of cancer are now seen as chronic illnesses rather than acute, terminal diseases. As a result, demand is increasing for evidence-based psychosocial interventions designed to improve the health and well-being of people living with cancer. This article reviews evidence-based psychosocial interventions designed to address the needs of persons with cancer and their family members. Traditional and technology enhance interventions are discussed as are complementary and alternative therapies designed to augment traditional interventions.     

Estimating the Effects of Residential Mobility: A Methodological Note

This article reviews the methodological challenges of estimating a causal association between mobility and children's cognitive, social, emotional, and physical development. Utilizing a comprehensive set of empirical articles published in the past 25 years that employ quantitative methods, it describes the limitations of previous studies and the innovative ways that researchers have attempted to deal with them. The concept of mobility is inconsistently operationalized along four dimensions: school versus residential, distance, timing, and frequency. Imprecise operationalization conflates different forms of mobility, which have differential effects on development. Attempts to estimate a causal association between mobility and development suffer from three sources of bias: selection, contextual shifts, and contemporaneous instigating events. (a) Methods that account for unobserved differences between mobile and nonmobile children have consistently shown smaller or even positive effects of mobility. (b) Moving can have a positive or negative effect on children's ecological contexts in ways that are systematically correlated with child development. (c) Moves are frequently catalyzed by changes in family structure and employment. The article concludes with recommendations for future research. Researchers should continue to engage fixed- and random-effect, matching, and instrumental variable techniques, each of which makes the question of causality explicit.     

Why Did Poverty Become Less Geographically Concentrated in the 1990s?*

Objective. After increasing sharply in the 1970s and 1980s, the number of high‐poverty neighborhoods in the United States unexpectedly and dramatically declined in the 1990s. This article examines the roles that residential and income mobility played in this decline. Methods. Using geocoded data from the Panel Study of Income Dynamics, this study analyzes changes during the 1990s and early 2000s in: (1) patterns of residential mobility between high‐poverty and lower‐poverty neighborhoods; and (2) patterns of income mobility for residents who remained in high‐poverty neighborhoods. Results. Both patterns of residential and income mobility changed in the 1990s and early 2000s. While patterns of residential migration to high‐poverty neighborhoods were largely unchanged over this period, patterns of residential migration from high‐poverty neighborhoods changed significantly, with poor individuals—especially poor blacks—becoming more likely to relocate from high‐poverty to lower‐poverty neighborhoods. Patterns of income mobility for residents who remained in high‐poverty neighborhoods also changed significantly, with nonpoor residents becoming less likely to become poor and poor residents becoming more likely to exit poverty. Conclusion. Poverty rates in high‐poverty neighborhoods fell primarily because of the net upward income mobility of residents who remained in these neighborhoods.     

Older people within transnational families: the social policy implications

Given that more people 'permanently' migrate today than in the past, migration has taken on a heightened profile internationally. Such mobility raises fundamental social policy questions of entitlement and (re)negotiation of caregiving obligations and arrangements. Social policy has traditionally approached problems and developed responses within the confines of the nation-state and faces difficulties in recognising and addressing issues arising from mobility. Migration contributes to family being 'stretched' beyond national boundaries to become dispersed, global or transnational families. This article focuses attention on one dimension of transnational living – older people as members of transnational families. The combination of increasing population mobility and the elongation of new post-retirement life-stages is resulting in a set of pressing social policy issues. It explores immigration, pension eligibility and portability, and social services and caregiving issues. To illustrate these issues the article draws on New Zealand's diverse transnational family forms and experience.     

Social Workers' Experiences of Virtual Psychotherapeutic Caregivers Groups for Alzheimer's,Parkinson's,Stroke, Frontotemporal Dementia,and Traumatic Brain Injury

ABSTRACT

The objective of this study was to examine the challenges for social workers who transition from facilitating face-to-face psychotherapeutic groups to online web-based video groups with family caregivers of persons with chronic disease. Study data consisted of survey responses of a group of therapists who had facilitated a series of web-based video-conferencing caregiver groups over a period of 4 years. All therapists were trained using an intervention training manual and weekly supervision. They received minimal training with regard to using technology (computers, Internet, web cams, and headsets). Despite reported challenges in how the technology affected the group process, therapists described overall positive experiences transitioning from face-to-face to working online. All therapists reported that group interactions and client outcomes in the Internet environment were overall comparable to those that occur in face-to-face groups.     

相对收入与主观幸福感:检验农民工的多重参照群体

尽管社会经济地位低于城市居民，农民工的主观幸福感却更高。这种客观经济地位与主观福利评判的不一致有两种解释：同质性参照群体假设和向上流动期望假设，暗示农民工在进行社会比较时会选择不同的参照群体。基于一项大规模全国代表性的调查数据，本文通过建构农民工的多个参照群体检验了上述假设，结果验证了同质性参照群体假设：控制个人收入后，同省其他农民的平均收入越高，农民工的生活满意度越低；加入农民的平均收入后，农民工相对于城市就业居民的生活满意度优势消失，甚至转为劣势。向上流动期望假设未获支持：城市就业居民的平均收入对农民工的生活满意度没有显著影响，而且这样的“零效应”可能并非由于向上流动期望的压抑影响造成的。     

FOUR PLUS FOUR

This article describes a family group with a changing, heterogeneous, short-term membership. The host setting is an alcoholism treatment unit within a traditional, private psychiatric hospital. Family group members come on behalf of another, not for themselves. This paper treats issues of selection process, structure, objectives. themes, specific problems of this type of group, leaders' techniques for dealing with such problems, and cotherapy roles and interactions, recording both individual and group change and applicability to other settings.     

Group Work with Low-Income Black Youths

Low-income Black youths face problems which negatively impact on their self-concepts and educational achievement. Without an education, the opportunities for social mobility for them are severely decreased. The small group is suggested as a medium of intervention in the public schools by which large numbers of low-income Black youths can be reached and assisted with problems which interfere with their cducation. This paper discusses group work with this population, the theoretical framework utilized, and the applicability of some of the insights gained from working with this population to group work wilh Blacks in general.     

An Evaluation of a Group Program for Men Who Batter

This article describes a research study which evaluated a group service for men who batter. Change was evaluated both by self report and as interpreted from the Hemler Scale of Social Functioning. It was demonstrated that male batterers who entered into the group treatment process showed significant change with respect to human social functioning and in the cessation of physical violence towards their partners. Although the personal journey along which a batterer takes responsibility for his actions and finds appropriate coping mechanisms is intensely individual, this study adds to the literature which confirms that a supportive group experience can facilitate this process.