Potential for the Abuse of Medication for the Elderly in Residential and Nursing Homes in the UK

ABSTRACT

Abuse of the medication prescribed to the elderly living in long-stay care homes may be perpetrated by a minority of unscrupulous doctors, pharmacists, or home staff caring for the residents. Disorganised practices and homes, poor communications, and sloppy professional practices may create opportunities for over-dosing, errors, fraud, or theft. This article describes the circumstances leading to the potential abuse of elderly residents' medication, and the measures that may be taken to avoid or minimise such abuse from occurring.     

Ethical and Racial Conflicts in Urban-Based Action Research

Abstract

Through the use of a case study of a joint faculty-student research project, this paper discusses how community-based action research, policy analysis, and community organizing can be synthesized in work with low-income communities. It outlines potential implications of this synthesis for both community practice and social work education.     

An Ecological Framework for Contextual Risk Factors in Elder Abuse by Adult Children

ABSTRACT

Future trends suggest both a continued growth of the elderly population, as well as the likelihood of increased demand for family caregiving which may, in turn, be associated with increasing rates of elder abuse. It is important to consider issues related to such caregiving, including potential abuse from an ecological perspective which, in turn, provides a fruitful basis for framing the problem of abuse as a set of contextually-based risk factors. This paper focuses on the contextual risk factors using an applied ecological model, a useful framework for understanding the intergenerational character of elder abuse in families, for developing recommendations for empirically-based action research, and for the development of community-based prevention and intervention strategies.     

From College Counselor to “Risk Manager”: The Evolving Nature of College Counseling on Today's Campuses

Abstract

College counselors are increasingly being called upon to assess “risk” and protect the college community from harm. This paper explores how this changing role for counselors might be impacting its reputation with students. It further discusses the complex and ever-changing dimensions of “risk,” noting the difficulty in developing reliable risk assessment tools.     

Acculturation,Premigration Traumatic Experiences,and Depression Among Vietnamese Americans

Summary

This study investigated the role of acculturation as a potential mediator or moderator for premigration traumatic experiences (PTE) and depression. The mediator effect refers to an effect in which acculturation mediates the negative impact of PTE on depression. On the other hand, the moderator effect signifies an interaction effect in which acculturation buffers the impact of PTE on depression. In other words, the negative impact of PTE on depression is hypothesized to vary according to different levels of acculturation. These two competing hypotheses were tested in a community-based sample of 261 adult Vietnamese Americans aged 25 and over. The sample consisted of 48% males and 64% of the sample were married. The average length of residence in the U.S. was 7 years. Multiple regression analyses did not support the mediator effect of acculturation, but did support its moderator effect as a buffer of PTE. Specifically, PTE had a much stronger effect on depression among those with lower levels of acculturation than those with higher levels of acculturation. Implications for future research and clinical practices are discussed.     

Dealing with Resistance: Working with Involuntary Clients in Community-Based Drug Treatment Programs in China

ABSTRACT

This study explores strategies for dealing with client resistance that are commonly used by a group of selected counsellors who work closely with illicit drug users in the community-based compulsory treatment programs in China. Through semistructured in-depth interviews with 16 counsellors, this study finds that different forms of client resistance were experienced in their day-to-day practice, encompassing passive and active behaviours. Five typical strategies are used by Chinese counsellors in this study to deal with client resistance: showing respect and caring and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination. Considering these strategies can also be seen as general principles for dealing with involuntary clients in other fields of social work services, the findings of this study may have broader impact.

IMPLICATIONS

• Effective ways that can be used by counsellors for reducing illicit drug users’ resistance during treatment include: showing respect and caring, and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination.

• Professional social work training is urgently needed among community-based drug treatment social work practitioners in China, to achieve efficient practices and better outcomes.

     

Breaking from Big Brother

Summary

Small non-profit organizations have difficulty computerizing their operations. This article describes such a process of computerization and software development carried out over the past several years to computerize the community-based organizations which receive funds from the New York State Weatherization Assistance Program. The process was based in and run by the local agencies and was attuned to the needs of these local organizations. Guidelines arc suggested for keeping such a process decentralized, democratic and interactive.     

An Integral Model of Well-Being and Development and Its Implications for Helping Professions

Abstract

This article describes a dieoretical construct that serves as a framework for anti-oppression social transformation work in Latino communities. The authors present an integral model that considers the structures and processes of individual well-being within the context of and in relationship to collective development. With this model as a baseline for a critical analysis of current realities, the authors also examine the forces that hinder individual and collective well-being, particularly, institutional oppression: racism, colonialism, classism, and other “isms.” Based on the belief that institutional oppression robs both oppressor and the oppressed of their humanity, the authors provide an overview of a transformative process model. Implications of the model for the development of professional selves among social workers, counselors, and other helping professionals in relationship to the communities they serve are discussed. Broader applications of the model to other practices of the helping professions are also presented.     

College Counselors’ Perceptions and Practices Regarding Anticipatory Guidance on Firearms

Abstract

Objectives: This study assessed college counselors’ anticipatory guidance on firearms for student clients. Participants: The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey. Methods: In the winter of 2008, a 3-wave mailing procedure was used to maximize the response rate. Completed surveys served as consent (as approved by the University Human Subjects Committee). Results: A total of 213 counselors (59%) responded. They were unlikely to provide anticipatory guidance (6%), chart/keep records on client ownership/access to firearms (17%), or to counsel the majority of clients from various diagnostic categories on firearms. Conclusions: University personnel are likely to refer students with suspected mental health problems to university counseling centers. The findings indicate that few counseling centers will address firearm issues with students.     

Domestic violence counselors and secondary traumatic stress (STS): A brief qualitative report and strategies for support

ABSTRACT

Mental health counselors who provide trauma counseling to domestic violence survivors are exposed to catastrophic stories of danger, physical and emotional vulnerability. As counselors try to assess and treatment plan for and with survivors, they are often deeply affected. For some practitioners, bearing witness to these frightening narratives results in a sympathetic form of trauma known as secondary traumatic stress. This article reports on the findings from a convenience sampling of domestic violence shelter counselors (N = 11). Patterns of emotional reactions emerge as a result of two focus groups. Four themes emerged: 1) hypervigilance, 2) impact on personal life, 3) a shift in worldview and 4) methods of coping.     

Environmental Evaluations and Modifications to Support Aging at Home With a Developmental Disability

ABSTRACT

Increasing numbers of people with developmental disabilities are living into old age and are now residing in community-based housing, largely due to the deinstitutionalization movement. The overlay of age-related impairments onto pre-existing, lifelong disabilities puts this population at a magnified risk for premature behavioral limitations and loss of independence. This article describes a demonstration project designed to enable people with developmental disabilities to age in place. Interviews and observational assessments with 45 older adults with developmental disabilities were conducted in their community-based homes to identify potential barriers to aging in place. An Individualized Environmental Intervention Plan was developed for each study participant, recommending ways to solve problems and eliminate potential barriers. Individualized Environmental Intervention Plans were implemented to the extent possible through home modifications and assistive technology. Pre- and post-modification task performance and self-report revealed the positive impact that home modifications and assistive technology can have. The study demonstrates the need for ongoing evaluation and assessment sensitive to the needs of people with developmental disabilities and the unique characteristics of supported living settings.     

Development of a Spiritual Support Scale for Use with Older Adults

SUMMARY

This study reports the development and empirical test of a measure of spiritual supports used by older adults in managing life challenge. The Spiritual Strategies Scale (SSS) consists of 18 items. Cronbach's coefficient alpha reliability for the measure was .86. The sample, gathered from interviews at four sites, consisted of 79 older adults who were predominantly Jewish European American and African American. Concurrent validity analyses suggest that this measure warrants further testing. This scale also has potential for clinical use in social work practice by counselors for older adults.     

Perceived consequences of hazing exposure during the first year of college: Associations with childhood victimization

Objective: This study investigates the association between histories of childhood victimization and perceived consequences of college hazing. Participants: First-year college students at four US universities (N?=?120). Method: Participants completed Web-based surveys asking about childhood victimization (eg, child maltreatment), peer victimization, and perceived consequences of hazing during college. Results: Results indicated that college students with childhood victimization histories perceived hazing to be negative. In particular, physical dating violence and a greater total number of childhood victimization exposures were related to a higher number of perceived negative consequences. Conclusion: Past victimization exposures confer risk on college students who experience hazing, in that these students are more likely to perceive negative consequences of hazing. Hazing-related policies and outreach efforts should consider these potential negative consequences, and counselors should be aware of the link between past victimization and how hazing might be experienced.     

Cybercounseling Online: The Development of a University-Based Training Program for E-mail Counseling

ABSTRACT

The development of a university-based cybercounseling certificate program through the continuing education department of a graduate faculty of social work is described. This web-based program consists of two levels: introductory and advanced, and offers experienced face-to-face counselors training in an asynchronous, e-mail form of cybercounseling. Ethical issues such as cross-jurisdictional concerns, client appropriateness, and counselor insurance are discussed. A system developed to provide online e-mail security through web-based access and encryption is highlighted. Several techniques for e-mail counseling such as presence, and spacing and pacing are discussed and illustrated. Demographics of learners and feedback from graduates are presented and lessons learned are discussed.     

School counseling practices related to postsecondary STEM participation

This qualitative exploratory cross-case analysis analyzed the beliefs and practices of high school counselors related to science, technology, engineering, and mathematics (STEM) academic advisement, postsecondary planning, and career participation. Interviews were conducted with high school counselors (N = 13) who were purposively sampled to represent a diversity of schools in terms of demographic variables. Findings indicated that high school counselors perceived that (a) sociocultural factors influenced student preparation for STEM, career planning, and decision making; (b) students’ STEM-related career goals and academic behaviors were sometimes misaligned, and academic advisement often mediated this tension; and (c) their professional STEM knowledge, beliefs, and practices were influenced by professional preparation, workplace characteristics, and their academic experiences. Implications include the need for early, sustained high school STEM counseling and academic advisement; accessible professional development in STEM preparation and careers to promote multiple pathways and reduce school counselor bias; and encouraging family involvement in STEM career decision making.     

Kaiser Permanente's Manifesto 2005 Demonstration

Summary

In 1996, the eight-million member Kaiser Permanente HMO adopted a vision statement that said by 2005 it would expand its services to include home- and community-based services for its members with disabilities. It funded a 3-year, 32-site demonstration that showed that it was feasible to link HMO services with existing home-and community-based (HCB) services and that members appreciated the improved coordination and access. This private-sector project showed that devolution can produce innovative and feasible models of care, but it also showed that without federal financial and regulatory support, such models are unlikely to take hold if they are focused on “unprofitable” populations, for example, those who are chronically ill, poor, and/or disabled.     

Interdisciplinary Collaboration for LGBTQ Students in Foster Care: Strategies for School Counselors

abstract

Unsafe and ill-prepared school environments exist for many lesbian, gay, bisexual, transgender, and queer (LGBTQ) students in foster care. School counselors are uniquely positioned to develop safe and inclusive schools for this vulnerable student population; however, strategies for interdisciplinary collaboration and advocacy with schools, families, and systems incorporated with LGBTQ youth in foster care are limited. This article explores how school counselors can advocate across disciplines for LGBTQ youth in foster care, including K-12 education systems, family/caregivers, and social service organizations providers.     

E-technology and Community Participation: Exploring the Ethical Implications for Community-based Social Workers

ABSTRACT

To date, much of the work on social work, ethics and technology has been focused on clinical social work and micromorality—the ethical practices of the worker and their clients in one-on-one or therapeutic group interactions. In contrast, this article foregrounds social workers engaged in community work and the ethical implications at a macromoral level. Central to community-based social work, also known as social development work, is the principle of participation. In observing the ways e-technology is affecting community participation, the focus is upon communicative and social technologies, rather than assistive technologies, or technology enabled assessment. The article explores the intersection of these three themes of community participation, technology, and ethics to examine the implications for social workers located in the complex context of community work.     

Understanding Asian American Clients

Abstract

Asian Americans are the fastest growing ethnic minority in the United States today. Therefore, the Asian American population greatly needs the services of qualified cross-cultural counselors. An ethnic match between an Asian American client and his/her counselor is generally recommended. However, due to the limited number of qualified Asian American counselors and problems sometimes encountered with an ethnic match, an ethnic match between the counselor and client is very often not realistic nor always preferred. However, Western counselors who work with Asian Americans need to understand their clients' acculturation problems. They also need to understand the preventable mistakes often made in counseling Asian American clients.     

Building Community-Based Alliances Between GLBTQQA Youth and Adults in Rural Settings

SUMMARY

This article discusses the need for community-based, gay-straight, youth-adult alliances in rural settings and provides a beginning framework for how to create this type of organization. It describes an emerging local community-based alliance of gay, lesbian, bisexual, transgender, queer, questioning, and youth and adult allies. Unlike school-based gay-straight alliances, this group, known as Prism, is open to youth from several schools in a college town and nearby rural communities.