The Subjective Experience of Youth Psychotropic Treatment

Abstract

The psychotropic treatment of youth is increasing dramatically. This article examines child and adolescent psychopharma-cological research and argues that social work practice and research must examine the complex relationships, social and psychological, in youth pharmacologic treatment. Regarding identity formation, this article explores the developmental consequences when youth adopt an illness narrative to make sense of everyday medication treatment. A conceptual framework for mapping the socio-cultural context of youth medication management is outlined. In the conclusion, youth psychotropic treatment is connected to a perplexing ‘interpretive gap,’ which highlights the subjective quality of medication treatment.     

Examining Two Facets of American Indian Identity: Exposure to Other Cultures and the Influence of Historical Trauma

SUMMARY

Specialized content about factors that influence the cultural identity of Native people must be included within the social work knowledge base to increase practitioners' effectiveness with this population. This article explores some of the factors which shape cultural identity for Native people and the implications of Native cultural identity for social work practice. The authors begin by recounting theoretical perspectives on culture, then report the findings of two studies that examine different factors which impact upon identity. The first study examines the impact of exposure to more than one culture on a sense of identity among Native youth in the Northeastern United States. The second study examines historical trauma and unresolved grief among the Lakota. Implications of multicultural exposure and historical unresolved grief for social work practice with Native people are discussed.     

Integrating youth participation and ecosocial work: New possibilities to advance environmental and social justice

ABSTRACT

This article reveals possibilities to expand the role of youth within ecosocial work practice. The Where I Stand Youth Summit held in Chicago, Illinois, provided a safe space for young people to reflect upon their understanding of, and roles within, social and environmental justice movements. Drawing upon critical youth empowerment theory and participant observation, we note that youth shared experiences of oppression across unique social identities, while displaying authentic communication, acceptance, and desire for solidarity. Re-defining what knowledge matters, along with intention and self-restoration, also emerged as critical to building young people’s agency and power to effect social change.     

A trauma-informed social work framework for the abortion seeking experience

ABSTRACT

This purpose of this article is to discuss the abortion seeking experience in relation to stress, trauma, and trauma-informed care. Definitions of stress and trauma are provided, and potential points of stress during the abortion seeking experience will be discussed in the areas of unintended pregnancy, policy barriers, provider access, and the external clinic environment. Abortion stigma will also be discussed in relation to individual stigma, mass media stigma, community stigma, social work practitioner stigma, and the impact of stigma on the abortion seeking experience. Next, we discuss a trauma-informed lens for considering the abortion seeking experience in the United States, and a trauma-informed social work framework for interacting with clients during the abortion experience is presented as a practice approach for reducing and eliminating trauma and trauma triggers. We then present the potential benefits of this approach. The article concludes with some additional recommendations for a trauma-informed approach to aspects of social work advocacy.     

Promoting Evidence-Based,Trauma-Informed Social Work Practice

ABSTRACT

Given the human costs of psychological trauma, social workers should be well versed in trauma-informed care (TIC). This framework helps guide the efforts of systems, organizations, and practitioners toward reducing trauma or mitigating its effects. The field has created TIC principles, although they have yet to be fully realized as practical applications. This article makes the case that theoretically and empirically grounded content on trauma should be foundational to social work education. We also argue that social work practice will be advanced by clearly defining trauma and by distinguishing TIC from trauma-focused and trauma-sensitive approaches. Finally, a TIC certificate program illustrates how graduate student training and social work practice are enhanced by integrating trauma content into classroom and field settings.     

The social reality of youth and social work: between visibility and invisibility

ABSTRACT

Social work has a long history of study and intervention in at-risk or vulnerable groups. Due to their diversity, the visibility or invisibility of such groups has varied over the twentieth and twenty-first centuries. The work presented here is focused on determining the place youth occupies in social work as a field of study and intervention. Demographic reality has shown a decreasing attention to young people when compare to other age groups, while its social relevance has been maintained or even increased. However, their social situation does not seem to be in accordance with this statement. Such imbalance may be the baseline of the actual-limited recognition of youth in current welfare policies, and with them, of Social Work. To confirm this loss of representation, International Social Work conferences were examined. Research lines, thematic areas and intervention models on youth were gathered as well as scientific work from two databases. The presented results show how social work, without losing its primary focus on social exclusion maintains a line of work with youth, but still understanding it as a problem rather than a resource.     

Visual methodologies for research with refugee youth

Abstract

In the current moment of social, political, economic and environmental disquiet, unprecedented numbers of children have been forced to leave their homes and settle in new communities. As schools worldwide receive increasing numbers of refugee youth, there is a pressing need for thoughtful educational research that inquires into the unique individual needs and experiences of displaced learners. Given that students’ journeys are shaped by movements across physical, cultural and linguistic spaces, we suggest that related scholarship might benefit from Third Space theory. Within this theoretical framework, neither language nor culture is static. Rather, both are continuously shaped through interactions – including those that are non-verbal. For students who may be learning in an unfamiliar language, visual methodologies offer a means and venue for communication. To explore how refugee youth might benefit from Third Space theory and visual methodologies, we first review scholarship that examines how children and schools negotiate educational space. We then describe a series of methodologies that scholars might consider when conducting research with refugee youth, including photovoice, fotonovela, digital storytelling and quilting. Significantly, pairing a Third Space theoretical framework with visual and participatory methodologies may address issues of language, power, vulnerability and ethics.     

Reconceptualizing Substance Abuse Treatment in Therapeutic Communities: Resiliency Theory and the Role of Social Work Practitioners

ABSTRACT

Although therapeutic communities (TC) have achieved promising results in the treatment of substance abusers, several areas have been identified which might further enhance TC treatment effectiveness. Two of these, resiliency theory and the role of social work practitioners, are discussed. Resiliency theory provides a framework for re-conceptualizing interventions as they apply to therapeutic communities. Resiliency is explicated and illustrated via a case study of a therapeutic community TROSA (Triangle Residential Options for Substance Abusers), a non-profit TC in Durham, North Carolina. A number of contributions that social work practitioners can make to TCs are described.     

Navigating post-trauma realities in family systems: Applying social constructivism and systems theory to youth and family trauma

Trauma affecting youth and families takes a variety of forms, from random one-time events such as accidents and natural disasters to chronic and highly personal trauma from child abuse or intimate partner violence. Though trauma has received increasing attention in theory and intervention research over the last several decades, the prevailing theories and treatments have limitations due to a linear perspective focused on the trauma problems of the individual. This is particularly concerning given the high dropout rates for trauma-focused treatments and the complexities of intergenerational trauma that cannot be adequately conceptualised at the level of the individual. To inform and improve family-based treatment of youth and family trauma, this paper proposes a theoretical framework informed by social constructivism and systems theory. Social constructivism upholds that reality is constructed through communication as an adaptive process for survival, with multiple potential realities possible. Systems theory promotes a non-linear view of causality within a system, such that the structure and properties of a system determine outcomes more than the inputs that go into the system. Together, the principles of these meta-theories contradict the orthodox focus on traumatic events causing trauma symptoms, and instead imply that family-based treatment should focus on helping families shift assumptions and dynamics that sustain the problem in the present. The joint application of a social constructivism–systems theory framework for trauma introduces several new principles to inform family-based treatment: (a) post-trauma realities; (b) mutual survival; (c) power–justice balance; and (d) adaptive reorganisation. The implications of these principles for youth and family trauma treatment will be discussed. Future intervention development and research should consider these principles in the ongoing effort to improve family therapy for youth and family trauma.     

Key misconceptions when assessing digital technology for municipal youth social work

ABSTRACT

Municipal youth protection work has become infused with digital technology, and yet there is still limited research on how to assess the impact of digital technology on municipal youth social work. This article reviews a range of misconceptions regarding the assessment of digital technology for youth social work in municipal contexts. This review was generated in connection with the development of an app system for communication between young clients and their municipal social workers in Denmark. The misconceptions relate to: variations in technologies and contexts; the impact of digital technologies on the relationship; social justice; differentiating between the user and the digital technology; digitalization and standardization; stakeholder and functional models of municipal social work. The paper concludes that the relationship between municipal social work and digital technology is complex and that thus complex comprehensions of municipal social work practice are needed if the relationship between technologies and practice is to be grasped adequately. The paper argues that given the complexity of the field and the speed of technological and legal changes, external support with regard to assessing how to use, develop and incorporate digital technology needs to be made available to municipalities and social workers.     

Ties That Protect

SUMMARY

An ecological risk and resiliency framework was applied to explore how social contexts, especially the role of families and schools, are affecting Latino/a pre-adolescent substance use in the urban Southwest. A mixed research design, using both quantitative and qualitative methodologies, guided the study. Quantitative data were collected through surveys administered as part of a school-based prevention intervention experiment (N = 2,125). Individual interviews conducted with a randomly selected number of matched students (N = 60) provided the qualitative data. The main theme emerging throughout both data sets was a strong resilience against drug use of the participating 7th grade urban youth. The vast majority of students did not use hard drugs, and agreed that alcohol use was inappropriate at their age. A high degree of attachment and strong ties to their parents and their school environment emerged as a shared protective factor. Recommendations include social work interventions that support the resiliency characteristics of urban Latino/a youth in different social contexts such as communities, schools, and families. Limitations of the study are reviewed and suggestions for future research are offered.     

Reflections of an Emerging Male-to-Female Transgendered Consciousness

Abstract

Professionals involved in social work practice with or designing approaches for working with male-to-female (MTF) transgend-ered youth must listen to the individual voices of these youth for the valuable information they can share with us. This paper provides the reader with the gift of a first-person account of one person's experiences as a “plainclothes transgender” person -a term he has coined to define his experiences. The paper concludes with implications for practice with both “plainclothes” and “fixed/prepared” male-to-female trans-gendered youth.     

Youth homelessness and self identity: a view from Canada

ABSTRACT

This paper is based on the analysis of data collected from the National Canadian Homeless Youth Survey and addresses the question: why do some youth who received support from social service agencies that cater to the needs of homeless youth self-identify as being homeless while others do not? According to self-report survey data obtained from 1103 young people from over 50 youth homeless service centres from across Canada, findings show that youth who self-identified as being homeless shared several backgrounds and current situational characteristics not common among youth in the sample who did not consider themselves to be homeless. The findings illustrate the importance of past trauma and the intensity of day to day hardship in self-identifying as a homeless young person.     

Rethinking Girls “At-Risk”

Abstract

This conceptual article critically analyzes influential theoretical frameworks concerning adolescent female development, including psychosocial identity stage theory, person-in-environment theory, and feminist psychology. Based on the strengths and limitations of these approaches, the author introduces social workers to an emerging framework that addresses the gender, race, and class intersections that contextualize adolescent girls' developmental experiences. This perspective also discusses young women's capacity to resist norms and stereotypes in their search for an authentic identity. This innovative theory complements a strengths-based approach to social work and can be used to guide research andpractice with this population.     

Toward a Critical Social Theory of Youth Empowerment

SUMMARY

This article contributes to the development of a critical social theory of youth empowerment which emphasizes collective efforts to create sociopolitical change. It draws upon analysis of four youth empowerment models, and upon findings from a participatory research study which identified key dimensions of critical youth empowerment: (1) a welcoming, safe environment, (2) meaningful participation and engagement, (3) equitable power-sharing between youth and adults, (4) engagement in critical reflection on interpersonal and sociopolitical processes, (5) participation in sociopolitical processes to affect change, and (6) integrated individual- and community-level empowerment. It concludes with discussion of the measurement of outcomes, and the challenges and opportunities for empowerment in youth organization.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

Assessing Power and Control Differentials

ABSTRACT

A critique of unidirectional understandings of power and control in social psychology, conflict theory, critical theory, and social work empowerment theories provides the framework for a new synthetic conceptualization of power and control in human behavior. A criminological theory called control balance is enlarged as an explanation of non-conforming behavior. Both a surplus of autonomy and an excess of repression provide subjective motivation for subversive acts that empower the actor. This dual-tension model is a theoretically useful predictor of human behavior, and in concert with symbolic interactionism, provides a theoretical frame for consideration of secondary socialization as a potential means of Social Work intervention     

Lessons learned while building a trauma-informed public behavioral health system in the City of Philadelphia

Exposure to traumatic experiences among youth is a serious public health concern. A trauma-informed public behavioral health system that emphasizes core principles such as understanding trauma, promoting safety, supporting consumer autonomy, sharing power, and ensuring cultural competence, is needed to support traumatized youth and the providers who work with them. This article describes a case study of the creation and evaluation of a trauma-informed publicly funded behavioral health system for children and adolescents in the City of Philadelphia (the Philadelphia Alliance for Child Trauma Services; PACTS) using the Exploration, Preparation, Implementation, and Sustainment (EPIS) as a guiding framework. We describe our evaluation of this effort with an emphasis on implementation determinants and outcomes. Implementation determinants include inner context factors, specifically therapist knowledge and attitudes (N = 114) towards evidence-based practices. Implementation outcomes include rate of PTSD diagnoses in agencies over time, number of youth receiving TF-CBT over time, and penetration (i.e., number of youth receiving TF-CBT divided by the number of youth screening positive on trauma screening). We describe lessons learned from our experiences building a trauma-informed public behavioral health system in the hopes that this case study can guide other similar efforts.